Att_03_VPSS_WBPS_SB_Participation_Form.xlsx
XLSX spreadsheet 26 KB Posted
- Solicitation number
- W900KK-17-R-0030
About this file
Attachment 03 Small Business Participation Form
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Other files
| File | Type | Posted |
|---|---|---|
| W900KK-17-R-0030-0001_Conformed.pdf | ||
| W900KK-17-R-0030-0001_Amendment_Document.pdf | ||
| Att_02_Question_and_Comment_Form.xlsx | XLSX spreadsheet | |
| W900KK-17-R-0030.pdf | ||
| Att_01_VPSS_WBPS_SOW_v1.7.pdf |
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Text version
Instructions
| VPSS WBPS Contract W900KK-17-D-TBD |
| Small Business Participation Form |
INSTRUCTIONS
The intent of this form is to collect subcontract award on a semi-annual basis. The report should reflect the cumulative total from all DOs awarded within the respective Ordering Period. The report should also include active orders issued in a previous ordering period.
This report is required on a semi-annual basis 30 days within the close dates of 31 March and 30 September. A separate cumulative report, to include all orders issued since inception of the contract, is required prior to the exercise of each subsequent Option Ordering Period.
| The report shall be submitted electronically (Email) to: |
| patricia.c.soucy.civ@mail.mil |
| Tara.M.Wagner3.civ@mail.mil |
| Randall.A.Edney.civ@mail.mil |
Block 1. Enter Prime Contractor Name
Block 2. Enter the Contract Number
Block 3. Enter the total funded amount of all awarded DO/TO(s)
Block 4. Indicate your socio-economic status by checking the applicable blocks
Block 5. Indicate cumulative dollar amounts funded and percentage subcontracted for each category. Follow these steps to complete this block:
Block 5a. Report the total value of all subcontracts awarded to Small Business Concerns
Block 5a (1). Report all subcontracts awarded to regular Small Businesses that do not contain any socio-economic classification
Block 5a (2). Report all subcontracts awarded to Small Disadvantaged Business (SDB) (may also include as applicable: WOSBs, VOSBs, SDVOSBs, HUBZone SBs and HBCU/MSIs)
Block 5a (3). Report all subcontracts awarded to Women-Owned Small Business (WOSB) (may also include as applicable: SDBs, VOSBs, SDVOSBs and HUBZone SBs)
Block 5a (4). Report all subcontracts awarded to Veteran-Owned Small Business (VOSB) (may also include as applicable: SDBs, WOSBs, SDVOSBs and HUBZone SBs)
Block 5a (5). Report all subcontracts awarded to Service-Disabled Veteran-Owned Small Business (SDVOSB) (may also include as applicable: SDBs, WOSBs, and HUBZone SBs)
Block 5a (6). Report all subcontracts awarded to HUBZones Small Businesses (HUBZone SB) (may also include as applicable: SDBs, WOSBs, VOSBs, SDVOSBs and HUBZone SBs)
Block 5b. Report all subcontracts with Historically Black Colleges/Universities and Minority Serving Institutions (HBCU/MSIs).
Block 5c. Report all subcontracts awarded to Large Businesses (LB).
Block 5d. Report the total subcontract effort by adding Blocks a, b and c.
Block 5e. Identify DO/TO(s) represented in above data.
VPSS WBPS
VPSS WBPS Contract W900KK-17-D-TBD Small Business Participation Reporting Form
Cumulative Report from Base award through: (enter date)
| 1. | CONTRACTOR NAME:TBD | |
| 2. | CONTRACT: W900KK-17-D-TBD | |
| 3. | TOTAL FUNDED AMT OF ALL AWARDED DO/TO(S): | $$ |
| 4. | SOCIO-ECONOMIC STATUS: (check all that apply) | |
| Small Business | ||
| SDB | ||
| WOSB | ||
| VOSB | ||
| SDVOSB | ||
| HUBZone | ||
| HBCU/MSI | ||
| Large Business |
5. SUBCONTRACT AWARDS
| SOCIO-ECONOMIC CATEGORY | DOLLAR VALUE | % OF TOTAL DO/TO(S) FUNDED AMOUNT | % OF TOTAL SUBCONTRACTED AMOUNT |
| a. SMALL BUSINESS CONCERNS (TOTAL) | ERROR:#VALUE! | ERROR:#DIV/0! | |
| (1) SMALL BUSINESS (REGULAR) | ERROR:#DIV/0! | ||
| (2) SMALL DISADVANTAGED BUSINESS (SDB) | ERROR:#DIV/0! | ||
| (3) WOMEN-OWNED SMALL BUSINESS (WOSB) | ERROR:#DIV/0! | ||
| (4) VETERAN-OWNED SMALL BUSINESS (VOSB) | ERROR:#DIV/0! | ||
| (5) SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS (SDVOSB) | ERROR:#DIV/0! | ||
| (6) HUBZONE SMALL BUSINESS (HUBZone SB) | ERROR:#DIV/0! | ||
| b. HISTORICALLY BLACK COLLEGES AND UNIVERSITIES AND MINORITY SERVING INSTITUTIONS (HBCU/MSIs) | ERROR:#DIV/0! | ||
| c. LARGE BUSINESS CONCERNS | ERROR:#DIV/0! | ||
| d. TOTAL SUBCONTRACT EFFORT (add a, b and c) | $0 | ||
| e. COMMENTS: |
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