Exhibit 4 DISA Subcontracting Plan Checklist 03SEP24.docx

DISA SUBCONTRACTING PLAN CHECKLIST

To Be Filled Out By Offeror Contractor Name and Address

Date of Subcontracting Plan

Solicitation Number & Title

Description of Requirement

Total Contract Price

Period of Performance

Individual

Approved Commercial Plan Approved by:

Date Signed:

Date Plan Approved Through:

DoD Test Program Comprehensive Plan or Master Plan Approved by:

Date Signed:

Date Plan Approved Through:

Total Prime Self Performing – Percentages and Dollars (Informational Only):

Base Period

REQUIRED ELEMENTS OF THE SUBCONTRACTING PLAN

1. Total Large and Small Business Subcontracting - Percentages & Dollars FAR 52.219-9(c)(1) & (d)(1)&(2)

Base Period

2. Small Business Subcontracting - Percentages & Dollars FAR 52.219-9(c)(1) & (d)(1)&(2)

Base Period

2. Small Disadvantaged Business Subcontracting - Percentages & Dollars FAR 52.219-9(c)(1) & (d)(1)&(2)

Base Period

2. Women-Owned Small Business Subcontracting - Percentages & Dollars FAR 52.219-9(c)(1) & (d)(1)&(2)

Base Period

2. HUBZone Small Business Subcontracting - Percentages & Dollars FAR 52.219-9(c)(1) & (d)(1)&(2)

2. Veteran-Owned Small Business Subcontracting - Percentages & Dollars FAR 52.219-9(c)(1) & (d)(1)&(2)

Base Period

2. Service-Disabled Veteran-Owned Small Business Subcontracting - Percentages & Dollars FAR 52.219-9(c)(1) & (d)(1)&(2)

3. A description of principal types of supplies and services to be subcontracted, and an identification of types planned for subcontracting to SB, VOSB, SDVOSB, HUBZone, SDB, WOSB concerns. FAR 52.219-9(d)(3)

4. A description of the method used to develop the subcontracting goals. FAR 52.219-9(d)(4)

5. A description of the method used to identify potential sources for solicitation purposes. FAR 52.219-9(d)(5)

6. A statement as to whether or not the Offeror included indirect costs in establishing goals, and a description of the method used to determine the proportionate share of indirect costs to be incurred with small businesses. FAR 52.219-9(d)(6)

7. The name of the individual employed by the Offeror who will administer the Offeror’s subcontracting program, and a description of the duties of the individual. FAR 52.219-9(d)(7)

8. A description of the efforts the Offeror will make to ensure SB, VOSB, SDVOSB, HUBZone, SDB, WOSB concerns have an equitable opportunity to compete for subcontracts. FAR 52.219-9(d)(8)

9. Assurances that the Offeror will include the clause of this contract entitled "Utilization of Small Business Concerns" in all subcontracts that offer further subcontracting opportunities, and that the Offeror will require all subcontractors (except small business concerns) that receive subcontracts in excess of the applicable threshold specified in FAR 19.702(a) on the date of subcontract award, with further subcontracting possibilities to adopt a subcontracting plan that complies with the requirements of this clause. FAR 52.219-9(d)(9)

10. Assurances that the Offer will: Cooperate in any studies or surveys as may be required. FAR 52.219-9(d)(10)(i)

Submit periodic reports so that the Government can determine the extent of compliance by the Offeror with the subcontracting plan. FAR 52.219-9(d)(10)(ii)

Include subcontracting data for each order when reporting subcontracting achievements for indefinite-delivery, indefinite-quantity contracts with individual subcontracting plans where the contract is intended for use by multiple agencies. FAR 52.219-9(d)(10)(iii)

Submit the Individual Subcontract Report (ISR) and/or the Summary Subcontract Report (SSR), in accordance with paragraph (I) of this clause using the Electronic Subcontracting Reporting System (eSRS) at http://www.esrs.gov. FAR 52.219-9(d)(10)(iv)

Ensure that its subcontractors with subcontracting plans agree to submit the ISR and/or the SSR using eSRS. FAR 52.219-9(d)(10)(v)

Provide its prime contract number, its unique entity identifier, and the e-mail address of the Offeror’s official responsible for acknowledging receipt of or rejecting the ISRs, to all first-tier subcontractors with subcontracting plans so they can enter this information into the eSRS when submitting their ISRs. FAR 52.219-9(d)(10)(vi)

