SDP Plan Form 3 Reporting.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Religious Services Master Agreement (MA) RFR
- Solicitation number
- BD-15-1022-DMH08-8210B-00000003178
- Issued by
- Worcester County, Massachusetts
About this file
The document is a Supplier Diversity Program (SDP) Spending Report Form 3 for a Commonwealth contract. It requires the contractor to report their quarterly spending with SDP partners, which are minority, women, veteran, and non-profit owned businesses. The form includes fields for the contractor's company information, their overall SDP spending commitment percentage, and the quarterly spending amounts with each SDP partner. The contractor must certify the accuracy of the information provided. This report must be submitted within 45 days of the end of each quarter to the Commonwealth Contract Manager.
The related state and local contract opportunity is for a Religious Services Master Agreement (MA) Request for Response (RFR) in the state of Massachusetts. No other details about the scope, timeline, or other requirements for this contract opportunity are provided.
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Other files
| File | Type | Posted |
|---|---|---|
| SDP Plan Form 2 Declaration.docx | DOCX document | |
| W-9.doc | DOC document | |
| SDP Plan Form 1 Commitment.docx | DOCX document | |
| Contractor Authorized Signatory Listing.doc | DOC document | |
| Business Reference Form.doc | DOC document | |
| Response Cover Sheet.doc | DOC document | |
| Terms and Conditions.doc | DOC document | |
| Reposting Notice 042115.docx | DOCX document | |
| EFT Link.doc | DOC document | |
| Religious Services MA RFR~2.doc | DOC document |
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Text version
SDP Spending Report
| 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 | Total 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) | |
| $ - 0 |
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 | (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) | |
| $ - 0 | |||||||
| $ - 0 | |||||||
| $ - 0 | |||||||
| $ - 0 | |||||||
| $ - 0 | |||||||
| $ - 0 | |||||||
| Year-To-Date Compliance Check (Do not change this line) | $ - 0 |
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 |
| MWBE - Minority and Woman Business Enterprise | |
| Authorized Signature | NPO - Non-Profit Organization |
| (May be left blank if submitted electronically) | SDVOBE - Service-Disabled Veteran-Owned Business Enterprise |
| Date |
| *This is your company's SDP Plan commitment percentage submitted in your Bid Response or established through negotiation. |
| **The Supplier Diversity Office and contracting department reserves 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. |
| ***Certification Status for SDP Partner(s) can be checked at www.mass.gov/sdo |
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