J.1(b)_Attachment_14_SF295.pdf

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1.4

C:\PERFORM\FORMS\S295_7.FRP

Barbara Williams ADOBEPS4.DRV Version 4.50 Acrobat Distiller 5.0 (Windows) D:20010924183942Z D:20030331131736-05'00'

SUMMARY SUBCONTRACT REPORT

(See instructions on reverse) OMB Control Number: 9000-0007 Expiration Date: 4/30/2016 Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by Section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB Control Number for this collection is 9000-0007. We estimate that it will take 16.2 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

17.

18.

1. CORPORATION, COMPANY OR SUBDIVISION COVERED

4. REPORTING PERIOD:

5. TYPE OF REPORT

6. ADMINISTERING ACTIVITY (Please check applicable box)

7. REPORT SUBMITTED AS (Check one)

8. TYPE OF PLAN

IF PLAN IS A COMMERCIAL PLAN, SPECIFY THE PERCENTAGE OF THE DOLLARS ON THIS REPORT ATTRIBUTABLE TO THIS AGENCY.

9. CONTRACTOR'S MAJOR PRODUCTS OR SERVICE LINES

CUMULATIVE FISCAL YEAR SUBCONTRACT AWARDS (Report cumulative figures for reporting period in Block 4)

TYPE

WHOLE DOLLARS

PERCENT

(To nearest tenth of a %)

a. NAME

b. TITLE

c. TELEPHONE NUMBER

AREA CODE

NUMBER

a. COMPANY NAME

b. STREET ADDRESS

c. CITY

d. STATE

e. ZIP CODE

2. CONTRACTOR IDENTIFICATION NUMBER

3. DATE SUBMITTED

OCT 1 - MAR 31

OCT 1 - SEPT 30

YEAR

REGULAR

FINAL

REVISED

10a.

SMALL BUSINESS CONCERNS (Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS) 10b.

LARGE BUSINESS CONCERNS (Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS) 10c.

TOTAL (Sum of 10a and 10b).

11.

SMALL DISADVANTAGED BUSINESS CONCERNS (SDB)

(Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS) 12.

WOMEN-OWNED SMALL BUSINESS (WOSB) CONCERNS (Dollar Amount and Percent of 10c).

(SEE SPECIFIC INSTRUCTIONS)

13.

HISTORICALLY BLACK COLLEGES AND UNIVERSITIES (HBCU) AND MINORITY

INSTITUTIONS (If Applicable) (Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS) 14.

HUBZONE SMALL BUSINESS (HUBZone SB) CONCERNS (Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS) 15.

VETERAN-OWNED SMALL BUSINESS (VOSB) CONCERNS (Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS) 16.

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS CONCERNS (Dollar Amount and Percent of 10c). (SEE SPECIFIC INSTRUCTIONS) ALASKA NATIVE CORPORATIONS (ANCs) AND INDIAN TRIBES THAT ARE NOT SMALL BUSINESSES (Dollar Amount) (SEE SPECIFIC INSTRUCTIONS) ALASKA NATIVE CORPORATIONS (ANCs) AND INDIAN TRIBES THAT HAVE NOT BEEN CERTIFIED BY THE SMALL BUSINESS ADMINISTRATION AS SMALL DISADVANTAGED BUSINESSES (Dollar Amount) (SEE SPECIFIC INSTRUCTIONS)

AUTHORIZED FOR LOCAL REPRODUCTION PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 295 (REV. 9/2015) Prescribed by GSA - FAR (48 CFR) 53.219 (b)

DEFENSE CONTRACT MANAGEMENT AGENCY

NASA

GSA

DOE

OTHER FEDERAL AGENCY (Specify)

ARMY

NAVY

AIR FORCE

PRIME CONTRACTOR

SUBCONTRACTOR

BOTH

INDIVIDUAL

COMMERCIAL PRODUCTS

a b

19. CONTRACTOR'S OFFICIAL WHO ADMINISTERS SUBCONTRACTING PROGRAM

100.0%

d. DATE

b. TITLE

c. SIGNATURE

a. NAME

21. CHIEF EXECUTIVE OFFICER

20. REMARKS

STANDARD FORM 295 (REV. 9/2015) PAGE 2

2. This form collects subcontract data from prime contractors/subcontractors that: (a) hold one or more contracts over $550,000 (over $1,000,000 for construction of a public facility); and (b) are required to report subcontracts awarded to Small Business (SB), Small Disadvantaged Business (SDB), Women-Owned Small Business (WOSB), Veteran-Owned Small Business (VOSB), Service-Disabled Veteran Owned Small Business, and HUBZone Small Business (HUBZone SB) concerns under a subcontracting plan. For the Department of Defense (DOD), the National Aeronautics and Space Administration (NASA), and the Coast Guard, this form also collects subcontract award data for Historically Black Colleges and Universities (HBCUs) and Minority Institutions (MIs).

