LGBTQ_Applicant_Data_Form Bid B2727714.pdf
PDF 2 MB Posted
- Attached to
- office Renovation - 11th flr.
- Solicitation number
- B2727714
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form issued by the City of Philadelphia's Procurement Department for Bid B2727714 related to an office renovation project on the 11th floor. The form is designed to collect voluntary demographic information from applicants regarding LGBTQ business ownership and certification status. The form requests applicants to identify whether their business is beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer, and whether the business holds current certification as an LGBTBE through the National LGBT Chamber of Commerce (NGLCC) via their Philadelphia affiliate, the Independence Business Alliance (IBA). Additionally, the form inquires about any secondary certifications held by the applicant through other third-party agencies such as the Eastern Minority Supplier Development Council, Pennsylvania Unified Certification Program, Disability:IN, or Women's Business Enterprise National Council, requiring applicants to identify the certifying agency and certification category if applicable.
The form also requests information regarding subcontractor involvement, specifically whether any subcontractors are LGBTBE certified and, if so, requires applicants to list all certified subcontractors by business name. The City of Philadelphia has indicated that submission of this form is entirely voluntary and that the data collected will be used to identify LGBTQ businesses currently conducting business with the City and to assist in expanding the City's vendor database to include LGBTQ certified businesses. The City reserves the right to use submitted data for other projects and may make the information publicly available at its discretion.
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Other files
| File | Type | Posted |
|---|---|---|
| Seller_SP_Checklist_Bid B2727714.pdf | ||
| PHL-Contracts-Consent_Authorization BID B2727714.pdf | ||
| HIT Terms and Conditions PHL Contracts~3.docx | DOCX document | |
| Micro Purchase Terms and Conditions B2727714.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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