ATTACHMENT E - Historical Small Business Utilization.docx
DOCX document 19 KB Posted
- Attached to
- P152 AIR TRAFFIC CONTROL TOWER DESIGN BID BUILD
- Solicitation number
- N4008021R7290
About this file
This document is a past performance questionnaire for a small business offeror on a solicitation to design and construct a new air traffic control tower at Webster Outlying Field in Massachusetts for the Department of the Navy Naval Facilities Engineering Command. The small business offeror is asked to provide details of up to three relevant prior contracts including contract numbers, values, completion dates, total amounts subcontracted, and percentages and dollar amounts subcontracted to various socioeconomic small business categories. They are also asked to provide references for each past contract including names, phone numbers, fax numbers, and email addresses. The purpose is to assess the offeror's success in meeting small business subcontracting goals on previous federal contracts.
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Text version
| Company Name: | N40080-21-R-7290 |
| P152 ATCT Webster Field | 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 .