Attachment D - Small Business Subcontracting Record.docx

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SOLICTATION - P1800/1801, DESIGN BUILD 2nd Marine Division and 2nd MLG Operations Center, Camp Lejeune, NC
Solicitation number
N40085-19-R-9147
Issued by

About this file

This document contains a small business subcontracting record template and details of a solicitation for design-build construction services. The template requires contractors to provide contract details including number, value, completion date and subcontracting achievements categorized by business type. Subcontracting must be reported for small businesses, small disadvantaged businesses, women-owned small businesses, HUBZone small businesses, veteran-owned small businesses and service disabled veteran-owned small businesses.

The solicitation is issued by the Naval Facilities Engineering Command on behalf of the Department of the Navy for the design and construction of headquarters, operations and training facilities at Camp Lejeune, North Carolina. Services required include multi-story administrative, academic and logistics facilities for II Marine Expeditionary Force, 2nd Marine Expeditionary Brigade, 2nd Marine Logistics Group and 2nd Marine Division. The full request for proposal and supporting documents are provided in attachments.

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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:

(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:

(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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