ATTACHMENT D - SMALL BUSINESS SUBCONTRACTING RECORD.docx
DOCX document 16 KB Posted
- Attached to
- P-5001 DBB, JOINT AIR DEFENSE OPERATIONS PHASE II, JOINT BASE ANACOSTIA-BOLLING, WASHINGTON, DC
- Solicitation number
- N4008021R3502
About this file
This document contains a template for reporting small business subcontracting achievements. The template collects information on contracts and subcontracts, including contract numbers and titles, prime or subcontract status, completion dates, total and subcontracted dollar values, and achievements against small business subcontracting goals. For each contract or subcontract, the template requires breakdowns of dollar values and percentages awarded to various small business categories, including small disadvantaged businesses, women-owned small businesses, HUBZone small businesses, veteran-owned small businesses, and service-disabled veteran-owned small businesses. It also collects reference information for each contract or subcontract.
The related federal contract opportunity is a solicitation for the second phase of construction of a Joint Air Defense Operations Center at Joint Base Anacostia-Bolling in Washington, DC. The project scope includes completing a two-story facility with structural steel frame, concrete masonry unit walls, controlled access spaces, and compatible exterior finishes. The facility design must meet Department of Defense, Air Force, and Joint Base standards and requirements for permanent construction, antiterrorism, and force protection. The solicitation is available on the Procurement Integrated Enterprise Environment website. The contracting agency is the Naval Facilities Engineering Command within the Department of the Navy.
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Text version
ATTACHMENT D
SMALL BUSINESS SUBCONTRACTING RECORD
COMPANY NAME: _______________________________________
SUBCONTRACTING ACHIEVEMENTS – Include actual dollar values subcontracted for each of the categories listed. Include the percentage goal only if a goal was established. Note: Form may be expanded.
(1) Contract Number/Title:
Check One: ____ Prime Contract ____ Subcontract
Subcontracting Plan Required ____ Yes ____ No
ACTUAL
SUBCONTRACTED
SUBCONTRACT GOAL
(if applicable)
Completion Date: Total Contract Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(a) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise), DVBE (Disabled Veteran Business Enterprise), SB (Small Business), WBE (Women’s Business Enterprise).
(b) Other Than Small (OTS) Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.) Including DVBE
Name of customer reference for this project: ___________________________________________ Phone Number: _______________________ FAX Number: _______________________ Email address: ________________________________________
(2) Contract Number/Title:
ACTUAL
SUBCONTRACT GOAL
Completion Date: Contract Dollar Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(b) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),
(b) OTS Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar
(3) Contract Number/Title:
ACTUAL
SUBCONTRACT GOAL
Completion Date: Contract Dollar Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(c) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),
(b) OTS Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar
(4)Contract Number/Title:
ACTUAL
SUBCONTRACT GOAL
Completion Date: Total Contract Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(d) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),
(b) Other Than Small (OTS) Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar
(5) Contract Number/Title:
ACTUAL
SUBCONTRACT GOAL
Completion Date: Contract Dollar Value: $
| Total Subcontracted Value: $ |
| Whole Dollars |
| Percent |
| Percent |
(e) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)
Small Business Concerns (Non-Federal Certifications Examples:
MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),
(b) OTS Business Concerns (Dollar amount and percent of line c.)
(c) Total (sum of lines a & b above)
(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE
(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE
(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)
(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.)
(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar
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