Last Day of This Report Period (3/31 or 9/30): (mm/dd/yyyy)

(All reports cover a 6-month period ending on either 31 Mar or 30 Sep)

(Reimbursable Only)

Reimbursable Credit

Air Force

Army

Navy

DCMA

DIA 

DLA

MDA

NGA

NSA

Other (specify)

DUNS:

Street Address2:

City:

Phone:

Defense Agency Sponsor

Fax:

ZIP:

City:

Street Address2:

Defense Procurement Contracting Officer (PCO) (if Reimbursable)

Email:

DoDAAC:

ZIP:

CAGE:

DUNS:

Fax:

Email:

DCMA Mentor-Protégé Division Chief POC (if Credit)

Street Address1:

Street Address2:

State:

Fax:

State:

Phone:

ZIP:

Street Address1:

DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

INSTRUCTIONS

1. Reporting requirements: Reports are due for all active agreements, both reimbursable and credit (including agreements with

 zero activity during the report period).

2. Reports are due not later than 30 days following the end of each semiannual reporting period (30 Apr or 31 Oct).

Name:

Street Address1:

Section A - General Information

Start Date:

End Date:

SB Category(ies): (e.g. SDB, SDVOSB, WOSB, etc.) 

Name:

0

Period of Performance (Official Dates IAW Contract/Modifications or 

DCMA Credit Mentor-Protégé Agreement (MPA) Approval Letter)

3. Official start date is the date of the contract/modification signed. For credit agreements, the Official start date is the date of the 

signed DCMA Approval Letter. Developmental assistance costs may only be incurred after receipt of an approval letter from DCMA.

Months of Performance Through End 

of Current Report Period

Type of Agreement:

4. An attachment may be included to provide additional information or explanation of any data items on this form or to provide

 pertinent information about the agreement that is not addressed on this form.

Title:

Name:

City:

Name:

CAGE:

 Agreement Number/Task Order/Delivery Order:

Mentor Firm

Protégé Firm

State:

Protégé Firm POC

Email:

Name:

Title:

Phone:

Mentor Firm POC

Page 1 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

$0

$0

$0 Cumulative Total of All UNPAID Invoices for This Agreement 

Thru End of This Report Period:

Cumulative Dollars Obligated on Entire MP Contract From Start 

of Agreement Thru End of This Report Period:

Cumulative Dollars Obligated on Entire MP Contract (Thru End of 

This Report Period) Remaining to be Invoiced:

Cumulative Total of All PAID Invoices for This Agreement Thru 

End of This Report Period:

Obligated Dollars

$0

All Invoices Submitted to DFAS (during this report period)1

Total of Invoices Submitted Prior to This Report Period:

Cumulative Total of All Invoices for This Agreement Thru End of 

This Report Period:

Invoice Number & Billing Period Date Amount 2

Total of Invoices Submitted During This Report Period:

DoDAAC:

State: ZIP:

Phone:

Section B - Obligations and Invoices

Street Address1:

Alternate POC

Email:

City:

Name:

Fax:

(This section applies ONLY to reimbursable agreements)

Street Address2:

% of Cumulative Dollars Obligated on MP Contract That Have Not 

Been Invoiced (Thru End of This Report Period) #DIV/0!

(Note: All figures or amounts submitted must reconcile with previous SAR submittals)

1

 Submit copies of all invoices, with supporting data, to the DCMA Program Manager 

2

 Invoice date is the date on the physical invoice. To ensure accurate accountability, when recording this 

date, make sure to properly track and submit all invoices for the entire agreement, even when they received 

and recorded outside the period of the SAR. 

Page 2 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

Please use one line for each item invoiced, do not lump together items that are billed in multiple increments (e.g. CMMI certification)

$0.00

$0.00

Amount

Type of Institution (mark one)

Name of Institution

PTAC Detailed Description of Service or Training

Amount

$0

Section D - Labor, ODC, & Other Incidental Costs to Mentor

Date Cumulative 

Amount HBCU MI

Section C - Expenditures to HBCU/MSIs, APEX ACCELERATORs, SBDCs, WBCs, MIIs, or MEPs (During Period of This Report)

(This section applies to BOTH reimbursable and credit agreements)

ODC Cumulative 

Amount

SBDC

(This section applies to BOTH reimbursable and credit agreements)

Date Labor

Total $0.00 $0.00 $0.00

Cost Type (mark one)

