ATT 7_SBPCD Template 3.4.22 Amendment 3.pdf

RFP 24368121R0002 BENEFEDS

ATTACHMENT 7

SMALL BUSINESS PARTICIPATION COMMITMENT DOCUMENT

(SBPCD)

Company Name:

(PRIME OFFEROR)

DUNS #:

1. Prime Contractor Business Size:

(Relative to the NAICS code and small business size standard listed in the solicitation) Indicate the applicable size and socioeconomic categories, mark all that apply:

Other than Small Business (includes Large business) Small Business (SB) (also check any of the below as applicable) Small Disadvantaged Business (SDB) Woman-Owned Small Business (WOSB) Historically Underutilized Business Zone (HUBZone) Small Business Service-Disabled Veteran Owned Small Business (SDVOSB) SBA 8(a) Business Development Program Participant Other Small Business Socioeconomic Categories (LIST)

2. Complete the table below for all Small Business (SB) Participation. List principal supplies/services to be performed or provided by Small Businesses, and nature of commitment.1 SB Company Name

DUNS#2 SB

Categories3

NAICS Product(s) / Service(s) to be Provided4, and Period(s) of Performance5

Nature and Level of Commitment6

Copies of any commitment agreements should be provided as an attachment to your SBPCD and will not count against any page limitations.

1 Add rows as needed.

2 DUNS # as registered in SAM.gov 3 SB, WOSB, SDB, SDVOSB, 8(a), etc.

4 Reference any categories of labor or services referenced in the PWS 5 Periods of Performance as noted in the PWS 6 Describe the extent of commitment to use small businesses specifically, what types of commitments, if any, are in place for this specific acquisition. Is the prime a small business? If so state “PRIME” in this column. Is there a written contract between prime and this small business? Is it verbal? Is it enforceable or non-enforceable? Is there a joint venturing or mentor-protégé arrangement?

3. Insert the following figures from your Attachment 2, Quote Schedule, TCV Calculation Tab to illustrate the Proposed Total Contract Value (TCV):

CLIN # & Description CLIN 00001 – Start Up Period: Initial Development and Transition Services $ CLINs 00003 through 00008 – Base Period Estimated Total $ CLINs 10003 through 10008 – Option Period One Estimated Total $ CLINs 20003 through 20008 – Option Period Two Estimated Total $ CLINs 30003 through 30008 – Option Period Three Estimated Total $ Proposed TOTAL CONTRACT VALUE (TCV), excluding Base Period Travel ODCs

4. Of the Proposed Total Contract Values (TCVs) noted in Item 3 above, identify the proposed dollar values and percentages that will be performed by the Prime Offeror versus Subcontractors. All percentages should use Proposed Total Contract Values (TCV) as a reference. Include ALL Subcontractors. 7

Amount to be performed by the PRIME Contractor $ Percentage to be Performed by the PRIME Contractor8 % Amount to be performed by Subcontractors $ Percentage to be Performed by Subcontractors % Proposed TOTAL CONTRACT VALUE9 $ Percentage Totals10 %

7 Show Percentages with no more than two decimal places (0.00%) 8 If the PRIME is a Small Business, the percentage of work to be performed by the prime must not be less than 50% .

9 The SUM of the dollar amounts for PRIME and Subcontractors in the table must total the Proposed TCV in Item 3 above.

10 Percentage totals for PRIME and Subcontractors must total 100%

5. Of the Proposed Total Contract Values (TCVs) noted in Item 3 above, identify the proposed dollar values and percentages that will be performed by Small Business versus Other than Small Business (regardless of business size). All percentages should use Proposed Total Contract Values (TCV) as a reference. 11

Amount to be performed by SMALL BUSINESSES 12 $ Percentage to be Performed by SMALL BUSINESSES1314 % Amount to be performed by OTHER THAN SMALL BUSINESSES $ Percentage to be Performed by OTHER THAN SMALL BUSINESSES % Proposed TOTAL CONTRACT VALUE15 $ Percentage Totals16 %

11 Show Percentages with no more than two decimal places (0.00%) 12 A Prime that is a Small Business itself shall include its own participation as the prime when noting the Amount to be performed by Small Business.

13 A Prime that is a Small Business itself shall include its own participation as the prime when noting the Percentage to be performed by Small Business.

14 Percentages to be performed by Small Business must meet or exceed the Baseline Percentage noted in the Solicitation 15 The SUM of the dollar amounts for SMALL and Other than Small in the table must total the Proposed TCVs in Item 2 above.

16 Percentage totals for SMALL and Other than Small must total 100%

6. Of the Proposed Total Contract Values (TCVs) noted in Item 3 above, identify the proposed dollar values and percentages that will be performed by the following socioeconomic categories of Small Businesses. All percentages should use Proposed Total Contract Values (TCV) as a reference. 17 18 19

In Reference to “Unit Pricing” Tab TCV

Amount to be performed by SMALL DISADVANTAGED BUSINESS (SDB) $ Percentage to be Performed by SMALL DISADVANTAGED BUSINESS (SDB) % Amount to be performed by WOMAN OWNED SMALL BUSINESSES (WOSB) $ Percentage to be Performed by WOMAN OWNED SMALL BUSINESSES (WOSB) % Amount to be performed by HUBZONE SMALL BUSINESSES $ Percentage to be Performed by HUBZONE SMALL BUSINESSES % Amount to be performed by SERVICE DISABLED VETERAN OWNED SMALL

BUSINESSES (SDVOSB)

Percentage to be Performed by SERVICE DISABLED VETERAN OWNED SMALL

BUSINESSES (SDVOSB)

Amount to be performed by SBA 8(a) Small Business Development Program Participants

Percentage to be Performed by SBA 8(a) Small Business Development Program Participants

Amount to be performed by all other Small Business Socioeconomic Categories $ Percentage to be Performed by all other Small Business Socioeconomic Categories %

List of all other Small Business Socioeconomic Categories to be utilized:

17 Show Percentages with no more than two decimal places (0.00%) 18 A Prime that is a Small Business itself shall include its own participation as the prime when noting the Amount to be performed by any socioeconomic category.

19 Leave no spaces blank. Use Zeroes ($0.00 or 0.00%) to show no participation.