A21 Appendix D Small Business Participation Commitment Document.pdf

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Attached to
L24 Pier Rehab and column Repair
Solicitation number
W912P923R0023
Issued by

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This document is a Small Business Participation Commitment template to be completed by contractors responding to Solicitation Number W912P923R0023 for L24 Pier Rehab and column Repair work issued by the Department of the Army Corps of Engineers Engineering District St Louis. The template requires contractors to report the total award amount and dollars allocated to work performed by various socio-economic small business categories including HubZone, SDB, VOSB, SDVOSB, WOSB, and other small businesses. Contractors must include both portions of work performed organically as a small business prime as well as portions subcontracted to small business partners.

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APPENDIX D

SMALL BUSINESS PARTICIPATION COMMITMENT DOCUMENT / UTILIZATION REPORTING

Company Name: _________________________ Date:_______________________

Contract No: ____________________________ Page ___ of _____

NOTE: If the prime contractor is a small business, they will include that portion of the effort that they performed organically, in addition to that portion that they subcontracted to small businesses. If more than one socio-economic category applies to a firm, the prime contractor shall choose one category under which to enter the dollar amount.

TOTAL DOLLARS

Small Business Participation Data

Project No.

Order Number

Mod No.

Award Date

Award Amount HubZone

SDB

(including

8(a) VOSB SDVOSB WOSB SB Other

Total Performed by SB SB %

TOTALS

COMMENTS:

Signature ____________________________________ Date:

File details come from the government source that posted it. Updated .