sdp-plan-form-2-declaration.docx

DOCX document 33 KB Posted

Attached to
MED50 Flu Vaccine 2016-2017season
Solicitation number
BD-16-1080-OSD03-SRC3-00000005621
Issued by
Massachusetts

About this file

This document is a Supplier Diversity Program (SDP) Plan Form that must be submitted by a contractor within 30 days of contract execution for a state and local contract opportunity. The form requires the contractor to provide information about their Minority-owned Business Enterprise (MBE), Women-owned Business Enterprise (WBE), and Service-Disabled Veteran-owned Business Enterprise (SDVOBE) partners, including their company names, contact information, and certification status. The contractor must also indicate the overall SDP percentage commitment for the life of the contract. The state and local contract opportunity referenced is for the procurement of flu vaccines for the 2016-2017 season, identified as MED50 Flu Vaccine, issued by the state of Massachusetts.

The form provides resources to assist prime bidders in finding potential MBE, WBE, and SDVOBE partners, and information about the Supplier Diversity Program's training and webinar offerings. The contractor is required to work with the Supplier Diversity Office to identify and establish business relationships with SDP partners if they do not yet have any identified at the time of submission.

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Supplier Diversity Program (SDP) Plan - Declaration of SDP Partner(s) SDP Plan Form #2 (Must be submitted by Contractor within a period of up to 30 days (or as stated in RFR) of Contract Execution)

Contract/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 within a period of up to 30 days (or as stated in RFR) of Contract Execution. See SDP and SDVOBE Resource information below to assist in partnering with certified businesses.

Part I Contractor Information (Required)

Business Name:
Contact Name:
Phone # ( ) -
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):

Final SDP Percentage Committed for Life of Contract:
%

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

Planned SDP Partner’s Company Name

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

|_| WBE

|_| SDVOBE

@ .
|_| MBE

|_| WBE

|_| SDVOBE

@ .
|_| MBE

|_| WBE

|_| SDVOBE

@ .
|_| MBE

|_| WBE

|_| SDVOBE

@ .
|_| MBE

|_| WBE

|_| SDVOBE

Alternative to Contractor Providing List of SDP Partners (above): If specifically authorized in the Request for Response (RFR) to utilize this option, by checking the box at right, Contractor acknowledges that they do not yet have any SDP Partners but will meet the percentage commitment in Part I (above) and all other contract requirements and will work with the SDO to identify and establish business relationships with SDO Partners:
|_|

*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).

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