Incidental Costs Detailed Description

$0.00

Total

Page 3 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

TOTAL CREDIT TO BE CLAIMED

$0.00

1

 As submitted on Gantt Chart in Agreement (or as Subsequently Amended) or revised Gantt Chart per approved Change Request(s)

HBCU, MI, PTAC or SBDC Credits Labor Credit

$0.00

ODC Credit

$0.00 $0.00

0

0

0

0

0

0

0

2

 Please accomplish and insert all calculations in this section manually if automatic features are not working

0

0

0

0

Actual End 

Date

0

0

0

0

0

0

(This section applies to BOTH reimbursable and credit agreements)

Section F - Developmental Assistance Provided / Milestones Achieved

Developmental Tasks 1

0

0

0

0

Approved, 

Planned or 

Actual Start Date

Approved, 

Planned End 

Date

(This section applies ONLY to credit agreements)

Variance2

Estimate of 

Actual % 

Complete as of 

End of Report 

Period2

At a minimum, changes of start dates, end dates, and negative variances must be briefly explained in the next section

Mentors: Section E TOTAL CREDIT TO BE CLAIMED amounts (below) should be added to the eSRS Summary Subcontract Report (SSR) 

"REMARKS" Section providing the HBCU/MI/PTAC/SBDC, Labor, ODC and other Incidental Credits.

0

0

0

0

0

0

0

0

$0.00

Other Incidental Cost Credit

Section E - SB, SDB, SDVOSB, VOSB, WOSB or HUBZone Subcontracting Credit To Be Taken By Mentor

0

Page 4 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

* A brief explanation must be entered for each addition/deletion, change of start date or end date, and/or negative variance 

shown in the previous section

(This section applies to BOTH reimbursable and credit agreements)

Explanation of Variance From Planned Developmental Task Schedule *

Page 5 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30 $0

#DIV/0!

#DIV/0!

Overrun

#DIV/0!

#DIV/0! $0

#DIV/0! $0 Overrun

Overrun

#DIV/0!

$0

$0 Overrun

0 #DIV/0!

0

0

#DIV/0!

$0

0 Overrun

Overrun

Note: ALL Data included in Section G is cumulative from start of agreement

0

0 #DIV/0! $0 Overrun

#DIV/0! $0 Overrun

TOTALS $0 $0

$0 Overrun

0

$0

0 #DIV/0! $0 Overrun

0

0 #DIV/0! $0 Overrun

0

Overrun

0 #DIV/0! $0 Overrun

0

0 #DIV/0! $0 Overrun

0 #DIV/0! $0

#DIV/0! $0 Overrun

#DIV/0! $0 Overrun

0 #DIV/0! $0 Overrun

0

0 #DIV/0! $0 Overrun

0

Overrun

0 #DIV/0! $0 Overrun

0

Overrun

0 #DIV/0! $0 Overrun

0 #DIV/0! $0

#DIV/0! $0 Overrun

$0

$0

#DIV/0! $0

0 #DIV/0! $0 Overrun

0

0

0

Base

0 #DIV/0!

Planned $ 

Expended as of 

End of This 

Report Period

Total $ Budgeted for 

Task

Developmental Tasks

As of End of This Report Period

#DIV/0! $0 Overrun

0

Overrun

#DIV/0! $0 Overrun

Overrun

#DIV/0!

0

$0

#DIV/0! $0

Cost Overrun 

or Surplus

Overrun

Overrun

Section G - Developmental Task Budget

$ Variance

% of Planned $ 

Incurred as of 

End of This 

Report Period

Actual $ 

Incurred as of 

End of Report 

Period

(This section applies to BOTH reimbursable and credit agreements)

Page 6 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Total 

* An explanation must be entered for each developmental task which has a positive (overrun) variance dollar figure in 

 

$0

Additional 

Funds 

Requested

Date Funds 

Requested

(This section applies to BOTH reimbursable and credit agreements)

Explanation of Developmental Task Cost Overruns *

Page 7 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

(This section applies to BOTH reimbursable and credit agreements)

Technology Transferred (Please 

provide detailed description associated with milestone(s))

Certifications Received

((e.g., ISO 9001:2000, MCSE, etc.) - Please send certificate copy(ies) to DCMA Program Manager)

Date

 

the previous section. Please refer to corresponding tasks from Section F/G.

