SDP plan form 3 - reporting~23.xlsx

XLSX spreadsheet 15 KB Posted

Attached to
DRM 2018-15 / C -Dorm Sprinkler Sprinkler System Installation @ MASAC @ Plymouth
Solicitation number
BD-20-1025-DOCFS-9882-48723
Issued by
Plymouth County, Massachusetts

About this file

This document is the Supplier Diversity Program (SDP) Spending Report that must be completed and submitted quarterly by contractors with the Commonwealth of Massachusetts. The report requires contractors to provide information on their spending with their SDP partner(s) including the partner's name, certification type, and quarterly spending amounts. Contractors must meet an annual SDP spending commitment percentage established in their bid response or through negotiation. The report includes instructions, contractor information, SDP partner information, and a certification statement.

The related state and local contract opportunity is for the installation of a combination dry/wet pre-action fire sprinkler system at the Massachusetts Maritime Academy in Plymouth, Massachusetts. The project is identified as DRM 2018-15 / C -Dorm Sprinkler Sprinkler System Installation @ MASAC @ Plymouth.

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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 CompanyContact NameTotal 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)
$ - 0

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(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.

NameSupplier Diversity Certification Acronyms:
TitleMBE - Minority Business Enterprise
PhoneWBE - Woman Business Enterprise
EmailMWBE - Minority and Woman Business Enterprise
Authorized SignatureMNPO/WNPO/MWNPO - Minority or Woman 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
Revised: November 13, 2013

&"-,Bold"&10Last Edit: &"-,Regular"&D

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