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Form Hud-40110-C - Annual Progress Report (Apr) - Housing Opportunities For Persons With Aids (Hopwa) Program Page 18

2. Subrecipient Information/Sponsor Activities

Provide the following information for each organization with a contract/agreement of $25,000 or greater that assist project

sponsor carrying out project sponsor functions. For example, use this section to report on organizations involved in an aspect of

service delivery for beneficiaries. Organizations listed may have contracts with project sponsors or other organizations beside

the grantee. Agreements include: grants, subgrants, loans, awards, cooperative agreements, and other foams of financial

assistance; and contracts, subcontracts, purchase orders, task orders, and delivery orders.

Subrecipient Name

Parent Company Name, if applicable

Name and Title of Contact at Contractor/

Sub-contractor Agency

Email Address

Business Address

City, County, State, Zip

Phone Number (included area code)

Fax Number (include area code)

Employer Identification Number (EIN) or

Dun & Bradstreet (DUNs), if applicable

Tax Identification Number (TIN)

North American Industry Classification

System (NAICS) Code

Congressional District of Business Address

Congressional District of Primary Service

Area

Zip Code(s) of Primary Service Area(s)

City (ies) and County (ies) of Primary Service

Area(s)

Total HOPWA Subcontract Amount for this

Organization

Previous editions are obsolete

Page

form HUD-40110-C (Expiration Date: 12/31/2010)

Form Hud-40110-C - Annual Progress Report (Apr) - Housing Opportunities For Persons With Aids (Hopwa) Program Page 18