Guidelines on Utilization of Small Minority and/or Women Business Enterprise (SMWBE)

Size: px
Start display at page:

Download "Guidelines on Utilization of Small Minority and/or Women Business Enterprise (SMWBE)"

Transcription

1 Attachment 14 The Alamo Community College District (ACCD) Office of Facilities Operations and Construction Management March 2010 Guidelines on Utilization of Small Minority and/or Women Business Enterprise (SMWBE) Page 1

2 The Alamo Community College District (ACCD) SMWBE Program Guidelines on Utilization of Small Minority and/or Women Business Enterprise (SMWBEs) Attachment 14 Table of Contents ACCD SMWBE Program Mission Statement page 3 ACCD Small Minority and/or Women Owned Business Enterprise Clause page 4-6 SMWBE Letter of Acknowledgement page 7 SMWBE Subcontracting Plan page 8-10 Self-Performance Justification page 10 SMWBE Subcontracting Plan Payment Request Form page 11 Minority and Trade Organizations Contact Information page 12 Page 2

3 ACCD SMWBE Program Mission Statement The Alamo Community College District (ACCD) Small, Minority and/or Women Business Enterprises (SMWBE) Program s initiative is to maximize the participation of SMWBE vendors on all contracting opportunities. Page 3

4 ACCD SMALL MINORITY AND/OR WOMEN OWNED BUSINESS ENTERPRISE CLAUSE It is the practice of the ACCD to encourage participation by small, minority and/or women owned business enterprise (SMWBE s) as professional/consulting firms to the ACCD. The term " small, minority and/or women owned business enterprise " means a business which is a Corporation, Sole Proprietorship, Partnership or Joint Venture in which at least 51 percent is owned, operated, and controlled by a person or persons who are socially disadvantaged because of their identification as members of certain groups, who historically have suffered the effects of discriminatory practices. SMWBE groups include: Black Americans - which includes persons having origins in any of the Black racial groups of Africa; Hispanic Americans - which includes persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish or Portuguese culture or origin, regardless of race; Asian Pacific Americans - which includes persons whose origins are from Japan, China, Taiwan, Korea, Vietnam, Laos, Cambodia, the Philippines, Samoa, Guam, the U.S. Trust Territories of the Pacific and the Northern Marianas; Native American - which includes persons who are American Indians, Eskimos, Aleuts, or Native Hawaiians; and Women - which includes all women of any ethnicity Small Business Enterprise. ACCD Acquisitions Department maintains an active program for the identification and placement of small and HUB businesses for request for proposals mailing lists, and to provide information and other assistance to facilitate the use of such firms as consultants to the maximum extent practical. Small and HUB businesses seeking contracting opportunities should file a "Request to be Added to Bidder/Vendor List" with the ACCD Acquisitions Office, 201 West Sheridan Street, Building A, Room 101, San Antonio, Texas or call at Firms seeking contracting opportunities will be encouraged to use their best efforts to carry out this practice through subcontracting of small and/or minority business enterprises to the fullest extent consistent with efficient performance. Page 4

5 DEFINITIONS 1. TYPES OF ENTERPRISES A. Minority Business Enterprise: B. Small Business Enterprise: C. Women Owned Business Enterprise: Means a business enterprise that is owned/controlled and operated by one or more minority person(s). Minority persons include Blacks, Mexican-Americans and other persons of Hispanic origin, American Indians, Alaskan Natives, and Asians and Pacific Islanders. Minority person(s) shall collectively own, operate, and share in payments from such an enterprise in the manner hereinafter set forth. Means a corporation, partnership, sole proprietorship or other legal entity for the purpose of making a profit, which is independently owned and operated, which includes small businesses as defined by certification agency. Means a sole proprietorship that is owned and controlled by a woman, a partnership at least 51.0% of whose assets or partnership interests are owned by one or more women, or a corporation, limited liability Company, or other form of entity, at least 51.0% of whose assets or ownership interests are owned by one or more women. Page 5

6 2. OWNERSHIP AND CONTROL A. Owned: B. Controlled/Operated: C. Share in Payments: 1. For a sole proprietorship to be deemed minority business enterprise, it must be owned by a minority person. 2. For an enterprise doing business as a partnership, it is necessary that at least 51.0% of its assets or interests in the partnership property be owned by one or more minority person(s). 3. For an enterprise doing business as a corporation, limited liability Company, or other form of entity, it is necessary that at least 51.0% of its assets or ownership interests be owned by one or more minority person(s). That the primary power to manage a business enterprise shall rest with minority person(s). Minority partners, proprietor, members, stockholders or other owners of the enterprise, as the case may be, shall be entitled to receive 51.0% or more of the total profits, bonuses, dividends, interest payments, commissions, consulting fees, rents, procurement, and subcontractor payments, and any other monetary distribution paid by the business enterprise. Page 6

7 (RESPONDENT S BUSINESS LETTERHEAD) Date Mr. John Strybos Associate Vice Chancellor of Facilities Operations and Construction Management The Alamo Community College District (ACCD) 7990 Pat Booker Road Live Oak, Texas Re: Small Minority and/or Women Owned Business Enterprise (SMWBE) Subcontracting Plan for (Project Title) CSP Number - Dear Mr. Strybos, In accordance with the statement outlined in Attachment 14, I have read and understand the Alamo Community College District s (ACCD) guidelines for the utilization of Small Minority and/or Women Owned Business Enterprise (SMWBE). Also, I am pleased to forward this (SMWBE) subcontracting plan as an integral part of our submission in referencing the above project. This (SMWBE) subcontracting plan includes subcontracting opportunities [refer to Attachment 14, page 8] representing (no. of subcontractors) trades with a total dollar value of $. These figures represent a cumulative percentage of %. For each of the listed (SMWBE) subcontractors, I have attached their certification document by an approved certifying agency and by completion of Section 6 of the (SMWBE) subcontracting plan, I affirm my intent to utilize the subcontractors selected to perform the scope of work to be subcontracted. Should we discover additional subcontractors claiming (SMWBE) status during the course of this contract we will notify you of the same. In addition, if for some reason a (SMWBE) is unable to fulfill its contract with us, we will notify you immediately in order to take the appropriate steps to amend this contractual obligation. Sincerely, (Project Executive) cc: Project Manager Page 7

8 ACCD SMWBE Subcontracting Plan - - Special Instructions/Additional Requirements - - Respondents shall submit a completed SMWBE Subcontracting Plan to be considered responsive (pages 7, 8, 9 and 10). Failure to submit a completed Subcontracting Plan shall result in point(s) reduction in the evaluation process for the bid and/or proposal. Respondents who intend to Self-Perform all of their work shall submit a Subcontracting Plan for Self- Performance (pages 8, and 10). SMWBE Subcontracting Plan Prime Contractor Payment Request Form page 11 shall be submitted with each request for payment as a condition of payment. SECTION 1 - RESPONDENT AND SOLICITATION INFORMATION a. Respondent (Company) Name: Point of Contact: Phone #: b. Is your company a certified SMWBE? - Yes - No c. CSP #: SECTION 2 - SUBCONTRACTING INTENTIONS - Yes, I will be subcontracting portion(s) of the contract. (If yes, in the spaces provided below, list the portions of work you will be subcontracting, and go to page 10.) - No, I will not be subcontracting any portion of the contract, and will be fulfilling the entire contract with my own resources. (Go to page 11) Line Item # - Subcontracting Opportunity Description Line Item # - Subcontracting Opportunity Description ( #1) - (#11) - ( #2) - (#12) - ( #3) - (#13) - ( #4) - (#14) - ( #5) - (#15) - ( #6) - (#16) - ( #7) - (#17) - ( #8) - (#18) - ( #9) - (#19) - (#10) - (#20) - Page 8

