PDF For Use With Contracts That Have Minority/Women-owned ...

NEW YORK CITY TRANSIT AUTHORITY Division of Materiel

PACKAGE 2

FOR USE WITH CONTRACTS THAT HAVE MINORITY/WOMEN-OWNED BUSINESS

ENTERPRISE ("M/WBE") GOALS AND DO NOT CONCERN CONSTRUCTION AND/OR

PUBLIC WORKS

THIS PACKAGE CONTAINS THE FOLLOWING FORMS: ? FORM EEO-1 (EMPLOYER INFORMATION REPORT) ? FORM WF-257 (WORK FORCE UTILIZATION REPORT - SERVICE AND/OR CONSULTANT FIRMS) ? STAFFING PLAN FORM ? FORM 15A.1 (MBE/WBE UTILIZATION PLAN FORM) ? FORM 15A.2 (REQUEST FOR TOTAL OR PARTIAL WAIVER OF MBE/WBE GOAL(S) PURSUANT TO MBE/WBE UTILIZATION PLAN FORM) ? FORM 15A.3 (MONTHLY MBE/WBE PARTICIPATION REPORT) ? FORM 15A.4 (INTENT TO PERFORM AS SUBCONTRACTOR/ SUBCONSULTANT)

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METROPOLITAN TRANSPORTATION AUTHORITY Office of Civil Rights

EQUAL EMPLOYMENT OPPORTUNITY

EMPLOYER INFORMATION REPORT EEO-1

Section A - TYPE OF REPORT

1. Indicate by marking in the appropriate box the type of reporting unit for which this copy of the form is submitted (MARK ONLY ONE BOX.) Multi-establishment Employer:

(1)

Single-establishment Employer Report

(2) Consolidated Report (Required)

(3) Headquarters Unit Report (Required)

(4) Individual Establishment Report (submit one for each establishment with 50 or more employees)

(5) Special Report

2. Total number of reports being filed by this Company (Answer on Consolidated Report only)

SECTION B -- COMPANY IDENTIFICATION (To be answered by all employers)

Office Use Only

1. Parent Company

a. Name of parent company (owns or controls establishment in item 2) omit if same as above

a.

Address (Number and street)

b.

City or town

State

ZIP code

c.

2. Establishment for which this report is filed. (Omit if same as above)

a. Name of establishment

d.

Address (Number and street)

City or Town

b. Employer Identification No. (IRS 9-DIGIT TAX NUMBER)

County State

c. Was an EEO-1 report filed for this establishment last year?

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1 YES

2 NO

ZIP code e. f.

METROPOLITAN TRANSPORTATION AUTHORITY Office of Civil Rights

EQUAL EMPLOYMENT OPPORTUNITY

EMPLOYER INFORMATION REPORT EEO-1

Section C - EMPLOYMENT DATA Page 2 Employment at this establishment-Report all permanent full-time and part-time employees including apprentices and on-the-job trainees unless specifically excluded as set forth in the instructions. Enter the appropriate figures on all lines and in all columns. Blank Spaces will be considered as zeros.

NUMBER OF EMPLOYEES

Job Categories

MALE

Overall Totals (Sum of Col. B thru K)

White (Not of Hispanic Origin)

Black (Not of Hispanic Origin)

Hispanic

Asian or Pacific Islander

A

B

C

D

E

Officials and Managers 1

Professionals

2

Technicians

3

Sale Workers 4

Office and Clerical 5

Craft Workers (Skilled)

Operatives (Semi-Skilled) 7

American Indian or Alaskan Native

F

FEMALE

White (Not of Hispanic Origin)

Black (Not of Hispanic Origin)

Hispanic

Asian or Pacific Islander

G

H

I

J

American Indian or Alaskan Native

K

Laborers

(Unskilled)

8

Service Workers 9

TOTAL

10

Total employment

reported in previous

EEO-1

report

11

NOTE: Omit questions 1 and 2 on the Consolidated Report.

1. Date(s) of payroll period used:

2.

Does this establishment employ apprentices?

1 Yes 2 No

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METROPOLITAN TRANSPORTATION AUTHORITY Office of Civil Rights

EQUAL EMPLOYMENT OPPORTUNITY

EMPLOYER INFORMATION REPORT EEO-1

Page 3

Section D -ESTABLISHMENT INFORMATION (Omit on the Consolidated Report)

1. What is the major activity of this establishment? (Be specific, i.e., manufacturing steel castings, retail grocer, OFFICE

wholesale plumbing supplies, title insurance, etc. Include the specific type of product or type of service provided, USE

as well as the principal business or industrial activity).

ONLY

g. Section E-REMARKS

Use this item to give any identification data appearing on last report which differs from that given above, explain major changes in composition or reporting units and other pertinent information.

Section F-CERTIFICATION

Check 1 one 2

All reports are accurate and were prepared in accordance with the instructions (check on consolidated only) This report is accurate and was prepared in accordance with the instructions.

Name of Certifying Official

Title

Signature

Date

Name of person of contact regarding this report (type or print)

Title

Address (Number and Street)

City and State

ZIP Code

Telephone Number (Including Area Code)

All reports and information obtained from individual reports will be kept confidential as required by Section 709(e) of Title VII. WILLFULLY FALSE STATEMENTS ON THIS REPORT ARE PUNISHABLE BY LAW, U.S. CODE, TITLE 18, SECTION 1001.

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Agency

Contractor Firm Name

City Type of Report:

Contract Specific Work Force

WORK FORCE UTILIZATION REPORT

SERVICE and/or CONSULTANT FIRMS

/Code

Reporting Period

Address

Check one:

State

Zip

Total Work Force

Quarterly Report

Semi-Annual Report Check if NOT-FOR-PROFIT

Federal Id/Payee Id No.

Check One: Subcontractor

Prime Contractor

Contract Amount: $---------------------------------------------

Contract No. ZIP Product/Service Provided: Contract Start Date:

Number of Employees

Location of Work Percent of Job Completed

Federal Occupational Category

Total Number of Employees

Male Officials/Admin Professionals Technicians Sales Workers Office & Clerical Craft Workers Operatives Laborers Service Workers

TOTALS Company Official's Name

Company Official's Signature

Female

Black (Not of Hispanic

Origin)

Male

Female

Hispanic

Asian or Pacific Islander

Native American/ Alaskan Native

Male

Female

Male

Female

Male

Female

Title Date

County

Total Percent

Total Percent Female

Minority Employees

Employees

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