Section H - Other Developmental Assistance Provided

Date

Date

Capabilities Enhanced

(e.g., database developer can now do web development as result of Mentor training)

Page 8 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

Section I - Protégé's Revenue, Employees, Prime Contracts & Subcontracts

During Six-Month Period of 

This Report Only

DoD 

Subcontracts 

From Protégé 

to Mentor

(Number)

DoD 

Subcontracts 

From Protégé 

to Mentor

(Dollars)

DoD 

Subcontracts 

From Protégé 

to Other Than 

Mentor

(Dollars)

<--During Six-Month Period of 

This Report Only-->

DLA Prime Contracts

DLA Prime

Contract

Awards to 

Protégé

(Number)

DLA Prime

Contract

Awards to 

Protégé

(Dollars)

DLA 

Subcontracts 

From Mentor 

to Protégé

(Number)

<--Start of Agreement (As 

Reported on Original Agreement 

Form)-->

Protégé's

Gross

Revenue 

During This 

Report Period

(Dollars)

Protégé's 

Employees 

at End of 

This Report 

Period

(Number)

Proposals 

Submitted to 

DLA by 

Protégé 

During 

Report Period

(Number)

Proposals 

Submitted to Other 

Fed Agencies 

(Excluding DLA) by 

Protégé During 

Report Period

(Number)

DoD 

Subcontracts 

From Protégé 

to Other Than 

Mentor

(Number)

DoD 

Subcontracts 

From Mentor 

to Protégé

(Dollars)

DoD Subcontracts 

to Protégé From All 

Sources Other Than 

Mentor

(Number)

DoD Subcontracts

Cumulative Awarded From Start 

of Agreement Through End of 

Report Period-->

DoD 

Subcontracts to 

Protégé From All 

Sources Other 

Than Mentor

(Dollars)

Start of Agreement (As 

Reported on Original 

Agreement Form)

DLA 

Subcontracts Protégé's Revenue, Employees & Proposals

Please note three rows of data; first row maintains baseline, second rows capture 6-months data in dollars and numbers 

categories. Third rows of data capture CUMULATIVE numbers and dollars from the start of the Mentor-Protégé Agreement. 

Cumulative Awarded From 

Start of Agreement Thru 

End of Report Period

Note: For the purposes of this Section, report only "obligated/funded" awards (prime and sub-contract) where dollars have been obligated with a line of accounting. DO 

NOT REPORT the IDIQ "estimated/potential value" type awards. Report only the TO/DO "funded/obligated" awards actually issued against the IDIQs. Do not report Charge 

Card orders or modifications that are not part of the contract award, unless they increase the value of the original award and are approved by the cognizant Contracting 

Officer. DO NOT REPORT awards that were finalized prior to the MPA, but awarded after the MPA, regardless whether the effort/work included both mentor and protégé 

participation. Contracts may be included if they are follow-on, add-on, new TO awards, or recompetes that were booked post MPA and/or are directly related to MentorProtégé developmental assistance efforts. "Informal" coordination between the mentors and protégés that results in award, but occurs prior to MPA contract award, will 

not be counted.

Page 9 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

Other Federal Prime Contracts

All Other Federal 

(excluding DoD) 

Subcontract 

Awards To 

Protégé From 

Mentor

(Number)

Start of Agreement (As 

Reported on Original 

Agreement Form)

During Six-Month Period of 

This Report Only

All Other 

Federal 

(excluding 

DoD) 

Subcontract 

Awards To 

Protégé From 

All Sources 

Other Than 

Mentor

(Number)

All Other 

Federal 

(excluding 

DoD) 

Subcontract 

Awards To 

Protégé From 

Mentor

(Dollars)

All Other 

Federal 

(excluding 

DoD) 

Subcontract 

Awards To 

Protégé From 

All Sources 

Other Than 

Mentor

(Dollars)

Other Federal Subcontracts

All Other Federal 

(excluding DoD) 

Subcontract 

Awards From 

Protégé To Other 

Than Mentor

(Number)

All Other 

Federal 

(excluding 

DoD) 

Subcontract 

Awards To 

Mentor From 

Protégé

(Number)

All Other Federal 

(excluding DoD) 

Subcontract Awards 

To Mentor From 

Protégé

(Dollars)

Cumulative Awarded From 

Start of Agreement Thru 

End of Report Period

During Six-Month Period of 

This Report Only

All Other Federal 

(excluding DoD) 

Prime Contract 

Awards to Protégé

(Dollars)

All Other 

Federal 

(excluding 

DoD) Prime 

Contract 

Awards to 

Protégé

(Number)

Other Federal Subcontracts

All Other 

Federal 

(excluding 

DoD) 

