DEPARTMENT OF HOMELAND SECURITY
SMALL BUSINESS REVIEW FORM
Items (1-8) Request - Completed by the Contracting Officer in consultation with the Requesting Office
(1) Requisitioner Name/Telephone Number |
(2) Office/Organization |
(3) Requisition Number |
|
|
|
(4) Contract Specialist Name/Telephone Number
(5) Contracting Officer Name/Telephone Number
(6) Description of Product or Service
(7) Estimated dollar value: Base Period: $___________________________ Total Estimated Value Incl.Options $ _________________
(8) Period of Performance: Base Period FROM: ________ TO: _________; Option Periods _______ FROM: _______TO: _______
Items (9-19) - Strategy; to include Proposed Procurement Method - Completed by the Contracting Officer
(9) NAICS Code |
(10) Small Business Size Standard |
(11) Synopsis Requirement |
|
Employees |
|
|
|
|
|
|
YES |
|
|
|
|
|
|
|
|
|
Avg. annual receipts |
|
|
|
|
|
NO, exceptions [FAR 5.202(a)] |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(12) Prior Procurement History: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
New Requirement |
|
|
|
YES |
|
|
NO |
(If no, consult with your SBS to complete Item(12)) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Contract/Delivery or Task Order Number |
|
|
|
|
|
|
|
|
|
Period of Performance |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Contractor Name & Address |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Price: |
|
|
|
|
|
|
|
|
|
|
Contractor Size/Preference Status: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
No. of Offerors: |
|
|
|
LB |
|
|
SB |
|
|
HUBZ. |
|
SDB |
|
8(a) |
|
WOB |
|
SDVO |
|
VET |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Remarks: ____________________________________________________________________________________________________
Items (13-19) - Proposed Procurement Method - Completed by the Contracting Officer
If planning an open market procurement of $100,000 or more, complete Items (13-17). If action is $2,000,000 or more and the use of Pre-existing Contract Vehicle (such as MAS (FSS)-GSA, MAC, GWAC, DHS-wide contract, multiple award contract, BPA) is planned, complete Items (18-19) for Substantial Bundling Review. Consult your Small Business Specialist for completion of this section.
* * * * * * * * |
FOR OPEN MARKET PROCUREMENT OF $100,000 OR MORE * * * * * * * * |
(13) First Consideration: Consider one of the socioeconomic initiatives. |
|
Competitive |
Sole Source |
Other |
|
|
|
8(a) |
|
|
8(a) |
Multiple Award (any socio-economic program + LB) |
|
|
|
|
|
|
|
|
HUBZone Set-Aside |
|
|
HUBZone |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SDVOSB Set-Aside |
|
|
SDVOSB |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total SB Set-Aside |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Partial SB Set-Aside |
|
|
|
|
|
|
|
|
|
|
|
(14)Second Consideration: If first consideration has been ruled out based on market research, then turn to full and open competition. Where an other than small business concern serves as the prime contractor, small business participation will be critical through subcontracting and the DHS Mentor Protégé Program. If no subcontracting opportunities exist, attach the associated documentation.
|
Competitive |
Sole Source |
|
Unrestricted (Full and Open) |
Other (Attach Justification and Approval (J&A)) |
|
Multiple Award (LB) |
|
(15) |
Subcontracting Plan Discussion with SBS |
Mentor-Protégé Program Discussion with SBS |
DHS Form 700-22 (Rev. 10/05) |
Page 1 of 2 |
(16) Reason for Unrestricted Procurement
No reasonable expectation that offers will be obtained from at least two 8(a), HubZone small, Service Disabled Veteran Owned small or traditional small business concerns offering the products of different small business concerns.
No reasonable expectation that award will be made at a fair market price. Sole Source/Proprietary item justified in accordance with FAR Part 6.3. Requirement not severable into two or more production runs or lots.
