Attachment 6 - SB Participation Reporting Format.xls
XLS spreadsheet 44 KB Posted
- Attached to
- Program Management, Knowledge Management, Administrative, Survey, Studies and Research Services
- Solicitation number
- HQ0034-12-R-3110
- Issued by
-
DOD Washington Headquarters Service
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Small Business Participation Reporting Format
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Monthly Report
| Attachment No. | ||||||||||||
| Report Format | ||||||||||||
| SMALL BUSINESS PARTICIPATION REPORTING | ||||||||||||
| Company Name: _________________________ | ||||||||||||
| Contract No: ____________________________ | Date:__________________________ | |||||||||||
| Small Business Type: If the prime contractor is a small business, they will include that portion of the effort that they performed organically, in addition to that portion that they subcotnracted to small business. If mor ethan one description listed in cells 1 through N apply, the prime contractor shall choose one category under which to enter the dollar amount. | ||||||||||||
| Note: Do not enter administrative modifications | ||||||||||||
| TOTAL DOLLARS | Small Business Participation Data | |||||||||||
| Project No. | Order Number | Mod No. | Award Date | Award Amount | HubZone | SDB (including 8(a) | VOSB | WOSD | SDVOSB | SDB Other | Total Performned by SB | SB % |
| EXAMPLE | ||||||||||||
| 0001 | 11/15/12 | $ 575,845.00 | $ 2,500.00 | $ - 0 | $ 10,000.00 | $ - 0 | $ - 0 | $ 2,500.00 | $ 15,000.00 | 2.60% | ||
| 0002 | 12/1/12 | $ 200,000.00 | $ - 0 | $ 4,500.00 | $ - 0 | $ 5,000.00 | $ 1,500.00 | $ 11,000.00 | 5.50% | |||
| TOTALS | $775,845.00 | $2,500.00 | $4,500.00 | $10,000.00 | $5,000.00 | $1,500.00 | $2,500.00 | $26,000.00 | 3.35% | |||
| FUNDING ACTIONS AND SMALL BUSINESS PARTICIPATION REPORTING | ||||||||||||
| (Continued) | ||||||||||||
| Page ____ of ______ | ||||||||||||
| Company Name: _________________________ | ||||||||||||
| Contract No: ____________________________ | Date:__________________________ | |||||||||||
| Small Business Participation Data | ||||||||||||
| Project No. | Order Number | Mod No. | Award Date | Award Amount | HubZone | SDB | VOSB | WOSD | SDVOSB | SDB | Total Performned by SB | SB % |
| Signatures | ____________________________________ | Date: __________________________ |
Cumulative Report
| Attachment No. | ||||
| Report Format | ||||
| FUNDING ACTIONS AND SMALL BUSINESS PARTICIPATION REPORTING | ||||
| YEAR:____________________ | ||||
| Company Name: _________________________ | ||||
| Contract No: ____________________________ | ||||
| Month | Total Orders | Total Performned by SB | Total SB % | |
| Sample | ||||
| Jan | $ 775,845.00 | $ 26,000.00 | 3.35% | |
| Feb | $ 50,000.00 | $ 5,000.00 | 10.00% | 13.35% |
| March | ||||
| Apri | ||||
| May | ||||
| Jun | ||||
| Jul | ||||
| Aug | ||||
| Sep | ||||
| Oct | ||||
| Nov | ||||
| Dec | ||||
| TOTAL FOR YEAR | ||||
| Signatures | ____________________________________ | |||
| Date: __________________________ |
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