Attachment_5_-_Small_Business_Participation_Commitment_Document.pdf

Attachment 5

Small Business Participation Commitment Document (SBPCD) Template

1. Prime Contractor Size:

Indicate the applicable size and socioeconomic categories – all that apply:

{ } Other than Small Business or { } Small Business also categorized as a { } Small Disadvantaged Business (SDB) { } Woman-Owned Small Business (WOSB) { } Historically Underutilized Business Zone (HUBZone) Small Business { } Service Disabled Veteran Owned Small Business (SDVOSB)

2. Quantitative Participation – Participation of Small Businesses* *CDRL A012, Small Business Participation Quarterly Reporting applies Total Contract Value (Awarded) $_______________________________ Quantitative Participation Business Category Dollar Value % of Total Contract Value Total Contract Value – Prime Contractor $_______________ ___________% Total Small Business $________________ ___________% Small Disadvantaged Business $________________ ___________% Woman-Owned Small Business $________________ ___________% HUBZone Small Business $________________ ___________% Veteran-Owned Small Business $________________ ___________% Service-Disabled Veteran-Owned Small Business $______________ _____________%

3. Small Business Participants *List all participants in the format below

Company Name

CAGE

Code (to the extent they are known)

Small Business Category(ies)

(SB, WOSB,

SDB,

HUBZone, VOSB, SDVOSB)

Product(s)/Service(s) to be provided, including type & variety of work

*NAICS

Code

Nature of Commitment

*NOTE: The NAICS code/size standard for this requirement is stated elsewhere in the solicitation and should be considered in making any business size determinations for any company that will contribute to contract performance.

SP3300-19-Q-5014

Attachment 5

Small Business Participation Commitment Document (SBPCD) Template

Business Category Dollar Value % of Total Contract Value Total Proposed Contract Value – Prime Offeror $ % Total Small Business $ % Small Disadvantaged Business $ % Woman-Owned Small Business $ % HUBZone Small Business $ % Veteran-Owned Small Business $ % Service-Disabled Veteran-Owned Small Business $ %

SP3300-19-Q-5014