Attachment K.docx

Solicitation # N44255-20-R-XXX Attachments

P907

ATTACHMENT A – PRE-PROPOSAL INQUIRY FORM

PRE-PROPOSAL INQUIRY (PPI) FORM

RFP: N44255-20-R-XXXX Offeror’s PPI No. _______ Gov’t PPI No. _______

SOLICITATION: P907 TPS Pier and Vessel Maintenance Facility, Naval Base Kitsap, Bangor, Silverdale, WA

NOTE: ALL PRE-PROPOSAL INQUIRIES (PPIs) SHALL BE SUBMITTED INDIVIDUALLY BY E-MAIL, ON THIS FORM TO GRACE.MONTERO@NAVY.MIL AND stephanie.averyguill@navy.mil NO LATER THAN 10 days prior to the Technical Proposal due date.

DATE PPI WAS SUBMITTED TO THE GOVERNMENT: _____________________

FROM FIRM: _______________________________ POC: ___________________________________

ADDRESS: ________________________________________________________________________________

PHONE No.: ________________________________ FAX No.: _______________________________

E-MAIL ADDRESS: ________________________________________________________________________

PRE-PROPOSAL INQUIRY: (Please type or print clearly)

(Include RFP Section, page number, and paragraph if applicable)

GOVERNMENT RESPONSE:

GOVERNMENT RESPONDER’S SIGNATURE: ______________________ DATE: ___________

ATTACHMENT B

INDIVIDUAL SMALL BUSINESS SUBCONTRACTING PLAN (Template) Edit or delete red font text and complete fill-ins as applicable

This template is designed to be consistent with FAR 19.704, Subcontracting Plan Requirements and FAR clause 52.219-9, Small Business Subcontracting Plan (“subcontracting plan”). Other formats may be acceptable, including commercial or master subcontracting plans; however, failure to include the essential information exemplified in this individual plan template may be cause for delay in acceptance or rejection of a bid/offer.

(TO BE SUBMITTED BY OTHER THAN SMALL BUSINESSES ONLY)

(Also referred to as large businesses)

(CONTRACTOR’S NAME)

(ADDRESS)

(CONTRACTOR’S CORPORATE HEADQUARTERS ADDRESS)

[If same as above, so indicate].

(Solicitation or Contract Number)

(Title of the Project and Location)

(Date Prepared)

PLAN SUBMITTED BY:

Signature: __________________________________ Date: ____________________

Printed Name: ___________________________________________________________

Title: __________________________________________________________________

REVIEWED:

REVIEWED:

Procurement Center Representative

ACCEPTED:

Attachment B continued

SUBCONTRACTING PLAN

This document, together with any attachments, is submitted as a subcontracting plan to satisfy the requirements of Federal Acquisition Regulations (FAR) 19.704. The following goals are established for the contract (including base period and all option items/periods (if applicable)). Attachment 1 provides breakdowns for the base year and option periods. Percentages may be rounded to nearest tenth of a percent. INCLUDE SUPPORTING RATIONALE FOR ALL PROPOSED GOALS AND ENSURE THIS PLAN IS CONSISTENT WITH ANY SMALL BUSINESS PARTCIPATION AND COMMITMENT STRATEGY ASSOCIATED WITH THIS ACQUISITION.

1. a. Total Contract Value $_______________ (including options)

b. Total Subcontracted $_______________ _______% of 1.a (inclusive of all planned subcontracting to all businesses, regardless of size)

c. Total Prime-performed $_______________ _______% of 1.a

2. The following dollars and percentage goals are applicable to the contract cited above. (See FAR 19.704(a)(1) and (2))

a. Large Business $_______________ _______% of 1.b

This number represents total planned subcontract dollars that will be awarded to other than small business concerns (including subcontracts awarded to Historically Black Colleges, Universities and Minority Institutions (HBCU/MIs).

b. Small Business (SB) $_______________ _______% of 1.b

This number represents total planned subcontract dollars that will be awarded to small business concerns** as well as subcontracts awarded under the AbilityOne Program to SourceAmerica (formerly NISH) and National Industries for the Blind (NIB) organizations and subcontracts awarded to Alaskan Native Corporations (ANCs) and Indian Tribes as prescribed in FAR 19.703(c) & FAR 52.219-9.