9 IMPORTANT: You must complete a copy of this page for each of the subcontracting opportunities you listed in SECTION 2. You may photocopy this page. SECTION 3 - SUBCONTRACTING OPPORTUNITY Enter the line item number and description of the subcontracting opportunity you listed in SECTION 2. Line Item # Description: SECTION 4 - NOTIFICATION OF SUBCONTRACTING OPPORTUNITY Complying with a, b and c of this section constitutes Good Faith Effort towards the portion of work listed in SECTION 3. After performing the requirements of this section, complete SECTION 5, 6 and 8. a. Provide written notification of the subcontracting opportunity listed in SECTION 3 to three (3) or more SMWBEs. You can use the State of Texas Centralized Master Bidders List (CMBL), found at and it s HUB Directory, found at Also, the South Texas Regional Certification Agency s (STRCA) database at to identify available SMWBEs. Note: Attach supporting documentation (letters, phone logs, fax transmittals, electronic mail, etc.) demonstrating evidence of the good faith effort performed. b. Provide written notification of the subcontracting opportunity listed in SECTION 3 to a minority or women trade organization or development center to assist in identifying potential SMWBEs by disseminating the subcontracting opportunity to their members/participants. A list of trade organizations and development centers are available on page 13. Attach supporting documentation (letters, phone logs, fax transmittals, electronic mail, etc.) demonstrating evidence of the good faith effort performed. c. Written notifications should include the scope of the work, information regarding the location to review plans and specifications, bonding and insurance requirements, required qualifications, and identify a contact person. Unless the contracting agency has specified a different time period, you must allow the SMWBEs no less than five (5) working days from their receipt of notice to respond, and provide notice of your subcontracting opportunity to a minority or women trade organization or development center no less than five (5) working days prior to the submission of your response to the contracting agency. SECTION 5 - SMWBE FIRMS CONTACTED FOR SUBCONTRACTING OPPORTUNITY List three (3) certified SMWBEs you notified regarding the portion of work (subcontracting opportunity) listed in SECTION 3. Specify the vendor ID number, date you provided notice, and if you received a response. Note: Attach supporting documentation (letters, phone logs, fax transmittals, electronic mail, etc.) demonstrating evidence of the good faith effort performed. Company Name VID # Notice Date (mm/dd/yyyy) Was Response Received? SECTION 6 - SUBCONTRACTOR SELECTION / / - Yes - No / / - Yes - No / / - Yes - No List the subcontractor(s) you selected to perform the portion of work (subcontracting opportunity) listed in SECTION 3. Also, specify the expected percentage of work to be subcontracted, the approximate dollar value of the work to be subcontracted, and indicate if the company is a SMWBE. Expected % Approximate Certified SMWBE? Company Name VID # of Contract Dollar Amount % $ - Yes - No* *If the subcontractor(s) you selected is not a SMWBE, provide written justification of your selection process below: Page 9

10 SECTION 7 - SELF PERFORMANCE JUSTIFICATION (If you responded No to SECTION 2, you must complete SECTION 7 and 8.) Does your response/proposal contain an explanation demonstrating how your company will fulfill the entire contract with its own resources? - Yes If Yes, in the space provided below, list the specific page/section of your proposal which identifies how your company will perform the entire contract with its own equipment, supplies, materials and/or employees. - No If No, in the space provided below, explain how your company will perform the entire contract with its own equipment, supplies, materials, and/or employees. SECTION 8 - AFFIRMATION As evidenced by my signature below, I affirm that I am an authorized representative of the respondent listed in SECTION 1, and that the information and supporting documentation submitted with the SMWBE Subcontracting Plan are true and correct. Respondent understands and agrees that, if awarded any portion of the solicitation: The respondent must submit monthly compliance reports (Payment Request Forms) to ACCD, verifying their compliance with the SMWBE Subcontracting Plan, including the use/expenditures they have made to subcontractors. The respondent must seek approval from ACCD prior to making any modifications to their SMWBE Subcontracting Plan. The respondent must, upon request, allow ACCD to perform on-site reviews of the company s headquarters and/or work-site where services are to be performed and must provide documents regarding staff and other resources. Signature Printed Name Title Date Page 10

11 SMWBE Subcontracting Plan Payment Request Form This form must be completed and submitted to ACCD each month to document compliance with your Subcontracting Plan. Contract/Requisition Number: Date of Award: Object Code: (mm/dd/yyyy) (ACCD Use Only) Contractor (Company) Name: Point of Contact: Phone #: Reporting Period: - Jan. - Feb. - Mar. - Apr. - May - Jun. - Jul. - Aug. - Sept. - Oct. - Nov. - Dec. (Check only one Month) Total Contract Amount Paid this Reporting Period to Contractor: $ Report SMWBE and Non-SMWBE subcontractor information Subcontractor s Name Subcontractor s VID or SMWBE Certificate Number Total Contract $ Amount from Subcontracting plan with Subcontractor Total $ Amount Paid This Period to Subcontractor TOTALS: $ Total Contract $ Amount Paid to Date to Subcontractor Object Code (agency use only) Signature Printed Name Title Date Page 11

12 Minority Contractors Association- San Antonio Hispanic Contractors Association de San Antonio 2800 NE Loop 410, Suite 207 San Antonio, Texas Office # & Fax # SMWBE Solicitations contact: admin@hca-sa.org SMWBE Resource List for San Antonio Greater San Antonio Black Contractors Association SMWBE Solicitations contact: sablackcontractors@sbcglobal.net Minority Chambers of Commerce- San Antonio Alamo Asian American Chamber of Commerce P. O. Box San Antonio, Texas Office # SMWBE Solicitations contact: Melinda A. Rodriguez- mrodriguez@accessqualitycare.com Alamo City Chamber of Commerce 600 Hemisfair Plaza Way Building San Antonio, Texas Office # & Fax # SMWBE Solicitations contact: Gwendolyn Robinson- info@alamocitychamber.org The San Antonio Hispanic Chamber of Commerce Casa De Mexico International Building 318 West Houston St. Suite 300 San Antonio, Texas Office # & Fax # SMWBE Solicitations contact: marisolr@sahcc.org Contractors Association- San Antonio Builders Exchange of Texas, Inc Naco Perrin Blvd. San Antonio, Texas Office # & Fax # Associated General Contractors (AGC) of San Antonio Gulfdale St. San Antonio, Texas Office # & Fax# Contact: Doug McMurry mcmurry@sanantonioagc.org The South Texas Regional Certification Agency: Texas Procurement and Support Services Division Page 12

