ATTACHMENT D Historical Small Business Utilization.docx
DOCX document 19 KB Posted
- Attached to
- P-3009, MILITARY WORKING DOG KENNEL Federal contract opportunity
- Solicitation number
- 5871178
About this file
This document contains a past performance questionnaire for a small business seeking an upcoming federal contract opportunity for a military working dog kennel project. The opportunity involves the construction of an administrative building, dog kennel, quarantine kennel, and dog training areas at a total project value of $6.5 million. Offerors must provide information on up to three prior contracts demonstrating utilization of small businesses, including percentages and dollar amounts awarded to small disadvantaged businesses, women-owned small businesses, HUBZone small businesses, veteran-owned small businesses, and service-disabled veteran-owned small businesses. References must also be provided for each past performance example. The federal agency issuing the solicitation is the Department of the Navy Naval Facilities Engineering Command for solicitation number 5871178.
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Text version
| Company Name: | N40080-21-R-1178 |
| P3009 Military Working Dog Kennel | Subcontracting Past Performance |
ATTACHMENT D
SMALL BUSINESS PAST PERFORMANCE
Small Business Offerors, newly established Large Business Offerors, or Large Business Offerors with no prior SF294/ISR history shall complete this form. Large Business Offerors with a SF294 or ISR history shall submit SF294s or ISRs in lieu of completing this form.
(a) SUBCONTRACTING ACHIEVEMENT – Include actual dollar values subcontracted for each of the categories listed. Include the percentage goal only if a goal was established.
(1) Contract Number/Title:
| ACTUAL |
| GOAL |
(if applicable)
Completion Date: Total Contract Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(a) Small Business Concerns (Including SDB, WOSB, HBCU/MI, HUBZone, VOSB, and SDVOSB) (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) Large 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:
| ACTUAL |
| GOAL |
Completion Date: Contract Dollar Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(b) Small Business Concerns (Including SDB, WOSB, HBCU/MI, HUBZone, VOSB, and SDVOSB) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),
(b) Large 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.)
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.)
(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
(3) Contract Number/Title:
| ACTUAL |
| GOAL |
Completion Date: Contract Dollar Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(c) Small Business Concerns (Including SDB, WOSB, HBCU/MI, HUBZone, VOSB, and SDVOSB) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),
(b) Large 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.)
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.)
(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
Note: Form may be expanded.
SOURCE SELECTION SENSITIVE INFORMATION
DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY
File details come from the government source that posted it. Updated .