LGBTQ Data Form.pdf
PDF 2 MB Posted
- Solicitation number
- 21240625164751
- Issued by
- Philadelphia County, Dale Borough, Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form used by the City of Philadelphia as part of its procurement process. The form is designed to collect voluntary demographic and certification information from vendors seeking to do business with the City, specifically identifying companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) persons. The form requests information regarding current LGBTBE certification status through the National LGBT Chamber of Commerce (NGLCC) or its local Philadelphia affiliate, the Independence Business Alliance (IBA), as well as 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). Applicants are also asked to identify any LGBTBE-certified subcontractors involved in the proposed project.
The City of Philadelphia utilizes the collected data to assess the number of LGBTQ-owned businesses currently conducting business with the municipality and to facilitate the inclusion of LGBTQ-certified enterprises into the City's vendor database. Submission of the form is entirely voluntary, and respondents acknowledge that the City may use the submitted data for other projects and may make it publicly available. The form applies to the City of Philadelphia's Department of Aviation procurement for a Digital Content Management System (CMS) implementation project and serves as part of the City's broader commitment to diversity, equity, and inclusion in all procurement activities.
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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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