5-Exh V 33-254.pdf
PDF 164 KB Posted
- Solicitation number
- 2093306
- Issued by
- Dallas County, Texas
About this file
This document is an Employee Information Report (DART Form 33.254) submitted to the Dallas Area Rapid Transit Authority in Dallas, Texas, in connection with a Rebuilt Static Inverter (SIV) Overhaul and Repair Services contract opportunity. The form serves as a standard employment data collection instrument requiring contractors to report detailed workforce composition across nine job categories, including officials/managers, professionals, technicians, sales workers, office and clerical staff, craft workers, operatives, laborers, and service workers. Contractors must complete this form for single or multi-establishment operations, providing establishment identification, major activity descriptions, and payroll period information, with separate reporting requirements for consolidated reports, headquarters units, and individual establishments with 50 or more employees.
The employment data section requires contractors to disaggregate all permanent full-time and part-time employees by gender and ethnicity across six demographic categories: white (non-Hispanic), black (non-Hispanic), Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native. Contractors must also indicate whether the establishment employs apprentices and provide certification that all reported data is accurate and prepared in accordance with instructions, with the certifying official required to sign and date the submission. This form functions as a compliance and demographic reporting mechanism for contract administration and equal employment opportunity monitoring purposes.
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Other files
| File | Type | Posted |
|---|---|---|
| 9-Exh F.pdf | ||
| 6-Coversheet.pdf | ||
| 3-Price Schedule.pdf | ||
| 7-Exh B.pdf | ||
| 1-Exh A.pdf | ||
| 8-Exh D.pdf | ||
| 4-Exh H.pdf | ||
| 12-2093306 SIV Solicitation.pdf | ||
| 10-Exh C.pdf | ||
| 11-Exh G.pdf | ||
| 2-Exh L.pdf |
Show all 11
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Text version
B-2093306
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-2093306
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 .