Attachment J-12 Small Business Participation Commitment Template.pdf

ATTACHMENT J-12

SMALL BUSINESS PARTICIPATION COMMITMENT

TEMPLATE

a) Check the applicable size and socioeconomic categories for the PRIME offeror for this procurement (check all that apply):

[ ] Large Business or

[ ] Small Business, also categorized as a

[ ] Small Disadvantaged Business (SDB) [ ] Woman-Owned Small Business (WOSB) [ ] Historically Underutilized Business Zone (HUBZone) Small Business [ ] Veteran-Owned Small Business (VOSB) [ ] Service Disabled Veteran-Owned Small Business (VOSB)

b) Indicate the percentage of work the PRIME intends to perform with its own workforce:

c) Total percentage of participation by large and small businesses (include the percentage for the Prime):

Business Category % of Total Contract Value Large Business % Small Business %

Total 100 %

d) Identify names (if available) of specific small business firms who will participate as joint venture partners, team members or subcontractors and the work they are to perform:

Small Business Name

Business Category(ies)

(SB, WOSB, SDB,

VOSB, SDVOSB)

DUNS

Number

Product(s)/Service(s) to be Provided

NAICS

Code

% of Total Contract

Value

Nature of Commitment

(attach evidence)

DRAFT

e) Describe proposed outreach efforts to meet or exceed the small business participation objectives listed above.

f) Describe the extent to which small business participation objectives were attained for the recent and relevant contracts submitted as part of Factor 2 Past Performance. Offerors may also submit an explanation of its efforts, where objectives were not met.

DRAFT