LGBTQ_Applicant_Data_Form_B2727750.pdf
PDF 2 MB Posted
- Attached to
- Jackhammers
- Solicitation number
- B2727750
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form for the City of Philadelphia related to a micro purchase opportunity for jackhammers in Pennsylvania. The form is designed to collect voluntary demographic information from applicants regarding the beneficial ownership and control of their businesses by individuals who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ). The form requests applicants to disclose whether their business is currently certified as an LGBTBE by the National LGBT Chamber of Commerce (NGLCC) through its local Philadelphia affiliate, the Independence Business Alliance (IBA), and to identify any additional third-party certifications held, such as those from the Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN, or Women's Business Enterprise National Council (WBENC).
The form also requests information regarding any LGBTQ-certified subcontractors involved in the contracting opportunity. The City of Philadelphia has indicated that this data collection effort supports its commitment to diversity, equity, and inclusion in municipal procurement and will be used to identify LGBTQ businesses currently conducting business with the City and to facilitate their inclusion in the City's vendor database. The micro purchase will be awarded as a whole or by line item, whichever serves the City's best interest, to the lowest responsive and responsible bidder, with the requirement that all items be quoted for bidder eligibility.
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Other files
| File | Type | Posted |
|---|---|---|
| MP_Terms_and_Conditions_B2727750.pdf | ||
| Seller_SP_Checklist_B227750.pdf | ||
| Consent_Authorization_B2727750.pdf |
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Text version
LGBTQ Applicant Opportunity Data
1. Is Applicant’s business beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender or Queer?
2. Is Applicant’s business currently certified as a Lesbian, Gay, Bisexual, Transgender, Business Enterprise (LGBTBE) by the National LGBT Chamber of Commerce (NGLCC) through their local Philadelphia affiliate, the Independence Business Alliance (IBA)?
a. If yes, Applicant is currently certified by NGLCC/IBA as an LGBTBE, is Applicant's business also certified by any other third party certifying agency such as Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN or Women's Business Enterprise National Council (WBENC)?
If yes please identify the name of the certifying agency and category of certification (e.g., MBE, WBE, DSBE, DBE):
Certifying Agency Certification Category
3. For this contracting opportunity, are any of Applicant’s subcontractors certified by NGLCC/IBA? If yes, how many subcontractors are certified as LGBTBE?
Please list all by business name below.
As part of the City’s commitment to diversity, equity and inclusion in all aspects of City procurement, the City is collecting data to identify the number of companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender and Queer persons who wish to do business with the City (collectively, “LGBTQ businesses”). The data will be used to identify the number of LGBTQ businesses currently doing business with the City. It will also assist in efforts to include LGBTQ certified businesses into the City’s vendor database. Response to this form is voluntary.
Applicant Name
Bid or Opportunity #
| CertifiedLGBTEYes: Y |
| CertifiedLGBTENo: N |
| Certification: |
| LGBTQTypeYes: Y |
| LGBTQTypeNo: N |
| CertifiedNGLCCNo: N |
| CertifiedNGLCCYes: Y |
| LGBTQTypeY: Off |
| LGBTQTypeN: Off |
| CertifiedLGBTEY: Off |
| CertifiedLGBTEN: Off |
| CertifiedNGLCCY: Off |
| CertifiedNGLCCN: Off |
| Subconsultants: |
| BusinessName3: |
| BusinessName4: |
| BusinessName5: |
| Reset: |
| btnContinue: |
| CertifyingAgency: |
| BusinessName: |
| BusinessName2: |
| ApplicantName: |
| BidNumber: |
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