Attachment 6 - Small Business Participation Evaluation Form.pdf

SOURCE SELECTION INFORMATION (SEE FAR 3.104)

SMALL BUSINESS PARTICIPATION PLAN FORM

All Offerors (both large and small businesses) are required to complete a Small Business Participation Proposal. Offerors should propose the level of participation of small businesses (as a small business prime and/or small business subcontractors) in the performance of the acquisition relative to the objectives/goals set forth in the evaluation of this area.

(a) Check the applicable size and categories for the PRIME offeror only -- Check all applicable boxes:

{ } Large Prime { } Historically Black Colleges or Universities and Minority Institutions (HBCU) or

{ } Small Business Prime; also categorized as a { } Small Disadvantaged Business (SDB) { } Woman-Owned Small Business (WOSB) { } Historically Underutilized Business Zone (HUB Zone) Small Business { } Veteran Owned Small Business (VOSB) { } Service Disabled Veteran Owned Small Business (SDVOSB)

(b) Of the proposed total contract value, not total subcontract value, submit the total combined percentage of work to be performed by both large and small businesses (include the percentage of work to be performed both by Prime and first tier U.S.

Subcontractors):

Example: If Prime proposes a price of $1,000,000 (including all options), and small business(es) will provide $250,000 in services/supplies as a prime or subcontractor, the % planned for small businesses is 25%; and 75% for large business equaling 100%.

Total Percentage of Total Contract Value planned for Large Business(es)

Total Percentage of Total Contract Value planned for Small Business(es)

100%

When combined, Large and Small Business totals must equal 100%.

W81K04-20-R-0020 Attachment 6

Note: Provide a chart for the basic contract period and each option period as well as a summary chart for the basic and all options.

(c) Please indicate the total percentage of participation to be performed by each type of subcategory small business. The percentage of work performed by Small Businesses that qualify in multiple small business categories may be counted in each category:

Example: Victory Prop Mgt (WOSB and SDVOSB) performing 2%; and Williams Group (SDB, HubZ and WOSB) performing 3%. Results equate to: SDB 3%;

HubZone 3%; WOSB 5%; SDVOSB 2%; VOSB 2%;). SDVOSBs are also VOSBs automatically; however VOSBs are not automatically SDVOSBs.

Small Disadvantaged Business _________% HUB Zone Small Business _________% Woman Owned Small Business _________% Service Disabled Veteran Owned SB _________% Veteran Owned Small Business _________%

HBCU /MI _________%

Note: Provide the information by base year, each option year, and a summary of the base and option years. Zero percent (0%) is not a goal.

(d) List principle supplies/services to be performed by Small Businesses:

Identify the intended subcontractors and CAGE Code for each subcontractor with the principal supplies/services to be provided by that subcontractor. Be as specific and detailed as possible (i.e., references to statement of work) in describing the type of service or supply being provided by each subcontractor in order to demonstrate the variety and complexity of the work to be performed.

Example: If a Small Business qualifies also as a WOSB and a SDVOSB, and you can add them to each category below in which they qualify.

Name of Company Identify Type of Service/Supply And Cage Code

Small Business (SB):

Small Disadvantaged Business (SDB):

Women-Owned Small Business (WOSB):

Historically Underutilized Business Zone (HUB Zone):

Veteran Owned Small Business (VOSB):

Service Disabled Veteran Owned Small Business (SDVO):

Historically Black Colleges and Universities and Minority Institutions (HBCU/MI):

(e) Describe the extent of commitment to use small businesses (for example, what types of commitments if any are in place for this specific acquisition either – small business prime, written contract, verbal, enforceable, non-enforceable, joint venturing, mentor-protégé, etc.)

(f) Small Business Participation Past Performance. All offerors shall submit information substantiating the offerors’ past performance in complying with FAR 52.219-8, “Utilization of Small Business,” maximizing opportunities for U.S. small business subcontractors.

In addition, large business concerns shall submit information substantiating the offerors’ past performance in complying with FAR 52.219-9, “Small Business Subcontracting Plan.”

Offerors shall also provide a statement indicating whether any negative information has been reported in the past three (3) years concerning the offerors’ past compliance with FAR 52.219-8 and/or FAR 52.219-9 (when applicable). If any such negative information has been reported, the offeror may submit explanations or comments responding to such negative information. Offerors with no prior contracts containing FAR 52.219-8 and/or FAR 52.219-9 shall certify the same.

The Government may, in evaluating the responses to this subfactor, conduct follow-up interviews with offerors and/or subcontractors, submit questionnaires to both offerors and subcontractors, as well as review offeror information contained in the Contractor Performance Assessment Reporting System (CPARS), the Past Performance Information Retrieval System (PPIRS), or the Electronic Subcontracting Reporting System (eSRS).

Additional Important Note for Other Than U.S. Small Businesses ONLY.

Small Business Subcontracting Plan is Required (FAR 52.219-9)

Separate from Small Business Participation Plan, other than U.S. Small Business offerors must also submit a subcontracting plan meeting the requirements of FAR 52.219-9 and DFARS 252.219-7003 (or DFARS 252.219-7004 if the offeror has a comprehensive subcontracting plan). Other than U.S. Small Businesses must submit acceptable subcontracting plans to be eligible for award. Subcontracting Plans shall reflect and be consistent with the commitments offered in the Small Business Participation Plan. The Small Business Subcontracting Plan is not a requirement for evaluation in source selection, but rather, a requirement for award to a large business and will be incorporated into any resultant contract. The Small Business Subcontracting Plan will not count against the page limitation for this volume.