Secure Spaces MACC - Exhibit D - Past Performance - Small Business Utilization REVISED.docx

EXHIBIT “D”

PAST PERFORMANCE – SMALL BUSINESS UTILIZATION

N62473-21-R-1011

This form is to be completed by all Offerors (both large and small businesses) in order to provide supporting information for evaluation of Factor 2, Past Performance. 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 percentage goal only if a goal was established. If established goals were not met on any submitted projects, an explanation for each unmet goal is required. If goals were not established for a project, mark N/A.

Items (a) – (h) are for SUBCONTRACTED values only. Small Business Offerors shall not include self-performed work under these items.

Project #1: Contract/Project Number/Task Order Number:

Project Title:

(if applicable)

Total Subcontracted Value: $

Detailed explanation of each unmet goal and the corrective actions taken (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #2: Contract/Project Number/Task Order Number:

Project Title:

(if applicable)

Total Subcontracted Value: $

(h) Service-Disabled Veteran-Owned Small Business Concerns

Detailed explanation of each unmet goal and the corrective actions taken (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #3: Contract/Project Number/Task Order Number:

Project Title:

(if applicable)

Total Subcontracted Value: $

Detailed explanation of each unmet goal and the corrective actions taken (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #4: Contract/Project Number/Task Order Number:

Project Title:

(if applicable)

Total Subcontracted Value: $

Detailed explanation of each unmet goal and the corrective actions taken (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #5: Contract/Project Number/Task Order Number:

Project Title:

(if applicable)

Total Subcontracted Value: $

Detailed explanation of each unmet goal and the corrective actions taken (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Note: Form may be expanded.

Exhibit “D” - Past Performance – Small Business Utilization, Page 3 of 3

(Rev 6/2019)