3. This report must be submitted semi-annually (for the six months ended March 31st and the twelve months ended September 30th) for contracts with the Department of Defense (DOD) and annually (for the twelve months ended September 30th) for contracts with civilian agencies, except for contracts covered by an approved Commercial Plan (see special instructions in right-hand column). Reports are due 30 days after the close of each reporting period.

4. This report may be submitted on a corporate, company, or subdivision (e.g., plant or division operating on a separate profit center) basis, unless otherwise directed by the agency awarding the contract.

7. Only subcontracts involving performance in the U.S. or its outlying areas should be included in this report.

BLOCK 2: For the Contractor Identification Number, enter the nine-digit Data Universal Numbering System (DUNS) number that identifies the specific contractor establishment. If there is no DUNS number available that identifies the exact name and address entered in Block 1, contact Dun and Bradstreet Information Services at 1-866-705-5711 or via the Internet at http://www.dnb.com. The contractor should be prepared to provide the following information: (i) Company legal business name. (ii) Tradestyle, doing business, or other name by which your entity is commonly recognized. (iii) Company physical street address, city, state and ZIP Code. (iv) Company mailing address, city, state and ZIP Code (if separate from physical). (v) Company telephone number. (vi) Date the company was started. (vii) Number of employees at your location. (viii) Chief executive officer/key manager. (ix) Line of business (industry). (x) Company Headquarters name and address (reporting relationship within your entity).

BLOCK 4: Check only one. Note that March 31 represents the six months from October 1st and that September 30th represents the twelve months from October 1st. Enter the year of the reporting period.

BLOCK 6: Identify the department or agency administering the majority of subcontracting plans.

BLOCK 7: This report encompasses all contracts with the Federal Government for the agency to which it is submitted, including subcontracts received from other large businesses that have contracts with the same agency. Indicate in this block whether the contractor is a prime contractor, subcontractor, or both (check only one).

BLOCK 8: Check only one. Check "Commercial Plan" only if this report is under an approved Commercial Plan. For a Commercial Plan, the contractor must specify the percentage of dollars in Blocks 10a through 16 attributable to the agency to which this report is being submitted.

BLOCKS 10a through 18: These entries must include all subcontract awards resulting from contracts or subcontracts, regardless of dollar amount, received from the agency to which this report is submitted. If reporting as a subcontractor, report all subcontracts awarded under prime contracts. Amounts must include both direct awards and an appropriate prorated portion of indirect awards. (The indirect portion is based on the percentage of work being performed for the organization to which the report is being submitted in relation to other work being performed by the prime contractor/subcontractor). Do not include awards made in support of commercial business unless "Commercial" is checked in Block 8 (see Special Instructions for Commercial Plans in right hand column). Report only those dollars subcontracted this fiscal year for the period indicated in Block 4.

BLOCK 10c: Report on this line the grand total of all subcontracts (the sum of lines 10a and 10b).

BLOCKS 11 through 16: Each of these items is a subcategory of Block 10a. Note that in some cases the same dollars may be reported in more than one block (e.g., SDBs owned by women); likewise subcontracts to HBCUs or MIs should be reported on both Block 11 and 13.

BLOCK 11: Report all subcontracts awarded to SDBs (including WOSB, VOSB, service-disabled VOSBs, and HUBZone SB SDBs). Include subcontracts awarded to ANCs and Indian tribes that have not been certified by SBA as SDBs where you have been designated to receive their SDB credit. Where your company and other companies have been designated by an ANC or Indian tribe to receive SDB credit for a subcontract awarded to the ANC or Indian tribe, report only the portion of the total amount of the subcontract that has been designated to your company. For DOD, NASA, and Coast Guard contracts, include subcontract awards to HBCUs and MIs.

BLOCK 15: Report all subcontracts awarded to VOSBs, including service-disabled VOSBs (and including SDBs, WOSBs, and HUBZone SBs that are also VOSBs).

1. This report is due on October 30th each year for the previous fiscal year ending September 30th.

1. Direct Subcontract Awards are those that are identified with the performance of one or more specific Government contract(s).

2. Indirect Subcontract Awards are those which, because of incurrence for common or joint purposes, are not identified with specific Government contracts; these awards are related to Government contract performance but remain for allocation after direct awards have been determined and identified to specific Government contracts.

For DOD contractors, send reports to the cognizant contract administration office as stated in the contract.

