Form A-1237 "Civil Rights/EEO Pre-construction Report" - New Mexico

What Is Form A-1237?

This is a legal form that was released by the New Mexico Department of Transportation - a government authority operating within New Mexico. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2015;
  • The latest edition provided by the New Mexico Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form A-1237 by clicking the link below or browse more documents and templates provided by the New Mexico Department of Transportation.

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Form A-1237
Rev. 4/15T CCRB
NEW MEXICO DEPARTMENT OF TRANSPORTATION
CIVIL RIGHTS/EEO PRE-CONSTRUCTION REPORT
The purpose of this report is to ensure that the Contractor, through his EEO Representative, is
aware of civil rights/EEO responsibilities under the Contract.
The Contractor and/or Contractor EEO Representative shall fill in the appropriate blanks of
Part A, read Part B, and sign Part C;
Part D is for the Contracting Agency Use.
PART A: Contractor Information for the Precon
Pre-Construction Conference Date:
Union
Open Shop
Contractor: ____________________________________________________
Project No.: ____________________________Control No: _______________________________
Contract Amount: $_______________________District___________ County________________
Location: _______________________________________________________________________
NMDOT or LPA Project Manager: _________________________________________________
NMDOT or LPA Project Office Manager: ___________________________________________
Company EEO Officer:
Project EEO Officer:
(Please attach EEO Officer Notification Letter(s))
 Company EEO Policy Statement – (Please attach)
Yes
No
 Minority / female referral contact letters and responses –(Please attach)
Yes
No
 Evidence of indoctrination of supervisory personnel on your Company
EEO Policy by letter or meeting – (Please attach)
Yes
No
DBE Liaison Officer: __________________________________________________________
Contract DBE Participation Goal: ________________________________________________
DBE Subcontractors/Vendors: __________________________________________________
Page 1 of 2
Form A-1237
Rev. 4/15T CCRB
NEW MEXICO DEPARTMENT OF TRANSPORTATION
CIVIL RIGHTS/EEO PRE-CONSTRUCTION REPORT
The purpose of this report is to ensure that the Contractor, through his EEO Representative, is
aware of civil rights/EEO responsibilities under the Contract.
The Contractor and/or Contractor EEO Representative shall fill in the appropriate blanks of
Part A, read Part B, and sign Part C;
Part D is for the Contracting Agency Use.
PART A: Contractor Information for the Precon
Pre-Construction Conference Date:
Union
Open Shop
Contractor: ____________________________________________________
Project No.: ____________________________Control No: _______________________________
Contract Amount: $_______________________District___________ County________________
Location: _______________________________________________________________________
NMDOT or LPA Project Manager: _________________________________________________
NMDOT or LPA Project Office Manager: ___________________________________________
Company EEO Officer:
Project EEO Officer:
(Please attach EEO Officer Notification Letter(s))
 Company EEO Policy Statement – (Please attach)
Yes
No
 Minority / female referral contact letters and responses –(Please attach)
Yes
No
 Evidence of indoctrination of supervisory personnel on your Company
EEO Policy by letter or meeting – (Please attach)
Yes
No
DBE Liaison Officer: __________________________________________________________
Contract DBE Participation Goal: ________________________________________________
DBE Subcontractors/Vendors: __________________________________________________
Page 1 of 2
Form A-1237
Rev. 4/15T CCRB
Peak Employment Date:
Estimated Peak Employment:
PART B: Labor Compliance
The Contractor is responsible for submittal of Certified Payrolls by its own organization and that
of its subcontractors on a weekly basis. O n F e d e r a l - a i d p r o j e c t s C ertified Payrolls will
be submitted in LCPtracker. On 100% State funded projects one hard copy shall be
submitted to Project Manager.
The Contractor is aware of and will comply with the
prevailing wage rate requirements under the contract
The construction contract is subject to the provisions of the USDOL Field Operations Handbook,
Davis-Bacon Act, Copeland Act, Contract Work Hours and Safety Standards Act, and related
Acts.
PART C: Contractor/EEO Representative Signature
I am aware of the above-mentioned information and have received a copy of the Contractor
EEO and Affirmative Action Compliance Information Package.
(Signature of Contractor and/or Contractor’s Company EEO Officer)
Date
PART D: CONTRACTING AGENCY USE
This form was completed by the PM at the pre-construction conference.
This form was completed by the PM at an EEO pre-construction conference.
This form was completed by the Contractor and/or Contractor’s EEO Representative and
submitted to the PM at the pre-construction conference.
The information contained in this form has been reviewed and verified with the exceptions and
action items noted below.
Project Manager
Date
Comments and/or Other Signatures: _________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Distribution: Project File
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