(** Small business concerns include SBs, Small Disadvantaged Businesses (SDB), Women-Owned Small Businesses (WOSB), Historically Underutilized Business Zone (HUBZone) small businesses, Veteran-Owned Small Businesses (VOSB) and Service-Disabled Veteran-Owned Small Businesses (SDVOSB))

(Include 2.c, 2.d, 2.e, 2.f, 2.g, 2.h, and 2.i, below).

Notes:

(1) Lines 1.b + 1.c=100% of Line 1.a

(2) Lines 2.a + 2.b = 100% of Line 1.b

(3) Lines 2.c, 2.d, 2.e, 2.f, 2.g, 2.h, and 2.i are calculated against Line 1.b, the total value of overall subcontract dollars.

(4) 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 SDB that is also a certified HUBZone SB, you will report $100,000 on line 2.b (SB), 2.c (HUBZone), 2.d (WOSB) and 2.e (SDB). Accordingly, the sum of 2.c through 2.i will not necessarily equate to the value of 2.b.

(5) Designated HUBZone SBs must be certified by the Small Business Administration (SBA).

c. HUBZone SB $______________ ________% of 1.b

This number represents total planned subcontract dollars that will be awarded to qualified HUBZone small business concerns certified by SBA. (Included in total for 2.b, above)

d. WOSB $_______________ ________% of 1.b

This number represents total planned subcontract dollars under that will be awarded to WOSBs. (Included in total for 2.b, above)

e. SDB $______________ ________% of 1.b

This number represents total planned subcontracting dollars that will be awarded to small business concerns owned and controlled by socially and economically disadvantaged individuals (include in this category the planned subcontracting dollars to ANCs and Indian Tribes shown in total for 2.i below). (Included in total for 2.b, above)

f. VOSB $_______________ ________% of 1.b

This number represents total planned subcontract dollars that will be awarded to small business concerns owned and controlled by veterans (include in this category the planned subcontracting dollars for SDVOSBs shown in 2.g below). (Included in total for 2.b, above)

g. SDVOSB $_______________ ________% of 1.b

This number represents total planned subcontract dollars under this contract that will be awarded to subcontractors who are small business concerns owned and controlled by service-disabled veterans. (Included in totals for 2.b and 2.f, above)

h. AbilityOne $_______________ ________% of l.b.

This number represents total planned subcontract dollars that will be awarded to AbilityOne associated nonprofit agencies through SourceAmerica and NIB. Per DFARS 219.703, subcontracts awarded to qualified non-profit agencies for the blind or severely disabled may be counted toward the small business subcontracting goal. (Included in total for 2.b, above)

This number represents total planned subcontract dollars that will be awarded to ANCs and Indian Tribes and for which the prime contractor has been designated to receive SDB credit. (See FAR 19.703 & FAR 52.219-9) (Included in totals for 2.b and 2.e, above)

3. The following principal products and/or services will be subcontracted under this contract. (See FAR 19.704(a)(3)

1. Products/services planned to be subcontracted to LB concerns (including HBCU/MIs):

Firm subcontract commitments:

Attachment B Continued

Firm subcontract commitments:

Name of Organization/DUNS Products or Services

i. Planned products/services to be subcontracted to ANCs and Indian Tribe businesses (See 2.i above for explanation):

7. The following employee will administer the subcontracting program: (See FAR 19.704(a)(7))

This individual has general overall responsibility for the company's small business program. This person should have knowledge of the federal small business programs and be knowledgeable about federal procurement practices. If the prime decides to change the person in this position, they must notify the Contracting Officer and the Deputy for Small Business. The administrator is responsible for the development, preparation and execution of this subcontracting plan, and for monitoring performance relative to contractual subcontracting requirements contained in this plan, including:

