sdp-rplan-form-3-reporting~28.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Pre-mixed Sodium and Calcium Chloride
- Solicitation number
- BD-17-1030-0H100-0H099-15374
- Issued by
- Suffolk County, Massachusetts
About this file
This document is a Supplier Diversity Program (SDP) Spending Report form for a state contract in Massachusetts. The form requires the contractor to report quarterly on their spending with certified diverse business partners, including minority-owned, women-owned, service-disabled veteran-owned, and non-profit businesses. The contractor must meet an annual SDP spending commitment percentage established during the bid process. The report includes the contractor's annual SDP spending commitment, quarterly spending by category, and a year-to-date compliance check. The contractor must certify the accuracy of the information under the pains and penalties of perjury.
The related state and local contract opportunity is for the procurement of pre-mixed sodium and calcium chloride products in the state of Massachusetts. No additional details about this contract opportunity are provided in the document.
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Other files
| File | Type | Posted |
|---|---|---|
| W9 Form~37.pdf | ||
| sdp-rplan-form-2-declaration~21.docx | DOCX document | |
| Authorized Signatory Form~41.doc | DOC document | |
| MassDOT Standard Contract Form~3.docx | DOCX document | |
| Premix RFR.docx | DOCX document | |
| Bid Spreadsheet~13.xlsx | XLSX spreadsheet | |
| Bid Response Form~37.docx | DOCX document | |
| EFT Form~40.pdf | ||
| MassDOT Terms and Conditions~44.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 | 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 .