REQ - Supplier Diversity Program Form 10-10-2016~16.docx
DOCX document 42 KB Posted
- Attached to
- RFR_185225 Fluoride Products
- Solicitation number
- BD-18-1031-BCHAP-BCH01-19741
- Issued by
- Suffolk County, Massachusetts
About this file
This document is a Supplier Diversity Program (SDP) Plan Commitment & Declaration of SDP Partner(s) form that must be submitted with quotes for the RFR 185225 Fluoride Products contract opportunity. The form requires the bidder to identify a certified Minority/Women-owned Business Enterprise (M/WBE), Minority/Women Non-Profit Organization (M/WNPO), Veteran-Owned Business Enterprise (VBE), or Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) as an SDP partner and commit a specific percentage of sales derived from the contract to be spent with that partner annually. Instructions are provided on locating certified partners through the Supplier Diversity Office and resources for assistance with SDP compliance. The contract opportunity is for the state of Massachusetts.
The form also includes sections for the bidder to provide their business information and the annual SDP percentage commitment for the life of the contract. The state reserves the right to contact SDP partners to verify the amounts reported as paid by the contractor. Failure to submit this completed form may result in the bid being deemed unresponsive.
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Text version
Supplier Diversity Program (SDP) Plan Commitment & Declaration of SDP Partner(s) (Form to be submitted with quote) Contract/RFR Document Number: Click here to enter text.
Instructions: Completing all parts of this form is mandatory. Please read all sections of the Bid related to the SDP. Complete one form and submit with your Quote. An SDP partner must be identified before a contract can be executed. See resource information below to assist in partnering with certified businesses.
Important: Prime bidders that are certified as an M/WBE, M/WNPO, VBE and SDVOBE must also submit an SDP Plan Form and may not list themselves or their affiliates as SDP Partners.
Part I Bidder/Contractor Information (Required)
| Business Name: Click here to enter text. |
| Contact Name: Click here to enter text. |
| Phone #: Click here to enter phone number. |
| Email address: Click here to enter email address. |
Part II Annual Financial Commitment (Required)
Provide a specific percentage of Bidder/Contractor sales derived from this contract to be spent with all certified SDP Partners on a Massachusetts fiscal year (July 1-June 30) basis.
Annual SDP Percentage Committed in Bid Response for Life of Contract:
Click here to enter percentage.%
Part III Contractor’s SDP Partners (Required) (Fill in Applicable Lines; Insert Additional Rows as Needed)
| Planned SDP Partner Company Name |
| Check Planned SDP Partner’s Certification(s) |
| Certifying Organization |
| Functions to be Performed by the Partner (optional unless otherwise stated in the RFR) |
| Click here to enter text. | Choose an item. | Choose an item. | Click here to enter text. |
| Click here to enter text. | Choose an item. | Choose an item. | Click here to enter text. |
| Click here to enter text. | Choose an item. | Choose an item. | Click here to enter text. |
*The Supplier Diversity Office and contracting Department reserve the right to contact SDP Partners at any time to request that they attest to the amounts reported to have been paid to them by the Contractor.
** SDP Partner Certification Acronyms: MBE = Minority-owned Business Enterprise; WBE = Women-owned Business Enterprise; SDVOBE = Service-Disabled Veteran-owned Business Enterprise.
*** Certification Status can be checked on the Supplier Diversity Program Webpage (www.mass.gov/sdp).
Supplier Diversity Program (SDP) Resources:
· Lists of M/WBEs, M/WNPOs, VBEs and SDVOBEs certified or verified by the Supplier Diversity Office (SDO) are located at www.mass.gov/sdo.
· Additional resources to assist Prime Bidders in finding potential Certified Partners can be found at www.mass.gov/sdp.
· The Operational Services Division offers trainings on compliance with the SDP Plan requirements. Registration information for upcoming trainings can be found on the Supplier Diversity Program Trainings webpage.
· The Supplier Diversity Business Directory can be found at https://www.sdo.osd.state.ma.us/BusinessDirectory/BusinessDirectory.aspx.
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