8. The following efforts will be taken to ensure that the small business community will have an equitable opportunity to compete for subcontracts. (See FAR 19.704(a)(8))

a. Outreach efforts will be made by identifying:

c. The following internal efforts will be made to guide and encourage buyers:

9. Provide assurances the offeror agrees that the FAR clause 52.219-8 entitled "Utilization of Small Business Concerns " will be included in all subcontracts which offer further subcontracting opportunities, and all subcontractors, except SB concerns, that receive subcontracts in excess of $700,000 ($1,500,000 for construction) will be required to adopt plans that comply with the requirements of the clause at 52.219-9, Small Business Subcontracting Plan. Such plans will be reviewed by comparing them with the provisions of P.L. 95-507 and assuring that all minimum requirements of an acceptable subcontracting plan have been satisfied. The acceptability of percentage goals shall be determined on a case-by-case basis depending on the supplies/services involved, the availability of potential small and small disadvantaged subcontractors, and prior experience. Once approved and implemented, plans will be monitored through the submission of periodic reports, and/or, as time and availability of funds permit, periodic visits to review subcontracting program progress. (See FAR 19.704(a)(9))

10. Provide assurances the offeror will submit such periodic reports and cooperate in any studies or surveys as may be required by the contracting agency or the Small Business Administration in order to determine the extent of compliance by the offeror (contractor) with the subcontracting plan and with FAR clause 52.219-8. (See FAR 19.704(a)(10)(i) and (ii))

Provide assurances the offeror will:

A separate “Final” ISR is required at contract completion.

Upon award of the contract, the identity of the individual(s) responsible for acknowledging receipt or rejecting the ISR and the SSR will be provided to the awardee.

*Note 1: If contract value is $30,000 or more and the solicitation includes FAR Clause 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards, ensure additional reporting requirements are met in eSRS in accordance with this clause.

11. The offeror will maintain at least the following types of records to document compliance with this subcontracting plan: (See FAR 19.704(a)(11))

1. Source lists, guides, and other data identifying small business, HUBZone small business, women-owned small business, small disadvantaged business, veteran owned small business and service disabled veteran owned small business.

1. Organizations contacted to locate small business, HUBZone small business, women-owned small business, small disadvantaged business, veteran owned small business and service disabled veteran owned small business.

12. Provide assurances that the offeror will make a good faith effort to acquire articles, equipment, supplies, services, or materials, or obtain the performance of construction work from the small business concerns that it used in preparing the bid or proposal, in the same or greater scope, amount, and quality used in preparing and submitting the bid or proposal. Responding to a request for a quote does not constitute use in preparing a bid or proposal if:

1. The Offeror identifies the small business concern as a subcontractor in the bid or proposal or associated small business subcontracting plan, to furnish certain supplies or perform a portion of the subcontract; or

1. The Offeror used the small business concern’s pricing or cost information or technical expertise in preparing the bid or proposal, where there is written evidence of an intent or understanding that the small business concern will be awarded a subcontract for the related work if the Offeror is awarded the contract. (See FAR 19.704(a)(12))

13. Provide assurances that the Contractor will provide the Contracting Officer with a written explanation if the Contractor fails to acquire articles, equipment, supplies, services or materials or obtain the performance of construction work as described in 12.

This written explanation must be submitted to the Contracting Officer within 30 days of contract completion. (See FAR 19.704(a)(13))

14. Provide assurances that the Contractor will not prohibit a subcontractor from discussing with the Contracting Officer any material matter pertaining to payment to or utilization of a subcontractor. (See FAR 19.704(a)(14))

15. Provide assurances that the offeror will pay its small business subcontractors on time and in accordance with the terms and conditions of the underlying subcontract, and notify the contracting officer when the prime contractor makes either a reduced or an untimely payment to a small business subcontractor. (See FAR 19.704(a)(15))

*****END OF PLAN*****

The original copy of this plan will be included in the file and made a material part of the contract.