1. NASA: Forward reports to NASA, Office of Procurement (HS), Washington, DC 20546

2. OTHER FEDERAL DEPARTMENTS OR AGENCIES: Forward report to the OSDBU Director unless otherwise provided for in instructions by the Department or Agency.

SMALL BUSINESS ADMINISTRATION (SBA): Send "info copy" to the cognizant Commercial Market Representative (CMR) at the address provided by SBA. Call SBA Headquarters in Washington, DC at (202) 205-6475 for the correct address if unknown.

STANDARD FORM 295 (REV. 9/2015) PAGE 3

11. See special instructions in right-hand column for Commercial Plans.

BLOCK 9: Identify the major product or service lines of the reporting organization.

SPECIFIC INSTRUCTIONS

1. This report is not required from small businesses.

GENERAL INSTRUCTIONS

BLOCK 10a: Report all subcontracts awarded to SBs including subcontracts to SDBs, WOSBs, VOSBs, service-disabled VOSBs, and HUBZone SBs. Include subcontracts awarded to ANCs and Indian tribes that are not small businesses and that are not certified by the SBA as SDBs where you have been designated to receive their SB and SDB credit. Where your company and other companies have been designated by an ANC or Indian tribe to receive SB and SDB credit for a subcontract awarded to the ANC or Indian tribe, report only the portion of the total amount of the subcontract that has been designated to your company. For DOD, NASA, and Coast Guard contracts, include subcontracting awards to HBCUs and MIs.

BLOCK 10b: Report all subcontracts awarded to large businesses and any other-than-small businesses. Do not include subcontracts awarded to ANCs and Indian tribes that have been reported in 10a above.

SPECIAL INSTRUCTIONS FOR COMMERCIAL PLANS

DEFINITIONS

SUBMITTAL ADDRESSES FOR ORIGINAL REPORT

For Civilian Agency Contractors, send reports to the awarding agency:

FOR ALL CONTRACTORS:

BLOCK 12: Report all subcontracts awarded to WOSBs (including SDBs, VOSBs (including service-disabled VOSBs), and HUBZone SBs that are also WOSBs).

BLOCK 17: Report all subcontracts awarded to ANCs and Indian tribes that are reported in Block 11, but have not been certified by SBA as SDBs.

BLOCK 18: Report all subcontracts awarded to ANCs and Indian tribes that are reported in Block 10a but are not small businesses.

BLOCK 13: (For contracts with DOD, NASA and Coast Guard): Enter the dollar value of all subcontracts with HBCUs/MIs.

5. If a prime contractor/subcontractor is performing work for more than one Federal agency, a separate report shall be submitted to each agency covering only that agency's contracts, provided at least one of that agency's contracts is over $550,000 (over $1,000,000 for construction of a public facility) and contains a subcontracting plan.

(Note that DOD is considered to be a single agency; see next instruction).

6. For DOD, a consolidated report should be submitted for all contracts awarded by military departments/agencies and/or subcontracts awarded by DOD prime contractors.

However, DOD contractors involved in construction and related maintenance and repair must submit a separate report for each DOD component.

8. Purchases from a corporation, company, or subdivision that is an affiliate of the prime/subcontractor are not included in this report.

BLOCK 5: Check whether this report is a "Regular," "Final," and/or "Revised," report.

A "Final" report should be checked only if the contractor has completed all the contracts containing subcontracting plans awarded by the agency to which it is reporting. A "Revised" report is a change to a report previously submitted for the same period.

BLOCK 16: Report all subcontracts awarded to service-disabled VOSBs (including SDBs, WOSBs, and HUBZone SBs that are also service-disabled VOSBs).

2. The annual report submitted by reporting organizations that have an approved company-wide annual subcontracting plan for commercial items shall include all subcontracting activity under commercial plans in effect during the year and shall be submitted in addition to the required reports for other-than-commercial items, if any.

10. FAR 19.703 sets forth the eligibility requirements for participation in the subcontracting program.

9. Subcontract award data reported on this form by prime contractors/subcontractors shall be limited to awards made to their immediate subcontractors. Credit cannot be taken for awards made to lower tier subcontractors unless you have been designated to receive SB and SDB credit from an Alaska Native Corporation (ANC) or Indian tribe.

3. Enter in Blocks 10a through 16 the total of all subcontract awards under the contractor's Commercial Plan. Show in Block 8 the percentage of this total that is attributable to the agency to which this report is being submitted. This report must be submitted to each agency from which contracts for commercial items covered by an approved Commercial Plan were received.

BLOCK 14: Report all subcontracts awarded to HUBZone SBs (including WOSBs, VOSBs (including service-disabled VOSBs), and SDBs that are also HUBZone SBs).