sdp-rplan-form-2-declaration~5.docx

DOCX document 40 KB Posted

Attached to
2019 Impaired Driving Conference
Solicitation number
BD-19-1044-EPS11-HWY-30848
Issued by
Suffolk County, Massachusetts

About this file

This document is a Supplier Diversity Program (SDP) Plan Declaration Form for a state and local contract opportunity in Massachusetts. The form requires the prime bidder to provide details on their SDP partner(s), including the partner company name, certification type, and functions to be performed. The prime bidder must also commit to a specific final percentage of contract sales to be spent with all certified SDP partners on a Massachusetts fiscal year basis. The contract opportunity is for the 2019 Impaired Driving Conference, which involves the jurisdictions of Suffolk County and the City of Boston. The form must be completed and submitted within 30 days of contract execution.

The form also provides guidance on SDP resources, including lists of certified businesses and assistance for prime bidders to identify potential partners. Pricing terms, set asides, funding requirements, and other salient information are not included in this document, as it is focused solely on the SDP plan requirements.

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Text version

Supplier Diversity Program (SDP) Plan - Declaration of SDP Partner(s) SDP Plan Form #2

Contract/RFR Document Number: Click here to enter text.

Instructions: Completing all parts of this form is mandatory. Please read all sections of the Bid related to the SDP. Complete one form and submit within a period of up to 30 days (or as stated in RFR) of Contract Execution. See SDP Resources information below to assist in partnering with certified businesses.

Important: Prime bidders that are certified as an M/WBE, M/WNPO, VBE, SDVOBE, DOBE or LGBTBE must also submit an SDP Plan Form and may not list themselves or their affiliates as SDP Partners.

Part I Contractor Information and Annual Financial Commitment (Required)

Business Name: Click here to enter text.
Contact Name: Click here to enter text.
Phone #: Click here to enter phone number.
Email address: Click here to enter email address.

Provide a specific final percentage of Bidder/Contractor sales derived from this contract to be spent with all certified SDP Partners on a Massachusetts fiscal year (July 1-June 30) basis.

Final Annual SDP Percentage Committed for Life of Contract:

Click here to enter percentage.%

Part II Contractor’s SDP Partners (Required) (Fill in Applicable Lines; Insert Additional Rows as Needed)

Planned SDP Partner Company Name
Check Planned SDP Partner’s Certification(s)
Certifying Organization
Functions to be Performed by the Partner (optional unless otherwise stated in the RFR)
Click here to enter text.Choose an item.Choose an item.Click here to enter text.
Click here to enter text.Choose an item.Choose an item.Click here to enter text.
Click here to enter text.Choose an item.Choose an item.Click here to enter text.
Click here to enter text.Choose an item.Choose an item.Click here to enter text.
Alternative to Contractor Providing List of SDP Partners:
☐If specifically authorized in the Request for Response (RFR) to utilize this option, by checking this box, the Contractor acknowledges that they do not yet have any SDP Partners but will meet the percentage commitment in Part I (above) and all other contract requirements and will work with the SDO to identify and establish business relationships with SDO Partners.

Part III Under the pains and penalties of perjury I certify that the information provided on this form is accurate. (Required)

Name: Click here to enter text.
Title: Click here to enter text.
Signature:

(May be left blank if submitted electronically) Date: Click here to enter a date.

Supplier Diversity Program (SDP) Resources:

· Lists of M/WBEs, M/WNPOs, VBEs, SDVOBEs, DOBEs and LGBTBEs certified or verified by the Supplier Diversity Office (SDO) are located at www.mass.gov/sdo.

· Resources to assist Prime Bidders in finding potential Certified Partners can be found at www.mass.gov/sdp.

Revised: June 8, 2018

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File details come from the government source that posted it. Updated .