EXHIBIT_D_-_Small_Business_Participation_Plan.docx
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- FY16 Poe Lock Electrical Modernization
- Solicitation number
- W911XK-16-R-0005
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Solicitation Exhibit D - Editable Document
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SOLICITATION W911XK-16-R-0005
FY16 POE LOCK ELECTRICAL MODERNIZATION
EXHIBIT D
SMALL BUSINESS PARTICIPATION PLAN
Small Business Participation Plan (Form)
In accordance with FAR Clause 52.219-9, and associated solicitation provisions, ALL offerors (both large and small businesses) are required to submit the following information to identify the extent of participation of small business concerns in performance of this contract opportunity. This is a distinct and separate requirement from the Clause 52.219-9 requirement for a Large Business offeror to submit a Small Business Subcontracting Plan with the proposal.
(1) Check the applicable size and categories for the PRIME offeror -- Check all applicable boxes:
{ } Large (not currently a certified small business enterprise) Business or { } Small Business Prime; also categorized as a
{ } 8(a) Registered Small Disadvantaged Businesses (8a) { } Small Disadvantaged Businesses (SDB) { } Woman-Owned Small Business (WOSB) { } HUBZone Small Business { } Veteran Owned Small Business (VOSB) { } Service Disabled Veteran Owned Small Business (SDVOSB) { } Historically Black Colleges and Universities/ Minority Institutions (HBCU/MIs)
(2) Submit the total combined percentage (must equal 100%) of work to be performed by both large and small businesses (include the percentage of work to be performed both by Prime and Subcontractors):
Example: If the Prime proposes a price of $1,000,000 (including all options), and small business(es) will provide $250,000 in services/supplies as a prime or subcontractor, the percentage planned for small businesses is 25% and 75% for large businesses, equaling 100%.
Percentage of Total Contract Dollars/Price
| Total Percentage planned for Large Business (es) | ______% | |
| Total Percentage planned for Small Business (es) | ______% | |
| Total: | 100% |
(3) Please indicate the total percentage of participation to be performed by each type of small business. The percentage of work performed by Small Businesses that qualify in multiple small business categories may be counted in each category:
Example: Firm A (WOSB and SDVOSB) performing 2%; and Firm B (HUBZone and WOSB performing 3%. Results equate to: HUBZone 3%; WOSB 5%; SDVOSB 2%; VOSB 2 %;). SDVOSBs are also Veteran Owned Small Business (VOSB) s automatically; however VOSBs are not automatically SDVOSBs.
| 8(a) Registered Small Disadvantaged Businesses | _________% | ||||
| Small, Disadvantaged Businesses | _________% | ||||
| HUBZone Small Business | _________% | ||||
| Woman Owned Small Business | _________% | ||||
| Service Disabled Veteran Owned SB | _________% | ||||
| Veteran Owned Small Business | _________% | ||||
| HBCU/MIs | _________% | ||||
| Other (describe) | |||||
| ____________________ | _________% | ||||
| ____________________ | _________% | ||||
| ____________________ | _________% |
(4) List principle supplies/services to be performed by Small Businesses:
Example: If a Small Business qualifies also as a WOSB and a SDVOSB, you can add them to each category below in which they qualify.
Name of Company Identify Type of Service/Supply
Small:
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
8(a):
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
Women-Owned Small:
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
HUBZone Small:
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
Veteran Owned Small:
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
Service Disabled Veteran Owned Small:
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
HBCU/MI:
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
Other (Describe):
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ | ||
| ____________________________ | __________________________ |
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