sdp-rplan-form-3-reporting~4.xlsx
XLSX spreadsheet 12 KB Posted
- Solicitation number
- BD-20-1071-AO-02021-44619
- Issued by
- Suffolk County, Massachusetts
About this file
This document is the Supplier Diversity Program (SDP) Spending Report form for a state and local contract opportunity. The form must be completed and submitted within 45 days of the end of each quarter by the contractor to the Commonwealth Contract Manager. It requires the contractor to report on their annual supplier diversity spending commitment percentage and quarterly spending with their SDP partner(s). The SDP partner(s) must be certified by the state's Supplier Diversity Office. The form also includes a year-to-date compliance check and requires the contractor to explain any non-compliance and the actions they will take to bring their company into compliance with the annual spending commitment.
The related state and local contract opportunity is for Durable Medical Equipment (DME) Reuse Partner services in the state of Massachusetts. The contract term and any renewal options are not specified.
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Other files
| File | Type | Posted |
|---|---|---|
| Contracting Qualification Form~18.docx | DOCX document | |
| MA DOR Certificate of Good Standing - 101718~8.docx | DOCX document | |
| RFR DME Reuse FY20 revised 5.docx | DOCX document | |
| Business Reference Form~19.doc | DOC document | |
| standard contract Form~4.doc | DOC document | |
| sdp-rplan-form-2-declaration~5.docx | DOCX document | |
| W9~20.doc | DOC document | |
| Supplier Diversity Program Form for Purchase of Service~18.xlsx | XLSX spreadsheet | |
| DME Reuse amendment.docx | DOCX document | |
| DME Bidders Conference Q and A revised.docx | DOCX document | |
| CORI Assurance Letter Agency~3.docx | DOCX document | |
| Contracting Qualification Form Instructions~3.pdf | ||
| Terms and Conditions for HSS~3.pdf | ||
| Contractor Authorized Signatory form~6.rtf | RTF text file | |
| Electronic Funds Transfer Sign Up Form~16.pdf | ||
| RFR Appendix MRC DME 9-2020.docx | DOCX document | |
| eppform~3.doc | DOC document | |
| Prompt Payment Discount Form~33.doc | DOC document | |
| RFR Cover Page DME Reuse FY20.docx | DOCX document | |
| sdp-plan-form-1-commitment~6.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 | ||
| *This is your company's SDP Plan commitment percentage submitted in your Bid Response | M/W/NPO - Minority and Women Non-Profit Organization | |
| or established through negotiation. | DOBE - Disability-Owned Business Enterprise | |
| **The Supplier Diversity Office and contracting department reserves the right to contact | LGBTBE - Lesbian, Gay, Bisexual or Transgender Business Enterprise | |
| 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: March 8, 2016 |
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File details come from the government source that posted it. Updated .