Atch_3_-_SB_Participation_Commitment_Document.pdf

RFP HTC711‐18‐R‐D005 Attachment 3

Revised 20 February 2018

SMALL BUSINESS PARTICIPATION COMMITMENT DOCUMENT TEMPLATE

All offerors (both other than small business concerns and small business concerns) are required to complete a Small Business Participation Commitment Plan.

I. IDENTIFICATION DATA:

Company Name:________________________________________________________________

DUNS Number:_________________________________________________________________

CAGE Code:____________________________________________________________________

Address: ______________________________________________________________________

Description of Supplies/Services: _______________________________________________________

Solicitation Number: ____________________________________________________________

Period of Performance Total Contract Value

Base Period

Option Period 1

Option Period 2

Option Period 3

Option Period 4

Total Price

SMALL BUSINESS PARTICIPATION REQUIREMENTS

Offerors shall propose the level of participation of small businesses (as primes and subcontractors) in the performance of this acquisition per stated RFP requirements.

(a) Check the applicable size and categories for the PRIME offeror only:

{ } Large Business or

{ } Small Business Prime

RFP HTC711‐18‐R‐D005 Attachment 3

Revised 20 February 2018

{ } Small Disadvantaged Business (SDB) { } Woman‐Owned Small Business (WOSB) { } Historically Underutilized Business Zone (HUB Zone) Small Business { } Veteran Owned Small Business (VOSB) { } Service Disabled Veteran Owned Small Business (SDVOSB)

(b) Dollar value and percent of small business participation:

Total Proposed Price (Contract Value): $__________________

Total Proposed Subcontracting Value: $__________________

Dollar value of small business participation (for contract and all options): $________________

Percent of small business participation as a percent of total (proposed) contract value: _____%

(c) In accordance with (IAW) Defense Federal Regulation Supplement (DFARS) 215.304(c)(i) and PGI

215.304 (c)(i)(A) identify specific small businesses, business size type/category, the types of products/services, and the type of commitment (letter of commitment, written contract, verbal commitment, joint venture, mentor‐protégé agreement, etc.) Increase below table size, if necessary.

Offerors may provide documentation that substantiates the commitment of the teaming partners / subcontractors listed. Documentation such as letters of commitment, joint venture agreements, teaming agreements are excluded from the page count.

(d) IAW DFARS 215.304(c)(i)(C), large business concerns shall include in their subcontracting plan the names of small business concerns identified in the participation commitment document.

NAME

BUSINESS SIZE

TYPE/CATEGORY

PRODUCT/SERVICE

(Ref. PWS Paragraph)

COMPLEXITY

OF WORK

TYPE OF

COMMITMENT

ESTIMATED

AMOUNT

EXAMPLE

Rock, Inc.

SB/HUBZone/SDB

1.3.1.7 Task 1

Subtask 7: Subject Matter Expertise

(SME)

Difficult, mediocre or not complicated type task

Enforceable Letter of Commitment or No letter of commitment at this time or verbal commitment