Number of Employees (Report employees in only one category) Race/Ethnicity Not Hispanic or Latino Hispanic or Latino Male Female Job Categories Native Native Total Black Black or or Two or or or Two or A-N Male Female White African Other Asian Indian more White African Other Asian Indian more Ameri-can Pacific or races Pacific or races Native Native A B C D E F G H I J K L M N O Executive/Senior-Level Officials and Managers First/Mid-Level Officials and Managers Professionals Technicians Sales Workers Administrative Support Workers Craft Workers Operatives Laborers and Helpers Service Workers TOTAL PREVIOUS YEAR TYPE OF Manufacturing Wholesale Construction Regular Dealer Selling Agent Service Establishment BUSINESS Signature of Certifying Official Company Name Printed Name and Title Code Date Submitted Telephone Number/Fax Number
Job Categories Number of Employees (Report employees in only one category) Race/Ethnicity Hispanic or Latino Not Hispanic or Latino Total A-N Male Female Male Female White Black or African Ameri-can Native or Other Pacific Asian Indian or Native Two or more races White Black or African Native or Other Pacific Asian Indian or Native Two or more races A B C D E F G H I J K L M N O Executive/Senior-Level Officials and Managers First/Mid-Level Officials and Managers Professionals Technicians Sales Workers Administrative Support Workers Craft Workers Operatives Laborers and Helpers Service Workers TOTAL PREVIOUS YEAR TYPE OF BUSINESS Manufacturing Wholesale Construction Regular Dealer Selling Agent Service Establishment Signature of Certifying Official Company Name Printed Name and Title Code Date Submitted Telephone Number/Fax Number
RFP_17-7069-39_BRT_SHELTERS__KIOSKS.docx