LGBTQ Applicant Opportunity Data Form B2727832.pdf

PDF 2 MB Posted

Attached to
certificate paper - BID
Solicitation number
B2727832
Issued by
Pennsylvania

About this file

This is an LGBTQ Applicant Opportunity Data Form for a Pennsylvania state and local contract opportunity (Bid B2727832) administered by the City of Philadelphia as part of its commitment to diversity, equity, and inclusion in municipal procurement. The form is designed to collect voluntary demographic data from applicants regarding LGBTQ business ownership and certification status. The document requires applicants to disclose whether their business is beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ), and whether the business holds current LGBTBE certification through the National LGBT Chamber of Commerce (NGLCC) or their Philadelphia affiliate, the Independence Business Alliance (IBA).

The form further requests information regarding any additional third-party certifications held by LGBTQ-certified businesses, 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), with specific notation of the certifying agency and certification category. Applicants must also identify any NGLCC/IBA-certified subcontractors participating in the bid. The City intends to use the collected data to identify and enumerate LGBTQ-owned businesses currently engaged with municipal government and to facilitate the inclusion of certified LGBTQ businesses in the City's vendor database. Submission of this form is voluntary and does not impact bid eligibility or award determination.

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Micro Purchase Terms and Conditions B2727832.pdf PDF
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Consent_Authorization_B2727832.pdf PDF

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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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