Business Enterprise Owned by Persons with Disabilities (BEPD) Survey

Vendor Name

Vendor Address

Email

1. Is your business located in the Counties of Cook, DuPage, Kane, Lake, McHenry, or Will in the State of Illinois?

Yes

No

2. Is your business located in the City of Chicago?

Yes

No

3. Is your business located in the State of Illinois?

Yes

No

4. Does any individual who identifies as disabled have an ownership interest in your business? For purposes of this survey, disabled means any individual who has a physical or mental condition that limits that individual’s movements, senses, or activities, or person who otherwise has a disadvantage or handicap, especially one that is imposed or recognized by law.

Yes

No

4a. If yes, what percentage of the business is owned by one or more individuals who identify as Disabled? If no, answer N/A.

5. Is your business certified as a Business Enterprise Owned and Operated by Persons with Disabilities by (1) the state of Illinois as the certifying agency, or (2) other certifying agency or assist agency whose certification process the District’s Diversity Administrator deems sufficiently dependable for purposes of gathering data related to BEPD businesses.

Yes

No

5a. If yes, what is/are your business’s area(s) of specialty(ies)? Please list applicable NIGP Codes below. If no, answer N/A.

6. Is your business certified by the Metropolitan Water Reclamation District of Greater Chicago (MWRDGC) as an MBE or WBE?

Yes

No

6a. If yes, what is/are your business’s area(s) of specialty(ies)? Please list applicable NIGP Codes below. If no, answer N/A.

7. Is your business certified by MWRDGC as a VBE?

Yes

No

7a. If yes, what is/are your business’s area(s) of specialty(ies)? Please list applicable NIGP Codes below. If no, answer N/A.

8. Is your firm certified by the Illinois Department of Transportation (IDOT), City of Chicago, Chicago Transit Authority (CTA), PACE, or Metra as an MBE, WBE, SBE, or VBE?

Yes

No

8a. If yes, what is/are your business’s area(s) of specialty(ies)? Please list applicable NIGP Codes below. If no, answer N/A.

9. Has your business bid on MWRD work within the past two (2) years?

Yes

No

9a. If yes, what specification numbers or project names? If no, answer N/A.

10. If your business has bid on MWRD work within the past two (2) years, has it been awarded a contract by MWRD?

Yes

No

10a. If yes, what is the contract number? If no, answer N/A.

11. Has your business been utilized on a MWRD contract as subcontractor or supplier within the past two (2) years?

Yes

No

11a. If yes, what specification numbers or project names? If no, answer N/A.

12. Has your business bid on work with another government entity such as Cook County, the State of Illinois, or MWRD’s sister agencies within the past two (2) years?

Yes

No

12a. If yes, which government entity and project name(s)? If no, answer N/A.

13. If your business has bid on other government work within the past two (2) year, has it been awarded a contract by such entity?

Yes

No

13a. If yes, which government entity and project name(s)? If no, answer N/A.

14. Has your business been utilized on another government entity’s contract as a subcontractor or supplier within the past two (2) years?

Yes

No

14a. If yes, which government entity and project name(s)? If no, answer N/A.

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