SDP Form 3~54.xlsx

XLSX spreadsheet 14 KB Posted

Attached to
DCR 841 Touch-free Parking in Parks and Revenue
Solicitation number
BD-21-1020-DCRCU-DC250-59569
Issued by
Massachusetts

About this file

This document is a Supplier Diversity Program (SDP) Spending Report Form required by the Commonwealth of Massachusetts for contractors on state and local contracts. It captures the contractor's annual SDP spending commitment percentage and quarterly spending with certified SDP partners, including Minority-Owned, Woman-Owned, Service-Disabled Veteran-Owned, and other diversity-certified businesses. The form must be submitted within 45 days of the end of each fiscal quarter.

The related state and local contract opportunity is for the implementation of a Software as a Service (SaaS) system for touch-free parking in parks and revenue collection, issued by the Massachusetts Department of Conservation and Recreation. The contract term and any renewal options are not specified.

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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 CompanyContact NameAnnual Supplier DiversityQuarterly Contract SalesFiscal Year
NameSpending 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) CompanyEmail 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.

NameSupplier Diversity Certification Acronyms:
TitleMBE - Minority Business Enterprise
PhoneWBE - Woman Business Enterprise
EmailM/WBE - Minority and Woman Business Enterprise
Authorized SignatureSDVOBE - Service-Disabled Veteran-Owned Business Enterprise
(May be left blank if submitted electronically)VBE - Veteran-Owned Business Enterprise
DateM/NPO - Minority Non-Profit Organization
W/NPO - Women Non-Profit Organization
*This is your company's SDP Plan commitment percentage submitted in your Bid ResponseM/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 contactLGBTBE - 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/sdoRevised: March 8, 2016

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