Copy to:

Small Business Professional SBA Procurement Center Representative

NEXT PAGE: Attachment 1 of RFP Attachment B ‘Breakdowns of Base Year and Options’

Attachment 1 of RFP Attachment B ‘Breakdowns of Base Year and Options

Values

2.i To ANCs/Indian Tribes

ATTACHMENT C - CONSTRUCTION EXPERIENCE PROJECT DATA SHEET

Project No. (check one) : |_| CON #1 |_| CON #2 |_| CON #3 |_| CON #4 |_| CON #5

1. Experience for: |_| Offeror |_| Joint-Venture |_| Other (Explain)

Firm Name:

Address:

Phone Number:

DUNS Number:

Point of Contact: Contact Phone Number:

2. Work Performed as: |_| Prime Contractor |_| Sub Contractor |_| Joint Venture |_| Other (Explain)

Percent of project work performed:

If subcontractor, who was prime (Name/Phone #):

3. Contract Number: Delivery/Task Order Number:

Title:

Location:

4. Award Date (mm/dd/yy): Completion Date (mm/dd/yy):

5. Type of work:

|_| New Construction |_| Renovation |_| Repair |_| Alteration |_| Other (explain):

6. Type of Contract/Task Order: (Check ALL that apply)

|_| Firm-Fixed Price |_| Cost/Time and Material |_| Other (explain):

Complete Block 7 for Construction Projects.

7. Construction Project:

Award Amount: Final Price:

Type of Contract/Task Order: (Check ALL that apply)

|_| Design-Build |_| Design-Bid-Build |_| Delivery/Task Order (IDIQ) |_| Other (explain):

If Design-Build, identify the Lead Design Firm:______________________________________________

8. Provide a detailed description of the project and the relevancy to the project requirements of this RFP (i.e.: unique features, square footage, construction methods), including any sustainable features or USGBC LEED certifications. If design-build, include a description of the design-effort.

Scope:

Complexity:

9. Provide a detailed description of what work your firm self-performed on this project:

10. If using experience information of a JV partner, subcontractor, or any other entity (name, DUNS, and/or address is not exactly as stated on the Cover Letter), describe the nature of the relationship of the entity to the Offeror, and clearly explain how that entity will have meaningful involvement in the performance of this contract, including the resources it will contribute.

ATTACHMENT D

PAST PERFORMANCE QUESTIONNAIRE

1. The NAVFAC Form PPQ shall be utilized for all evaluations that require a Past Performance Questionnaire (PPQ).

2. Solicitations utilizing PPQs shall include the language cited below in the RFP. The current NAVFAC Form PPQ-0 is available in BMS S-17.2.15 Source Selection.

Solicitation Submittal Requirements: IF A COMPLETED CPARS EVALUATION IS AVAILABLE, IT SHALL BE SUBMITTED WITH THE PROPOSAL. IF THERE IS NOT A COMPLETED CPARS EVALUATION, the Past Performance Questionnaire (PPQ) included in the solicitation is provided for the Offeror or its team members to submit to the client for each project the Offeror includes in its proposal for Factor 2. AN OFFEROR SHALL NOT SUBMIT A PPQ WHEN A COMPLETED CPARS IS AVAILABLE.

IF A CPARS EVALUATION IS NOT AVAILABLE, ensure correct phone numbers and email addresses are provided for the client point of contact. Completed PPQs should be submitted with your proposal. If the Offeror is unable to obtain a completed PPQ from a client for a project(s) before proposal closing date, the Offeror should complete and submit with the proposal the first page of the PPQ (Attachment D1 and D2), which will provide contract and client information for the respective project(s). Offerors should follow-up with clients/references to ensure timely submittal of questionnaires. If the client requests, questionnaires may be submitted directly to the Government's point of contact, GRACE MONTERO AND DECLAN JARRY, via email at grace.montero@navy.mil and Declan.jarry@navy.mil prior to proposal closing date. Offerors shall not incorporate by reference into their proposal PPQs or CPARS previously submitted for other RFPs. However, this does not preclude the Government from utilizing previously submitted PPQ information in the past performance evaluation.

