Attachment C Small Business Subcontracting Record.pdf
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- Solicitation number
- N62742-24-R-0001
About this file
This document is an Attachment C Small Business Subcontracting Record related to a federal contract opportunity. It provides a form for a company to report on their small business subcontracting achievements for a particular contract, including the total contract and subcontracted values, the percentage and dollar amounts for small business concerns, small disadvantaged businesses, women-owned small businesses, HUBZone small businesses, veteran-owned small businesses, and service-disabled veteran-owned small businesses. The related federal contract opportunity is an Indefinite Delivery Indefinite Quantity (IDIQ) contract for architect-engineer services for electrical engineering projects and related services under the cognizance of Naval Facilities Engineering Command, Pacific. The contract will have a one-year base period and four one-year option periods, with a total fee not to exceed $249 million. The contract is being solicited on an unrestricted basis, with a small business size standard of NAICS Code 541330, Engineering Services. Key evaluation criteria include specialized experience, key personnel qualifications, past performance, capacity, design quality control, commitment to small business, firm location, and volume of work.
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ATTACHMENT C
SMALL BUSINESS SUBCONTRACTING RECORD
COMPANY NAME: _______________________________________
SUBCONTRACTING ACHIEVEMENTS – Include actual dollar values subcontracted for each of the categories listed. Include the percentage goal only if a goal was established. Note: Form may be expanded.
(1) Contract Number/Title:
Check One: ____ Prime Contract ____ Subcontract
Subcontracting Plan Required ____ Yes ____ No
ACTUAL
SUBCONTRACTED
SUBCONTRACT
GOAL
(if applicable)
Completion Date: Total Contract Value: $
Total Subcontracted Value: $ Whole Dollars Percent Percent
(a) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise), DVBE (Disabled Veteran Business Enterprise), SB (Small Business), WBE (Women’s Business Enterprise).
(b) Other Than Small (OTS) Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.) Including DVBE
Name of customer reference for this project: ___________________________________________
Phone Number: _______________________ FAX Number: _______________________
Email address: ________________________________________
(2) Contract Number/Title:
Check One: ____ Prime Contract ____ Subcontract
Subcontracting Plan Required ____ Yes ____ No
ACTUAL
SUBCONTRACTED
SUBCONTRACT
GOAL
(if applicable)
Completion Date: Contract Dollar Value: $
Total Subcontracted Value: $ Whole Dollars Percent Percent
(b) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise), DVBE (Disabled Veteran Business Enterprise), SB (Small Business), WBE (Women’s
Business Enterprise).
(b) OTS Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.) Including DVBE
Name of customer reference for this project: ___________________________________________
Phone Number: _______________________ FAX Number: _______________________
Email address: ________________________________________
(3) Contract Number/Title:
Check One: ____ Prime Contract ____ Subcontract
Subcontracting Plan Required ____ Yes ____ No
ACTUAL
SUBCONTRACTED
SUBCONTRACT
GOAL
(if applicable)
Completion Date: Contract Dollar Value: $
Total Subcontracted Value: $ Whole Dollars Percent Percent
(c) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise), DVBE (Disabled Veteran Business Enterprise), SB (Small Business), WBE (Women’s
Business Enterprise).
(b) OTS Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.) Including DVBE
Name of customer reference for this project: ___________________________________________
Phone Number: _______________________ FAX Number: _______________________
Email address: ________________________________________
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