ATTACHMENT E - Small Business Participation Commitment.docx
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- Solicitation number
- N40080-20-Q-5857
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ATTACHMENT E
SMALL BUSINESS PARTICIPATION COMMITMENT DOCUMENT (SBPCD)
N40080-20-Q-5857
This form is to be completed by all Offerors (both large and small businesses) in order to provide supporting information for evaluation of Factor 2, Small Business Utilization and Participation. Round all percentages to the nearest tenth of a percent (i.e., include only 1 number after the decimal point).
1. Offeror Info:
| Offeror Name: |
| Applicable size category for the Offeror under the NAICS Code identified (check one): |
| Large Business (LB) ☐ |
Small Business (SB) ☐
If the Offeror is a Small Business, check all socioeconomic categories that apply to the Offeror.
If none of the socioeconomic categories apply to the Offeror, check NONE:
Historically Underutilized Business Zone Small Business (HUBZone SB) ☐ Woman-Owned Small Business (WOSB) ☐ Economically Disadvantaged Woman-Owned Small Business (EDWOSB) ☐ Small Disadvantaged Business (SDB) ☐ Veteran-Owned Small Business (VOSB) ☐ Service-Disabled Veteran-Owned Small Business (SDVOSB) ☐
NONE ☐
2. Subcontracting Breakdown:
| a. Total contract value (sum of b + c): |
| $ |
| 100% |
| b. Estimated value of all planned subcontracting (inclusive of all planned subcontracting to all businesses, regardless of size): |
| $ |
| % of 2.a |
| c. Estimated value of all work to be self-performed by Offeror’s workforce: |
| $ |
| % of 2.a |
3. Subcontracts for products and services to be awarded under this contract:
a. Large Business:
| Name of Subcontractor |
| Type and Complexity of Product/Service |
| Type of Commitment to Subcontractor: |
| Estimated Subcontract Value |
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are Large Business concerns. |
| $ |
b. Small Business:
| Name of Subcontractor |
| Type and Complexity of Product/Service |
| Type of Commitment to Subcontractor: |
| Estimated Subcontract Value |
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| 1. This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are Small Business concerns (includes all SB, HUBZone SB, WOSB/EDWOSB, SDB, VOSB, and SDVOSB concerns); Historically Black Colleges, Universities, and Minority Institutions (HBCU/MI); AbilityOne participating non-profit agencies for the blind or severely disabled; and Alaskan Native Corporations (ANCs) and Indian Tribes as prescribed in FAR 19.703(c) & FAR 52.219-9. |
| $ |
| 2. If the Offeror is a Small Business concern, enter the dollar amount that the Offeror will self-perform (line 2.c). |
| $ |
| 3. Total planned dollars under this contract that will go to SB concerns (sum of 3.b.1 + 3.b.2): |
| $ |
| 4. Total proposed small business participation rate (in terms of percentage of total contract value): |
| % of 2.a |
All Offerors provide a detailed explanation supporting the total small business participation rate (methods used to develop the rate):
All Offerors who are not able to meet the minimum total small business participation rate (20% of the total contract value) shall provide a detailed explanation why the minimum total small business participation rate cannot be achieved:
c. HUBZone SB:
| Name of Subcontractor |
| Type and Complexity of Product/Service |
| Type of Commitment to Subcontractor: |
| Estimated Subcontract Value |
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| 1. This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are qualified HUBZone SB concerns certified by the Small Business Administration (SBA). |
| $ |
| 2. If the Offeror is a HUBZone SB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). |
| $ |
| 3. Total planned dollars under this contract that will go to HUBZone SB concerns (sum of 3.c.1 + 3.c.2): |
| $ |
| 4. Total proposed HUBZone SB participation rate (in terms of percentage of total contract value): |
| % of 2.a |
d. WOSB/EDWOSB:
| Name of Subcontractor |
| Type and Complexity of Product/Service |
| Type of Commitment to Subcontractor: |
| Estimated Subcontract Value |
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| 1. This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are small business concerns 51% owned and controlled by one or more women. |
| $ |
