LGBTQ Applicant Data Form B2728313.pdf
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- B2728313
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- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form (B2728313) used by the City of Philadelphia to collect diversity and inclusion information from businesses seeking to contract with the municipality. The form requests applicants to voluntarily provide data regarding their ownership structure, certifications, and subcontractor participation, specifically targeting businesses beneficially owned and controlled by individuals who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ). The form collects information on current LGBTBE certification status through the National LGBT Chamber of Commerce (NGLCC) and their local Philadelphia affiliate, the Independence Business Alliance (IBA), as well as any additional third-party certifications from 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 form further requests disclosure of any LGBTQ-certified subcontractors being utilized for the specific contracting opportunity. The data collection initiative is part of the City's broader commitment to diversity, equity, and inclusion in procurement processes, with the stated purpose of identifying LGBTQ businesses currently conducting business with the City and facilitating their inclusion in the City's vendor database. Completion of the form is voluntary, and applicants are required to provide their business name, applicable bid or opportunity number, and certification details through a series of yes/no selections and narrative fields for certifying agencies and subcontractor information.
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Other files
| File | Type | Posted |
|---|---|---|
| Micro Purchase Terms and Conditions B2728313~1.pdf | ||
| Seller_SSE_ChecklistB2728313.pdf | ||
| Consent_AuthorizationB2728313.pdf | ||
| B2728313 spec sheet.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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