Attachment_17-_CUF_Evaluation_Worksheet__reference_only_.pdf

COMMERCIALLY USEFUL FUNCTION (CUF)

EVALUATION AND DETERMINATION WORKSHEET

Complete one (1) CUF Evaluation and Determination Worksheet for the portion of the contract that each certified Small Business (SB) and/or Disabled Veteran Business Enterprise (DVBE) identified on the Bidder Declaration will be performing.

CHECK THE SUPPLIER TYPE

BEING EVALUATED

PRIME SUBCONTRACTOR

OSDS # # ______________ # ________________

CIRCLE THE CERTIFICATION

TYPE

SB MB DVBE SB MB DVBE

SUPPLIER NAME

DOING BUSINESS AS (DBA)

NAME

EVALUATION DATE

SOLICITATION NUMBER

DESCRIBE THE GOODS AND /

OR SERVICES TO BE

PERFORMED BY THE

EVALUATED SUPPLIER

IS THIS SUPPLIER CUF

COMPLIANT? Yes No

EVALUATOR SIGNATURE

EVALUATOR PRINTED NAME

DIVISION/OFFICE

Note: SB and DVBE certification is not CUF compliance. CUF must be evaluated for each contract prior to award. Additional information and instructions can be found in the Commercially Useful Function Requirements Policy or the Frequently Asked Questions (FAQ) link within the Policy Document.

INSTRUCTIONS FOR CUF EVALUATION AND DETERMINATION

Based on the documentation submitted by the bidder, answer each of the following questions for each Small Business and/or DVBE (prime or subcontractor). Sub questions have been provided to assist in identifying CUF elements for each question. Indicate whether the SB and/or DVBE supplier appears to meet each requirement by checking the appropriate box for each question.

1. SUPPLIER MUST BE RESPONSIBLE FOR THE EXECUTION OF A DISTINCT ELEMENT OF THE WORK.

a) The bidder has indicated on the Bidder Declaration form1 (GSPD-05-105 or GSPD-05-

106) or within the Confirmation Letter/Form (signed by the bidder and the subcontractor) that the following goods and/or services will be provided by the SB or DVBE company in relation to the scope of work (e.g. training, transportation, installation, ordering, delivery, etc.).

b) Are the goods/services the supplier is providing described in the scope of work and/or considered to be distinct elements of the contract work?

YES NO

2. SUPPLIER MUST CARRY OUT THE OBLIGATION BY ACTUALLY PERFORMING, MANAGING, OR

SUPERVISING THE WORK INVOLVED.

On the Bidder Declaration form (GSPD-05-105 or GSPD-05-106) or within the Confirmation Letter/Form (signed by the prime and the subcontractor) does the supplier commit to its obligation to actually performing, managing, and/or supervising the work?

YES NO

1 Departments may use their own forms for bids for Non-IT Services

3. PERFORMS WORK THAT IS NORMAL FOR ITS BUSINESS SERVICES AND FUNCTIONS.

a) Describe the supporting documentation either provided by the supplier (Bidder’s

Declaration, Confirmation Letter/Form, Std. Form 843) or from additional research (certifications, resumes, UNSPSC, website, marketing research, etc.) below that supports the supplier is performing work that is normal for its business services and functions (Attach supporting documents).

Supporting Information:

b) Based on the information above, do the goods/services listed in question #1 appear to be consistent with this suppliers normal activities?

YES NO

4. IS RESPONSIBLE, WITH RESPECT TO THE PRODUCTS, INVENTORIES, MATERIALS, AND SUPPLIES

REQUIRED FOR THE CONTRACT, FOR NEGOTIATING PRICE, DETERMINING QUALITY AND

QUANTITY, ORDERING, INSTALLING, IF APPLICABLE, AND MAKING PAYMENT.

a) If this is a SERVICE with NO goods involved, check N/A and go to #5.

If Goods are involved, proceed to b).

b) Will the supplier provide products, inventories, materials and supplies required for the contract as well as perform ALL of the following duties related to the distinct element of work as stated in question #1?

1. Negotiating price

2. Determining quality and quantity

3. Ordering

4. Making payment

5. Installing (if applicable)

N/A YES NO

Rev. 10-24-2015

5. SUPPLIER IS NOT FURTHER SUBCONTRACTING A PORTION OF THE WORK THAT IS GREATER

THAN THAT EXPECTED TO BE SUBCONTRACTED BY NORMAL INDUSTRY PRACTICES.

a) Is this supplier a Prime performing all of the work?

If “Yes”, check the box and complete determine compliance If “No”, proceed to question b)

b) Based on the percentage of goods or services that will be subcontracted as stated on the Bidders Declaration and/or Confirmation Letter/Form, is this amount normal per industry standards?

YES NO

Compliance Determination

If the answer to all five (5) questions is “YES” or “N/A” (#4), the supplier is CUF compliant.

If the answer to any of the five (5) questions is “NO", the supplier is NOT CUF compliant.

Rev. 10-24-2015