C.1.5.2 (Procedure) Small, Minority, and Women Owned Business Enterprise Program PURPOSE DEFINITIONS

C.1.5.2 (Procedure) Small, Minority, and Women Owned Business Enterprise Program PURPOSE DEFINITIONS PURPOSE Alamo Colleges encourages the use of Small, Minority, and/or Women Owned Business Enterprises as herein below defined to assist in the implementation of this procedure through race, ethnicity,

More information

Office of Administration

Office of Administration Rules of Office of Administration Division 30 Division of Facilities Management, Design and Construction Chapter 5 Minority/Women Business Enterprises Title Page 1 CSR 30-5.010 Minority/Women Business

More information

Minority- and Women-Owned Business Enterprise (MBE/WBE) Guide ALL RECIPIENTS MUST COMPLY NO ONE IS EXEMPT

Minority- and Women-Owned Business Enterprise (MBE/WBE) Guide ALL RECIPIENTS MUST COMPLY NO ONE IS EXEMPT Minority- and Women-Owned Business Enterprise (MBE/WBE) Guide ALL RECIPIENTS MUST COMPLY NO ONE IS EXEMPT 1 I. Introduction This document is designed to assist all recipients of Coastal Bend Bays & Estuaries

More information

Minority and Women-Owned Business Enterprise (M/WBE) Participation Goals Pursuant to Article 15-A of the New York State Executive Law

Minority and Women-Owned Business Enterprise (M/WBE) Participation Goals Pursuant to Article 15-A of the New York State Executive Law Minority and Women-Owned Business Enterprise (M/WBE) Participation Goals Pursuant to Article 15-A of the New York State Executive Law The following M/WBE requirements apply when an applicant submits an

More information

South Coast Air Quality Management District

South Coast Air Quality Management District South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765 4178 (909) 396 2000 www.aqmd.gov Business Information Request Dear SCAQMD Contractor/Supplier: South Coast Air Quality

More information

APPENDIX A. Definitions of Terms

APPENDIX A. Definitions of Terms APPENDIX A. Definitions of Terms This appendix provides explanations and definitions useful to understanding the Disparity Study. These definitions are only relevant in the context of the ITD Disparity

More information

MIT LINCOLN LABORATORY REPRESENTATIONS AND CERTIFICATIONS-COMMERCIAL (JUNE 2014)

MIT LINCOLN LABORATORY REPRESENTATIONS AND CERTIFICATIONS-COMMERCIAL (JUNE 2014) The MIT Lincoln Laboratory preferred method of verifying annual representations and certifications is through an on-line U.S. government website, which is available at https://ww.sam.gov We request that

More information

http://www. Ownership Information Sole Proprietor Partnership Corporation Joint Venture Other:

http://www. Ownership Information Sole Proprietor Partnership Corporation Joint Venture Other: PATRICIA TERRELL SUPPLIER DIVERSITY COORDINATOR OFFICE: 586-825-0200 FAX: 586-825-0225 supplierdiversity@madisonelectric.com Supplier Diversity Vendor Profile All sections of this form must be completed

More information

MIT S MASTER SMALL BUSINESS PROGRAM

MIT S MASTER SMALL BUSINESS PROGRAM MIT S MASTER SMALL BUSINESS PROGRAM Policy: It is the policy of the United States that small business concerns shall have the maximum practicable opportunity to participate in the performance of contracts

More information

GUIDELINES FOR RECRUITMENT AND SELECTION OF MINORITY BUSINESSES FOR PARTICIPATION IN STATE CONSTRUCTION CONTRACTS

GUIDELINES FOR RECRUITMENT AND SELECTION OF MINORITY BUSINESSES FOR PARTICIPATION IN STATE CONSTRUCTION CONTRACTS GUIDELINES FOR RECRUITMENT AND SELECTION OF MINORITY BUSINESSES FOR PARTICIPATION IN STATE CONSTRUCTION CONTRACTS In accordance with G.S. 143-128.2 (effective January 1, 2002) these guidelines establish

More information

VENDOR REGISTRATION AND DISCLOSURE STATEMENT AND SMALL, WOMEN-, AND MINORITY-OWNED BUSINESS CERTIFICATION APPLICATION

VENDOR REGISTRATION AND DISCLOSURE STATEMENT AND SMALL, WOMEN-, AND MINORITY-OWNED BUSINESS CERTIFICATION APPLICATION WV-1A New Update REV. 06/16/14 STATE OF WEST VIRGINIA - PURCHASING DIVISION VENDOR REGISTRATION AND DISCLOSURE STATEMENT AND SMALL, WOMEN-, AND MINORITY-OWNED BUSINESS CERTIFICATION APPLICATION Before

More information

Minority and Women. Business Enterprise Plan. for the. Greenville Utilities Commission

Minority and Women. Business Enterprise Plan. for the. Greenville Utilities Commission Minority and Women Business Enterprise Plan for the Greenville Utilities Commission MWBE Program P. O. Box 7207 200 Martin Luther King, Jr. Drive Greenville, NC 27835 252-329-4490 TABLE OF CONTENTS POLICY

More information

MINORITY AND WOMEN-OWNED BUSINESS UTILIZATION AGREEMENT

MINORITY AND WOMEN-OWNED BUSINESS UTILIZATION AGREEMENT MINORITY AND WOMEN-OWNED BUSINESS UTILIZATION AGREEMENT This MINORITY AND WOMEN-OWNED BUSINESS UTILIZATION AGREEMENT ( Agreement ) is entered into as of, 20, by and among ( General Contractor ), having

More information

REGULATIONS GOVERNING PARTICIPATION BY MINORITY BUSINESS ENTERPRISES IN STATE FUNDED AND DIRECTED PUBLIC CONSTRUCTION

REGULATIONS GOVERNING PARTICIPATION BY MINORITY BUSINESS ENTERPRISES IN STATE FUNDED AND DIRECTED PUBLIC CONSTRUCTION REGULATIONS GOVERNING PARTICIPATION BY MINORITY BUSINESS ENTERPRISES IN STATE FUNDED AND DIRECTED PUBLIC CONSTRUCTION PROJECTS, CONSTRUCTION CONTRACTS AND PROCUREMENT CONTRACTS FOR GOODS AND SERVICES I.