(17) Substantial Bundling Review (Completed for all open market actions of $2,000,000 or more)
YES |
NO |
Does the procurement meet the definition of a Bundled Contract (FAR Part 7.107 and 13 CFR |
Part 125.2 (d)(1)(i))? If YES continue, if NO proceed to item (20). |
YES |
NO |
Did procuring activity coordinate acquisition strategy with the small business specialist and the Small Business |
Administration (SBA) Procurement Center Representative (PCR) (FAR Part 7.104(d)(1) and FAR Part 19.202-1(e)(1)? |
YES |
NO |
Was requirement to notify the affected incumbent small business concerns of the Government's intention to |
bundle the requirement performed, at least 30 days before release of the solicitation (FAR Part 10.001(C)(2)(i)? |
YES |
NO |
If procuring activity believes bundling is necessary and justified, was proper analysis submitted to CPO |
(HSAM 3007.107(b))? |
* * * * * * * * |
FOR ALL ORDERS OF $2M OR MORE UNDER PRE-EXISTING CONTRACT VEHICLES * * * * * * * * |
(18) Select from the following Pre-existing Contract Vehicles:
Multiple Award Schedule - MAS (FSS) - GSA Multi-Agency Contract - MAC
Govt-Wide Acquisition Contract - GWAC
Other (such as DHS-wide contract, multiple award contract, BPA, etc.) Specify: ______________________________
(Attach proposed list of vendors, including size status)
(19) Substantial Bundling Review (Completed for all actions of $2,000,000 or more planned under a pre-existing contract vehicle)
YES |
NO |
Does the procurement meet the definition of a Bundled Contract (FAR Part 7.107 and 13 CFR Part 125.2 |
(d)(1)(i))? If YES continue, if NO proceed to item (20). |
YES |
NO |
Did procuring activity coordinate acquisition strategy with the small business specialist and the Small Business |
Administration (SBA) Procurement Center Representative (PCR) (FAR Part 7.104(d)(1) and FAR Part 19.202-1(e)(1)? |
YES |
NO |
Was requirement to notify the affected incumbent small business concerns of the Government's intention to |
bundle the requirement performed, at least 30 days before release of the solicitation (FAR Part 10.001(c)(2)(i)? |
YES |
NO |
If procuring activity believes bundling is necessary and justified, was proper analysis submitted to CPO |
(HSAM 3007.107(b))? |
|
* * * * |
* * * * |
* * * * SUBMISSION AND REVIEW SIGNATURES * * * * * * * * * * * * |
Items (20-23) Submission and Reviews (Completed by appropriate officials)
(20) |
Contracting Officer |
|
|
|
Concurrence |
|
|
Non-Concurrence (Attach justification) |
Signature of Contracting Officer: |
_______________________________________________ Date _____________________ |
(21) |
Small Business Specialist |
|
|
Concurrence |
|
|
Non-Concurrence (Attach justification) |
Signature of Small Business Specialist: _________________________________________ Date _____________________ |
(22) |
Contracting Officer response to SBS Non-Conur |
Concurrence |
Non-Concurrence (Attach justification) |
Signature of Contracting Officer: |
_______________________________________________ Date _____________________ |
(23) |
Completed for all unrestricted actions of $2,000,000 or more, including sole source procurements to other than small business. |
SBA Procurement Center Representative |
|
Concurrence |
|
|
|
Non-Concurrence |
Signature of SBA PCR: |
_______________________________________________ Date _____________________ |
DHS Form 700-22 (Rev. 10/05) |
Page 2 of 2 |
INSTRUCTIONS FOR DHS FORM 700-22, SMALL BUSINESS REVIEW
(FOR ACQUISITIONS OVER $100,000)
Execution of the DHS small business program requires coordination and participation from all members of the acquisition team. The appropriate acquisition personnel to complete this form [i.e. Contracting Officer, Requesting Office (consultation), and the Small Business Specialist (consultation)] are identified by item. The form shall be completed prior to synopsis or solicitation release.
1. The following provides instructions for the completion of each item on the DHS Form 700-22:
Request - Items (1-8) are self explanatory.
Strategy - Items (9-12) are self explanatory.
Proposed Procurement Method - Items (13-19):
If planning an open market procurement of $100,000 or more, complete items 13-17:
Item (13) Indicate the socioeconomic program planned for the requirement, after proper market research. Item (14) Indicate the full and open competition contracting method in the open market scenario.
Item (15) Indicate if the Subcontracting Plan and Mentor-Protégé Program have been considered for procurement. Item (16) Indicate reason for unrestricted procurement.
Item (17) Complete substantial bundling review for all open market actions of $2,000,000 or more.
If planning to use a pre-existing contract vehicle for an action of $2,000,000 or more, complete items 18-19 for the bundling review:
Item (18) Indicate the pre-existing contract vehicle planned for the requirement.
Item (19) Complete substantial bundling review when use of a pre-existing contract vehicle of $2,000,000 or more is planned.
Submission and Review Signatures. Items (20-23): Item (20) Signature of Contracting Officer.
Item (21) Signature of Small Business Specialist (SBS) to indicate concurrence or non-concurrence.
Item (22) Signature of Contracting Officer to indicate concurrence or non-concurrence in the event the SBS non-concurs.
Item (23) Signature of Small Business Administration (SBA) Procurement Center Representative (PCR) to indicate concurrence or non-concurrence.
2. Review and Required Signatures:
Types of Reviews |
Contracting |
Small Business |
SBA |
X - indicates review and signature unless noted otherwise. |
Officer |
Specialist |
PCR |
|
|
|
|
All open market procurement of $100,000 to $2,000,000. |
X |
X |
|
All open market procurement of $2,000,000 or more when an unrestricted procurement is contemplated |
|
|
|
(including sole source procurement). |
X |
X |
X |
All actions of $2,000,000 or more planned under a pre-existing contract vehicle (MAS (GSA-FSS), MAC, |
|
|
|
|
|
|
GWAC, DHS wide contract, multiple award, BPA, etc.) for bundling. |
X |
X |
X |
|
|
|
|
|
|
|
|
3. Additional Requirements for Substantial Bundling:
Whenever substantial bundling is contemplated for any requirement over $2,000,000, a separate justification is to accompany the Small Business Review Form. This justification shall be prepared in accordance with HSAM 3007.107 and 3019.202-271 (b)(2).
4.Standard timeframes for completion of form by review officials: The SBS shall complete the review process within 2 business days.
The SBA PCR shall complete the review process within 2 business days.
5.The completed DHS Form 700-22 shall be placed in the solicitation file.
