LGBTQ Applicant Opportunity Data Sheet B2626766.pdf
PDF 2 MB Posted
- Attached to
- Adhesive foam mounting boards
- Solicitation number
- B2626766
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Sheet for the City of Philadelphia, administered in conjunction with the National LGBT Chamber of Commerce (NGLCC) through its local Philadelphia affiliate, the Independence Business Alliance (IBA). The document serves as a voluntary data collection form designed to identify businesses beneficially owned and controlled by individuals who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ) that wish to conduct business with the City. The form is associated with a micro-purchase opportunity for adhesive foam mounting boards in Pennsylvania, to be awarded as a whole or by line item to the lowest responsive and responsible bidder. Applicants must quote all items to be eligible for award, and delivery or services should not commence until official notification is received from the department.
The data collection form requests information regarding the applicant's LGBTBE certification status through NGLCC/IBA, any additional third-party certifications from organizations such as ESMDC, PAUCP, Disability:IN, or WBENC, and identification of any LGBTBE-certified subcontractors. The City of Philadelphia intends to utilize the submitted data to enhance diversity, equity, and inclusion initiatives in municipal procurement and to expand the representation of LGBTQ-owned businesses in the City's vendor database. Respondents are advised that submission of this form constitutes agreement allowing the City to use the data for other projects and potentially make it publicly available. Response to the form is entirely voluntary and does not impact bid eligibility or award determination.
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Other files
| File | Type | Posted |
|---|---|---|
| Micro Purchase Terms and Conditions B2626766.pdf | ||
| Consent and Authorization B2626766.pdf | ||
| Seller SOP Checklist B2626766.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 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 #
| 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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