Form BPA F 4220.04 BPA F 4220.04 Subcontracting Report for Individual Contracts

BPA F 4220.04e

U.S. DEPARTMENT OF ENERGY
BONNEVILLE POWER ADMINISTRATION (BPA)

[Date]

Page 1 of 2

OMB #
Expiration Date: XX/2024

SUBCONTRACTING REPORT FOR INDIVIDUAL CONTRACTS

PAPERWORK REDUCTION ACT BURDEN DISCLOSURE STATEMENT
This data is used to amend a solicitation or modify a contract or order. This form will assist in ensuring all changes are applied appropriately. Public reporting burden for this collection of
information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching for existing data sources, gathering and maintaining the data needed and
completing and reviewing the collection of information. Send any comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to Office of the Chief Information Officer, Enterprise Policy Development & Implementation Office, IM-22, Paperwork Reduction Program
(OMB XXXXX ), US Department of Energy, 1000 Independence Ave, SW, Washington, DC 20585-1290; and to the Office of Management & Budget (OMB), OIRA, Paperwork Reduction
Project (OMB XXXXX ), Washington, DC 20503.

a. Prime Contractor Name

b. Street Address

c. City

d. State

e. Zip Code

2. Contractor Identification Number (D-U-N-S)
4. Reporting Period from Inception of Contract thru
MAR 31
SEPT 30

3. Date Submitted
YEAR

5. Type of Report
Regular

■ Revised

Final

6. Report Submitted As (Check and provide appropriate number)
Prime Contract Number

7. Name of Contracting Officer:
Bonneville Power Administration - NSS

Prime Contractor
Sub Contract Number

P.O. Box 3621
Portland, OR 97208

8. Dollars and Percentages in the following blocks:
Do Include Indirect Costs

Do Not Include Indirect Costs

SUBCONTRACT AWARDS
TYPE

CURRENT GOAL
Whole Dollars

Percent

ACTUAL CUMULATIVE
Whole Dollars

Percent

9. Small Businesses (SB) (Dollar Amount and Percent) (See Specific
Instructions)
10. Disadvantaged Small Businesses (DSB) Concerns (Dollar Amount
and Percent) (See Specific Instructions)
11. Women-Owned Small Businesses (WOSB) (Dollar Amount and
Percent) (See Specific Instructions)
12. Veteran-Owned Small Businesses (VOSB) (Dollar Amount and
Percent) (See Specific Instructions)
13. Service-Disabled Veteran-Owned Small Businesses (SDVOSB)
(Dollar Amount and Percent) (See Specific Instructions)
14. Large Businesses (Dollar Amount and Percent) (See Specific
Instructions)
15. Indian Tribes (TR) (Dollar Amount and Percent) (See Specific
Instructions)

16. Comments (Attach additional sheets if more room is needed)

16a. Name of Contractor Individual Administering Subcontracting Plan

16b. Work Phone Number
Area Code

16c. Work E-Mail Address

Number

File Code; SU-12a and SU-12b

Retention; See Agency File Plan

BPA F 4220.04e
(03/19)

Page 2 of 2

U.S. DEPARTMENT OF ENERGY
BONNEVILLE POWER ADMINISTRATION (BPA)

OMB #

SUBCONTRACTING REPORT FOR INDIVIDUAL CONTRACTS
GENERAL INFORMATION
1. This report is not required from small businesses.
2. This form collects subcontract award data from prime contractors that:
(a) hold one or more contracts over $650,000 (over $1,500,000 for
construction of a public facility); and (b) are required to report subcontracts
awarded to Small Businesses (SB), Disadvantaged Small Businesses
(SDB), Women-Owned Small Businesses (WOSB), Veteran-Owned Small
Businesses (VOSB) and Service-Disabled Veteran-Owned Small
Businesses under a subcontracting plan.
4. This report is required for each contract containing a subcontracting
plan and must be submitted to the contracting officer (CO) semi-annually,
during contract performance for the periods ended March 31st and
September 30th. A separate report is required for each contract at contract
completion. Reports are due no later than 25 days after the close of each
reporting period unless otherwise directed by the contracting officer.
Reports are required when due, regardless of whether there has been any
subcontracting activity since the inception of the contract or since the
previous report.

BLOCK 6: Indicate that the reporting contractor is submitting this
Information as a prime contractor and the prime contract number.
Block 7: Return completed form to BPA Contracting Officer.
BLOCK 8: Check the appropriate block to indicate whether indirect costs
are included in the dollar amounts in blocks 9 through 14. To ensure
comparability between the goal and actual columns, the contractor may
include indirect costs in the actual column only if the subcontracting plan
included indirect costs in the goal.

