LGBTQ_Applicant_Data_Form B2727986.pdf
PDF 2 MB Posted
- Attached to
- Plastic Bags, 13" x 18" Slider Bags
- Solicitation number
- B2727986
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form from the City of Philadelphia's Procurement Department, designed to collect diversity and inclusion information from businesses seeking to contract with the city. The form requests applicants to self-identify whether their business is beneficially owned and controlled by individuals who identify as Lesbian, Gay, Bisexual, Transgender, or Queer. The specific contract opportunity referenced is for Plastic Bags, 13" x 18" Slider Bags, classified as a micro purchase to be awarded to the lowest responsive and responsible bidder. Sellers must quote all items to be eligible for award, and no delivery or services should commence until formal notification is received from the department. The award will be made as a whole or by line item, whichever serves the city's best interest.
The form collects data regarding current certification status through the National LGBT Chamber of Commerce (NGLCC) and its Philadelphia affiliate, the Independence Business Alliance (IBA), as well as any additional third-party certifications 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). Applicants are also asked to identify any certified LGBTBE subcontractors being utilized on the project. Submission of the 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 as part of its commitment to diversity, equity, and inclusion in municipal procurement. The city intends to use this information to identify LGBTQ-owned businesses and include certified vendors in its procurement database.
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Other files
| File | Type | Posted |
|---|---|---|
| Seller_SOP_Checklist B2727986.pdf | ||
| Consent_Authorization B2727986.pdf | ||
| Micro Purchase Terms and Conditions B2727986.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: |
File details come from the government source that posted it. Updated .