Optional Form 312 - Small Disadvantaged Business (Sdb) Participation Report

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OF
PAGES
SMALL DISADVANTAGED BUSINESS (SDB)
OMB No.: 9000-0150
PARTICIPATION REPORT
Expires:
11/30/2012
Public reporting burden for this collection of information is estimated to average 8.66 hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the FAR Secretariat (MVR), Federal Acquisition Policy Division, GSA, Washington, DC 20405.
1A. CONTRACTOR'S NAME
2. CONTRACT NUMBER
1B. CONTRACTOR'S ADDRESS
3. TOTAL PARTICIPATION OF SDBs IN THE CONTRACT ($)
4. SDB PARTICIPATION AT PRIME CONTRACT LEVEL
A. NAICS INDUSTRY
B. DOLLAR AMOUNT
C. PERCENTAGE
SUBSECTOR
5. BREAKDOWN OF SDB PARTICIPATION AT SUBCONTRACT LEVEL BY NAICS INDUSTRY SUBSECTOR
A. NAICS INDUSTRY SUBSECTOR
B. DOLLARS
C. PERCENT
B. DOLLARS
C. PERCENT
A. NAICS INDUSTRY SUBSECTOR
6. PREPARED BY
A. NAME OF INDIVIDUAL
B. DATE PREPARED
C. TELEPHONE NUMBER
D. E-MAIL ADDRESS
AREA CODE
NUMBER
EXTENSION
OPTIONAL FORM 312
AUTHORIZED FOR LOCAL REPRODUCTION
(REV. 10-2000)
PREVIOUS EDITION IS NOT USABLE
Prescribed by GSA/FAR (48 CFR) 53.219(c)

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