Attachment L SB Subcontracting Record.docx
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- Attached to
- NORTHWEST MULTIPLE AWARD CONSTRUCTION CONTRACT (NW MACC) Federal contract opportunity
- Solicitation number
- N4425521R4000
About this file
This document contains a small business subcontracting record template and details of the Northwest Multiple Award Construction Contract opportunity.
The subcontracting record template requires contractors to provide contract details including number, value, completion date and subcontracting goals and achievements in categories such as small businesses, small disadvantaged businesses, women-owned small businesses, HUBZone small businesses, veteran-owned small businesses and service disabled veteran-owned small businesses.
The Northwest Multiple Award Construction Contract is an indefinite delivery/indefinite quantity multiple award construction contract for design-build and design-bid-build projects located primarily in Washington, Oregon, Idaho, Montana, Alaska, Iowa, Minnesota, North Dakota, South Dakota, Nebraska and Wyoming. Project types include administrative facilities, housing, childcare centers, warehouses and other similar facilities. The solicitation number is N4425521R4000 and it represents a partial small business set-aside for NAICS code 236220 with an annual size standard of $36.5 million. The contract will be awarded by the Department of the Navy Naval Facilities Engineering Command.
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Text version
ATTACHMENT E
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
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