Attachment_18_-_Small_Business_Participation_Commitment_Form_AMD0012.docx

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ONE OIT
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503102-18-R-0005
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Attachment 18 - Small Business Participation Commitment Form_AMD0012

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Attachment 18: Small Business Participation Commitment Document

1. Prime Contractor Size Indicate the applicable size and socioeconomic categories – check all that apply:

☐ Other than Small Business Or

☐Small Business also categorized as a
☐Small Disadvantaged Business (SDB)
☐Service-Disabled Veteran-Owned Small Business (SDVOSB)
☐Woman-Owned Small Business (WOSB)
☐Historically Underutilized Business Zone (HUBZone) Small Business

2. Minimum Quantitative Requirement Including Small Business prime offeror’s participation.

Business Category
% of Total Contract Value
Total Contract Value – Prime Contractor
Enter text.
Total Small Business
Enter text.
Small Disadvantaged Business (SDB)
Enter text.
Service-Disabled Veteran-Owned Small Business (SDVOSB)
Enter text.
Woman-Owned Small Business (WOSB)
Enter text.
Historically Underutilized Business Zone (HUBZone) Small Business
Enter text.

3. Small Business Participants Changes must be pre-approved by the Contracting officer per H.4, 6004.00 Approval of Subcontracts (Feb 2012)

Company Name
Business Category(ies)

(SB, SDB, SDVOSB, WOSB, HubZone) Service to be Provided

NAICS

Code Nature of Commitment

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