AttachmentD.2.pdf

FEDERAL CONTRACTOR VETERANS' EMPLOYMENT REPORT VETS-100

OMB NO:1293-0005 RETURN COMPLETED REPORT TO:

Expires 06-30-2000 U.S. DEPARTMENT OF LABOR

VETERANS' EMPLOYMENT AND TRAINING SERVICE

VETS-100 REPORTING

Persons are not required to respond to this collection 6101 STEVENSON AVE of information unless it displays a valid OMB number ALEXANDRIA, VA 22304

TYPE OF REPORTING

ORGANIZATION

(Check only one) p Prime Contractor (P) p Subcontractor (S) p Both (B)

TYPE OF FORM (Check only one) p Single Establishment (S) p Multiple Establishment-Headquarters

(MHQ)

p Multiple Establishment-Hiring Location

(MHL)

p Multiple Establishment-State Consolidated

(specify number of locations)

______________. (MSC)

COMPANY IDENTIFICATION INFORMATION (Omit preprinted items, enter address changes below) COMPANY No: TWELVE MONTH PERIOD ENDING

M M D D Y Y Y Y

NAME OF PARENT COMPANY: ADDRESS (NUMBER AND STREET):

CITY: COUNTY: STATE: ZIP CODE:

NAME OF HIRING LOCATION: ADDRESS (NUMBER AND STREET):

CITY: COUNTY: STATE: ZIP CODE:

SIC: DUNS:

EMPLOYER I.D. No. (IRS TAX No.) —

INFORMATION ON VETERANS

REPORT ALL REGULAR FULL-TIME OR PART-TIME EMPLOYEES AND NEW HIRES WHO ARE VETERANS, AS DEFINED ON REVERSE SIDE. DATA ON NUMBER OF EMPLOYEES ARE TO BE ENTERED IN COLUMN L, M, AND N. DATA ON NEW HIRES ARE TO BE ENTERED IN COLUMNS O, P, Q, AND R.

ENTRIES IN COLUMNS O THROUGH R, LINES 1 THROUGH 9; AND COLUMNS L, M, AND N, LINE 10 (AREAS SHADED DARK GRAY) ARE OPTIONAL.

ENTRIES IN COLUMN N, LINES 1-9; COLUMN Q, LINE 10; AND THE MAXIMUM AND MINIMUM NUMBER OF EMPLOYEES (AREAS SHADED LIGHT GRAY)

ARE OPTIONAL FOR 1999 ONLY AND WILL BE REQUIRED FOR THE 2000 REPORTING CYCLE. DETAILED INSTRUCTIONS ARE FOUND

ON THE REVERSE SIDE OF THIS FORM.

NUMBER OF EMPLOYEES NEW HIRES (PREVIOUS 12 MONTHS)

JOB

CATEGORIES

SPECIAL DISABLED

VETERANS

(L)

VIETNAM ERA

VETERANS

(M)

OTHER ELIGIBLE

VETERANS

(N)

SPECIAL DISABLED

VETERANS

(O)

VIETNAM ERA

VETERANS

(P)

OTHER VETERANS

(Q)

TOTAL NEW HIRES, BOTH

VETERANS

AND NON-VETERANS (R)

OFFICIALS AND

MANAGERS 1

PROFESSIONALS 2

TECHNICIANS 3

SALES WORKERS 4

OFFICE AND CLERICAL 5

CRAFT WORKERS

(SKILLED) 6

OPERATIVE

(SEMI-SKILLED) 7

LABORERS

(UNSKILLED) 8

SERVICE WORKERS 9

TOTAL 10

Report the total maximum and minimum number of regular employees on board during the period covered by this report.

Maximum Number Minimum Number

FEDERAL CONTRACTOR VETERANS' EMPLOYMENT REPORT (VETS-100)

WHO MUST FILE

The Vets-100 Report is to be completed by all nonexempt federal contractors and subcontractors with contracts or subcontracts for the furnishing of supplies and services or the use of real or personal property for $25,000 or more. Services include but are not limited to the following services: Utility, construction, transportation, research, insurance, and fund depository, irrespective of whether the government is the purchaser or seller.

The existence of $25,000 or more in federal contracts or subcontracts during a given calendar year establishes the requirement to file a VETS-100 Report during the following calendar year.

WHEN TO FILE

This annual report must be filed no later than September 30. Mail to the address pre-printed on the front of the form.

LEGAL BASIS FOR REPORTING REQUIREMENTS

Title 38, United States Code, Section 4212(d) and PL 105-339, require that federal contractors report at least annually the numbers of: 1) special disabled veterans, 2) veterans of the Vietnam era, and 3) other veterans who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized who are in their workforce. Reporting is required by hiring location and includes both the number employed and the number of new hires, within the three categories listed above. The number of veterans employed within these categories is to be broken out by job category and maximum and minimum total employment is to be reported as well.

HOW TO SUBMIT THE VETS-100 REPORTS

Single-establishment employers must file one completed form. All multi-establishment employers, i.e., those doing business at more than one hiring location, must file (A) one form covering the principal or headquarters office: (B) a separate form for each hiring location employing 50 or more persons: and (C) EITHER, (I) a separate form for each hiring location employing fewer than 50 persons, OR (ii) consolidated reports that cover hiring locations within one State that have fewer than 50 employees. Each state consolidated report must also list the name and address of the hiring locations covered by the report. Company consolidated reports such as those required by EEO-1 reporting procedures are NOT required for the VETS-100 Report. Completed reports for the headquarters location and all other hiring locations for each company should be mailed in one package to the address indicated on the front of the form.

RECORD KEEPING

Employers must keep copies of the completed annual VETS-100 Report submitted to DOL for a period of two years.