More information

City of Greenville/Greenville Utilities Commission Minority and Women Business Enterprise Program

City of Greenville/Greenville Utilities Commission Minority and Women Business Enterprise Program City of Greenville/Greenville Utilities Commission Minority and Women Business Enterprise Program City of Greenville MWBE Guidelines for Professional Service Contracts $50,000 and above These instructions

More information

Talen Energy Corporation MWBE Commitment

Talen Energy Corporation MWBE Commitment Talen Energy Corporation MWBE Commitment BACKGROUND At Talen Energy Corporation, diversity planning applies not only to employment practices but to sourcing practices as well. Talen Energy Corporation

More information

Minority & Women Business Enterprise Plan. Economic Development Department

Minority & Women Business Enterprise Plan. Economic Development Department Minority & Women Business Enterprise Plan Economic Development Department Housing Division Approved by City Council, September 3, 2008 CITY OF PALMDALE Minority Women and Business Enterprise Plan MINORITY

More information

NOW, THEREFORE, THE BOARD OF COMMISSIONER FOR THE COUNTY OF ALAMANCE DOTH ORDAIN:

NOW, THEREFORE, THE BOARD OF COMMISSIONER FOR THE COUNTY OF ALAMANCE DOTH ORDAIN: ORDINANCE FOR THE ESTABLISHMENT OF ALAMANCE COUNTY MINORITY BUSINESS ENTERPRISE (MBE) OUTREACH PLAN AND GUIDELINES FOR RECRUITMENT AND SELECTION OF MINORITY BUSINESSES WHEREAS, the Board of Commissioners

More information

LINCOLN SCHOOL DISTRICT 156 410 157 th Street Calumet City, Illinois 60409-4798

LINCOLN SCHOOL DISTRICT 156 410 157 th Street Calumet City, Illinois 60409-4798 LINCOLN SCHOOL DISTRICT 156 410 157 th Street Calumet City, Illinois 604094798 Dear Applicant: APPLICATION FOR EMPLOYMENT FOR CERTIFIED PERSONNEL We welcome your application for employment in Lincoln Elementary

More information

KANSAS DEPARTMENT OF HEALTH & ENVIRONMENT DIVISION OF ENVIRONMENT BUREAU OF WATER

KANSAS DEPARTMENT OF HEALTH & ENVIRONMENT DIVISION OF ENVIRONMENT BUREAU OF WATER Appendix E-1 Page 1 of 4 July 2008 KANSAS DEPARTMENT OF HEALTH & ENVIRONMENT DIVISION OF ENVIRONMENT BUREAU OF WATER KANSAS PUBLIC WATER SUPPLY LOAN FUND KANSAS WATER POLLUTION CONTROL REVLOVING LOAN FUND

More information

16 LC 34 4725 A BILL TO BE ENTITLED AN ACT

16 LC 34 4725 A BILL TO BE ENTITLED AN ACT House Bill 712 By: Representatives Bruce of the 61 st, Smyre of the 135 th, Marin of the 96 th, Dukes of the 154 th, Dawkins-Haigler of the 91 st, and others A BILL TO BE ENTITLED AN ACT 1 2 3 4 5 6 7

More information

Application Process: There is a two-stage application process, which includes a Conditional Approval and then a Final Application package.

Application Process: There is a two-stage application process, which includes a Conditional Approval and then a Final Application package. Small Business Lending Center Microenterprise Loans Loans from $500-$10,000 Rates and Terms: Fixed Rates 8.75%-10%, for up to six years 7% for up to 10 years for Energy Efficiency Projects (see Loan Manager

More information

COUNTY OF FULTON M C C O N N E L L S B U R G, P E N N S Y L V A N I A. February 2014. 1 P a g e

COUNTY OF FULTON M C C O N N E L L S B U R G, P E N N S Y L V A N I A. February 2014. 1 P a g e COUNTY OF FULTON M C C O N N E L L S B U R G, P E N N S Y L V A N I A M I N O R I T Y B U S I N E S S E N T E R P R I S E A N D W O M E N B U S I N E S S E N T E R P R I S E ( M B E / W B E ) A C T I O

More information

REQUIRED KNOWLEDGE/SKILLS:

REQUIRED KNOWLEDGE/SKILLS: Sysco Portland, an Operating Company of North America s Leading Foodservice Distributor, is looking for an exceptional Contract Compliance Coordinator. PURPOSE OF POSITION: This position is responsible

More information

STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION ALASKA CLEAN WATER FUND & ALASKA DRINKING WATER FUND

STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION ALASKA CLEAN WATER FUND & ALASKA DRINKING WATER FUND STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION ALASKA CLEAN WATER FUND & ALASKA DRINKING WATER FUND DISADVANTAGE BUSINESS ENTERPRISES OVERVIEW The loan recipient, consultant and contractor of

More information

State of Delaware. Office of Supplier Diversity Certification Application. Complete application and mail, email or fax to:

State of Delaware. Office of Supplier Diversity Certification Application. Complete application and mail, email or fax to: State of Delaware Office of Supplier Diversity Certification Application Complete application and mail, email or fax to: Office of Supplier Diversity (OSD) 100 Enterprise Place, Suite 4 Dover, DE 19904-8202

More information

ACHIEVE Human Services, Inc.

ACHIEVE Human Services, Inc. ACHIEVE Human Services, Inc. 3250-A East 40th Street, Yuma, AZ 85365 Phone: (928) 341-0335 Fax: (928) 341-9462 OUR MISSION STATEMENT: Empower the individuals that we serve to live their lives to their

More information

Chapter 200 1999 EDITION. Disadvantaged, Minority, Women and Emerging Small Business Enterprises

Chapter 200 1999 EDITION. Disadvantaged, Minority, Women and Emerging Small Business Enterprises Chapter 200 1999 EDITION Disadvantaged, Minority, Women and Emerging Small Business Enterprises GENERAL PROVISIONS 200.005 Definitions for ORS 200.005 to 200.075 200.015 Legislative findings 200.025 Advocate

More information

Last Name First M.I. Date. Street Address Apartment/Unit # License Number: License Expiration Date:

Last Name First M.I. Date. Street Address Apartment/Unit # License Number: License Expiration Date: Employment Application Please note: The information you enter on this form cannot be saved. After completing this form, print and provide an original signature before submitting it as application for a

More information

City of Tuscaloosa Affirmative Marketing Policy for Affordable Housing Programs

City of Tuscaloosa Affirmative Marketing Policy for Affordable Housing Programs City of Tuscaloosa Affirmative Marketing Policy for Affordable Housing Programs Note: Affirmative Marketing procedures do not apply to families with Section 8 tenant-based rental housing assistance or

More information

Johns Hopkins University School of Medicine. Application for Postdoctoral Research Fellowship Training

Johns Hopkins University School of Medicine. Application for Postdoctoral Research Fellowship Training Johns Hopkins University School of Medicine Application for Postdoctoral Research Fellowship Training General Instructions for Completion of this Application Each section must be complete and legible or

More information

Neillsville Care & Rehab

Neillsville Care & Rehab 216 Sunset Pl Phone: (715) 743-5444 Fax: (715) 743-5448 An Equal Opportunity, Affirmative Action Employer Employment Application Position Applying for: PLEASE PRINT IN INK PERSONAL DATA LAST NAME FIRST

More information

Food Safety and Inspection Service Research Participation Program

Food Safety and Inspection Service Research Participation Program Food Safety and Inspection Service Research Participation Program Application Date: Applicant Type: If other, please specify: Position Posting Number: 1. Name: First Name Middle Name Last Name Suffix 2.

