ATT 7_SBPCD Template 4-13-20.docx
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- Attached to
- Federal Flexible Spending Account Program (FSAFEDS) Administration Services (MULTI-AGENCY CONTRACT)
- Solicitation number
- 24361820R0002
- Issued by
-
Office of Personnel Management
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RFP 24368120R0002
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 to illustrate the Proposed Total Contract Value (TCV):
| CLIN # & Description |
| As noted on “Unit Pricing” Tab |
| As noted on “Opt Debit Card Unit Pricing” Tab |
CLIN 00001 – Start Up Services
| $ |
| $ |
CLIN 00002 – Subtotal Base Period One
| $ |
| $ |
CLIN 00003 – Subtotal Base Period Two
| $ |
| $ |
CLIN 00004 – Subtotal Base Period Three
| $ |
| $ |
CLIN 10001 – Subtotal Option Period One
| $ |
| $ |
Proposed TOTAL CONTRACT VALUE (Sum of CLINS 00001 through 10001)
| $ |
| $ |
4. Of the Proposed Total Contract Values (TCVs) noted in Item 2 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%)]
| In Reference to “Unit Pricing” Tab TCV |
| In Reference to “Opt Debit Card Unit Pricing” Tab TCV |
| 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 51% in either column.]
| % |
| % |
| 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 TCVs in Item 2 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 2 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%)]
| In Reference to “Unit Pricing” Tab TCV |
| In Reference to “Opt Debit Card Unit Pricing” Tab TCV |
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 2 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 |
| In Reference to “Opt Debit Card 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 .