GSA Form 2689 Small Business Analysis Record

GSA Form 2689 or the "Small Business Analysis Record" is a form issued by the U.S. General Services Administration.

The form was last revised in August 1, 2018 and is available for digital filing. Download an up-to-date GSA Form 2689 in PDF-format down below or look it up on the U.S. General Services Administration Forms website.

ADVERTISEMENT
Solicitation Number
RFI/Sources Sought Number (if applicable)
SMALL BUSINESS ANALYSIS RECORD
Contracting Officer's preferred procurement method
Items 1-9, New Acquisition Details - To be completed by the Contracting Officer
1a.
Contracting Officer (Last, First, Middle Initial)
1b. Office Symbol
1c. E-Mail/Telephone Number
3. Project/Requisitioner Name (if applicable)
4. Project(s)/Requisition(s) Number
2. Office/Organization
5. Description of Product(s) or Service(s), including place of performance
6a.
7. GSA Funded?
Federal Supply Class/Product Service Code
6b. NAICS Code
No
Partial
Yes
8a. Estimated Dollar Value Base Period
8b. Total Estimated Dollar Value Including Options
8c. Estimated Dollar Value Set-Aside
8d. Estimated Dollar Value Not Set-Aside
9. Period of Performance/Delivery Date Base Period for the contract
To
From
Option Periods
From
To
Item 10 to be completed by the Contracting Officer. Item 11 to be completed by the Supervisory Official. Item 12 to be completed by the SBTA.
Item 13 to be completed by the SBA PCR. Item 14 to be completed by the AA OSBU, as applicable.
10a. Name of Contracting Officer
11a. Name of Supervisory Official
10b. Signature of Contracting Officer and Date
11b. Concurrence by Supervisory Official and Date
12a. Small Business Technical Advisor (SBTA) (Check One) 12b. SBTA Reviewer Name
Concur
12c. SBTA Signature
Non-concur
Additional Sources
12d. Date
12e. SBTA's rationale/additional sources provided for the Contracting Officer's consideration
13b. SBA PCR Reviewer Name
13a. Small Business Administration (SBA) Procurement
Center Representative (PCR) (Check One)
13c. SBA PCR Signature
Concur
Non-concur
Additional Sources
13d. Date
13e. SBA PCR's rationale/additional sources provided for the Contracting Officer's consideration
14a. Associate Administrator of the Office of Small
14b. AA OSBU Reviewer Name
Business Utilization (AA OSBU) (Check One)
14c. AA OSBU Signature
Concur
Non-concur
14d. Date
14e. AA OSBU's rationale provided for the Contracting Officer
GSA 2689 (REV. 8/2018)
GENERAL SERVICES ADMINISTRATION
Solicitation Number
RFI/Sources Sought Number (if applicable)
SMALL BUSINESS ANALYSIS RECORD
Contracting Officer's preferred procurement method
Items 1-9, New Acquisition Details - To be completed by the Contracting Officer
1a.
Contracting Officer (Last, First, Middle Initial)
1b. Office Symbol
1c. E-Mail/Telephone Number
3. Project/Requisitioner Name (if applicable)
4. Project(s)/Requisition(s) Number
2. Office/Organization
5. Description of Product(s) or Service(s), including place of performance
6a.
7. GSA Funded?
Federal Supply Class/Product Service Code
6b. NAICS Code
No
Partial
Yes
8a. Estimated Dollar Value Base Period
8b. Total Estimated Dollar Value Including Options
8c. Estimated Dollar Value Set-Aside
8d. Estimated Dollar Value Not Set-Aside
9. Period of Performance/Delivery Date Base Period for the contract
To
From
Option Periods
From
To
Item 10 to be completed by the Contracting Officer. Item 11 to be completed by the Supervisory Official. Item 12 to be completed by the SBTA.
Item 13 to be completed by the SBA PCR. Item 14 to be completed by the AA OSBU, as applicable.
10a. Name of Contracting Officer
11a. Name of Supervisory Official
10b. Signature of Contracting Officer and Date
11b. Concurrence by Supervisory Official and Date
12a. Small Business Technical Advisor (SBTA) (Check One) 12b. SBTA Reviewer Name
Concur
12c. SBTA Signature
Non-concur
Additional Sources
12d. Date
12e. SBTA's rationale/additional sources provided for the Contracting Officer's consideration
13b. SBA PCR Reviewer Name
13a. Small Business Administration (SBA) Procurement
Center Representative (PCR) (Check One)
13c. SBA PCR Signature
Concur
Non-concur
Additional Sources
13d. Date
13e. SBA PCR's rationale/additional sources provided for the Contracting Officer's consideration
14a. Associate Administrator of the Office of Small
14b. AA OSBU Reviewer Name
Business Utilization (AA OSBU) (Check One)
14c. AA OSBU Signature
Concur
Non-concur
14d. Date
14e. AA OSBU's rationale provided for the Contracting Officer
GSA 2689 (REV. 8/2018)
GENERAL SERVICES ADMINISTRATION
Items 15 - 17, Acquisition History - To be completed by the Contracting Officer
15. First Time Buy
YES
NO
*** If YES, skip to 18.
16. Were there multiple previous acquisitions?
YES - Attach separate supporting documentation for 17a-i.
(Include up to the 3 most recent award histories.)
NO - Complete 17a-i on the form.
17a. NAICS Code
17b. Small Business Size Standard
(visit
www.sba.gov
for size standard)
Number of Employees
