Attachment_5_Small_Businesses_and_Small_Disadvantaged_Businesses_Participation_6_Jan_2016.pdf

W58RGZ-15-R-0166

Attachment 0005

Proposed Utilization of Small Businesses and Small Disadvantaged Businesses

(a) Type of Business of Prime Contractor: Check all applicable boxes.

Large Small (also check type of Small Business below)

Small Non-Disadvantaged Business Small Disadvantaged Business Woman-Owned Small Business HUB Zone Small Business Veteran Owned Small Business Service Disabled Veteran Owned Small Business

(b) Total Contract Value: (Include options, etc) $___________

(c) Dollar Value of your participation as a Prime Contractor: $__________

(d) Dollar Values, Percentage of Total Contract Value, and Percentage of Subcontracted dollar value planned for:

Category Dollar Value % of Total Expected

Prime Contract Effort

% of Sub- Contracted

Dollars Value Large $________ _______% _______% Total Small (SB) $________ _______% _______% Small Non-Disadvantaged $________ _______% _______% Small Disadvantaged (SDB) $________ _______% _______% Woman-Owned Small (WOSB) $________ _______% _______% HUB Zone Small (HUBZone) $________ _______% _______% Veteran Owned Small (VOSB) $________ _______% _______% Service Disabled Veteran Owned Small (SDVOSB) $________ _______% _______%

Each participation percentage above should be accompanied by detailed supporting documentation regarding the individual commitments. Detailed explanations should also be provided when the percentages fall short of the DOD goals.

DOD Subcontracting Goals

Small Business HUBZone Small Business Service-Disabled Veteran-Owned Small Business Small Disadvantaged Business Women-Owned Small Business HBCU and Minority Institutions

NOTE: The sum of the dollar values and percentages of Small Non-Disadvantaged and Small Disadvantaged should equal the entries for Total Small.