8-11 - Exhibit V - 33-254.pdf

PDF 165 KB Posted

Attached to
Furniture & Equipment Moving Services
Solicitation number
2097404
Issued by
Dallas County, Texas

About this file

This is an Employee Information Report form (DART Form 33.254) submitted to the Dallas Area Rapid Transit Authority in Dallas, Texas, in connection with Solicitation No. 2097404 for Furniture & Equipment Moving Services. The form serves as a reporting mechanism for contractor employment data and requires respondents to classify their organization as either a single establishment employer or a multi-establishment employer entity. Contractors must complete Section B to identify their parent company and establishment information, along with their employer identification number. The form requests detailed establishment information in Section C, including a description of the major activity and specific services or products provided by the establishment.

Section D of the form requires contractors to report all permanent full-time and part-time employees, including apprentices and on-the-job trainees, categorized by job classification (Officials/Managers, Professionals, Technicians, Sales Workers, Office & Clerical, Craft Workers, Operatives, Laborers, and Service Workers) and demographic composition (Male/Female and racial/ethnic categories including White, Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native). The form also requests payroll period dates and inquires whether the establishment employs apprentices. A certifying official must sign and date the completed form, confirming its accuracy and compliance with instructions provided in Exhibit G, with contact information provided for the certifying official.

View the file

Other files

File Type Posted
2-4 - Exhibit B - 33B.pdf PDF
9-1 - Offer Award Form - 33-201.pdf PDF
5-7 - Exhibit F - 33-401.pdf PDF
7-9 - Exhibit H - SOW.pdf PDF
4-8 - Exhibit G - 33-216L.pdf PDF
3-5 - Exhibit C - 33-205L.pdf PDF
12-209740 - Prospetive SBE Vendors.XLS XLS spreadsheet
10-6 - Exhibit D - 33D.pdf PDF
11-10 - Exhibit L - 33-253.pdf PDF
6-2 - Bid Schedule.pdf PDF
1-3 - Exhibit A -33 - 204.pdf PDF
Show all 11

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

Solicitation No. 2097404

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.)

Solicitation No. 2097404

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 .