ATTACHMENT JL.5 Small Business Past Perf+.pdf

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Attached to
Marine Species Monitoring, Evaluation, and Related Environmental
Solicitation number
N6247020R2000
Issued by

About this file

This document contains a past performance template for small businesses seeking a federal contract opportunity to provide marine species monitoring, evaluation, and related environmental services. The template requires contractors to provide details on up to three past or current contracts including the contract number, whether it was a prime or subcontract, completion date, dollar values, subcontracting achievements broken down by business type, and references.

The related federal contract opportunity is solicitation number N6247020R2000 to provide marine species monitoring, evaluation, and related environmental planning services for the Navy worldwide. Services will be obtained through the issuance of task orders over five years with a maximum value of $75 million. Contractors must be able to perform monitoring and program management in support of Navy environmental compliance and reporting requirements at locations within the Naval Facilities Engineering Command Atlantic and Pacific areas of responsibility.

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ATTACHMENT JL.5

Small Business Past Performance/SB Achievement 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

(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:

SUBCONTRACT

GOAL

(if applicable) 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.)

(3) Contract Number/Title:

SUBCONTRACT

GOAL

(if applicable) 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.)

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