SDP plan form 3 - reporting~48.xlsx

XLSX spreadsheet 27 KB Posted

Attached to
DRM 2024-57 #07B Emergency Notification System at MCI-Shirley
Solicitation number
BD-25-1025-DOCFS-9843-113038
Issued by
Middlesex County, Massachusetts

About this file

This is a Supplier Diversity Program (SDP) Spending Report Form (Form #3) used by the Commonwealth of Massachusetts to track contractor spending with diverse suppliers. The form requires contractors to submit quarterly spending reports within 45 days of each quarter end, covering fiscal year quarters from July through June. The document outlines a structured reporting format where contractors must provide their company information, contact details, and total contract sales.

The form requires detailed reporting of spending with SDP Partners, including partner company names, email addresses, and certification types (MBE, WBE, MWBE, MNPO/WNPO/MWNPO, SDVOBE). Contractors must document quarterly spending with each diversity partner and demonstrate compliance with their committed SDP spending percentage. The form includes a compliance check calculation and requires explanation if spending targets are not met. The document must be certified under penalty of perjury, with the Supplier Diversity Office and contracting department maintaining the right to verify reported payment amounts directly with SDP Partners.

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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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