"Affirmative Action Form" - Alabama

Affirmative Action Form is a legal document that was released by the Alabama Department of Transportation - a government authority operating within Alabama.

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Statement Required To Be Submitted By Proposed Subcontractor Pursuant To Notice
of Requirement For Affirmative Action To Ensure Equal Employment Opportunity
(Executive Order 11246) And Regulations In 41 CFP Part 60-4 On All Federal And
Federally Assisted Contracts In Excess of $10,000.
Project Number
County
Name of Subcontractor
Mailing Address
Street
City
State
Zip
Telephone Number
Employer Identification Number
“Employer Identification Number” means the Federal Social Security Number
used on the Employer’s Quarterly Federal Tax Return, U. S. Treasury
Department Form 941.
Amount of Subcontract: $
Estimated Starting Date
Estimated Completion Date
State-County-City Where Work is to be Performed
Information Furnished By:
(Printed)
Title:
By:
(Signed)
The above information must be furnished for approval of your subcontract.
Statement Required To Be Submitted By Proposed Subcontractor Pursuant To Notice
of Requirement For Affirmative Action To Ensure Equal Employment Opportunity
(Executive Order 11246) And Regulations In 41 CFP Part 60-4 On All Federal And
Federally Assisted Contracts In Excess of $10,000.
Project Number
County
Name of Subcontractor
Mailing Address
Street
City
State
Zip
Telephone Number
Employer Identification Number
“Employer Identification Number” means the Federal Social Security Number
used on the Employer’s Quarterly Federal Tax Return, U. S. Treasury
Department Form 941.
Amount of Subcontract: $
Estimated Starting Date
Estimated Completion Date
State-County-City Where Work is to be Performed
Information Furnished By:
(Printed)
Title:
By:
(Signed)
The above information must be furnished for approval of your subcontract.