sdp-rplan-form-3-reporting~5.xlsx
XLSX spreadsheet 12 KB Posted
- Attached to
- MRC AT 4-2020 - Assistive Technology Services
- Solicitation number
- BD-20-1071-AO-02021-50657
- Issued by
- Massachusetts
About this file
This document is the Supplier Diversity Program (SDP) Spending Report Form 3 for a Commonwealth of Massachusetts contract. The form requires the contractor to report on its spending with SDP partner companies on a quarterly basis. It includes fields for the contractor's annual SDP spending commitment percentage, quarterly and annual spending with SDP partners, and a year-to-date compliance check. The form must be submitted within 45 days of the end of each quarter to the Commonwealth Contract Manager.
The related state and local contract opportunity is for Assistive Technology Services in the state of Massachusetts. No additional details about the scope, quantities, response dates, or contract term are provided in the 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 .