Semi-Annual Report On Representatives Used And Compensation Pain
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2OMB Approval No.: 3245-0270
Expiration Date:
10/31/2015
SEMI-ANNUAL REPORT ON REPRESENTATIVES USED AND COMPENSATION PAID
FOR SERVICES IN CONNECTION WITH OBTAINING FEDERAL CONTRACTS
FOR THE PERIOD ____________________ TO _____________________.
As required by 15 USC 637(a)(20) (a) and 13 CFR Part 124.601, all 8(a) Participants are required to semiannually report to SBA
information on compensation provided to any Agents or Representatives (hereafter referred to as “Representatives”), including attorneys,
accountants, and consultants, for assisting the Participants to obtain a Federal contract. The information includes the amount of
compensation provided to the Representative and a description of the services performed in return for such compensation. The
information is used to ensure that Participants do not engage in any improper or illegal activity in connection with obtaining a contract.
please provide SBA with a list of any agents, representatives, attorneys, accountants, consultants and other parties (other than employees)
receiving fees, commissions, or compensation of any kind for purposes of assisting the Participant in obtaining a Federal contract. Failure
to provide this information is good cause for SBA to initiate proceedings to terminate your 8(a) Program participation.
Representative’s Name:
Address:
City:
State:
ZIP Code:
Fees, Commissions or Compensation:
Amount Paid (If any)
$
Amount Due (If any)
$
Total Amount of Compensation
$
Description of Services Provided:
Representative’s Name:
Address:
City:
State:
ZIP Code:
Fees, Commissions or Compensations:
Amount Paid (If any)
$
Amount Due (If any)
$
Total Amount of Compensation
$
SBA Form 1790 (6-12) Previous Edition Obsolete
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