10-Exh V.pdf
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- Attached to
- LRV Pantograph Carbon Shoe
- Solicitation number
- 2089485
- Issued by
- Dallas County, Texas
About this file
This document is an Employee Information Report (Exhibit V) from the Dallas Area Rapid Transit Authority (DART) in Dallas, TX. The form is a standard employment data collection document designed to capture detailed workforce demographic information across various job categories and employee classifications. The report includes sections for company identification, employment data breakdown by race, gender, and job category, and a certification section.
The form provides a comprehensive template for tracking workforce diversity, with columns for males and females across different racial and ethnic groups, including White (Not of Hispanic Origin), Black (Not of Hispanic Origin), Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native. Job categories range from Officials/Managers to Service Workers, allowing for a granular view of the organization's workforce composition. The document is formatted to collect precise employment statistics, with instructions to report all permanent full-time and part-time employees, and to consider blank spaces as zeros in the data entry process.
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Text version
B-2089485
DART Form 33.254(04/04) Page 1 of 2
DALLAS AREA RAPID TRANSIT AUTHORITY
DALLAS, TX
EXHIBIT V
EMPLOYEE
INFORMATION REPORT
SECTION A - TYPE OF REPORT
Indicate by marking in the appropriate box the type of reporting unit for which this copy of the form is submitted (MARK ONLY ONE BOX).
Single Establishment Employer Report Multi-Establishment Employer, Consolidated Report (Required) Multi-Establishment Employer, Headquarters Unit Report (Required) Multi-Establishment Employer, Individual Establishment Report (submit one for each establishment with 50 or more employees) Multi-Establishment Employer, Special Report
Total number of reports being filed by this company (answer only if consolidated report).
SECTION B-COMPANY IDENTIFICATION
(To be answered by all)
Parent Company Name & Address:
Establishment Completing Report
Name & Address (Omit if same as above)
Employer ID Number:
SECTION C - ESTABLISHMENT INFORMATION
(Omit on the Consolidated Report)
1. What is the major activity of this establishment? (Be specific, i.e., manufacturing steel castings, retail grocer, wholesale plumbing supplies, title insurance, etc. Include the specific type of product or type of service provided, as well as the principal business or industrial activity.)
B-2089485
DART Form 33.254(04/04) Page 2 of 2
SECTION D-EMPLOYMENT DATA
Employment at this establishment -- Report all permanent full-time and part-time employees including apprentices and on-the-job trainees unless specifically excluded as set forth in the instructions. Enter the appropriate figures on all lines and in all columns.
Blank spaces will be considered zeros.
JOB
CATEGORIES
NUMBER OF EMPLOYEES
Overall Totals
(Sum of Col. B
Thru K)
MALE
FEMALE
White (Not of
Hispanic Origin)
Black (Not of
Hispanic Origin)
Hispanic Asian or Pacific
Islander America n Indian or Alaskan Native
White (Not of
Hispanic Origin)
Black (Not of
Hispanic Origin)
Hispanic Asian or Pacific
Islander America n Indian or Alaskan Native
Officials/Managers Professionals Technicians Sales Workers Office & Clerical Craft Workers (Skilled)
Operatives (Semi-Skilled)
Laborers (Unskilled)
Service Workers
TOTAL
Answer if not consolidated report: Dates of Payroll Period
Used
Does the establishment employ apprentices?
SECTION E - CERTIFICATION
(See Instructions concerning certification in Exhibit G)
Check One: All reports are accurate and were prepared in accordance with the instructions (check on consolidated only)
This report is accurate and was prepared in accordance with the instructions.
Name/Title of Certifying Official
Signature Date:
Contact Name
Address (Number & Street)
Title City & State
Zip Code Telephone Extension
File details come from the government source that posted it. Updated .