180-26 - Exhibit A. CDBG 2025 SPECS_compressed.pdf

INITIAL PROJECT WORKFORCE REPORT - CONSTRUCTION Official Use Only STATE OF NEW JERSEY Assignment DIVISION OF CONTRACT COMPLIANCE EQUAL EMPLOYMENT OPPORTUNITY IN PUBLIC CONTRACTS Code FORM 16-261 Reed 1803 INITIAL PROJECT WORKFORCE REPORT CONSTRUCTION Ee READ IN TONS ON PLEASE TYPE OR PRINT IN FID NUMBER BLACK OR BLUE INK. 2 CONTRACTOR 0 NUMEER ‘3. NAME AND ADORESS OF PUBLIC AGENCY AWARDING CONTRACT 3. NAME AND ADDRESS OF PRIME CONTRACTOR Came) CONTRACT NUMBER DATE OF AWARD DOLLAR AMOUNT OF AWARD Gieiadareny © NAME AND ADDRESS OF PROJECT PROTECT NUMBER (cigs) Gan) (Zip Code) county 8. 1S THIS PROJECT COVERED BY A PROJE( 4. 1S THIS COMPANY MINORITY OWNED [_] OR WOMAN OWNED [ ) LABOR AGREEMENT (PLA}? OYES ONC —— — — TRADE OR CRAFT PROJECTED PROJECTED PHASE -IN COMPLETION DATE DATE cone PROJECTED TOTAL EMPLOYEES PROJECTED MINORITY EMPLOYEES aa 1. ASBESTOS WORKER | 4. ELECTRICIAN 5. GLAZIER 6, HVAC MECHANIC 7. IRONWORKER 8. OPERATING ENGINEER 9, PAINTER 10. PLUMBER 11, ROOFER 12. SHEET METAL WORKER | 13. SPRINKLER FITTER 14. STEAMFITTER 15. SURVEYOR 16. TILER i= 17. TRUCK DRIVER 18. LABORER 19. OTHER 20, OTHER 4 —— Thereby certify that the foregoing statements made by ine are (rue. Lain aware (iat if any of tre for false, Lam subject to punishment. (Signature) To (Pleace Print Your Name) Tide (Area Code) (Telephone Number) Ext.) Dare) P-54