HOW TO PREPARE THE FORMS

Multi-establishment employers submitting hard copy reports should produce facsimile copies of the headquarters form for reporting data on each location.

Type of Reporting Organization Indicate the type of contractual relationship (prime contractor or subcontractor) that the organization has with the Federal Government. If the organization serves as both a prime contractor and a subcontractor on various federal contracts, check the “Both” box.

Type of Form If a reporting organization submits only one VETS-100 Report form for a single location, check the Single Establishment box. If the reporting organization submits more than one form, only one form should be checked as Multiple Establishment- Headquarters. The remaining forms should be checked as either Multiple Establishment- Hiring Location or Multiple Establishment-State Consolidated. For state consolidated forms, the number of hiring locations included in that report should be entered in the space provided. For each form, only one box should be checked within this block.

COMPANY IDENTIFICATION INFORMATION

Company Number Do not change the Company Number that is printed on the form. If there are any questions regarding your Company Number, please e-mail the VETS-100 staff at HELPDESK@VETS100.com or call (703) 461-2460.

Twelve Month Period Ending Enter the end date for the twelve month reporting period used as the basis for filing the VETS-100 Report. To determine this period, select a date in the current year between July 1 and September 1 that represents the end of a payroll period.

That payroll period will be the basis for reporting Number of Employees, as described below. Then the twelve month period preceding the end date of that payroll period will be your twelve month period covered. This period is the basis for reporting New Hires, as described below. Any federal contractor or subcontractor who has written approval from the Equal Employment Opportunity Commission to use December 31 as the ending date for the EEO-1 Report may also use that date as the ending date for the payroll period selected for the VETS-100 Report.

Name and Address for Single Establishment Employers COMPLETE the identifying information under the Parent Company name and address section (omit if preprinted).

LEAVE BLANK all of the identifying information for the Hiring Location.

Name and Address for Multi Establishment Employers For parent company headquarters location, COMPLETE the name and address for the parent company headquarters (omit if preprinted), LEAVE BLANK the name and address of the Hiring Location. For hiring locations of a parent company, COMPLETE the name and address for the Parent Company location, COMPLETE the name and address for the Hiring Location.

SIC Code, DUNS Number, and Employer ID Number Single Establishment and Multi Establishment Employers should COMPLETE the SIC Code, DUNS Number, and Employer ID Number as described below.

SIC Code Enter the four (4) digit SIC Code applicable to the hiring location for which the report is filed. If there is not a separate SIC Code for the hiring location, enter the SIC Code for the parent company.

Dun and Bradstreet I.D. Number (DUNS) If the company or any of its establishments has a Dun and Bradstreet Identification Number, please enter the nine (9) digit number in the space provided. If there is a specific DUNS Number applicable to the hiring location for which the report is filed, enter that DUNS Number. Otherwise, enter the DUNS number for the parent company.

Employer I.D. Number (EIN) Enter the nine (9) digit numbers assigned by the I.R.S.

to the contractor. If there is a specific EIN applicable to the hiring location for which the report is filed, enter that EIN. Otherwise, enter the EIN for the parent company.

INFORMATION ON VETERANS

Number of Employees Select any payroll period ending between July 1 and September 1 of the current year. Provide all data for regular full-time and part-time employees who were special disabled veterans, Vietnam-era veterans, or other veterans employed as of the ending date of the selected payroll period. Do not include employees specifically excluded as indicated in 41 CFR 61-250.2(b)(2). For 1999, employees must be counted by veteran status for each of the nine occupational categories (Lines 1-9) in Columns L and M. The information in Column N, Lines 1-9 also will be required for the 2000 reporting cycle but this information is optional for 1999. Blank spaces will be considered zeros.

New Hires Report the number of regular full-time and part-time employees by veteran status who were hired (both veterans and non-veterans) and who were included in the payroll for the first time during the 12-month period ending between July 1 and September 1 of the current year. For 1999, the totals in Columns O, P and R (Line 10) are required.

The information in Column Q, Line 10 also will be required for the 2000 reporting cycle but this information is optional for 1999. Enter all applicable numbers, including zeros.

Maximum/Minimum Number of Employees Report the maximum and minimum number of regular employees on board during the period covered as indicated by PL 105-339. This information will be required for the 2000 reporting cycle but it is optional for 1999.

DEFINITIONS:

Hiring location means an establishment as defined at 41 CFR 61 250.2(b).

Special Disabled Veteran means (A) a veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans' Affairs for a disability (I) rated at 30 percent or more, or (ii) rated at 10 or 20 percent in the case of a veteran who has been determined under Section 1506 of Title 38, U.S.C. to have a serious employment handicap or (B) a person who was discharged or released from active duty because of a service-connected disability.

Veteran of the Vietnam-era means a person who: (A) served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred: (I) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (ii) between August 5, 1964, and May 7, 1975, in all other cases; or (B) was discharged or released from active duty for a service-connected disability if any part of such active duty was performed (I) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (ii) between August 5, 1964, and May 7, 1975, in all other cases.

Other Veterans means veterans who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized. To identify the campaigns or expeditions that meet this criterion, contact the Office of Personnel Management (OPM) and ask for the OPM VETS Guide, Appendix B. A local OPM telephone number may be found in the telephone book under Federal Government or consult Directory Assistance for your area code for the nearest OPM location. For those with Internet access, the information required to make this determination is available at http://www.opm.gov/veterans/html/vgmedal2.htm.

Public reporting burden for this collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data source, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden to the Department of Labor, Office of Information Management, Room N-1301, 200 Constitution Avenue, NW, Washington D.C. 20210.