New Search
EXHIBIT C <br /> STATE OF OREGON -DEPARTMENT OF ENVIRONMENTAL QUALITY <br /> MBE/WBE UTILIZATION -FEDERAL GRANTS <br /> PART 1. REPORTS ARE REQ UIRED EVEN IF NO PROCUREMENTS ARE MADE DURING THE REPORTING PERIOD. <br /> lA. FEDERAL FISCAL YEAR 200 1B. REPORTING QUARTER (Federal Fiscal Year) <br /> (Federal Fiscal Year Oct. 1-Sept. 30) ? 1st (Oct-Dec) ? 2nd (Jan-Mar) [mod (Apr-Juo) ? 4th (Jut-Sep) <br /> 1C. REVISON Year: Quarter: HIGHLIGHT ITEMS TO BE REVISED AND PROVIDE EXPLANATIONINBLOC% # 6. <br /> 2A. FEDL''iZALF1N:~NC1,1i,ASSTS"1"ANCFA<:ENCY 3A. REPORTING RECIPIENT (Name and Address) <br /> US Lnvironmarial Protection A~encY <br /> 8C 5 f?e a2.~~ ~ ~{.tst. <br /> > d- <br /> 213.UE(1REPORTINGCON'l'ACT 2C.TIIONE ~ 3B. REPORTING CONTACT 3C. PHONE <br /> - s.. - <br /> 3,- <br /> - - <br /> 4A~-: FN;DEKALGEZANI'NU11113ER/ DGQPCA/PROJF,[T -~B' [~fp'F,,~I FT{;1'Ah(,]~~'~ C NKO ~11(GFDA) Q <br /> ~ . - <br /> ~ <br /> 5;\. (:R:~NT AMOUNT B. Check and skip to Block # 7 if SC. TOTAL PROCUREMENT AMOUNT <br /> I'cdcrsl Funds : / p no procurements and accomplishments TffiS REPORTING PERIOD (ONLY include <br /> ~t atch Funds : f ~ ~ ~ were made this reporting period. the amount not in any prior reporting period): <br /> ~Sti<ACTLjQLTiS~VBH PR[KUR-HniFh1'S ~ C~ 1ES-1~~1~1t.?' SE. ACTUAL~MBE/WBEPROCUREMENTSACCOMPLISHED <br /> REPOKTINC' PF R10I) I3Y bl+ (Z ~ " ~ ~ a ' THIS REPORTING PERIOD BY RECIPIENT: <br /> ~ ~ ~ ~ ti~~~ ~"~S ril I3F : ~ }YI "`o, ~ r S MBE S WBE <br /> a, ~ ~ ~ <br /> ns[ructiun w~ ~ ~ - ~ ~ ~ ~ Construction <br /> a <br /> <br /> ~Nqupm nt; r k~ ~ ~ Equipment <br /> ` c , <br /> * s ` . r ~r Services 3 !D . O U <br /> S~ rV icc ~ ~ F t , <br /> PP ~a/. 9O <br /> SilOplle F:~, t ~ ~ r~ ~ . tF ' Sn Iles <br /> 4 `CO1.~1. ~ / TOTAL g4 <br /> 6. COMMENTS: <br /> 7. NAME OF AUTHORIZED REPRESENTATIVE '~TLE <br /> e <br /> & SIGNATURE OF AUTHORIZED REPRESENTATIVE DATE <br /> 7 _ ~ <br /> MAIL COMPLETED FORM TO: Dept. of Environmental Quality <br /> Contracts Office <br /> 811 SW Sixth Avenue <br /> Portland OR 97204 <br /> Oeg570C-52A 11/2003 <br /> <br />