SOP-LGBTQ Applicant Data Form_B2626795.pdf

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Attached to
Service Line Verification Outreach 2026 #1
Solicitation number
B2627260
Issued by
Pennsylvania

About this file

This is an LGBTQ Applicant Opportunity Data Form used by the City of Philadelphia to collect diversity and inclusion information from businesses participating in municipal procurement opportunities. The form is designed to identify companies beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ) and seeking to conduct business with the City. The form pertains to the Service Line Verification Outreach 2026 #1 micro purchase opportunity in Pennsylvania. Applicants are required to provide their business name, bid or opportunity number, and indicate whether their company is beneficially owned and controlled by LGBTQ individuals, currently certified as an LGBTBE by the National LGBT Chamber of Commerce (NGLCC) through the Independence Business Alliance (IBA), or certified by other third-party certifying agencies such as ESMDC, PAUCP, Disability:IN, or WBENC.

The form also requests information regarding LGBTQ-certified subcontractors participating in the project, including the number of certified subcontractors and their business names. Response to the form is entirely voluntary, and by submitting the data, applicants agree that the City of Philadelphia may use the information for other projects and may make it publicly available. This data collection effort supports the City's commitment to diversity, equity, and inclusion in municipal procurement and assists in building a vendor database of LGBTQ-certified businesses eligible for future City contracting opportunities.

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LGBTQ Applicant Opportunity Data

1. Is Applicant’s business beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender or Queer?

2. Is Applicant’s business currently certified as a Lesbian, Gay, Bisexual, Transgender, Business Enterprise (LGBTBE) by the National LGBT Chamber of Commerce (NGLCC) through their local Philadelphia affiliate, the Independence Business Alliance (IBA)?

a. If yes, Applicant is currently certified by NGLCC/IBA as an LGBTBE, is Applicant's business also certified by any other third party certifying agency such as Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN or Women's Business Enterprise National Council (WBENC)?

If yes please identify the name of the certifying agency and category of certification (e.g., MBE, WBE, DSBE, DBE):

Certifying Agency Certification Category

3. For this contracting opportunity, are any of Applicant’s subcontractors certified by NGLCC/IBA? If yes, how many subcontractors are certified as LGBTBE?

Please list all by business name below.

As part of the City of Philadelphia’s commitment to diversity, equity and inclusion in all aspects of City procurement, the City is collecting data to identify the number of companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender and Queer persons who wish to do business with the City (collectively, “LGBTQ businesses”). The data will be used to identify the number of LGBTQ businesses currently doing business with the City. It will also assist in efforts to include LGBTQ certified businesses into the City’s vendor database. By submitting this form you are agreeing that the City may, in its discretion, use the data submitted for other projects and may cause it to become publicly available. Response to this form is entirely voluntary.

Applicant Name

Bid or Opportunity #

CertifiedLGBTEYes: Y
CertifiedLGBTENo: N
Certification:
LGBTQTypeYes: Y
LGBTQTypeNo: N
CertifiedNGLCCNo: N
CertifiedNGLCCYes: Y
LGBTQTypeY: Off
LGBTQTypeN: Off
CertifiedLGBTEY: Off
CertifiedLGBTEN: Off
CertifiedNGLCCY: Off
CertifiedNGLCCN: Off
Subconsultants:
BusinessName3:
BusinessName4:
BusinessName5:
Reset:
btnContinue:
CertifyingAgency:
BusinessName:
BusinessName2:
ApplicantName:
BidNumber:

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