Project Labor Agreement (PLA) Workforce Participation Quarterly Reporting Form Contractor Name: Contract Number: Quarterly Submission: (check one) Jan - Mar Apr - June Jul - Sept Oct - Dec Contact Information Name: Title: Phone: E-mail: PLA Workforce Data Please indicate the number of minority and female individuals employed under the above referenced project labor agreement contract: Female Black or African American Hispanic or Latino Asian American Native American or Alaskan Native Native Hawaiian or Other Pacific Islander Verification Statement On behalf of, , I, ,certify that all information reported herein is true and accurate to the best of my knowledge and belief. Signature: Date:
Project Labor Agreement (PLA) Workforce Participation Quarterly Reporting Form Contractor Name: Contract Number: Quarterly Submission: (check one) Jan - Mar Apr - June Jul - Sept Oct - Dec Contact Information Name: Title: Phone: E-mail: PLA Workforce Data Please indicate the number of minority and female individuals employed under the above referenced project labor agreement contract: Female Black or African American Hispanic or Latino Asian American Native American or Alaskan Native Native Hawaiian or Other Pacific Islander Verification Statement On behalf of, , I, ,certify that all information reported herein is true and accurate to the best of my knowledge and belief. Signature: Date:
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