Federal Requirements For Construction Contracts Page 20
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355.
Does any owner of your enterprise who is not a minority group member also have an
ownership interest in any other firm working on this project?
Yes
No
(If yes, state the name of each such owner and the names of the firms in which such
ownership interests exists.)
6.
Has your enterprise entered into any agreement with any of the firms named in
Question #5?
Yes
No
(If yes, describe such agreements.)
7.
Are any of the minority owners listed in Question #3 or any minority group member
officers of your business a former or current employee of any other firm working on the
project?
Yes
No
(If yes, state the name(s) of the individual(s), name(s) of the employer(s), date(s) of
employment with the other firm(s), and responsibilities in such employment.)
8.
Has your enterprise subcontracted with other firms any work to be performed on this
project?
Yes
No
(If yes, state the percentage of work subcontracted and the nature of such work.)
I certify that the foregoing information is correct and complete.
Printed or Typed Name of Owner or Officer
Signature of Owner or Officer
Title of Owner or Officer Above
Date
Page 18
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