More information

Raleigh-Durham Airport Authority. Minority and Women-Owned Small Business Program

Raleigh-Durham Airport Authority. Minority and Women-Owned Small Business Program Raleigh-Durham Airport Authority Minority and Women-Owned Small Business Program Adopted October 2007 Revised April 2013 Policy Statement 4 Program Scope, Objectives and Initiatives 5 A. MWSB Program Scope

More information

Bonding Guarantee Assistance Program. Rules and Regulations

Bonding Guarantee Assistance Program. Rules and Regulations Bonding Guarantee Assistance Program Rules and Regulations 1 Bonding Guarantee Assistance Program xxnycrr Chapter x Part xxxx Statutory Authority Section 16-f of the New York State Urban Development Corporation

More information

Executive Search Services for University of Missouri-Kansas City Dean - Henry W. Bloch School of Management

Executive Search Services for University of Missouri-Kansas City Dean - Henry W. Bloch School of Management Request for Qualifications/Proposals #16-6030-JS-K Executive Search Services for University of Missouri-Kansas City Dean - Henry W. Bloch School of Management Dated: May 13, 2016 URGENT TURNAROUND NEEDED

More information

APPLICATION FOR EMPLOYMENT City of Los Altos

APPLICATION FOR EMPLOYMENT City of Los Altos APPLICATION FOR EMPLOYMENT City of Los Altos One North San Antonio Road, Los Altos, California 94022 (650) 947-2765 Fax (650) 947-2731 www.ci.los-altos.ca.us AN EQUAL OPPORTUNITY EMPLOYER FOR OFFICE USE

More information

STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Contractor License Application

STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Contractor License Application STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Contractor License Application General Policies and Procedures IMPORTANT: THE DEPARTMENT WILL NOT REVIEW HAND-DELIVERED APPLICATIONS AT THE TIME

More information

TABLE OF CONTENTS. 1. Understanding 1. 2. Subcontracting Goals 2. 3. Method Used to Develop Subcontracting Goals 2. 4. Master Subcontracting Plan 2

TABLE OF CONTENTS. 1. Understanding 1. 2. Subcontracting Goals 2. 3. Method Used to Develop Subcontracting Goals 2. 4. Master Subcontracting Plan 2 TABLE OF CONTENTS Page 1. Understanding 1 2. Subcontracting Goals 2 3. Method Used to Develop Subcontracting Goals 2 4. Master Subcontracting Plan 2 5. Master Subcontracting Plan Administration 4 6. Opportunities

More information

Doing Business With State Agencies & Universities. Statewide HUB Program Comptroller of Public Accounts

Doing Business With State Agencies & Universities. Statewide HUB Program Comptroller of Public Accounts Doing Business With State Agencies & Universities Statewide HUB Program Comptroller of Public Accounts Agenda Historically Underutilized Business Centralized Master Bidders List How to do Business with

More information

GUILFORD TECHNICAL COMMUNITY COLLEGE COLLEGE PLAN TO INCREASE PARTICIPATION BY

GUILFORD TECHNICAL COMMUNITY COLLEGE COLLEGE PLAN TO INCREASE PARTICIPATION BY GUILFORD TECHNICAL COMMUNITY COLLEGE COLLEGE PLAN TO INCREASE PARTICIPATION BY HISTORICALLY UNDERUTILIZED BUSINESSES IN THE PROCUREMENT OF GOODS AND SERVICES --_ Revised February 2008 Approved: November

More information

EMPLOYMENT APPLICATION An Equal Opportunity Affirmative Action Employer

EMPLOYMENT APPLICATION An Equal Opportunity Affirmative Action Employer Waukesha County Technical College 800 Main Street, Pewaukee, WI 53072 EMPLOYMENT APPLICATION An Equal Opportunity Affirmative Action Employer Position(s) Applied For Full Time Part Time Name Last First

More information

ATTORNEY APPLICATION FOR EMPLOYMENT DIVISION OF LAW DEPARTMENT OF LAW AND PUBLIC SAFETY STATE OF NEW JERSEY

ATTORNEY APPLICATION FOR EMPLOYMENT DIVISION OF LAW DEPARTMENT OF LAW AND PUBLIC SAFETY STATE OF NEW JERSEY ATTORNEY APPLICATION FOR EMPLOYMENT DIVISION OF LAW DEPARTMENT OF LAW AND PUBLIC SAFETY STATE OF NEW JERSEY The Division of Law provides legal counsel and representation to agencies of State government

More information

Pages 1 of 8 Employment Application - Tennessee

Pages 1 of 8 Employment Application - Tennessee Page 1 of 8 Employment Application Tennessee College of Applied Technology Position Applying For: Personal Information: First Name: Middle Name: Last Name: Maiden Name (If applicable): Address: City: State

More information

Collection: Hispanic or Latino OR Not Hispanic or Latino. Second, individuals are asked to indicate one or more races that apply among the following:

Collection: Hispanic or Latino OR Not Hispanic or Latino. Second, individuals are asked to indicate one or more races that apply among the following: Overview: The United States Office of Management and Budget (OMB) issued standards for maintaining, collecting, and reporting federal data on race and ethnicity. On October 19, 2007 the Department of Education

More information

GRAYSON COUNTY, VIRGINIA SHERIFF S DEPARTMENT

GRAYSON COUNTY, VIRGINIA SHERIFF S DEPARTMENT GRAYSON COUNTY, VIRGINIA SHERIFF S DEPARTMENT SHERIFF S DEPARTMENT AVAYA IP OFFICE SYSTEM Project Manual February 12, 2016 IFB# 02122016 Grayson County Sheriff s Department P.O. Box 160 122 Davis Street

More information

Boones Creek Animal Hospital PLEASE COMPLETE THE FOLLOWING INFORMATION:

Boones Creek Animal Hospital PLEASE COMPLETE THE FOLLOWING INFORMATION: Boones Creek Animal Hospital PLEASE COMPLETE THE FOLLOWING INFORMATION: Job Applied For: q Receptionist q RVT q Assistant q Other HOW DID YOU LEARN ABOUT THIS POSITION? q Newspaper (List Publication) q

More information

Employment Application An Equal Opportunity Employer

Employment Application An Equal Opportunity Employer Employment Application An Equal Opportunity Employer PO Box 520 76 East Market Street Xenia, Ohio 45385 937-352-4000 The Greene County Public Library considers applications for all positions without regard

More information

Certified Nursing Assistant Instructor/Program Coordinator

Certified Nursing Assistant Instructor/Program Coordinator V A C A N C Y A N N O U N C E M E N T Certified Nursing Assistant Instructor/Program Coordinator Position Description: Duties & Responsibilities: Helena College University of Montana, a comprehensive two-year

More information

STATE UNIVERSITY CONSTRUCTION FUND GUIDELINES FOR AWARD OF PROCUREMENT CONTRACTS

STATE UNIVERSITY CONSTRUCTION FUND GUIDELINES FOR AWARD OF PROCUREMENT CONTRACTS STATE UNIVERSITY CONSTRUCTION FUND GUIDELINES FOR AWARD OF PROCUREMENT CONTRACTS Section I. Purpose The purpose of these Guidelines is to describe the methods and procedures governing the use, awarding,

More information

CITY OF HIGH POINT. Minority-owned, Woman-owned, Disadvantaged-owned Outreach Plan and Guidelines

