ETHNICITY/RACE/GENDER BUSINESS OWNERSHIP REPORT Per PCC 10116

RACE Classifications / GOODS / SERVICES / CONSTRUCTION
/ All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other
COLUMN TOTAL CONTRACTS
ETHNICITY Classifications / GOODS / SERVICES / CONSTRUCTION
/ All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000
Asian-Indian
Black
Hispanic
Native American
Pacific-Asian
Other
COLUMN TOTAL CONTRACTS
GENDER Classifications / GOODS / SERVICES / CONSTRUCTION
/ All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000
Female
Male
COLUMN TOTAL CONTRACTS

MINORITY/WOMEN/DISABLED VETERAN-OWNED BUSINESS ENTERPRISE OWNERSHIP REPORT Per PCC 10115.5 and GC 11139.8

MINORIITY Classifications / GOODS / SERVICES / CONSTRUCTION / INFORMATION TECHNOLOGY / ARCHITECTURE AND ENGINEERING
/ All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000
Asian-Indian
Black
Hispanic
Native American
Pacific-Asian
Other
COLUMN TOTAL CONTRACTS
WOMEN-OWNED / GOODS / SERVICES / CONSTRUCTION / INFORMATION TECHNOLOGY / ARCHITECTURE AND ENGINEERING
/ All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000
COLUMN TOTAL CONTRACTS
DISABLED VETERAN-OWNED BUSINESS ENTERPRISE / GOODS / SERVICES / CONSTRUCTION / INFORMATION TECHNOLOGY / ARCHITECTURE AND ENGINEERING
/ All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000 / All Contracts / Contracts Under $25,000
COLUMN TOTAL CONTRACTS
PREPARED BY: / DIVISION/BRANCH/OFFICE: / APPROVED BY:
Name /

Division

/

Name

Title / Branch/Office / Title
Phone / Address / Phone
Fax / City / Fax
E-Mail / ZIP / E-Mail
Signature / Signature
Date / Date

Per statute, each awarding department is responsible for submitting this information directly to the Governor and the Legislature. ERGMWDVBE Form: November 2003