LGBTQ Applicant Opportunity Data Form B2727868.pdf

PDF 2 MB Posted

Attached to
BID- Tick puller plus identification card
Solicitation number
B2727868
Issued by
Pennsylvania

About this file

This file is an LGBTQ Applicant Opportunity Data Form used by the City of Philadelphia to collect diversity and inclusion information from bidders on state and local contract opportunities in Pennsylvania. The form requests applicants to provide their business name and bid or opportunity number while voluntarily disclosing whether their business is beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ). The specific contract opportunity associated with this form is a micro purchase for a tick puller plus identification card to be awarded to the lowest responsible bidder. Sellers must quote all items to be eligible for award and are instructed not to deliver or provide services until notified by the department. The form indicates this micro purchase will be awarded as a whole or by line item, whichever serves the best interest of the city.

The data collection form inquires whether applicants are currently certified as an LGBTBE (Lesbian, Gay, Bisexual, Transgender Business Enterprise) by the National LGBT Chamber of Commerce (NGLCC) through their Philadelphia affiliate, the Independence Business Alliance (IBA). The form also requests information about 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), and asks applicants to identify subcontractors certified by NGLCC/IBA. The City explicitly states that response to this form is voluntary and is being used to identify LGBTQ businesses interested in doing business with the City and to build the City's vendor database of diverse suppliers.

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Other files

File Type Posted
Seller_SOP_Checklist B2727868.pdf PDF
tick puller.jpg JPG image
Consent_Authorization_B2727868.pdf PDF
Micro Purchase Terms and Conditions B2727868.pdf 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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