CITY OF HIGH POINT. Minority-owned, Woman-owned, Disadvantaged-owned Outreach Plan and Guidelines CITY OF HIGH POINT Minority-owned, Woman-owned, Disadvantaged-owned Outreach Plan and Guidelines Municipal Office Building 211 South Hamilton Street High Point, North Carolina OUTREACH PLAN AND GUIDELINES

More information

STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Worker and Supervisor Application

STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Worker and Supervisor Application STATE OF CONNECTICUT ASBESTOS Worker and Supervisor Application General Policies and Procedures IMPORTANT: THE DEPARTMENT WILL NOT REVIEW HAND-DELIVERED APPLICATIONS AT THE TIME OF RECEIPT. PROFESSIONAL

More information

ERLANGER HEALTH SYSTEM SUPPLY CHAIN MANAGEMENT DEPARTMENT 979 EAST THIRD STREET, SUITE 708 CHATTANOOGA, TENNESSEE 37403 REQUEST FOR PROPOSAL

ERLANGER HEALTH SYSTEM SUPPLY CHAIN MANAGEMENT DEPARTMENT 979 EAST THIRD STREET, SUITE 708 CHATTANOOGA, TENNESSEE 37403 REQUEST FOR PROPOSAL ERLANGER HEALTH SYSTEM SUPPLY CHAIN MANAGEMENT DEPARTMENT 979 EAST THIRD STREET, SUITE 708 CHATTANOOGA, TENNESSEE 37403 REQUEST FOR PROPOSAL RFP REFERENCE: 0018-1213 FOR: AUDIO VISUAL EQUIPMENT RENOVATION

More information

MINORITY/WOMEN BUSINESS ENTERPRISE CERTIFICATION PROCEDURES

MINORITY/WOMEN BUSINESS ENTERPRISE CERTIFICATION PROCEDURES Minority/Women Contracting MINORITY/WOMEN BUSINESS ENTERPRISE CERTIFICATION PROCEDURES PROCEDURES FOR ASSURANCE OF BONA FIDE MINORITY/WOMEN BUSINESS ENTERPRISE PARTICIPATION IN THE M/WBE PROGRAM I. General

More information

SAMPLE. $ $ $ $ Base year or Option #1 Option #2 Option #3 Multi-year amount (If applicable) (If applicable) (If applicable)

SAMPLE. $ $ $ $ Base year or Option #1 Option #2 Option #3 Multi-year amount (If applicable) (If applicable) (If applicable) Revised November 5, 2012 SAMPLE FY 2013 MODEL SMALL BUSINESS SUBCONTRACTING PLAN CONTRACTOR: ADDRESS: CONTRACT NUMBER: DUNN & BRADSTREET NO.: ITEM/SERVICE: PERIOD OF CONTRACT PERFORMANCE: (DAY, MONTH,

More information

A document attesting that a person or organization meets minimum standards or qualifications in a specific area. Usually issued by an organization

A document attesting that a person or organization meets minimum standards or qualifications in a specific area. Usually issued by an organization A document attesting that a person or organization meets minimum standards or qualifications in a specific area. Usually issued by an organization with recognized expertise in the area. No- Federal and

More information

CITY OF SAVANNAH MINORITY AND WOMEN BUSINESS ENTERPRISE PROGRAM (M/WBE) POLICY JUNE 2009

CITY OF SAVANNAH MINORITY AND WOMEN BUSINESS ENTERPRISE PROGRAM (M/WBE) POLICY JUNE 2009 Authorized by: Effective Date: CITY OF SAVANNAH MINORITY AND WOMEN BUSINESS ENTERPRISE PROGRAM (M/WBE) POLICY JUNE 2009 I. M/WBE IMPLEMENTATION OF THE POLICY The City Manager shall implement and administer

More information

Speech-Language Pathologist Limited License Application Checklist

Speech-Language Pathologist Limited License Application Checklist Speech-Language Pathologist Limited License Application Checklist I. All Applicants Must Submit: $100.00 Fee (check or money order payable to the Board of SLP) A recent 2x2 passport size color photo Signed

More information

Patrece Richardson, Minority Business Officer REVISED 04/092015 PAGE 1

Patrece Richardson, Minority Business Officer REVISED 04/092015 PAGE 1 DALLAS COUNTY MINORITY/WOMEN OWNED BUSINESS ENTERPRISE DISADVANTAGED BUSINESS ENTERPRISE AND HISTORICALLY UNDERUTILIZED BUSINESS PROGRAM SPECIFICATIONS Patrece Richardson, Minority Business Officer REVISED

More information

Computer Systems Analyst II

Computer Systems Analyst II V A C A N C Y A N N O U N C E M E N T Computer Systems Analyst II Position Description: Duties & Responsibilities: Qualifications: Salary: Helena College University of Montana, a comprehensive two-year

More information

APPLICATION FOR APPOINTMENT TO BERKLEY/ALBANY MENTAL HEALTH COMMISSION

APPLICATION FOR APPOINTMENT TO BERKLEY/ALBANY MENTAL HEALTH COMMISSION Thank you for your interest in improving community mental health in Berkeley and Albany. Below is some important information about the Berkeley/Albany Mental Health Commission you should review before

More information

APPLICATION FOR EMPLOYMENT INSTRUCTION SHEET

APPLICATION FOR EMPLOYMENT INSTRUCTION SHEET APPLICATION FOR EMPLOYMENT INSTRUCTION SHEET Thank you for your interest in Navarro College. Please take a moment to read the following instructions before completing this application. Please follow the

More information

REQUIREMENTS FOR ORIGINAL OPTOMETRY LICENSURE

REQUIREMENTS FOR ORIGINAL OPTOMETRY LICENSURE REQUIREMENTS FOR ORIGINAL OPTOMETRY LICENSURE Applicants must have attained their 18 th birthday. The academic requirements are at least six calendar years at the college level, four years of which shall

More information

Thank you for your interest in DePaul Fire Watch Division. We appreciate you taking the time to apply for possible employment with us.

