Attachment F - Historical Small Business Utilization Form.docx
DOCX document 45 KB Posted
- Solicitation number
- N4008023R0010
About this file
This document is an historical small business utilization form to be completed by offerors on a Navy solicitation for the design-build replacement of a steam boiler at the Naval Support Facility in Indian Head, Maryland. The form requires offerors to provide data on past contract performance including total project values, dollars subcontracted to small and large businesses, and achievement of small business subcontracting goals. Small business categories include small disadvantaged businesses, women-owned small businesses, HUBZone small businesses, veteran-owned small businesses, and service-disabled veteran-owned small businesses. For each prior project example listed, offerors must include a customer reference, explain any unmet small business subcontracting goals, and rationalize any lack of small business participation. This form will be evaluated under Factor 6 of the solicitation to assess offerors' small business utilization and participation on prior contracts.
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment 0008.pdf | ||
| Amendment 0007.pdf | ||
| 1374726_Steam B_Amendment 0002.pdf | ||
| Amendment 0006.pdf | ||
| Amendment 0005.pdf | ||
| Amendment 0004.pdf | ||
| Steam B Site Visit Sign-In Sheet.pdf | ||
| Amendment 0003.pdf | ||
| Attachment D - Expected Visitor Form Steam B.docx | DOCX document | |
| Attachment H - Small Business Subcontracting Plan.docx | DOCX document | |
| Amendment 0002 - Phase II.pdf | ||
| Attachment J - Price Proposal Form.docx | DOCX document | |
| Attachment I - Steam B Site Visit Map.pdf | ||
| Attachment G - Small Business Commitment Participation (SBPCD).docx | DOCX document | |
| Attachment E - SECNAV 5512.pdf | ||
| Amendment 0001.pdf | ||
| Attachment C - Pre-Proposal Inquiry (PPI Form).xlsx | XLSX spreadsheet | |
| Attachment B - Past Performance Questionnaire (PPQ) Form.docx | DOCX document | |
| N4008023R0010 Steam Boiler Replacement - Phase I RFP.pdf | ||
| Attachment A - Construction and Design Experience Project Data Sheet.docx | DOCX document |
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Text version
ATTACHMENT F
HISTORICAL SMALL BUSINESS UTILIZATION
This form is to be completed by all Offerors (both large and small businesses) in order to provide supporting information for the evaluation of Factor 6, Small Business Utilization and Participation. Attachment F documents the offeror’s historical small business utilization and achievements for each project submitted under Factor 2, Experience. Round all percentages to the nearest tenth of a percent (i.e., include only 1 number after the decimal point).
Include actual dollar values subcontracted for each of the categories listed. Include the whole dollar and percentage goals ONLY if a goal was established. If established goals were not met on any submitted projects, an explanation for each unmet goal is required. Acknowledging a goal was missed, is not the same as providing an explanation for why a goal was missed. If goals were not established for a project, mark N/A. Enter zeroes (0) where applicable.
Project #1: Contract/Project Number/Task Order Number:
Project Title:
Offeror Size: Large Business |_| Small Business |_|
Performed as: Prime Contractor |_| Subcontractor |_| JV Member |_|
Subcontracting Plan Required: |_| Yes |_| No
| ACTUAL |
| GOAL |
(if applicable)
| Total Project Dollar Value: $ |
| Whole Dollars |
| Percent of line (c) |
| Whole Dollars |
| Percent of line (c) |
| N/A |
Total Self Performed Value: $
Total Subcontracted Value: $
| (a) Small Business Concerns (Include Values from d-h below and Self-Performed Value IF Small Business) |
| $ |
| % |
| $ |
| % |
| |_| |
| (b) Large Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (c) Total (sum of lines a & b above) |
| $ |
| % |
| $ |
| % |
| |_| |
| (d) Small Disadvantaged Business Concerns (SDB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (e) Women-Owned Small Business Concerns (WOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (f) HUBZone Small Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (g) Veteran-Owned Small Business Concerns (VOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (h) Service-Disabled Veteran-Owned Small Business Concerns (SDVOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
Explanation of each unmet goal (if applicable):
Explanation for a lack of small business subcontracting achievements (if applicable):
Name of customer reference for this project:
Phone Number:
Email address:
Project #2: Contract/Project Number/Task Order Number:
Project Title:
Offeror Size: Large Business |_| Small Business |_|
Performed as: Prime Contractor |_| Subcontractor |_| JV Member |_|
Subcontracting Plan Required: |_| Yes |_| No
| ACTUAL |
| GOAL |
(if applicable)
| Total Project Dollar Value: $ |
| Whole Dollars |
| Percent of line (c) |
| Whole Dollars |
| Percent of line (c) |
