SDP Form 3~44.xlsx
XLSX spreadsheet 14 KB Posted
- Solicitation number
- BD-21-1020-DCRCU-DC250-58758
- Issued by
- Hampshire County, Massachusetts
About this file
This document is a Supplier Diversity Program (SDP) Spending Report Form required for a contract with the Commonwealth of Massachusetts. The form must be completed by the contractor and submitted quarterly, providing details on the contractor's spending with SDP partners (minority, women, veteran, disability, and LGBTQ-owned businesses) as part of the contract. The form requires the contractor to report their annual SDP spending commitment percentage, as well as the quarterly and year-to-date spending with each SDP partner. The contractor must certify the accuracy of the information under pains and penalties of perjury.
The related state and local contract opportunity is for the Department of Conservation and Recreation's Forest Health Program to purchase insect detection and monitoring materials, including traps, chemical lures, and insect collection tools. This is a recurring contract, and the Commonwealth reserves the right to contact the SDP partners to verify the reported spending amounts.
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Text version
Sheet1
| Supplier Diversity Program (SDP) Spending Report |
| SDP Plan Form #3 |
| Document Number/Name: |
| Instructions: This form must include information on your company's spending with your Supplier Diversity Program (SDP) Partner(s) and must be completed and submitted |
| within 45 days of the end of each quarter to Commonwealth Contract Manager. |
Part I Contractor Information (Required)
| Contractor Company | Contact Name | Annual Supplier Diversity | Quarterly Contract Sales | Fiscal Year | |||
| Name | Spending Commitment %* | Quarter 1 (7/1-9/30) | Quarter 2 (10/1-12/31) | Quarter 3 (1/1-3/31) | Quarter 4 (4/1-6/30) | Total (calculates automatically) | |
| $- |
Part II SDP Partner Information (Required) (Insert additional lines as needed)
| SDP Partner(s) Company | Email Address** | Certification Type*** | Quarterly Spending with Supplier Diversity Partner(s) | Fiscal Year | |||
| Name (as it appears on a list at www.mass.gov/sdo) | (Choose One) | Quarter 1 (7/1-9/30) | Quarter 2 (10/1-12/31) | Quarter 3 (1/1-3/31) | Quarter 4 (4/1-6/30) | Total (calculates automatically) | |
| $- | |||||||
| $- | |||||||
| $- | |||||||
| $- | |||||||
| $- | |||||||
| $- | |||||||
| Year-To-Date Compliance Check (Do not change this line) | $- |
If not in compliance, please explain why and what actions will be taken to bring your company to compliance with the annual spending commitment:
Part III Under the pains and penalties of perjury I certify that the information provided in this report is accurate.
| Name | Supplier Diversity Certification Acronyms: | |
| Title | MBE - Minority Business Enterprise | |
| Phone | WBE - Woman Business Enterprise | |
| M/WBE - Minority and Woman Business Enterprise | ||
| Authorized Signature | SDVOBE - Service-Disabled Veteran-Owned Business Enterprise | |
| (May be left blank if submitted electronically) | VBE - Veteran-Owned Business Enterprise | |
| Date | M/NPO - Minority Non-Profit Organization | |
| W/NPO - Women Non-Profit Organization | ||
| *This is your company's SDP Plan commitment percentage submitted in your Bid Response | M/W/NPO - Minority and Women Non-Profit Organization | |
| or established through negotiation. | DOBE - Disability-Owned Business Enterprise | |
| **The Supplier Diversity Office and contracting department reserves the right to contact | LGBTBE - Lesbian, Gay, Bisexual or Transgender Business Enterprise | |
| SDP Partners at any time to request that they attest to the amounts reported to have been | ||
| paid to them by the Contractor. | ||
| ***Certification Type for SDP Partner(s) can be checked at www.mass.gov/sdo | Revised: March 8, 2016 |
File details come from the government source that posted it. Updated .