Thank you for your interest in DePaul Fire Watch Division. We appreciate you taking the time to apply for possible employment with us. Dear Fire Watch Applicant, Thank you for your interest in DePaul Fire Watch Division. We appreciate you taking the time to apply for possible employment with us. Throughout the application process there

More information

NON-DEGREE/SPECIAL STUDENT ENROLLMENT

NON-DEGREE/SPECIAL STUDENT ENROLLMENT NON-DEGREE/SPECIAL STUDENT ENROLLMENT Enrolling as a non-degree student enables a person to take one or two graduate level social work courses per term in order to help focus their interests, to test capabilities

More information

University of Michigan STUDENT SERVICES: ADMISSIONS

University of Michigan STUDENT SERVICES: ADMISSIONS RACKHAM GRADUATE SCHOOL University of Michigan STUDENT SERVICES: ADMISSIONS 915 E. Washington Street 0120 Rackham Building Ann Arbor, MI 48109-1070 E-Mail: rackadmis@umich.edu www.rackham.umich.edu/prospective-students/admissions

More information

DALLAS COUNTY COMMUNITY COLLEGE DISTRICT

DALLAS COUNTY COMMUNITY COLLEGE DISTRICT DALLAS COUNTY COMMUNITY COLLEGE DISTRICT REQUEST FOR QUALIFICATIONS NUMBER 12006 EXECUTIVE SEARCH COMPANY for SELECTION OF CHANCELLOR PROPOSALS DUE BY 2:00 P.M. APRIL 18, 2013 INDEX CONTENTS PAGE NUMBER

More information

NON-DEGREE STUDENT APPLICATION PROCESS

NON-DEGREE STUDENT APPLICATION PROCESS NON-DEGREE STUDENT APPLICATION PROCESS Thank you for your interest in taking classes as a non-degree student at St. Mary s College of Maryland. Individuals who wish to take a limited number of credit classes

More information

STATE OF OREGON - OREGON YOUTH AUTHORITY EMPLOYMENT APPLICATION PERSONAL INFORMATION PREFERENCES EDUCATION COLLEGE/UNIVERSITY EDUCATION

STATE OF OREGON - OREGON YOUTH AUTHORITY EMPLOYMENT APPLICATION PERSONAL INFORMATION PREFERENCES EDUCATION COLLEGE/UNIVERSITY EDUCATION STATE OF OREGON - OREGON YOUTH AUTHORITY EMPLOYMENT APPLICATION State of Oregon Website: http://www.oregonjobs.org For instructions on where to submit your application please see the Description section

More information

TABLE OF CONTENTS I. PURPOSE... 3 II. GOALS...3 III. DEFINITIONS... 3-4

TABLE OF CONTENTS I. PURPOSE... 3 II. GOALS...3 III. DEFINITIONS... 3-4 CARROLL COUNTY MINORITY BUSINESS ENTERPRISE POLICY Department of the Comptroller Bureau of Purchasing 10/03/02 TABLE OF CONTENTS I. PURPOSE... 3 II. GOALS...3 III. DEFINITIONS... 3-4 IV METHODS OF PROCURMENENT

More information

NAME: LAST NAME FIRST NAME MIDDLE INITIAL

NAME: LAST NAME FIRST NAME MIDDLE INITIAL JOHNSTON PUBLIC SCHOOLS 10 Memorial Avenue Johnston, Rhode Island 02919 Phone: 401-233-1900 / Fax: 401-233-1907 www.johnstonschools.org FULL TIME PART TIME SUBSTITUTE APPLICAT ION FO R EM PLOYM ENT C ER

More information

Minority and Women Business Enterprises (MBE/WBE) Program

Minority and Women Business Enterprises (MBE/WBE) Program Minority and Women Business Enterprises (MBE/WBE) Program The Indiana Department of Transportation will ensure that all certified Minority and Women s Business Enterprises (MBE/WBE) will be afforded full

More information

UNDERGRADUATE NON-DEGREE ENROLLMENT FORM

UNDERGRADUATE NON-DEGREE ENROLLMENT FORM UNDERGRADUATE NON-DEGREE ENROLLMENT FORM UNDERGRADUATE STUDENTS ONLY: You WILL NOT be eligible for non-degree enrollment if any of the following statements apply to you. If you have: n Previously attended

More information

PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY APPLICATION PROCEDURES

PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY APPLICATION PROCEDURES PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY APPLICATION PROCEDURES 1. A completed Application for Employment and Consent to Procurement of Consumer Credit Report are mandatory. The Office of Human Resources

More information

Ohio Civil Service Application forstateandcountyagencies

Ohio Civil Service Application forstateandcountyagencies Ohio Civil Service Application forstateandcountyagencies GEN-4268 (REVISED 01/12) ThestateofOhioisanEqualOpportunityEmployerandproviderofADAservices. POSITION: AGENCY: POSITION NUMBER: POSITION: DEPARTMENT:

More information

REQUEST FOR QUOTE #7006243 Debt Management Software. D/FW International Airport Procurement & Materials Management Department

REQUEST FOR QUOTE #7006243 Debt Management Software. D/FW International Airport Procurement & Materials Management Department REQUEST FOR QUOTE #7006243 Debt Management Software The Dallas-Fort Worth International Airport Board (Airport Board) intends to procure an Amazing Race themed Team Building Services as described within

More information

Collecting and Reporting Racial and Ethnic Data Instructions and Guidance on the Federal Guidelines effective December 3, 2007

Collecting and Reporting Racial and Ethnic Data Instructions and Guidance on the Federal Guidelines effective December 3, 2007 Collecting and Reporting Racial and Ethnic Data Instructions and Guidance on the Federal Guidelines effective December 3, 2007 January 2008 Maryland State Department of Education Division of Accountability

More information

EEO Employer/Vet/Disabled

EEO Employer/Vet/Disabled Job Title: Reports to: Direct Reports: Location: Staff Accountant / Payroll Finance None San Jose, CA Education Required: High School Diploma Skills Required: The ideal candidate will have at least 3 to

More information

Housing Counseling Agency Activity Report

Housing Counseling Agency Activity Report Housing Counseling Agency Activity Report U.S. Department of Housing and Urban Development Office of Housing Counseling Federal Housing Commissioner Read the instructions and Public Reporting Statement

More information

Homebuyer(s) Property Address 8-30-13 REQUIREMENT DOCUMENT LENDER COMMENTS

Homebuyer(s) Property Address 8-30-13 REQUIREMENT DOCUMENT LENDER COMMENTS Frederick County Department of Housing and Community Development Neighborhood Conservation Initiative (NCI) Program LENDER CHECKLIST for NCI/AG APPLICATION PACKAGE Homebuyer(s) Property Address 8-30-13

More information

Graduate Certificate Application Form and Checklist

Graduate Certificate Application Form and Checklist Graduate Certificate Application Form and Checklist 6530 Haven Hall, 505 South State Street, Ann Arbor, MI 48109 Tel: (734) 615-3275 Email Application to: cogsciprog@umich.edu www.lsa.umich.edu/weinberginstitute

More information

APPLICATION FOR STUDENT EMPLOYMENT

APPLICATION FOR STUDENT EMPLOYMENT LAST NAME FIRST MIDDLE INITIAL APPLICATION FOR STUDENT EMPLOYMENT N-0613 (03-13) An Equal Opportunity Employer IT IS IMPORTANT TO NOTE THAT THIS APPLICATION IS FOR STUDENT EMPLOYMENT ONLY. We realize the

More information

Certified Payrolls Certified Payrolls Submittal Requirements Notice of Delinquent Certified Payroll

Certified Payrolls Certified Payrolls Submittal Requirements Notice of Delinquent Certified Payroll Certified Payrolls Certified Payrolls Weekly certified payrolls covering the s and sub s workforce shall be submitted to the engineer on all MDOT-let contracts. Certified payrolls are required for all

More information

New U.S. Department of Education Race and Ethnicity Data Standards

New U.S. Department of Education Race and Ethnicity Data Standards New U.S. Department of Education Race and Ethnicity Data Standards December 2009 Data Collection and Reporting Changes Starting School Year 2010-11 11 Data Analysis and Progress Reporting Division Illinois

More information

Sample Employment Application

Sample Employment Application Employment Application Please complete application in full and answer all questions completely. Type or print legibly. Indicate N/A if not applicable. Do not indicate See Résumé. A résumé may be attached

More information

SHORT FORM For Use by presently certified firms.

