ATT 7_SBPCD Template 3.4.22 clean.docx
DOCX document 28 KB Posted
- Attached to
- Benefits Enrollment and Premium Administration Services for BENEFEDS Program Federal contract opportunity
- Solicitation number
- 24361821R0002
- Issued by
- Office of Personnel Management
About this file
This document contains a Small Business Participation Commitment Document template for a solicitation seeking Benefits Enrollment and Premium Administration Services for the BENEFEDS program. Key details include:
-
The solicitation seeks proposals to provide benefits enrollment and premium administration services as described in the attached Performance Work Statement. The Office of Personnel Management anticipates awarding a single IDIQ contract with a maximum period of 54 months of performance periods available. Proposals are due in two phases by the dates specified in the solicitation.
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Offerors must complete the template to describe any proposed small business participation, including commitments from small businesses as subcontractors or joint venture partners. Details such as small business categories, products/services, and periods of performance must be provided. Percentage commitments and total contract values must be specified for the prime contractor, all subcontractors, small businesses, and socioeconomic categories of small businesses.
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Text version
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.[footnoteRef:1] [1: Add rows as needed.]
| SB Company Name |
| DUNS#[footnoteRef:2] [2: DUNS # as registered in SAM.gov] |
SB Categories[footnoteRef:3] [3: SB, WOSB, SDB, SDVOSB, 8(a), etc.]
| NAICS |
| Product(s) / Service(s) to be Provided[footnoteRef:4], and Period(s) of Performance[footnoteRef:5] [4: Reference any categories of labor or services referenced in the PWS] [5: Periods of Performance as noted in the PWS] |
Nature and Level of Commitment[footnoteRef:6] [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?]
Copies of any commitment agreements should be provided as an attachment to your SBPCD and will not count against any page limitations.
Company Name:
DUNS #:
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 Value (TCV) 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. [footnoteRef:7] [7: Show Percentages with no more than two decimal places (0.00%)]
| Amount to be performed by the PRIME Contractor |
| $ |
Percentage to be Performed by the PRIME Contractor[footnoteRef:8] [8: If the PRIME is a Small Business, the percentage of work to be performed by the prime must not be less than 50% .]
| Amount to be performed by Subcontractors |
| $ |
| Percentage to be Performed by Subcontractors |
| % |
Proposed TOTAL CONTRACT VALUE[footnoteRef:9] [9: The SUM of the dollar amounts for PRIME and Subcontractors in the table must total the Proposed TCV in Item 3 above.]
Percentage Totals[footnoteRef:10] [10: Percentage totals for PRIME and Subcontractors must total 100%]
DUNS #:
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. [footnoteRef:11] [11: Show Percentages with no more than two decimal places (0.00%)]
Amount to be performed by SMALL BUSINESSES [footnoteRef:12] [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.]
Percentage to be Performed by SMALL BUSINESSES[footnoteRef:13][footnoteRef:14] [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]
| Amount to be performed by OTHER THAN SMALL BUSINESSES |
| $ |
| Percentage to be Performed by OTHER THAN SMALL BUSINESSES |
| % |
Proposed TOTAL CONTRACT VALUE[footnoteRef:15] [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.]
Percentage Totals[footnoteRef:16] [16: Percentage totals for SMALL and Other than Small must total 100%]
DUNS #:
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. [footnoteRef:17] [footnoteRef:18] [footnoteRef:19] [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.]
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:
File details come from the government source that posted it. Updated .