SDP plan form 3 - reporting~47.xlsx
XLSX spreadsheet 27 KB Posted
- Solicitation number
- BD-25-1025-DOCFS-9892-113027
- Issued by
- Worcester County, Massachusetts
About this file
This is a Supplier Diversity Program (SDP) Spending Report Form (Form #3) for Commonwealth of Massachusetts contractors. The form requires contractors to report quarterly spending with SDP partners within 45 days of each quarter's end, covering four fiscal quarters from July 1 through June 30. The form consists of three parts: contractor information, SDP partner information, and certification of accuracy under penalty of perjury.
The form tracks spending commitments with certified diverse suppliers including Minority Business Enterprise (MBE), Woman Business Enterprise (WBE), Minority and Woman Business Enterprise (MWBE), Minority or Woman Non-Profit Organizations (MNPO/WNPO/MWNPO), and Service-Disabled Veteran-Owned Business Enterprise (SDVOBE). Contractors must report their total contract sales and specify their SDP spending commitment percentage. The form includes automated calculations to track year-to-date compliance and requires explanation if spending falls below commitment levels. The Supplier Diversity Office reserves the right to verify reported payment amounts directly with SDP partners.
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Other files
| File | Type | Posted |
|---|---|---|
| Bid Intent Form~29.doc | DOC document | |
| Prevailing Wage Payroll Report Form~76.pdf | ||
| SBCC Sign In Sheet.pdf | ||
| Prevailing Wage Statement of Compliance~74.pdf | ||
| Bid Results~63.doc | DOC document | |
| Prevailing Wages~33.pdf | ||
| Bid Package~36.doc | DOC document | |
| Where to get plans and specs~51.docx | DOCX document | |
| Bidder Checklist~65.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 | MNPO/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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