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EXIT C <br />I, STATE OF OREGON -DEPARTMENT OF ENVIRONMENTAL QUALITY <br />MBE/WBE UTILIZATION -FEDERAL GRANTS <br />PART 1. REPORTS ARE REQ UIRED EVENIF NO PROCUREMENTS ARE MADE D URING THE REPORTING PERIOD. <br />1A. FEDERAL FISCAL YEAR 200 B. REPORTING QUARTER (Federal Fiscal Year) <br />( Federal Fiscal Year Oct. l -Sept. 30) ^ 1st (Oct-Dec) ^ 2nd (Jan-Mar) ^ 3rd (Apr-Jun) ^ 4th (Jul-Sep) <br />1C. BENISON Year: Quarter: IGHLIGHT ITEMS TO BE REVISED AND PROVIDE EXPLANATIONINBLOCg # 6. <br />'2:1. 1~'IDERAI: FINANCIAL ASSISTANCI~ AGENCI' 3A. REPORTING RECIPIENT (Name and Address) <br />LIS Ln~°ironmcn~al Protccti~m As~ rnc~~ <br />2B. llEQ RLI'OR'fING CON'f.,~C"C C. PIfO~VI; 3B. REPORTING CONTACT 3C. PHONE"' <br />4:~. FEllFRAL GRANT N U~113FR / DEQ PC~i / PRO.)ECT 413. }'EUERAL P1N:~NCIAL ASS}ti f ~1NCE PRgGRAM <br />C)-000451-04 (G22214-04) 64743 1V 04556-00 (CF DA} 66.460 <br />5:1. C R ;1 N T ;1 M O tl N'I' ~ B: Check and skip to Black-# T-if - ---- - SC: TOTAL--PROCUREMENT-AMOUN3' ----- <br />Federal t~ uads : ~o pr~e~rements aud-accomplishments-were- --T-HIS-REPORTING-PERIOD_(QNLY~T_ .-___ <br /> jade this reporting period. include the amount not in any prior <br />A}atcli Funds : <br />_~,.-_ ~ TT ~. __ <br />_, _. T_ _ _ , <br />rr-eporting_period):_ ,._ m_ <br />~~ <br />TOTAL <br /> $ __ <br />~.C'TL'~XC"n7T3H:1'~~4T}Ta'"t KtTOCJ'[2F.~TFiVTS /~l~Of711iPi,}5}IE.D C~Tf~ ` <br />SU SE. ACTUAL lt"I$E/WBE PROCUREft'I'ENTS <br />~ <br />i7 CIN(; PF' kIOD BY nEQ ;; ,, , ,r~. ? <br />-` ~; ~ AGCOMPLISI$~,D THIS REP-OR-T-Il~IG=PERIOD BY-==---_ <br />, . <br />`~ ~.. ~ h}aE~.=, <br />~. . <br />,,; <br />~, .~~wR} <br />J NT. <br />RECrniE <br /> <br />$ MBE $ WISE <br />Lyui~~me t .; Construction <br /> Equipment <br />$e~tiices , <br />.. -, `. <br />bi~pplie~ m ~µ a ~w~.K.ww.~...,,,.w„ ~.~~A~.:~ „,..,..,,.~M µ ~ ~~. ~+ Services. <br />Supplies <br />~; <br />'O'I`r1l <br />` TOTAL <br />.,.. ~ ~ _ ®..._ .. i <br />6. COMMENTS: <br />7. NAME OF AUTHORIZED REPRESENTATIVE <br />TITLE <br />SIGNATURE OF <br />MAIL COMPLETED FORM TO: Dept. of Environmental Quality <br />Contracts Office <br />811 SW Sizth Avenue <br />Portland OR 97204 <br />Deg5700-52A 11/2003 <br />