LGBTQ_Applicant_Data_Form_B2727861.pdf
PDF 2 MB Posted
- Attached to
- Photography
- Solicitation number
- B2727861
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form issued by the City of Philadelphia's Procurement Department to gather diversity and inclusion information from businesses seeking to contract with the city. The form is designed to identify companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) persons and collect data on their certification status and participation in the city's vendor ecosystem. Applicants are required to indicate whether their business is LGBTQ-owned and controlled, provide current certification status through the National LGBT Chamber of Commerce (NGLCC) via the Philadelphia-based Independence Business Alliance (IBA), identify any additional third-party certifications held, and list any LGBTQ-certified subcontractors participating in the contract opportunity. The form applies to the Photography micro purchase opportunity in Pennsylvania.
Submission of the LGBTQ Applicant Data Form is entirely voluntary, and the City of Philadelphia reserves the right to use the collected data for other projects and to make it publicly available at its discretion. The data collected serves dual purposes: to establish a baseline understanding of LGBTQ business participation with the city and to support efforts to expand inclusion of LGBTQ-certified enterprises in the city's vendor database. Applicants may hold concurrent certifications from other recognized certifying agencies such as the Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN, or Women's Business Enterprise National Council (WBENC). The micro purchase will be awarded as a whole or by line item to the lowest responsive and responsible bidder, with sellers required to quote all items to be eligible for award.
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Other files
| File | Type | Posted |
|---|---|---|
| MP TERMS AND CONDITIONS B2727861.pdf | ||
| Consent_Authorization -B2727861.pdf | ||
| Seller Checklist B2727861.pdf |
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Text version
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 of Philadelphia’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.
By submitting this form you are agreeing that the City may, in its discretion, use the data submitted for other projects and may cause it to become publicly available.
Response to this form is entirely voluntary.
Applicant Name:
Bid or Opportunity #:
LGBTQ Applicant Opportunity DataLGBTQ Applicant Opportunity Data
CCIITTY Y OF OF PHIPHILALADDELPHELPHIIA
1401 JFJFK K BBllvvdd. . RoRooom m 117700B B - - PhPhiillaaddeellpphhiiaa, , PA PA 1199110022--11668855 www.phila.gov/procurement
| 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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