LGBTQ Data Form.pdf
PDF 2 MB Posted
- Solicitation number
- 21260830093254
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form issued by the City of Philadelphia for a communications services provider contract to support the Communications Office. The form is designed to collect diversity data from applicants and does not contain specifications regarding products, services, project scope, quantities, response dates, due dates, site visits, bidder conferences, award dates, or contract terms. Instead, it functions as a supplementary documentation requirement for the bidding process.
The form requests applicants to self-identify whether their business is beneficially owned and controlled by persons who identify as Lesbian, Gay, Bisexual, Transgender, or Queer, and whether they hold current LGBTBE certification from the National LGBT Chamber of Commerce through its Philadelphia affiliate, the Independence Business Alliance. Applicants are also asked to disclose any additional third-party certifications from organizations such as ESMDC, PAUCP, Disability:IN, or WBENC, and to identify any LGBTBE-certified subcontractors involved in the project. Submission of this form is entirely voluntary, and the City of Philadelphia has indicated that collected data may be used for other projects and potentially made publicly available as part of the City's commitment to diversity, equity, and inclusion in procurement.
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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 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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