8. BPI Part 8.3 sets forth the eligibility requirements for participating in the
subcontracting program.

BLOCKS 9 through 14: Under "Current Goal," enter the dollar and
percent goals in each category (SB, DSB, WOSB, VOSB, SDVOSB,
Indian Tribe) from the subcontracting plan approved for this contract. (The
amounts entered in Blocks 9 through 15 should reflect any revised goals.).
Under "Actual Cumulative," enter actual subcontract achievements (dollars
and percent) from the inception of the contract through the date of the
report shown in Block 4. In cases where indirect costs are included, the
amounts should include both direct awards and an appropriate prorated
portion of indirect awards. However, the dollar amounts reported under
"Actual Cumulative" must be for the same period of time as the dollar
amounts shown under "Current Goal" For a contract with options, the
current goal should represent the aggregate goal since the inception of the
contract. For example, if the contractor is submitting the report during
Option 2 of a multiple year contract, the current goal would be the
cumulative goal for the base period plus the goal for Option 1 and the goal
for Option 2.

9. Actual achievements must be reported on the same basis as the goals
set forth in the contract. For example, if goals in the plan do not include
indirect and overhead items, the achievements shown on this report
should not include them either.

BLOCK 9: Report all subcontracts awarded to Small Businesses (SBs).
This category includes awards to small businesses that do not belong in
another category on this list.

5. Only subcontracts involving performance in the U.S. or its outlying areas
should be included in this report.
6. Purchases from a corporation, company, or subdivision that is an
affiliate of the prime/subcontractor are not included in this report.
7. Subcontract award data reported on this form by prime contractors shall
be limited to awards made to their immediate subcontractors.

SPECIFIC INSTRUCTIONS
BLOCK 2: For the Contractor Identification Number, enter the nine-digit
Data Universal Numbering System (DUNS) number that identifies the
specific contractor establishment. If there is no DUNS number available
that identifies the exact name and address entered in Block 1, contact Dun
and Bradstreet Information Services at 1-866-705-5711 or via the Internet
at http://www.dnb.com. The contractor should be prepared to provide the
following information: (i) Company legal business name. (ii) Tradestyle,
doing business, or other name by which your entity is commonly
recognized. (iii) Company physical street address, city, state and ZIP
Code. (iv) Company mailing address, city, state and ZIP Code (if separate
from physical). (v) Company telephone number. (vi) Date the company
was started. (vii) Number of employees at your location. (viii) Chief
executive officer/key manager. (ix) Line of business (industry). (x)
Company Headquarters name and address (reporting relationship within
your entity).
BLOCK 4: Check only one. Note that all subcontract award data reported
on this form represents activity since the inception of the contract through
the date indicated on this block.
BLOCK 5: Check whether this report is a "Regular," "Final," and/or
"Revised" report. A "Final" report should be checked only if the contractor
has completed the contract or subcontract reported in Block 6. A "Revised"
report is a change to a report previously submitted for the same period.

BLOCK 10: Report all subcontracts awarded to Disadvantaged Small
Businesses (DSB’s). This category includes Native American Small
Businesses, 8-A Certified Small Businesses, and Hub-Zone
Disadvantaged Small Businesses.
BLOCK 11: Report all subcontracts awarded to Women-Owned Small
Businesses (WOSB’s)
BLOCK 12: Report all subcontracts awarded to Veteran-Owned Small
Businesses (VOSBs).
BLOCK 13: Report all subcontracts awarded to Service-Disabled VeteranOwned Small Businesses (SDVOSB’s).
BLOCK 14: Report all subcontracts awarded to large businesses and any
other-than-small businesses.
BLOCK 15: Report all subcontracts awarded to Indian Tribes (TR).
BLOCK 16: Enter a short narrative explanation if (a) SB, DSB, WOSB,
VOSB, SDVOSB, and TR accomplishments fall below that which would be
expected using a straight-line projection of goals through the period of
contract performance, or (b) if this a final report, any one of the six goals
were not met.

DEFINITION
1. Indirect costs are those which, because of incurrence for common or joint purposes, are not identified with specific BPA contracts.
DISTRIBUTION OF THIS REPORT
For the Awarding Agency or Contractor
The original copy of this report should be provided to the contracting officer at the agency identified in Block 7.

File Code; SU-12a and SU-12b

Retention; See Agency File Plan