Average Annual Receipts
17d. Award Date
17e. Total Award Amount
17c. Previous Contract/Delivery or Task Order Number
17f. Contractor Name & Address
17g. Contractor Size/Preference Status at Award
17h. Total Number of Offerors (if known)
and Business Size Status (check below)
Other Than Small
SB
HUBZone
SDB
8(a)
WOSB
SDVOSB
EDWOSB
17i. Comments
GSA 2689 (REV. 8/2018) PAGE 2
Items 18-27, Proposed Acquisition Method, Justifications and Considerations - To be completed by the Contracting Officer
18a. Is this procurement a sole source or limited source acquisition? (FAR 6.3, 8.4, 16.5)
YES
NO
Note: If "Yes", attach the approved sole-source or limited source justification, complete item 18b, and submit the form without proceeding further. If "No", proceed to item 19.
Other than
18b. Sole source or limited source business information:
SB
8(a)
SDVOSB
WOSB
EDWOSB
HUBZone
SB
(check all that apply)
YES
NO
19. Will this procurement be solicited off of a pre-existing contract vehicle?
If "Yes," identify the contract name or number:
Note: GSA employees are required to use existing acquisition vehicles (unless an exception is applicable) before establishing new contracts for similar
products or services
(Acquisition Alert 2014-07
and GSA memo dated October 11, 2012).
YES
NO
20. Acquisition Authority: FAR Part
21. Is a synopsis required?
(FAR 8.4, 13, 14, 15, or 16.5)
(Exceptions see FAR Subpart 5.202)
22. Multiple Item Acquisition (product/supplies only)
YES
NO
Note: If "Yes," complete items 23a-c for each acquisition item as a separate attachment. If "No," complete item 23 on this form.
23. Prioritized Small Business Consideration:
(reference FAR 19.203)
YES
NO
a. First, will this procurement be considered for a socioeconomic program set-aside?
If "Yes," identify the type of set-aside:
WOSB
EDWOSB
8(a)
HUBZone
SDVOSB
If your procurement is consolidation and you set aside for a socioeconomic program, the GSA 2689 is required and skip to item 27. If your procurement is
not consolidation and you set aside for a socioeconomic program, this form is not required but may be used as a memo to the file to document market
research.
YES
NO
b. Second, if "No" to 23a, then will this procurement be considered for a small business set aside?
Partial SB set-aside
Total SB set-aside
If "Yes," identify the type of set-aside:
Incorrect
Correct
c. Third, if "No' to 23b, then the procurement will not be set aside.
24. After consideration of the following source selection factors, will any be used in the source selection evaluation plan?
If "No," explain why in the supporting documentation.
a. Socioeconomic Status (See 15 USC 644(g))
YES
NO
YES
NO
b. Subcontracting Plan (See GSAM 519.7 for reference)
c. Mentor Protégé
YES
NO
d. Small Business Teaming Arrangements or Joint Ventures (See FAR 7.107-6)
YES
NO
Market Research Conducted to Support Selected Method
25.
Attach additional documentation supporting determination in accordance with GSAM 519.502-70, FAR 7.105, and FAR 10.001.
26. Justifications for non-set-aside determination (check all that apply)
No reasonable expectation that offers will be received from at least two responsible 8(a), HUBZone, SDVOSB, WOSB, or EDWOSB
that are competitive in terms of fair market prices, quality, and delivery.
No reasonable expectation that offers will be received from at least two or responsible small business concerns that are competitive
in terms of fair market prices, quality, and delivery.
No reasonable expectation that offers will be received from at least two 8(a), HUBZone, SDVOSB, WOSB, or EDWOSB offering on
the product of different small business manufacturers (See FAR 19.102(f) and 19.502).
No reasonable expectation that offers will be received from at least two small business concerns offering on the product of different
small business manufacturers (See FAR 19.102(f) and 19.502).
Item on a Qualified Products List (QPL)/Qualified Products Database (QPD) and large businesses are interested in offering (See
FAR 19.502-6).
Other (Attach supporting documentation)
27. Contract Consolidation, Bundling, or Substantial Bundling Review
Does the procurement meet the definition of a consolidated, bundled, or substantially bundled contract? (See FAR
YES
NO
2.101 and 7.107-4) ***If "Yes," attach the approved determination. (See GSAM 507.107-1) If "No," then the form is
complete.
For consolidated, bundled, or substantially bundled contracts, is this form being submitted at least 30 days in advance
YES
NO
of your planned solicitation date? (See FAR 19.202-1(e)(1)(iii) and GSAM 519.202-1)
For bundled or substantially bundled contracts, was the affected small business incumbent notified of the
YES
NO
N/A
Government's intention to bundle the requirement performed at least 30 days in advance of the solicitation?
(See FAR 7.107-5(a))
GSA 2689 (REV. 8/2018) PAGE 3
INSTRUCTIONS FOR GSA 2689, SMALL BUSINESS ANALYSIS RECORD
The General Services Administration Acquisition Manual (GSAM) subsection 519.502-70, Review of non-set-aside determinations,