ATTACHMENT D

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: |_| Prime Contractor |_| Sub Contractor |_| Joint Venture |_| Other (Explain) Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: |_| Firm Fixed Price |_| Cost Reimbursement |_| Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work |_| High |_| Med |_| Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

CLIENT INFORMATION (Client to complete Blocks 5-8)

5. Client Information Name:

Title:

Phone Number:

Email Address:

6. Describe the client’s role in the project:

7. Date Questionnaire was completed (mm/dd/yy):

8. Client’s Signature:

NOTE: NAVFAC REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE COMPLETED QUESTIONNAIRE TO NAVFAC WITH THEIR PROPOSAL, AND MAY DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON NAVFAC SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY BE SUBMITTED DIRECTLY TO NAVFAC. PLEASE CONTACT THE OFFEROR FOR NAVFAC POC INFORMATION. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

Contractor Information (Firm Name): ________________________________________________

Client Information (Name): ________________________________________________________

TO BE COMPLETED BY CLIENT

Attachment D – Past Performance Questionnaire (PPQ)

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY:

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

3. CUSTOMER SATISFACTION:

4. MANAGEMENT/ PERSONNEL/LABOR

5. COST/FINANCIAL MANAGEMENT

6. SAFETY/SECURITY

7. GENERAL

Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):

ATTACHMENT E

SAFETY DATA SHEET

N44255-20-R-5002

This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor. EMR, DART and TRC rates shall not be submitted for subcontractors.

Joint Venture (JV) or Partnership: Complete Blocks 1 through 8 for each contractor who is part of the JV or partnership. Only one safety narrative (Block 9) is required.

1. Offeror Name:

Name of JV partner providing the information below (if applicable):

Offeror’s Three Previous Complete Calendar Years of Reported Safety Data:

Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers.

3a. For EMRs greater than 1.0, explain any extenuating circumstances and corrective actions taken:

3b. Explain any negative EMR trends:

3c. If you do not have an EMR for a given year, state so here and explain why:

4. Insurance Carrier Information:

Insurance Carrier Name:

Instructions for calculating the DART rate can be found at http://www.bls.gov/iif/osheval.htm.

6a. For DART Rates of 3.0 or greater, explain any extenuating circumstances and corrective actions taken:

6b. Explain any negative DART Rate trends:

6c. If you do not have a DART Rate for a given year, state so here and explain why:

ATTACHMENT E

SAFETY DATA SHEET

N44255-20-R-5002

Instructions for calculating the TRC rate can be found at http://www.bls.gov/iif/osheval.htm.

8a. For TRC Rates of 4.5 or greater, explain any extenuating circumstances and corrective actions taken:

8b. Explain any negative TRC Rate trends:

8c. If you do not have a TRC Rate for a given year, state so here and explain why:

ATTACHMENT E

SAFETY DATA SHEET

N44255-20-R-XXXX

9. Technical Approach for Safety: Provide the Safety narrative using this form. Do not exceed page limitation specified in the RFP. Any additional pages will not be considered.

Describe the plan that the Offeror will implement to evaluate safety performance of potential subcontractors, as a part of the selection process for all levels of subcontractors.

Describe the safety management system that the Offeror will use to oversee the safety compliance and performance of self-performed and subcontractor performed work.

ATTACHMENT E

SAFETY DATA SHEET

N44255-20-R-5002

9. Technical Approach for Safety (continuation): Provide the Safety Narrative using this form. Do not exceed page limitation specified in the RFP. Any additional pages will not be considered.

Describe any innovative methods that the Offeror will employ to ensure and monitor safe work practices at self-performed/and or all subcontractor levels:

Describe the methodology that the Offeror will use in order to execute an effective program that facilitates sound mishap prevention techniques and processes, employee reporting of unsafe conditions, unsafe activities, and near-miss mishaps:

Page 4 or 4

ATTACHMENT F

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: $

(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: $

(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

Name of customer reference for this project: ___________________________________________

(3) Contract Number/Title:

ACTUAL

SUBCONTRACT GOAL

Completion Date: Contract Dollar Value: $

(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

Name of customer reference for this project: ___________________________________________

Revised September 2016 11

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY

IN FAR 2.101 & 3.104 APPLY

ATTACHMENT G

SMALL BUSINESS PARTICIPATION AND COMMITMENT STRATEGY

(OFFEROR’S NAME)