Subcontract 

Awards From 

Protégé To 

Other Than 

Mentor

(Dollars)

Cumulative Awarded From 

Start of Agreement Thru 

End of Report Period

Start of Agreement (As 

Reported on Original 

Agreement Form)

Page 10 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

1 Oct - 31 Mar (6 months - first half of government fiscal year)

1 Oct - 30 Sep (12 months - full government fiscal year)

Section J - DoD Subcontract Awards by Mentor

The dollar figures shown on the SSR (former SF 295)/eSRS 12-month report (the report submitted in October) for the same 

fiscal year should be entered in section "B" below as shown on the eSRS SSR, if applicable. (See notes 1 & 2 below.)

NOTE 1: eSRS SSR (former SF 295) reports are required to be submitted in April of each year (covering the preceding 6-

month period - 1 Oct thru 31 Mar) and in October (covering the preceding 12-month period - 1 Oct thru 30 Sep). Under a 

certain special circumstance (Commercial Subcontracting Plan), however, a mentor is required to submit only the October 

report which covers the entire 12-month government fiscal year (1 Oct - 30 Sep).

NOTE 2: Under certain circumstances (such as construction contracts), a mentor may be required to submit multiple eSRS 

SSR (former SF 295) reports (one to each applicable DoD component) for a single 6-month period. If this circumstance 

applies, the applicable category dollar figures from the multiple DoD reports must be added together and the totals entered 

below.

YES, the mentor did submit either an eSRS report of DoD subcontracting during the semi-annual period covered by 

this report. If yes, indicate the reporting period covered by the SSR or ISR below and then enter the appropriate 

subcontracting dollar figures in the appropriate section(s) on the next page.

The dollar amounts of subcontracting done by the mentor (under DoD contracts only) should be entered in the appropriate 

section(s) below via Electronic Subcontracting Reporting System (eSRS) Summary Subcontract Report (SSR) (former SF 

295), or Subcontracting Report for Individual Contracts (ISR) (former SF294) to DoD (or to any DoD components) and any of 

those reports pertained to the same semiannual period covered by this report. Please indicate below whether the mentor did 

or did not submit any eSRS summary report(s) of DoD subcontracting for this semiannual report period. (Reference: FAR 

52.219-9)

NO, the mentor did not submit any eSRS report (SSR) of DoD subcontracting during the semiannual period covered 

by this report. (If no, you may proceed directly to the certification section of this report.)

When determining the DoD subcontracting dollar figures to enter below, please note that the eSRS SSR (former SF 295) 

reports submitted in April report the dollar figures for a 6-month period -- the first 6 months of the government fiscal year. 

However, the SSR reports submitted in October cover a 12-month period -- the entire government fiscal year -- and the 12-

month report includes the dollars previously submitted on the 6-month report for the same fiscal year. Therefore, steps must 

be taken to avoid "double counting" the dollars reported on the 6-month SSR (Oct thru Mar -- first half of the government fiscal 

year) when calculating the SB category(ies) credit dollars for the second half of the fiscal year. When the 6-month and 12-

month dollar figures (for the same fiscal year only) are entered in sections "A" and "B" below as described above, this form will 

automatically calculate the dollars figures in section "C" for the second half of the government fiscal year on which the SDB 

credit dollars for that period should be based.

The dollar figures shown on the eSRS SSR 6-month report (the report submitted in April) should be entered in section "A" 

below as shown on the SSR (former SF 295), if applicable. (See notes 1 & 2 below.)

Page 11 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

 Yes No

Mentor Protégé

Reason for Termination:

If other, explain:

Part 4 - SB/SDB Credit Taken (credit agreements ONLY)

Please indicate whether or not the SB category(ies) credit calculated in Section E of this report was claimed/included 

by the Mentor on the SSR (former SF 295) or eSRS Summary Report covering the same period as this report:

If no, please explain:

$0

Part 3 - DoD Subcontracting Dollars for April - September (6 months)

(These dollar figures are calculated by subtracting the 6-month figures in section "A" above from the 12-month figures in 

section "B" above)

Termination Requested By:

Subcontracting to ALL Firms Subcontracting to SDB Firms Only

Total Dollar Value of all DoD 

Subcontracts Awarded by the 

Mentor to all Firms (includes both 

large and small businesses, 

including Protégé, if applicable) as 

reported on the or eSRS SSR 

Report (former SF 295) indicated 

above.

