Atch10-SDVOSB SelfPerformanceWorksheet-Rev16Jan2020.pdf
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- Attached to
- Repair Lift Station Pumps Bldgs. 650 and 1497 & Replace Lift Station Bldg. 943, Patrick AFB, FL
- Solicitation number
- FA252120B0001
About this file
This solicitation is for the repair of lift station pumps at two buildings and replacement of a lift station at Patrick Air Force Base in Florida. The work includes repairing lift station pumps at Buildings 650 and 1497 and replacing Lift Station 943. A mandatory site visit will be held on January 7, 2020 for up to two people per contractor. Questions regarding the solicitation are due by January 14, 2020, with bids due by January 9, 2020 at 9:00 AM EST. The solicitation is issued by the Department of the Air Force Space Command. Funds are not presently available and no award will be made until funding is allocated.
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CALCULATION OF SELF-PERFORMED/SUBCONTRACTED WORK
Revised 16 Jan 2020
FA2521-20-B-0001
Repair Lift Stations Pumps Bldg. 650, Bldg. 1497 and Replace Lift Station 943
In accordance with FAR 52.219-14, (JAN 2019) DEVIATION 2019-O0003(e) By submission of an offer and execution of a contract, the Offeror/Contractor agrees that in performance of the contract in the case of a contract for (3) General construction, it will not pay more than 85 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count toward the 85 percent subcontract amount that cannot be exceeded.
Complete Calculation below and submit with your proposal.
Calculation
#1. Total Contract Value (TCV) for Prime Offeror/Contractor (SDVOSB) and similarly situated entities $ _____________
#2. ALL Material Costs associated with this contract - $ _____________
#3. Subtract ALL Material Costs (#2) from TCV (#1) $ _____________ SubTotal 1
#4. Total Value of all NON-SDVOSB (excluding Materials Costs) $ _____________
#5. Subtract Total Value of all NON-SDVOSB costs (#4) from SubTotal 1 (#3) $ _____________ SubTotal 2
#6. (SubTotal 2 (#5) divided by SubTotal 1 (#3)) X 100% ___________% (must be 15% or more)
I certify the above representations are true and correct to the best of my knowledge.
(Signature and Typed Name of Authorized Representative) Date
(Title of Authorized Representative) Name of Company
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