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-BCH01-19065
Issued by
Suffolk County, Massachusetts

About this file

This document is a Supplier Diversity Program (SDP) Plan Commitment & Declaration of SDP Partner(s) form for a state and local contract opportunity in the state of Massachusetts. The form requires bidders to identify certified minority-owned, women-owned, veteran-owned, and service-disabled veteran-owned business enterprises as partners and commit a specific percentage of the contract value to be spent with those partners. Bidders must complete the form and submit it with their quote in order to be eligible for the contract. The contract opportunity is for the provision of Fluoride Products, with the contracting agency and associated details provided.

The form outlines the required annual financial commitment to SDP partners, which must be a specific percentage of the total contract value for the life of the contract. Bidders must identify their SDP partners, including the partner company name, certification status, and functions to be performed. The Supplier Diversity Office and contracting department reserve the right to verify the amounts reported as paid to SDP partners. Additional resources are provided to assist bidders in identifying and partnering with certified businesses.

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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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