sdp-rplan-form-3-reporting~24.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Track Maintenance Power Tools
- Solicitation number
- BD-17-1030-0T100-0T281-13953
- Issued by
- Plymouth County, Massachusetts
About this file
This document is a Supplier Diversity Program (SDP) Spending Report form required by the Commonwealth of Massachusetts for a state and local contract opportunity. The form must be completed and submitted quarterly by the contractor to report their spending with SDP partner companies, which can include minority, women, service-disabled veteran, and veteran-owned businesses as well as minority and women non-profit organizations. The report tracks the contractor's quarterly and annual spending commitment percentage outlined in their bid response. The related state and local contract opportunity is for Track Maintenance Power Tools in the state of Massachusetts.
The form requires the contractor to provide their company information, annual supplier diversity spending commitment percentage, and quarterly spending amounts with each of their SDP partners. The contractor must certify the accuracy of the information provided under pains and penalties of perjury. The Commonwealth reserves the right to contact the SDP partners to verify the reported spending amounts.
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Other files
| File | Type | Posted |
|---|---|---|
| Authorized Signatory Form~36.doc | DOC document | |
| MassDOT Standard Contract Form~15.doc | DOC document | |
| W9 Form~32.pdf | ||
| Bid Response Form~31.docx | DOCX document | |
| Tools RFR.docx | DOCX document | |
| Bid Spreadsheet~9.xlsx | XLSX spreadsheet | |
| EFT Form~35.pdf | ||
| MassDOT Terms and Conditions~39.doc | DOC document | |
| sdp-rplan-form-2-declaration~17.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 | Annual 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 (as it appears on a list at www.mass.gov/sdo) | (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 | |
| M/WBE - Minority and Woman Business Enterprise | ||
| Authorized Signature | SDVOBE - Service-Disabled Veteran-Owned Business Enterprise | |
| (May be left blank if submitted electronically) | VBE - Veteran-Owned Business Enterprise | |
| Date | M/NPO - Minority Non-Profit Organization | |
| W/NPO - Women Non-Profit Organization | ||
| M/W/NPO - Minority and Women Non-Profit Organization | ||
| *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 Type for SDP Partner(s) can be checked at www.mass.gov/sdo | Revised: February 22, 2016 |
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File details come from the government source that posted it. Updated .