Supplier Diversity Program Form for Purchase of Service~15.xlsx

SDP Form Supplier Diversity Program (SDP) Form for Purchase of Service (POS) Submission for Fiscal Year_______ Instructions: Completing all parts of this form is required in order for a provider to be qualified to contract with Commonwealth Agencies for POS services. This form is due annually with a provider's Uniform Financial Report and a copy of the completed form is to be submitted when responding to POS contract opportunities with an Executive Agency or Department

Contact Name: Phone # Email address:

Name: Title: Signature: Date: / /

Overall Providers that hold POS contracts with Commonwealth Agencies are required to file a “Supplier Diversity Program (SDP) Form for Purchase of Service (POS)” each year and upload with their Uniform Financial Report (UFR). This requirement includes bidders who have already been certified as SDO Certified Partners by OSD. Providers that are exempt from UFR filing requirements must submit the SDP form when they upload their exemption request. Providers responding to POS bids posted on COMMBUYS will be directed to submit the most recent copy of their "SDP Form for Purchase of Service" with their proposals/quotes.

Part I Bidder/Contractor Information: Business name, full address, contact name, phone number and email.

Part II - Contractor's SDP Partners SDP Partner(s) must be a Women Owned (WBE), Minority Owned (MBE) or Minority and Woman Owned (M/WBE) Business Enterprise, a Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) or Woman Nonprofit (WNP) or Minority Nonprofit (MNP) certified by the Supplier Diversity Office. You must include the partner’s business name and full address.

Description of Business Relationship: In this section, the prime Bidder/Contractor must provide a description of the business relationship/arrangement with the SDO Certified Partner. The Supplier Diversity Program offers trainings on the SDP Plan requirements. See link below for information on upcoming trainings.

Check SDP Partners Certification: Check the appropriate box(es)

Financial Commitment: In fourth column, include the amount (as an exact dollar figure) your organization is committed to spend with identified SDP partners during the current Fiscal Year. In the fifth column, enter the amount (as an exact dollar figure) that your organization expended with SDP partners during the past fiscal (UFR reporting year). Total commitment is for the organization and not by contract. As an example, for the FY2014 UFR reporting year, the commitment column would include total expenditures anticipated to be made in FY2015. The expended amount would include all expenditures with SDP Certified Partners in FY2014.

The total SDP spend will automatically calculate. The total POS spend amount can be found on the Federal Listing posted by OSD on the provider’s UFR eFiling site. Once this amount is entered, the percent will automatically calculate.

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· For a complete list of certified vendors refer to: https://www.sdo.osd.state.ma.us/BusinessDirectory/BusinessDirectory.aspx

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The dates of upcoming SDP trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

MBE

WBE

M/WBE

SDVOBE

M/W Non Profit

MBE

WBE

M/WBE

SDVOBE

M/W Non Profit

MBE

WBE

M/W Non Profit

M/WBE

SDVOBE

MBE

WBE

M/WBE

SDVOBE

M/W Non Profit