SDP_PlanForm3_Reporting~2.xlsx
XLSX spreadsheet 14 KB Posted
- Attached to
- SPECIAL BATTERIES-MDOTFCS111
- Solicitation number
- BD-16-1030-0H100-0H010-00000006905
- Issued by
- Middlesex County, Massachusetts
About this file
This document is a Supplier Diversity Program (SDP) Spending Report for a contract with the Commonwealth of Massachusetts. The report requires the contractor to provide quarterly spending information with their SDP partners, which includes minority-owned, women-owned, service-disabled veteran-owned, and non-profit organization businesses. The report details the contractor's total quarterly and annual SDP spending commitment and actual spending, broken down by quarter. The contractor must certify the accuracy of the information provided under pains and penalties of perjury.
The related state and local contract opportunity is for "SPECIAL BATTERIES - MDOTFCS111" in Massachusetts. No additional details about the scope, quantities, response dates, or term of the contract are provided in the given information.
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Other files
| File | Type | Posted |
|---|---|---|
| busreffm~1.doc | DOC document | |
| EFT_FORM~1.pdf | ||
| eppform~3.doc | DOC document | |
| MDOTFCS111.doc | DOC document | |
| MassDOTTermsandConditions~4.doc | DOC document | |
| AuthorizedSignatoryForm~3.doc | DOC document | |
| StandardContractForm ~1.doc | DOC document | |
| newmass-w9~1.doc | DOC document | |
| prompt-pay-frm~1.doc | DOC document | |
| SDP_PlanForm1_Commitment~1.docx | DOCX document | |
| SDP_PlanForm2_Declaration~1.docx | DOCX 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 |
&"-,Bold"&10Last Edit: &"-,Regular"&D
File details come from the government source that posted it. Updated .