ATTACHMENT F - Small Business Subcontracting Record.docx
DOCX document 16 KB Posted
- Solicitation number
- N39430-21-R-2305
About this file
This document contains a template for reporting small business subcontracting achievements. The template collects information on contracts including contract numbers and titles, completion dates, total values, subcontracted values, and percentages subcontracted to various small business categories. For each contract reported, it requests the name and contact information of a customer reference. The template appears to be for reporting past subcontracting performance and does not specify any current procurement opportunity.
The related federal contract opportunity is solicitation number N39430-21-R-2305 for Hyperbaric Systems Support Services issued by the Department of the Navy Naval Facilities Engineering Command. The solicitation requests proposals to provide hyperbaric systems support services and was amended to correct the proposal due date. The description indicates further details can be found in the solicitation document.
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Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT I - P463 Floor Plan.pdf | ||
| N39430-21-R-2305 Amendment 0003.pdf | ||
| N39430-21-R-2305 Amendment 0002.pdf | ||
| ATTACHMENT C - Past Performance Questionaire.doc | DOC document | |
| ATTACHMENT G - Safety Data Sheet.docx | DOCX document | |
| N39430-21-R-2305 Amendment 0001.pdf | ||
| ATTACHMENT A - Schedule of FFP Rates.xlsx | XLSX spreadsheet | |
| ATTACHMENT D - Small Business Participation and Commitment Strategy.docx | DOCX document | |
| ATTACHMENT H - Seed Task Order Performance Work Statement.pdf | ||
| ATTACHMENT E - Individual Small Business Subcontracting Plan.docx | DOCX document | |
| N39430-21-R-2305.pdf | ||
| ATTACHMENT B - Financial Questionnaire.doc | DOC document |
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Text version
ATTACHMENT F
SMALL BUSINESS SUBCONTRACTING RECORD
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:
ACTUAL
SUBCONTRACT GOAL
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),
(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
(3) Contract Number/Title:
ACTUAL
SUBCONTRACT GOAL
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),
(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
File details come from the government source that posted it. Updated .