Attachment_3_-_Small_Business_Participation_Commitment_Document_Template.docx

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Programmable Logic Controllers (PLCs) and Controls Upgrade
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SP3300-19-Q-5029
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Attachment 3 SBPCD Template

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SP3300-19-Q-5029 Attachment 3

Small Business Participation Commitment Document (SBPCD) Template

1. Small Business Participants:

Fill-in the information 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

2. Participation of Small Businesses*

* CDRL A018, Small Business Participation Quarterly Reporting applies Total Contract Value (Awarded) $__________________________________ 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. 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)

3/11/2019

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