Effective Date of Termination: Funds Remaining:

Section K - Termination of Agreement

Total Dollar Value of all DoD 

Subcontracts Awarded by the Mentor 

to SDB Firms (Including Protégé, if 

applicable) as reported on the eSRS 

SSR (former SF 295) indicated above.

Subcontracting to ALL Firms Subcontracting to SDB Firms Only

(These dollar figures should be entered as shown on the eSRS SSR (in lieu of SF 295) report submitted in October)

$0

$0

Part 2 - DoD Subcontracting Dollars for October - September (12 months)

Subcontracting to SDB Firms Only

Total Dollar Value of all DoD 

Subcontracts Awarded by the 

Mentor to all firms (includes both 

large and small businesses, 

including Protégé, if applicable) as 

reported on the eSRS SSR (former 

SF 295) indicated above.

Subcontracting to ALL Firms

Part 1 - DoD Subcontracting Dollars for October - March (6 months)

Total Dollar Value of all DoD 

Subcontracts Awarded by the Mentor 

to SDB Firms (Including Protégé, if 

applicable) as reported on the eSRS 

SSR (former SF 295) indicated above.

$0

Total Dollar Value of All DoD 

Subcontracts Awarded by the 

Mentor to all Firms (includes both 

large and small businesses, 

including Protégé, if applicable)

$0

Total Dollar Value of all DoD 

Subcontracts Awarded by the Mentor 

to SDB Firms (Including Protégé, if 

applicable)

$0

(These dollar figures should be entered as shown on the eSRS SSR (former SF 295) report submitted in April)

Page 12 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

By my signature below, I certify that the representations above are true and correct to the best of my knowledge.

Date Signature of Mentor Title

Date Signature of Protégé Title

Funds Deobligation Date:

Credit Agreements:

Reimbursable Agreements:

Section M - Distribution of Form

Section L - Certification

By my signature below, I certify that I have reviewed and concur with the representations above and certify that they are true 

and correct to the best of my knowledge.

If clarification or assistance is needed in preparing this report, please contact your requisite DCMA MPP 

Program Manager, then your cognizant component MPP Program Manager, or the DoD Office of Small 

Business Programs, Mentor-Protégé Program Assistance, at 571-372-6312 or send email:

1. Cognizant Component Director of Small Business Programs 

2. DCMA Mentor-Protege Division Chief 

3. DCMA Program Manager 

4. OSD Director of Small Business Programs

 (Soft copy preferred, email to: programinformationmp@osd.mil) 

1. Cognizant Component Director of Small Business Programs 

2. Contracting Officer 

3. DCMA Mentor-Protege Division Chief 

4. DCMA Program Manager 

5. Cognizant Program Manager 

6. OSD Director of Small Business Programs

 (Soft copy preferred, email to: programinformationmp@osd.mil) 

 osd.pentagon.ousd-atl.mbx.dod-mentor-protege-program@mail.mil

Page 13 of 14 Revised September 2013
DLA MENTOR-PROTÉGÉ PROGRAM SEMIANNUAL REPORT

Expensed: Funds invoiced/billed against obligated dollars, not expenditures incurred.

Obligated: Funds provided on contract (specifically related to Section B) to date, not the total cost of the agreement. Total 

should include all funding provided for each year of the agreement, not what was provided during this report period.

Allocable MPP Costs: Costs that are directly related to or in direct support of the MPA, and that have been approved by the 

cognizant Service, Agency or DCMA PM, will be considered allocable by the Government.

Return on Investment (ROI): For the purposes of the MPP, ROI means generating value for money spent. Put another way, in 

terms of reimbursable MPP agreements, the growth in Protégé personnel and contracts (prime and/or subcontracts) should be 

greater than the money invested by DoD in the endeavor.

Glossary of Terms

Billing Period or Delivery Period: When documenting invoice or other billing/delivery periods, use the date on the invoice, bill or 

delivery documents respectively. Do not use the date received, unless it happens to coincide with the date on the document. 

For accounting purposes, all documents must be reconciled with previous SARs or final reports, regardless of when they were 

received.

Costs: While the total cost of a contract includes all costs properly allocable to the contract, the allowable costs to the 

Government are limited to those allocable costs which are allowable pursuant to Part 31 and applicable agency supplements.

Incidental Costs: Incidental expenses are costs incurred as part of daily life during business activities. For the purposes of the 

Mentor-Protege Program, unless otherwise specified, follow guidance in DFARS Subpart 291.71 and Appendix I. 

Page 14 of 14 Revised September 2013