prescribes the requirement for when to complete the GSA 2689. Specifically use the table in subsection (g) to help determine whether the
form is applicable to the procurement. Execution of the GSA small business program requires coordination and participation from all
members of the acquisition team. Therefore, the appropriate acquisition personnel shall complete this form [e.g. Contracting Officer, and
the Small Business Technical Advisor (SBTA) and the Small Business Administration Procurement Center Representative (SBA PCR)].
This form is utilized to record evidence that consideration has been given to small business (SB), service-disabled veteran-owned small
business (SDVOSB), Historically Underutilized Business Zone (HUBZone) small business, women-owned small business (WOSB), and
8(a) Business Development Program Participants. The form also documents that small businesses received maximum practicable
opportunity to participate in a proposed acquisition; including instances of contract consolidation, bundling, and substantial bundling. The
form may be used in place of a "Memo to File" when documenting market research if appropriate.
Form Instructions
1. The following instruction prescribes how to complete each item on the GSA 2689 and what additional documentation must be submitted
with the form:
Items 1-9: Fill in as required.
Items 10-14: Signatures required before the next level of review.
Items 15-17: Fill in as required.
Item 18: Fill in as required. If sole source or limited source is selected, attach the approved justification required pursuant to
FAR 6.302, 8.405-6, or 16.505.
Item 19: Identify if the procurement will be solicited of a pre-existing vehicle. Pre-existing contract vehicles include Multiple
Award Schedule (MAS) or MAS Blanket Purchase Agreement (BPA), Multi-Agency Contract (MAC), Government-Wide
Acquisition Contract (GWAC), and Multiple Award Indefinite Delivery Indefinite Quantity (IDIQ) Contracts.
Item 20: Enter in the acquisition authority being used for the procurement (i.e. FAR Part 8.4, 13, 14, 15, or 16.5)
Item 21: Identify if a synopsis is required. See FAR 5.2 for exceptions to the synopsis requirement.
Item 22: Multiple item acquisitions, which are not bundling, combine related items under one solicitation and make awards either on
an item-by-item basis, or an all-or-none basis, to one or more sources. For multiple item acquisitions, set-aside determinations must
be determined on an individual basis if item-by-item award basis and as a whole if under an all-or-none basis. "Items" may be called
a National Stock Number (NSN), Contract Line Item Number (CLIN), Special Item Number (SIN), Functional Area (FA), or Pool.
Item 23: After proper market research, indicate if the procurement will be considered for a socioeconomic program set-aside (e.g.
8(a), HUBZone, SDVOSB, WOSB, EDWOSB). If the procurement will not be set aside for a socioeconomic program, indicate if the
procurement will be considered for a small business set-aside. A small business set-aside can be a partial set-aside or a full set-
aside. If the procurement will not be set aside for small business, then verify by selecting "correct" or "incorrect." Note: if the
procurement is a consolidation, the GSA 2689 is required even if the procurement will be set aside for a socioeconomic program.
Item 24: Identify whether consideration was given to the source selection factors listed. Address in your supporting documentation
and Acquisition Plan the source selection evaluation factors that will be used and indicate on the form whether consideration was
given to Subcontracting Plan and/or Mentor Protégé involvement as an evaluation factor. Also indicate whether socioeconomic
status will be considered in order to help achieve/exceed GSA's socioeconomic goals established in accordance with the Small
Business Act (15 USC 644(g)).
Item 25: Attach market research conducted to support determination in accordance with GSAM 519.502-70, FAR 7.105, and FAR
10.001 (e.g. Sources sought notice and responses, Dynamic Small Business Search results.
Item 26: Select reason(s) for not setting aside for a socioeconomic program (e.g. 8(a), HUBZone, SDVOSB, WOSB, EDWOSB)
or small business (FAR 19.203(c)).
Item 27: Complete Contract Consolidation, Bundling, and Substantial Bundling Review and attach the approved written
determination required pursuant to FAR 7.107 and GSAM 507.107. For construction IDIQs being established in accordance with
GSAM 507.107-1(a)(2)(ii), the CO shall submit supporting documentation to support the determination.
2. The level of concurrence and standard timeframes for completion are listed at GSAM 519.502-70(h)).
3. The completed and approved GSA 2689 shall be placed in the contract file as required.
GSA 2689 (REV. 8/2018) PAGE 4

Download GSA Form 2689 Small Business Analysis Record

657 times
Rate
4.4(4.4 / 5) 46 votes
ADVERTISEMENT
Page of 4