ATTACHMENT “D” OFFICE OF BUSINESS OPPORTUNITY AND CONTRACT COMPLIANCE M/WBE UTILIZATION REPORT Report Period: PROJECT NAME & NUMBER: AWARD DATE: PRIME CONTRACTOR: CONTRACT NO.: ADDRESS: CONTRACT AMOUNT: LIAISON/PHONE NO.: M/WBE GOAL: % OF % OF M/WBE DATE OF OBO DATE OF SUBCONTRAC TOTAL AMOUNT CONTRACT SUB/VENDOR NAME CERTIFICATION SUBCONTRACT T AMOUNT CONTRACT PAID TO DATE TO DATE Use additional pages if needed. Submit by the 15th day of the following month. Office of Business Opportunity Provide support documentation on all revenues paid to end of the report period to: ATTN: Carlecia Wright 713-837-9000 M/WBE’s to reflect up/down variances on Contract amount. 611 Walker, 7th Floor Houston, Texas 77002 Page 61 of 75
ATTACHMENT “D” OFFICE OF BUSINESS OPPORTUNITY AND CONTRACT COMPLIANCE M/WBE UTILIZATION REPORT Report Period: PROJECT NAME & NUMBER: AWARD DATE: PRIME CONTRACTOR: CONTRACT NO.: ADDRESS: CONTRACT AMOUNT: LIAISON/PHONE NO.: M/WBE GOAL: M/WBE SUB/VENDOR NAME DATE OF OBO CERTIFICATION DATE OF SUBCONTRACT SUBCONTRAC T AMOUNT % OF TOTAL CONTRACT AMOUNT PAID TO DATE % OF CONTRACT TO DATE Use additional pages if needed. Submit by the 15th day of the following month. Office of Business Opportunity Provide support documentation on all revenues paid to end of the report period to: ATTN: Carlecia Wright 713-837-9000 M/WBE’s to reflect up/down variances on Contract amount. 611 Walker, 7th Floor Houston, Texas 77002 Page 61 of 75
PCMS%20Word%20Version%20of%20Required%20Forms.docx