RFP - Managed Care SLBP - Appendix 2 S&P Form 8.11.2026.pdf
PDF 379 KB Posted
- Solicitation number
- 21260911160658
- Issued by
- Pennsylvania
About this file
This is a Solicitation & Participation Form (Appendix 2) issued by the City of Philadelphia's Office of Economic Opportunity for an RFP related to Managed Care services. The form is designed to document the respondent's outreach and engagement with Small Business Enterprises (SBEs) and Local Business Enterprises (LBEs) for commercially acceptable functions on the project. Respondents are required to list all SBEs and LBEs solicited, provide their contact information, specify the scope of work, identify NAICS codes, indicate whether they serve as subcontractors or suppliers, and document dollar amounts and percentages of the total proposal. Supporting quotations must be attached with the form, and respondents may be required to provide additional information within 48 hours of the City's request.
The form requires documentation of Best and Good Faith Efforts to solicit SBEs and LBEs, regardless of whether the Office of Economic Opportunity has established participation ranges for the project. All SBEs and LBEs listed must be certified at the time of contract award. The form includes fields to indicate whether quotes were received and whether vendors are registered in the OEO Registry, as well as ethnicity classifications. The document was last revised in August 2026 and serves as a mandatory submission component for respondents bidding on the Managed Care RFP to demonstrate compliance with the City's small and local business participation requirements.
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Text version
CITY OF PHILADELPHIA
OFFICE OF ECONOMIC OPPORTUNITY
APPENDIX 2
Solicitation & Participation Form
SLBP – Appendix 2 Rev. Date August 2026
RESPONDENT PROJECT #
PROJECT NAME
POSTED DATE ESTIMATED VALUE
List all SBEs and LBEs you have solicited to use for a Commercially Acceptable Function on this Project - copy this form as necessary.
• SBEs and LBEs listed must be certified at the time of contract award.
• Respondent should attach supporting quotations with this form. The City reserves the right to request additional information which must be provided by Respondent within 48 hours of the City's request.
• If OEO did not set participation ranges for this Project, Respondent is still required to complete this form and attach documentation demonstrating Best and Good Faith Efforts to solicit SBEs and LBEs.
SBE and LBE Information
Name of SBE or LBE Contact Information including, address, telephone number, and e-mail address
Scope of Work NAICS Code
Subcontractor or Supplier
Dollar Amount for SBE and LBE
Percent of Total Proposal
Quote Received (Y/N)
Registry (Y/N)
SBE, LBE
or S/LBE
I hereby certify that the above information is accurate to the best of my knowledge (Title) (Signature)
Additional Sheets May Be Used as Necessary
| Name of SBE Contact Information including address telephone number and email addressRow1: |
| Scope of WorkRow1: |
| NAICS CodeRow1: |
| Subcontractor or SupplierRow1: |
| Dollar Amount for SBERow1: |
| Percent of Total ProposalRow1: |
| Quote Received YNRow1: |
| OEO Registry YNRow1: |
| EthnicityRow1: |
| Name of SBE Contact Information including address telephone number and email addressRow2: |
| Scope of WorkRow2: |
| NAICS CodeRow2: |
| Subcontractor or SupplierRow2: |
| Dollar Amount for SBERow2: |
| Percent of Total ProposalRow2: |
| Quote Received YNRow2: |
| OEO Registry YNRow2: |
| EthnicityRow2: |
| Name of SBE Contact Information including address telephone number and email addressRow3: |
| Scope of WorkRow3: |
| NAICS CodeRow3: |
| Subcontractor or SupplierRow3: |
| Dollar Amount for SBERow3: |
| Percent of Total ProposalRow3: |
| Quote Received YNRow3: |
| OEO Registry YNRow3: |
| EthnicityRow3: |
| Name of SBE Contact Information including address telephone number and email addressRow4: |
| Scope of WorkRow4: |
| NAICS CodeRow4: |
| Subcontractor or SupplierRow4: |
| Dollar Amount for SBERow4: |
| Percent of Total ProposalRow4: |
| Quote Received YNRow4: |
| OEO Registry YNRow4: |
| EthnicityRow4: |
| Name of SBE Contact Information including address telephone number and email addressRow5: |
| Scope of WorkRow5: |
| NAICS CodeRow5: |
| Subcontractor or SupplierRow5: |
| Dollar Amount for SBERow5: |
| Percent of Total ProposalRow5: |
| Quote Received YNRow5: |
| OEO Registry YNRow5: |
| EthnicityRow5: |
| Submitter: |
| Project Number: |
| Project Name: RFP - Managed Care |
| Posted Date: |
| Estimated Value: |
| Signature: |
| Title: |
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