sdpplan.doc

Supplier Diversity Program (SDP) Plan Form

Contract/RFR Document Number:

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form for each Supplier Diversity Office (SDO) Certified M/WBE Partner Business.

For a complete list of certified vendors please go to http://www.somwba.state.ma.us/BusinessDirectory/BusinessDirectory.aspx .

Part I Bidder/Contractor Information Help with Part I

Business Name:

Full Address: number, street, and apt. or suite no., city, state, zip

Contact Name:

Phone # ( FORMTEXT

) - x Email address:

Check one of the following if applicable:

FORMCHECKBOX

MBE FORMCHECKBOX

WBE FORMCHECKBOX

M/WBE FORMCHECKBOX

M/W Non-Profit If not yet certified, check here if you have applied for Certification: FORMCHECKBOX

Certification Expiration Date If Applicable (copy of the SDO certification letter must be attached):

Part II SDP Partner (Cannot be the same company as the Bidder/Contractor or an affiliate) Help with Part II f

M/WBE Business Name:

Full Address: number, street, and apt. or suite no., city, state, zip

Contact Name:

Check one of the following if applicable:

FORMCHECKBOX

MBE FORMCHECKBOX

WBE FORMCHECKBOX

M/WBE FORMCHECKBOX

M/W Non-Profit If not yet certified, check here if your partner has applied for Certification: FORMCHECKBOX

Certification Expiration Date If Applicable (copy of the SDO certification letter must be attached):

Certification Expiration Date If Applicable (copy of the SDO certification letter must be attached):

If not yet certified, check here if you have applied for Certification: FORMCHECKBOX

Certification Expiration Date If Applicable (copy of the SDO certification letter must be attached):

Part III Description of Business Relationship Help with Part III III f

Check a minimum of one of these options that best describe the business relationship between Bidder/Contractor and SDP Partner:

FORMCHECKBOX

Subcontract: include a copy of the written agreement between the Bidder and Subcontractor.

FORMCHECKBOX

Ancillary: include a copy of the written agreement between the Bidder and Ancillary Partner.

FORMCHECKBOX

Growth & Development: enclose plan for education, training, sponsorship, mentoring, resource sharing, and/or other initiatives.

Briefly describe the products and/or services the SDP Partner will provide your business:

Part IV Financial Commitment Help with Part IV

Provide information on the committed amount (as a percentage of Bidder/Contractor gross revenue derived from this contract or as an exact dollar figure) to be spent with the certified SDP Partner as part of this relationship.

Part V Past Performance Help with Part V Have you had past relationships/spending with this SDP partner FORMCHECKBOX Yes FORMCHECKBOX No

If yes, please provide total spending in previous two years $ .

Sign

Here:

Print Name ► Title ► Authorized Signature ► ___________________________ Date ►

Supplier Diversity Program (SDP) Plan Form Instructions

Part I

Bidder/Contractor Information: Business name, full address, contact name, phone #, email address and your SDO certification status, if you have one, i.e. if you are SDO certified, please put in the expiration date of your certification. Please be aware you will not received additional points based on your certification status. Submit a copy of your SDO certification, if applicable.

Part II

SDP Partner must be a Women Owned (WBE), Minority Owned (MBE) or Minority and Woman Owned (M/WBE) Business Enterprise or Woman Nonprofit (WNP) or Minority Nonprofit (MNP) certified by the State Office of Minority and Women Business Assistance (SOWMBA). You must include the partner’s business name, full address, contact name, phone #, email address and SDO certification status. You must also submit a copy of the partner’s SDO certification or check the applicable box stating that they have applied for Certification. For a complete list of SDO certified vendors please visit their website at www.mass.gov/SDO . Please note that if you are a SDO certified vendor you cannot put yourself as the SDP partner or an affiliate but will be required to partner with another SDO certified business. SDO certified vendors responding to Requests for Response (RFR) are not exempt from this requirement.

Part III

Description of Business Relationship: In this section the prime Bidder/Contractor must provide a description of the business relationship with the SDP Partner. Please refer to the SDP section of the solicitation (RFR) to determine if any of these options are required in your response and to determine how many options you can use for your SDP plan. For example, unless the RFR requires otherwise, you can select Subcontracting and Growth and Development or you can select Ancillary Services and Growth and Development. However, you must select at least one business relationship and provide a description of the services rendered.

1) Subcontracting: submit SDP Plan form, a partnership agreement and SDP partner’s certification.

2) Ancillary: submit SDP Plan form, a partnership agreement (if available) and SDP partner’s certification.

3) Growth and Development: submit SDP Plan form, growth and development plan (please use a separate sheet) and SDP partner’s certification.

Definitions and examples of the three components can be found at: http://www.mass.gov/Eoaf/docs/osd/sdo/sdp/subcontracting.doc The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings are located on the SDP website at www.mass.gov/SDP .

Part IV Financial Commitment: provide the minimum amount you will spend with the SDP partners as a percentage of the gross revenue derived from the contract or an exact dollar amount. If you select the same percentage or dollar amount for each contract year, please input this information in the Annual Amount or Percentage field(s). If the committed amount is different each contract year, input the percentage or dollar amount in the field that corresponds with the appropriate contract year.

Part V Past Performance: Historical spending with the SDP partner. If you have a previous relationship with this partner provide the total for the past two years

Resources available to assist Prime Bidders in finding potential M/WBE partners can be found at: http://www.mass.gov/Eoaf/docs/osd/sdo/sdp/20guidance.doc Sensitivity level – high (when filled in) low (when blank)

Form SDP Plan (Rev. September 2010)