| N/A |
Total Self Performed Value: $
Total Subcontracted Value: $
| (a) Small Business Concerns (Include Values from d-h below and Self-Performed Value IF Small Business) |
| $ |
| % |
| $ |
| % |
| |_| |
| (b) Large Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (c) Total (sum of lines a & b above) |
| $ |
| % |
| $ |
| % |
| |_| |
| (d) Small Disadvantaged Business Concerns (SDB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (e) Women-Owned Small Business Concerns (WOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (f) HUBZone Small Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (g) Veteran-Owned Small Business Concerns (VOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (h) Service-Disabled Veteran-Owned Small Business Concerns (SDVOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
Explanation of each unmet goal (if applicable):
Name of customer reference for this project:
Email address:
Project #3: Contract/Project Number/Task Order Number:
Project Title:
Offeror Size: Large Business |_| Small Business |_|
Performed as: Prime Contractor |_| Subcontractor |_| JV Member |_|
Subcontracting Plan Required: |_| Yes |_| No
| ACTUAL |
| GOAL |
(if applicable)
| Total Project Dollar Value: $ |
| Whole Dollars |
| Percent of line (c) |
| Whole Dollars |
| Percent of line (c) |
| N/A |
Total Self Performed Value: $
Total Subcontracted Value: $
| (a) Small Business Concerns (Include Values from d-h below and Self-Performed Value IF Small Business) |
| $ |
| % |
| $ |
| % |
| |_| |
| (b) Large Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (c) Total (sum of lines a & b above) |
| $ |
| % |
| $ |
| % |
| |_| |
| (d) Small Disadvantaged Business Concerns (SDB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (e) Women-Owned Small Business Concerns (WOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (f) HUBZone Small Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (g) Veteran-Owned Small Business Concerns (VOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (h) Service-Disabled Veteran-Owned Small Business Concerns (SDVOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
Explanation of each unmet goal (if applicable):
Name of customer reference for this project:
Email address:
Project #4: Contract/Project Number/Task Order Number:
Project Title:
Offeror Size: Large Business |_| Small Business |_|
Performed as: Prime Contractor |_| Subcontractor |_| JV Member |_|
Subcontracting Plan Required: |_| Yes |_| No
| ACTUAL |
| GOAL |
(if applicable)
| Total Project Dollar Value: $ |
| Whole Dollars |
| Percent of line (c) |
| Whole Dollars |
| Percent of line (c) |
| N/A |
Total Self Performed Value: $
Total Subcontracted Value: $
| (a) Small Business Concerns (Include Values from d-h below and Self-Performed Value IF Small Business) |
| $ |
| % |
| $ |
| % |
| |_| |
| (b) Large Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (c) Total (sum of lines a & b above) |
| $ |
| % |
| $ |
| % |
| |_| |
| (d) Small Disadvantaged Business Concerns (SDB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (e) Women-Owned Small Business Concerns (WOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (f) HUBZone Small Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (g) Veteran-Owned Small Business Concerns (VOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (h) Service-Disabled Veteran-Owned Small Business Concerns (SDVOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
Explanation of each unmet goal (if applicable):
Name of customer reference for this project:
Email address:
Project #5: Contract/Project Number/Task Order Number:
Project Title:
Offeror Size: Large Business |_| Small Business |_|
Performed as: Prime Contractor |_| Subcontractor |_| JV Member |_|
Subcontracting Plan Required: |_| Yes |_| No
| ACTUAL |
| GOAL |
(if applicable)
| Total Project Dollar Value: $ |
| Whole Dollars |
| Percent of line (c) |
| Whole Dollars |
| Percent of line (c) |
| N/A |
Total Self Performed Value: $
Total Subcontracted Value: $
| (a) Small Business Concerns (Include Values from d-h below and Self-Performed Value IF Small Business) |
| $ |
| % |
| $ |
| % |
| |_| |
| (b) Large Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (c) Total (sum of lines a & b above) |
| $ |
| % |
| $ |
| % |
| |_| |
| (d) Small Disadvantaged Business Concerns (SDB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (e) Women-Owned Small Business Concerns (WOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (f) HUBZone Small Business Concerns |
| $ |
| % |
| $ |
| % |
| |_| |
| (g) Veteran-Owned Small Business Concerns (VOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
| (h) Service-Disabled Veteran-Owned Small Business Concerns (SDVOSB) |
| $ |
| % |
| $ |
| % |
| |_| |
Explanation of each unmet goal (if applicable):
Name of customer reference for this project:
Email address:
Attachment X – Historical Small Business Utilization, Page 4 of 4
(Rev 3/2020)
File details come from the government source that posted it. Updated .