B09_Amendment_0003-Small_Business_Participation_Plan_Worksheet_0003.docx

SMALL BUSINESS PARTICIPATION DOCUMENT

All Offerors (both large and small businesses) are required to complete a Small Business Participation Proposal. Offerors should propose the level of participation of small businesses (as a small business prime and/or small business subcontractors) in the performance of the acquisition relative to the objectives/goals set forth in the evaluation of this area.

1. Check the applicable size and categories for the PRIME offeror only -- Check all applicable boxes:

{ } Large Prime { } Small Business Prime; also categorized as a { } Small Disadvantaged Business (SDB) { } Woman-Owned Small Business (WOSB) { } Historically Underutilized Zone (HUB Zone) Small Business { } Veteran Owned Small Business (VOSB) { } Service Disabled Veteran Owned Small Business (SDVOSB)

2. Submit the total percentage of work to be performed by both large and small businesses (include the percentage of work to be performed both by Prime and Subcontractors):

Example: If Prime proposes a price of $1,000,000 (including all options), and small business(es) will provide $250,000 in services/supplies as a prime or subcontractor, the % planned for small businesses is 25%; and 75% for large business equaling 100%.

Total Percentage planned for Large Business (es) _______% = $ _______ Total Percentage planned for Small Business (es) _______% = $ _______ NOTE: 100% when combined, large and Small Business totals must equal 100%

3. Please indicate the total percentage of participation to be performed by small business. The percentage of work performed by Small Businesses that qualify for small business:

Small Business(es) __________% Small Disadvantaged Business _________% HUB Zone Small Business _________% Woman Owned Small Business _________% Service Disabled Veteran Owned SB _________% Veteran Owned Small Business _________% NOTE: When combined, large and Small Business totals must equal 100%

4. List principle supplies/services to be performed by Small Businesses:

Example: If a Small Business qualifies also as a WOSB and a SDVOSB, and you can add them to each category below in which they qualify. Name of Company Identify Type of Service/Supply Small Business

(SB):

5. Describe the extent of commitment to use small businesses (for example, what types of commitments if any are in place for this specific acquisition either – small business prime, written contract, verbal, enforceable, non-enforceable, joint venturing, mentor protégé, etc.)

Additional Important Note for Other Than U.S. Small Businesses ONLY.

Small Business Subcontracting Plan is Required (FAR 52.219-9). Separate from Small Business Participation Plan, other than U.S. Small Business offerors must also submit a subcontracting plan meeting the requirements of FAR 52.219-9 and shall address all 15 elements per FAR 19.704. Other than U.S. Small Businesses must submit acceptable subcontracting plans to be eligible for award. Subcontracting Plan shall reflect and be consistent with the commitments offered in the Small Business Participation Plan.