Require that each subcontractor with a subcontracting plan provide the prime contract number, its own unique entity identifier, and the e-mail address of the subcontractor’s official responsible for acknowledging receipt of or rejecting the ISRs, to its subcontractors with subcontracting plans. FAR 52.219-9(d)(10)(vii)

11. Description of the types of records that will be maintained concerning procedures that have been adopted to comply with the requirements and goals in the plan, including establishing source lists; and a description of the Offeror’s efforts to locate SB, VOSB, SDVOSB, HUBZone, SDB and WOSB concerns and award subcontracts to them. The records shall include at least the following: FAR 52.219-9(d)(11)

Source lists, guides, and other data that identify SB, VOSB, SDVOSB, HUBZone, SDB, and WOSB concerns. FAR 52.219-9(d)(11)(i)

Organizations contacted in an attempt to locate sources that are SB, VOSB, SDVOSB, HUBZone, SDB, and WOSB sources. FAR 52.219-9(d)(11)(ii)

Records on each subcontract solicitation resulting in an award of more than the simplified acquisition threshold, as defined in FAR 2.101 on the date of subcontract award, indicating whether SB, VOSB, SDVOSB, HUBZone, SDB, and WOSB concerns were solicited; and if not, why not. If applicable, the reason award was not made to a small business concern. FAR 52.219-9(d)(11)(iii)

Records of any outreach efforts to contact trade associations; Business development organizations; Conferences and trade fairs to locate SB, HUBZone, SDB, SDVOSB, WOSB sources; and Veterans service organizations. FAR 52.219-9(d)(11)(iv)

Records of internal guidance and encouragement provided to buyers through workshops, seminars, training, etc.; and monitoring performance to evaluate compliance with the program’s requirements. FAR 52.219-9(d)(11)(v)

For other than Commercial Plans, on a contract-by-contract basis, records to support subcontract award submitted by the Offeror to the Government, including the name, address and business size of each subcontractor. FAR 52.219-9(d)(11)(vi)

12. Assurances that the Offerors will make a good faith effort to acquire articles, equipment, supplies, services, or materials, or obtain the performance of construction work from the small business concerns that the offeror used in preparing the bid or proposal, in the same or greater scope, amount, and quality used in preparing and submitting the bid or proposal. FAR 52.219-9(d)(12)

13. Assurances that the Contractor will provide the Contracting Officer with a written explanation if the Contractor fails to acquire articles, equipment, supplies, services or materials or obtain the performance of construction work as described in FAR Clause 52.219-9(d)(12). This written explanation must be submitted to the contracting officer within 30 days of contract completion. FAR 52.219-9(d)(13)

14. Assurances that the Contractor will not prohibit a subcontractor from discussing with the Contracting Officer any material matter pertaining to payment to or utilization of a subcontractor. FAR 52.219-9(d)(14)

15. Assurances that the Offeror will pay its small business subcontractors on time and in accordance with the terms and conditions of the underlying subcontract, and notify the contracting officer when the prime contractor makes either a reduced or an untimely payment to a small business subcontractor. FAR 52.219-9(d)(15)

16. Is the proposed small disadvantaged business goal greater than five percent (5%)? Note: If no, the proposed goal of less than 5% must be approved one level above the contracting officer. DFARS 219.705-4(d)

17. If the contract contains options, are there separate goals provided in the plan and listed in paragraph 1 of this checklist?

18. The plan has a signature page which includes the name, title and company name for the person submitting the plan; the name, title and department/agency contracting organization for the person approving the plan; signature and date signed.

Rating

SIGNATURES/REVIEW

PSD Contracting Officer **Upon completion for this evaluation sheet, the DISA Contracting Officer should provide this checklist and the apparent awardee(s) Subcontracting Plan to disa.meade.osbp.mbx.ditco-small-business-office@mail.mil**

Reviewed By: ________________________________ Date: ______________ Acceptable: ☐ Comments:

DISA Office of Small Business Programs

Reviewed By: _________________________________ Date: _________________ Concur: ☐ Comments:

SBA (PCR)

Reviewed By: __________________________________Date: ________________ Concur: ☐ Comments:

Source Selection Information - See FAR 2.101 and 3.104 October 2022