Attachment_9_-_SB_Participation_Commitment_Document.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:

Base Period Year 1

Base Period Year 2

Base Period Year 3

Option Period 1

Option Period 2

Award Term 1

Award Term 2

Option Period 3

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

HTC-711-19-R-R004

Attachment 9

{ } 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)

(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: %

· 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 businesses, business size type/category, the types of products/services, the type of commitment (letter of commitment, written contract, verbal commitment, joint venture, mentor-protégé agreement, etc.), dollar value of task, and percentage value. Add rows to below table, 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.

COMPANY

NAME

BUSINESS SIZE TYPE/CATEGORY

PRODUCT/SERVICE (Ref. PWS Paragraph)

COMPLEXITY OF WORK

TYPE OF COMMITMENT

ESTIMATED AMOUNT

PERCENTAGE

VALUE

Small Business/Small Disadvantaged Business/Veteran- Owned Small Business/Service Disabled Veteran- Owned Small Business/HUBZone

1.3.1.7 Task 1 Subtask 7: Subject Matter Expert (SME)

Difficult/Mediocre/Not Complicated Subcontract Agreement/Enforceable Letter of Commitment/No Letter of Commitment (Negotiating at this time)/Verbal Commitment

(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).