SHORT FORM For Use by presently certified firms. Economic Development Department Minority and Women-Owned Business Enterprise Certification Application SHORT FORM For Use by presently certified firms. M/WBE Certification Application, Short Form Rev.

More information

Munoz Engineering P.C.

Munoz Engineering P.C. Munoz Engineering P.C. Subcontractor Prequalification Questionnaire Business Applicant Name TIN D/B/A or Trade Name (if any) Business address Mailing address (if different) Delivery address (if different)

More information

1. Name Last First Middle/Maiden. 2. Home Address. 3. Home Phone Alternate # Email. 4. Date of Birth Social Security #

1. Name Last First Middle/Maiden. 2. Home Address. 3. Home Phone Alternate # Email. 4. Date of Birth Social Security # State of Maryland Department of Health and Mental Hygiene Board of Examiners for Audiologists, Hearing Aid Dispensers and Speech-Language Pathologists 4201 Patterson Avenue, Baltimore, Maryland 21215-2299

More information

University of Illinois College of Veterinary Medicine Coordinated Degree Program Application Package Augustana College 2015

University of Illinois College of Veterinary Medicine Coordinated Degree Program Application Package Augustana College 2015 Augustana College and University of Illinois Coordinated Degree Program Baccalaureate of Arts/Doctorate of Veterinary Medicine (BA/DVM) (version 8/28/2015) Augustana College and the College of Veterinary

More information

Guidelines for Certification of Minority Business Enterprises (MBEs) and Women-owned Business Enterprises (WBEs)

Guidelines for Certification of Minority Business Enterprises (MBEs) and Women-owned Business Enterprises (WBEs) Guidelines for Certification of Minority Business Enterprises (MBEs) and Women-owned Business Enterprises (WBEs) Office of Business Diversity and Civil Rights 233 Park Avenue South, 4 th Floor New York,

More information

AN EQUAL OPPORTUNITY EMPLOYER ~ THROUGH AFFIRMATIVE ACTION

AN EQUAL OPPORTUNITY EMPLOYER ~ THROUGH AFFIRMATIVE ACTION APPLICATION FOR EMPLOYMENT ACTION FOR BRIDGEPORT COMMUNITY DEVELOPMENT 1070 PARK AVENUE, BRIDGEPORT, CT O6604 PLEASE PRINT 203 366-8241 =========================================================================================

More information

Homeowner Rehab Set Up and Completion Form HOME Program (For single and multi-address activities)

Homeowner Rehab Set Up and Completion Form HOME Program (For single and multi-address activities) U.S. Department of Housing and Urban Development Office of Community Planning and Development Homeowner Rehab Set Up and Completion Form HOME Program (For single and multi-address activities) Check the

More information

UNIVERSITY OF ROCHESTER SCHOOL OF NURSING. Accelerated Bachelor s Program for Non-Nurses

UNIVERSITY OF ROCHESTER SCHOOL OF NURSING. Accelerated Bachelor s Program for Non-Nurses UNIVERSITY OF ROCHESTER SCHOOL OF NURSING Accelerated Bachelor s Program for Non-Nurses Web Page Address: www.son.rochester.edu Thank you for your interest in the University of Rochester School of Nursing.

More information

HOUSTON COMMUNITY COLLEGE SYSTEM SMALL BUSINESS DEVELOPMENT PROGRAM PROCEDURES MANUAL

HOUSTON COMMUNITY COLLEGE SYSTEM SMALL BUSINESS DEVELOPMENT PROGRAM PROCEDURES MANUAL HOUSTON COMMUNITY COLLEGE SYSTEM SMALL BUSINESS DEVELOPMENT PROGRAM PROCEDURES MANUAL November 26, 2013 TABLE OF CONTENTS I. SUMMARY OF THE HOUSTON COMMUNITY COLLGE SYSTEM S SMALL BUSINESS DEVELOPMENT

More information

ILLINOIS STATE BOARD OF EDUCATION Nutrition Programs Division 100 North First Street, W-270 Springfield, IL 62777-0001

ILLINOIS STATE BOARD OF EDUCATION Nutrition Programs Division 100 North First Street, W-270 Springfield, IL 62777-0001 ILLINOIS STATE BOARD OF EDUCATION Nutrition Programs Division 100 North First Street, W-270 Springfield, IL 62777-0001 CHILD AND ADULT CARE FOOD PROGRAM MANAGEMENT ASSESSMENT FOR NEW INSTITUTIONS Directions:

More information

UNDERGRADUATE TEACHER CERTIFICATION ENROLLMENT FORM

UNDERGRADUATE TEACHER CERTIFICATION ENROLLMENT FORM UNDERGRADUATE TEACHER CERTIFICATION ENROLLMENT FORM ELED, SPED and ECED are not available through the Teacher s Certification program. For any K 12 programs listed below, please seek advising from the

More information

Thank you for your interest in partnering with AppraisalBridge

Thank you for your interest in partnering with AppraisalBridge Thank you for your interest in partnering with AppraisalBridge AppraisalBridge is a management agent for lenders, regulatory and enforcement agencies and other institutions that rely on real estate valuation

More information

FIREFIGHTER/PARAMEDIC EMPLOYMENT APPLICATION (Please Print)

FIREFIGHTER/PARAMEDIC EMPLOYMENT APPLICATION (Please Print) FIREFIGHTER/PARAMEDIC EMPLOYMENT APPLICATION (Please Print) FOR OFFICE USE ONLY CITY OF SPRINGFIELD, OHIO PERSONNEL DEPARTMENT 76 EAST HIGH STREET SPRINGFIELD, OHIO 45502 INSTRUCTIONS: Please fill out

More information

CITY OF JERSEY CITY REQUEST FOR QUALIFICATIONS LABOR/EMPLOYMENT LAW SERVICES. Contract Term: May 5, 2009-May 5, 20010 SUBMISSION DEADLINE 10:00 A.M.

CITY OF JERSEY CITY REQUEST FOR QUALIFICATIONS LABOR/EMPLOYMENT LAW SERVICES. Contract Term: May 5, 2009-May 5, 20010 SUBMISSION DEADLINE 10:00 A.M. CITY OF JERSEY CITY REQUEST FOR QUALIFICATIONS LABOR/EMPLOYMENT LAW SERVICES Contract Term: May 5, 2009-May 5, 20010 SUBMISSION DEADLINE 10:00 A.M. April 23, 2009 ADDRESS ALL PROPOSALS TO: William Matsikoudis,

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION 2900 E. Del Mar Blvd. Pasadena, CA 91107 (626) 356-2700 Fax (626) 356-2695 EMPLOYMENT APPLICATION Aurora Behavioral Health Care- Las Encinas Hospital is an equal opportunity employer. Las Encinas Hospital

More information