REQ - Supplier Diversity Program Form~29.doc

DOC document 73 KB Posted

Attached to
173024 - PACS with Voice Dictation & Image Sharing
Solicitation number
BD-17-1031-LSH00-LSH01-00000009641
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 a bid response for a state and local contract opportunity. The contract opportunity is for a PACS with Voice Dictation & Image Sharing system, issued by the state of Massachusetts. The form requires the prime bidder to identify any Minority Business Enterprise (MBE), Women-owned Business Enterprise (WBE), or Service-Disabled Veteran-owned Business Enterprise (SDVOBE) partners they intend to utilize, along with the percentage of the contract committed to those partners. The form also provides resources to assist prime bidders in finding eligible partners. The contract term is not specified.

The form indicates that prime bidders who are SDO-certified cannot list themselves as an SDP partner. Pricing terms, funding sources, and other commercial details are not provided in this document. The focus is on the bidder's commitment to and identification of diverse business partners for the state and local contract opportunity.

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Supplier Diversity Program (SDP) Plan Commitment & Declaration of SDP Partner(s)

(To be submitted with Bid Response)

RFR Document Number:

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form and submit with Bid. An SDP partner must be identified before a contract can be executed. See SDP and SDVOBE Resource information below to assist in partnering with certified businesses.

Part I Contractor Information (Required)

Business Name:
Contact Name:
Phone # ( FORMTEXT

Email address:

Please note that prime bidders who are SDO-certified must also submit an SDP Plan Form and may not list themselves as an SDP Partner. Check any of the following that are applicable to the Bidder:

Minority-owned Business Enterprise (MBE); Certification Expiration Date (If applicable):

Women-owned Business Enterprise (WBE); Certification Expiration Date (If applicable):

Service-Disabled Veteran-owned Business Enterprise (SDVOBE); Certification Expiration Date (If applicable):

Identify Business Opportunities for SDP Partners (Optional):

SDP Percentage Committed for Life of Contract:

Part II Contractor’s SDP Partners (Required)(Fill in Applicable Lines; Insert Additional Rows as Needed)

SDP Partner’s Company Name

SDP Partner’s Contact Person’s Email Address*
Check SDP Partner’s Certification(s)**
@ .
MBE

WBE

SDVOBE

@ .
MBE
@ .
MBE
@ .
MBE

WBE

SDVOBE

FORMTEXT

@ .
MBE

*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:

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· The Supplier Diversity Business Directory can be found at https://www.sdo.osd.state.ma.us/BusinessDirectory/BusinessDirectory.aspx Page | 2

File details come from the government source that posted it. Updated .