X hits on this document

136 views

0 shares

0 downloads

0 comments

58 / 63

APPENDIX THREE

Attachment H

HISTORICALLY UNDERUTILIZED BUSINESS PROGRESS ASSESSMENT REPORT

DOCUMENTATION OF SUBCONTRACTED WORK

Date of Award

_________

Contract/Requisition Number____________

Object Code (agency use): ______

NON-HUB/Prime Contractor Name

________________________________________________________

HUB Prime Contractor Name

____________________________________________________________

C o n t r a c t o r / V e n d o r I d e n t i f i c a t i o n N u m b e r ( V I D N u m b e r ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

T o t a l C o n t r a c t A m o u n t P a i d t h i s R e p o r t i n g P e r i o d t o C o n t r a c t o r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Report Subcontractor Information below:

Object

Total

Total $

Total

Code

Contract $

Amount

Contract $

(agency

Amount

Paid This

Amount

use only)

from LOI

Period to

Paid to Date

with HUB

Subcontract

to

Subcontract

or

Subcontract

or

or

Subcontractor

TBPC Subcontractor/Supplie VID/Certificate

r

Number for

Name

HUB

TOTAL REPORTED

$

$

$

__________

__________

__________

__________

Form to be completed and submitted to the Contracting Agency, Procurement Team on a monthly or quarterly basis according to the dates below. Please identify the month or quarter being reported:

Signature:

Date:

__________________________ Month or Quarter Included Deadline Identify Month/Quarter

First

(Sep., Oct., Nov.)

Second (Dec., Jan., Feb.)

  • -

    13 -

______________________________

_________________________

Title:

Document info
Document views136
Page views136
Page last viewedWed Dec 07 11:18:56 UTC 2016
Pages63
Paragraphs1594
Words21443

Comments