| 2. If the Offeror is a WOSB/EDWOSB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). |
| $ |
| 3. Total planned dollars under this contract that will go to WOSB/EDWOSB concerns (sum of 3.d.1 + 3.d.2): |
| $ |
| 4. Total proposed WOSB/EDWOSB participation rate (in terms of percentage of total contract value): |
| % of 2.a |
e. SDB:
| Name of Subcontractor |
| Type and Complexity of Product/Service |
| Type of Commitment to Subcontractor: |
| Estimated Subcontract Value |
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| 1. This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are small business concerns owned and controlled by one or more socially and economically disadvantaged individuals (include in this category the planned subcontracting dollars to HBCU/MIs, and the planned subcontracting dollars to ANCs and Indian Tribes). |
| $ |
| 2. If the Offeror is a SDB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). |
| $ |
| 3. Total planned dollars under this contract that will go to SDB concerns (sum of 3.e.1 + 3.e.2): |
| $ |
| 4. Total proposed SDB participation rate (in terms of percentage of total contract value): |
| % of 2.a |
f. VOSB:
| Name of Subcontractor |
| Type and Complexity of Product/Service |
| Type of Commitment to Subcontractor: |
| Estimated Subcontract Value |
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
Teaming Agreement (TA)
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| 1. This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are small business concerns 51% owned and controlled by one or more qualifying veterans (include in this category the planned subcontracting dollars to SDVOSB concerns shown in 3.g below). |
| $ |
| 2. If the Offeror is a VOSB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). |
| $ |
| 3. Total planned dollars under this contract that will go to VOSB concerns (sum of 3.f.1 + 3.f.2): |
| $ |
| 4. Total proposed VOSB participation rate (in terms of percentage of total contract value): |
| % of 2.a |
g. SDVOSB:
| Name of Subcontractor |
| Type and Complexity of Product/Service |
| Type of Commitment to Subcontractor: |
| Estimated Subcontract Value |
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| Teaming Agreement (TA) |
☐YES ☐ NO
Date of Agreement:
Letter of Commitment ☐YES ☐ NO Date of the LOC:
Other Type of Commitment:
☐YES ☐ NO
Other Commitment Date:
DUNS NUMBER
| 1. This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are small business concerns 51% owned and controlled by one or more qualifying service-disabled veterans. |
| $ |
| 2. If the Offeror is a SDVOSB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). |
| $ |
| 3. Total planned dollars under this contract that will go to SDVOSB concerns (sum of 3.g.1 + 3.g.2): |
| $ |
| 4. Total proposed SDVOSB participation rate (in terms of percentage of total contract value): |
| % of 2.a |
4. If the Offeror does not intend to subcontract, provide a detailed explanation why subcontracting would not result in efficient contract performance.
Notes:
(1) Lines 2.b + 2.c = 100% of Line 2.a
(2) Lines 3.a + 3.b.1 = 100% of Line 2.b
(3) Subcontracts to companies that qualify in multiple categories of SB must be reported under each category. For example: if you are planning to subcontract $100,000 to company ABC, a woman-owned, small disadvantaged business that is also a certified HUBZone SB, you will report $100,000 in block 3.b (SB), 3.c (HUBZone SB), 3.d (WOSB) and 3.e (SDB).
(4) The sum of 3.c.1 through 3.g.1 does not automatically equate to the value of line 3.b.1.
(5) Designated HUBZone SB concerns must be certified by SBA.
(6) Large business Offerors selected for award shall be required to submit an acceptable Small Business Subcontracting Plan incorporating the proposed subcontract values and any specifically identified small business concerns. The Small Business Subcontracting Plan shall also include small business subcontracting goals that meet or exceed the minimum small business subcontracting targets stated in the solicitation. If the Offeror fails to negotiate an acceptable subcontracting plan, the Offeror will be ineligible for award.
(7) This form may be expanded as needed.
Rev. Apr 2017 9
SOURCE SELECTION SENSITIVE INFORMATION
DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY
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