Attachment_9_-_SB_Participation_Commitment_Document,_Amend_01.docx

SMALL BUSINESS PARTICIPATION COMMITMENT DOCUMENT

Attachment 9 All offerors (both large business and small business concerns) are required to complete a Small Business Participation Commitment Document.

I. IDENTIFICATION DATA:

Company Name:

DUNS Number:

CAGE Code:

Address:

Description of Supplies/Services:

Solicitation Number:

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 { } 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)

HTC711-19-R-R004

Attachment 9, Amendment 01

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

· Total Proposed Domestic Contract Value: $______________

· Total Proposed Domestic Subcontracting Value (Large and Small Concerns): $______________

· Total Proposed Domestic Subcontracting Value for Small Business and Socioeconomic categories (for contract and all options): $______________

· Percentage detailing Total Proposed Domestic Subcontracting Value for Small Business and Socioeconomic categories of the Total Proposed Domestic Contract Value (minimum is 40%; however, offeror should enter actual proposed percentage based on estimated amount entered in chart below):_______%

· Explanation/Comments:

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

215.304 (c)(i)(A) identify specific small business company name, small business category, the tier level, the types of products/services being performed, and the estimated amount. Increase below table size, if necessary. Under the Estimated Amount column, sum each line of the Estimated Amount to give a final total dollar value (this total should equal the amount listed in paragraph b., bullet 3).

(1, 2, OR 3)

(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 Small Business Participation Commitment Document pursuant to Federal Acquisition Regulation Clause 52.219-9 to facilitate compliance with Defense Federal Acquisition Regulation Supplement Clause 252.219-7003(e).