SDP plan form 3 - reporting~43.xlsx

XLSX spreadsheet 27 KB Posted

Attached to
DRM 2024-57 #9 Emergency Notification System
Solicitation number
BD-25-1025-DOCFS-9848-108856
Issued by
Worcester County, Massachusetts

About this file

This document is a Supplier Diversity Program (SDP) Spending Report form that must be completed and submitted quarterly by contractors to the Commonwealth of Massachusetts. The form requires the contractor to report on their total quarterly spending and commitment percentage with SDP partner companies, which include Minority Business Enterprises (MBE), Woman Business Enterprises (WBE), Minority and Woman Business Enterprises (MWBE), Minority or Woman Non-Profit Organizations (MNPO/WNPO/MWNPO), and Service-Disabled Veteran-Owned Business Enterprises (SDVOBE). The contractor must provide the name, email address, certification type, and quarterly spending for each SDP partner. If the contractor is not in compliance with their annual spending commitment, they must explain why and what actions will be taken to bring their company into compliance.

The form also requires the contractor to certify under pains and penalties of perjury that the information provided is accurate. The Commonwealth reserves the right to contact the SDP partners at any time to verify the amounts reported as paid to them by the contractor.

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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 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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