Exhibit_K_-_MWBE_Information_&_Form.pdf

County of Volusia Office of Recovery and Resiliency

1578 N. Woodland Blvd DeLand, FL 32720

Minority & Women Business Reporting Form (MWBE) Information and Instructions for Contractors & Subcontractors

Reporting

This report shall be completed by all contractors and subcontractors for reporting contract and subcontract activities for construction projects as required by the County of Volusia Office of Recovery and Resiliency. Subcontracts of less than $10,000 must be reported individually only if such contracts represent a significant portion of the total contracting activity.

• Section 7a:

Amount of Contract/Subcontract: Enter the dollar amount rounded to the nearest dollar. If subcontractor

ID number is provided in 7f, the dollar figure would be for the subcontract only and not for the prime contract.

• Section 7b:

Type of Trade: Enter the numeric code which best indicates each contractor’s/subcontractor’s service type. If subcontractor ID number is provided in 7f, the type of trade code would be for the subcontractor only and not for the prime contractor.

* The “other” category includes supply, professional services, and all other activities except construction and education/training activities

• Section 7c:

Business Racial/Ethnic/Gender Code: Enter the numeric code which best indicates the racial/ethnic/gender character of the owner(s) and controller(s) of 51% of the business. When 51% or more is not owned and controlled by any single racial/ethnic/gender category, enter the code which seems most appropriate. If the subcontractor ID number is provided, the code would apply to the subcontractor and not the prime contractor

• Section 7d:

Women Owned Business: Enter “yes” or “no” to if each listed agency is women owned

• Section 7e:

Contractor Identification Number: Enter the Employer (IRS/FEIN) Number of the Prime Contractor as the unique identifier of the prime recipient of HUD funds. Note that the Employer (IRS) Number must be provided for each contract/subcontract awarded.

• Section 7f:

Subcontractor Identification Number: Enter the Employer (IRS/FEIN) Number of the subcontractor as the unique identifier for each subcontract awarded from HUD funds. When the subcontractor ID number is provided, the respective Prime Contractor ID Number must also be provided.

• Section 7g:

Contractor/Subcontractor Business Name and Address: Enter this information for each firm receiving contract/subcontract activity only one time on each report for each firm.

EXHIBIT K

Amount of Contract or

Subcontract

7a.

Type of Trade

Code

(See below)

7b.

Contractor or

Subcontractor

Business

Racial/Ethnic

(See below)

7c.

Woman Owned

Business

(Yes or No)

7d.

State Zip

1= White Amercians

2= Black Americans

3= Native Americans

4= Hispanic American

Subcontractor

Identification

Number

(IRS/FEIN)

7f.

Project Name: ____________________________________________________________________

Prime Contractor

Identification

Number

(IRS/FEIN)

7e.

Contractor/Subcontractor Business Name and Address

7g.

StreetBusiness Name

County of Volusia Office of Recovery and Resiliency - Contract and Subcontract - Minority and Women Business Reporting Form

7c: Racial/

Ethnic Codes

Name/Title: _______________________________________________ Signature: ___________________________________________ Date: _______________________

5= Asian/Pacific American

3 = Other

2 = Education/Training

7b: Type of Trade Codes:

CPD

1 = New Construction

City

EXHIBIT K