To: Area Director, Office of Federal Contract Compliance Program, U.S. Department of Labor (DOL) (Insert address for your DOL area, from exhibit E, FmHA or its successor agency under Public Law 103-354 Instruction 1901-E)
We submit the following information relative to a construction contract in excess of $10,000:
1. Contractor's name:
Address: _______________________________
Telephone Number: _______________________________
Employer's Identification Number: _______________________________
2. Contract for: ____ $__________
Starting Date: _______________________________
Completion Date: _______________________________
Contract Number: _______________________________
City: _______________________________
DOL Region: _______________________________
7 C.F.R. 1901 app Exhibit C to Subpart E of Part 1901