(ADDRESS)

Solicitation or Contract Number (Title of the Project) (Location) (Date Prepared)

INSERT INTRODUCTION/EXECUTIVE SUMMARY (Up to 2 pages maximum)

SMALL BUSINESS PARTICIPATION AND COMMITMENT STRATEGY – (Base and Option Years)

4. Subcontracts for products and services to be awarded under this project.

a. Self-Performed Work:

TYPE OF SERVICE/PRODUCT $ VALUE OF WORK

If the Offeror is a small business, the Government will add self-performed work to the appropriate category(ies) in c. (1) through c. (6) below to calculate overall small business participation rates.

b. Other Than Small (OTS) Business Subcontracts**

NAME OF COMPANY* TYPE OF SERVICE/PRODUCT $ VALUE OF SUBCONTRACT

c. Small Business (SB) Subcontracts

NAME OF COMPANY* TYPE OF SERVICE/PRODUCT $ VALUE OF SUBCONTRACT

(1) SMALL DISADVANTAGED BUSINESSES: (SDB)

NAME OF COMPANY* TYPE OF SERVICE/PRODUCT $ VALUE OF SUBCONTRACT

(2) WOMEN-OWNED SMALL BUSINESSES: (WOSB)

NAME OF COMPANY* TYPE OF SERVICE/PRODUCT $ VALUE OF SUBCONTRACT

(3) HISTORICALLY UNDERUTILIZED BUSINESS ZONE (HUBZone) CONCERN:

NAME OF COMPANY* TYPE OF SERVICES $ VALUE OF SUBCONTRACT

(4) VETERAN OWNED SMALL BUSINESS: (VOSB)

NAME OF COMPANY* TYPE OF SERVICES $ VALUE OF SUBCONTRACT

(5) SERVICE-DISABLED VETERAN OWNED SMALL BUSINESS: (SDVOSB)

NAME OF COMPANY* TYPE OF SERVICES $ VALUE OF SUBCONTRACT

(6) ABILITYONE PROGRAM ORGANIZATIONS

NAME OF ORG* TYPE OF SERVICES $ VALUE OF SUBCONTRACT

* For each company/organization listed, describe the nature of commitment to subcontract and whether or not it is legally binding. If unknown/to be determined, so indicate.

** Include any subcontracts to Historically Black Colleges and Universities/Minority Institutions (HBCU/MI) in the OTS Business listing.

NOTES:

1. The dollar sum of lines 4.b and 4.c (excluding (1)-(6)) must equal line 1.

2. Lines 4.c. (1) through 4.c. (6) identify various subcategories of small businesses. Subcontracts to companies that qualify in multiple categories must be reported under each category. For example: A $100,000 subcontract to ABC, a woman-owned, small disadvantaged business that is also a certified HUBZone concern, will be reported as $100,000 on line 4.c., SB, line 4.c. (1), SDB, line 4.c. (2), WOSB and line 4.c.(3), HUBZone concern.

3. Subcontracts to qualified nonprofit agencies participating in the AbilityOne Program are considered small business subcontracts for the purposes of this strategy and any associated small business subcontracting plan.

INSERT SUPPLEMENTAL NARRATIVES (limited to five pages) TO ADDRESS JOINT VENTURE PARTICULARS AND OTHER STRATEGY ELEMENTS SUCH AS THE NATURE OF COMMITMENTS/AGREEMENTS COVERING POST AWARD ROLES, SPECIFIC INITIATIVES AND TOOLS TO ENHANCE SMALL BUSINESS PARTICIPATION AND CAPABILITIES AND HOW SMALL BUSINESS PARTICIPATION RATES WERE DETERMINED.

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY

CONTRACT LEVEL PERFORMANCE SUMMARY

This document summarizes participation (total contract performance, including self-performance and subcontracted efforts) by type of business entity in terms of both dollar value and percentage of total contract value.

Base

Option 1

Option 2

TOTAL

DOLLARS

Total contract…