EXHIBIT_X_COMPLETE_14-R-0022.docx

Repair Aircraft Maintenance Hangar Building 15 RFP W912SV-14-R-0022 F-15 Shop Addition

EXHIBIT X

SMALL BUSINESS PARTICIPATION PLAN EVALUATION FORM

All Offerors (both large and small businesses) are required to complete a Small Business Participation Plan. Offerors shall propose the level of participation of small businesses (as a small business prime and/or small business subcontractors) in the performance of the acquisition relative to the objectives/goals set forth in the evaluation of this area.

(a) Check the applicable size and categories for the PRIME offeror only -- Check all applicable boxes:

{ } Large Prime or

{ } Small Business Prime; also categorized as a { } 8(a) Or Small Disadvantaged Business { } Woman-Owned Small Business { } HUB Zone Small Business { } Service Disabled Veteran Owned Small Business

(b) Submit the total combined percentage 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 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 % planned for small businesses is 25%; and 75% for large business equaling 100%.

Total Percentage planned for Large Business(es) _______% = $ _______

When combined, Large and Small Business totals must equal 100%.

)Total Percentage planned for Small Business(es) _______% = $ _______

100%

(c) Please indicate the total percentage of participation to be performed by each type of subcategory small business. The percentage of work performed by Small Businesses that qualify in multiple small business categories may be counted in each category:

Example: Victory Prop Mgt (WOSB and SDVOSB) performing 2%; and Williams Group (8(a), HUBZone and WOSB) performing 3%. Results equate to: 8(a) 3%; HUBZone 3%; WOSB 5%; SDVOSB 2%; ;).

(d) List principle supplies/services to be performed by Small Businesses:

Example: If a Small Business qualifies also as a WOSB and a SDVOSB, and you can add them to each category below in which they qualify.

Name of Company Identify Type of Service/Supply If Known

Small:

8(a):

Woman-Owned Small:

HUB Zone Small:

Service Disabled Veteran Owned Small:

Veteran Owned Small:

(e) Describe the extent of commitment to use small businesses (for example, what types of commitments if any are in place for this specific acquisition either – small business prime, written contract, verbal, enforceable, non-enforceable, joint venturing, mentor-protégé, etc.)