STAFFINGPLAN

SubmitwithBidorProposal–Instructions onpage2

SolicitationNo.: / ReportingEntity: / ReportincludesContractor’s/Subcontractor’s:
□Workforcetobeutilizedonthiscontract
Offeror’sName:
/ □Offeror
□Subcontractor
Subcontractor’sname
Offeror’sAddress:

Enter the total number of employees for each classification in each of the EEO-Job Categories identified

EEO-JobCategory / TotalWorkforce / WorkforcebyGender / WorkforcebyRace/EthnicIdentification
TotalMale(M) / TotalFemale(F) / White
(M)(F) / Black
(M)(F) / Hispanic
(M)(F) / Asian
(M)(F) / NativeAmerican
(M)(F) / Disabled
(M)(F) / Veteran
(M)(F)
Officials/Administrators
Professionals
Technicians
SalesWorkers
Office/Clerical
CraftWorkers
Laborers
ServiceWorkers
Temporary
/Apprentices
Totals
PREPAREDBY(Signature): / TELEPHONENO.:
EMAILADDRESS: / DATE:
NAMEANDTITLEOFPREPARER(PrintorType): / Submitcompletedwithbidorproposal

Generalinstructions:AllOfferorsandeachsubcontractoridentifiedinthebidorproposalmustcompleteanEEOStaffingPlan(M/WBE101)andsubmititaspartofthebidorproposalpackage.WheretheworkforcetobeutilizedintheperformanceoftheStatecontractcanbeseparatedoutfromthecontractor’sand/orsubcontractor’stotalworkforce,theOfferorshallcompletethisformonly fortheanticipatedworkforcetobeutilizedontheStatecontract.WheretheworkforcetobeutilizedintheperformanceoftheStatecontractcannotbeseparatedoutfromthecontractor’sand/orsubcontractor’stotalworkforce,theOfferor shallcompletethisformforthecontractor’sand/orsubcontractor’stotalworkforce.

Instructions forcompleting:

1.EntertheSolicitationnumberthatthisreportappliestoalongwiththenameandaddressoftheOfferor.

2.Checktheboxacknowledgingworkforcetobeutilizedonthecontract.

3.CheckofftheappropriateboxtoindicateiftheOfferorcompletingthereportisthecontractororasubcontractor.

4.EnterthetotalworkforcebyEEO jobcategory.

5.Breakdowntheanticipatedtotalworkforcebygenderandenterundertheheading‘WorkforcebyGender’.

6.Breakdowntheanticipatedtotalworkforceby race/ethnicidentificationandenterundertheheading‘WorkforcebyRace/EthnicIdentification’.ContacttheOM/WBEPermissiblecontact(s)forthesolicitationifyouhaveanyquestions.

7.Enterinformationondisabledorveteransincludedintheanticipatedworkforceundertheappropriateheadings.

8.Enterthename,title,phonenumberandemailaddressforthepersoncompletingtheform.Signanddatetheforminthedesignatedboxes.

RACE/ETHNICIDENTIFICATION

Race/ethnicdesignationsasusedby theEqualEmploymentOpportunityCommissiondonotdenotescientificdefinitionsofanthropologicalorigins.Forthepurposesofthisform,anemployeemaybeincludedinthegrouptowhichheorsheappearstobelong,identifieswith,orisregardedinthecommunityasbelonging.However,nopersonshouldbecountedinmorethanonerace/ethnic group.Therace/ethniccategoriesforthissurvey are:

  • WHITE(NotofHispanicorigin)AllpersonshavingoriginsinanyoftheoriginalpeoplesofEurope,NorthAfrica,ortheMiddleEast.
  • BLACKaperson,notofHispanicorigin,whohasoriginsinanyoftheblackracialgroupsoftheoriginalpeoplesofAfrica.
  • HISPANICapersonofMexican,PuertoRican,Cuban,CentralorSouthAmericanorotherSpanishcultureororigin,regardlessofrace.
  • ASIANPACIFICapersonhavingoriginsinanyoftheoriginalpeoplesoftheFarEast,SoutheastAsia,theIndiansubcontinentorthePacificIslands.

ISLANDER

  • NATIVEINDIAN(NATIVEapersonhavingoriginsinanyoftheoriginalpeoplesofNorthAmerica,andwhomaintainsculturalidentificationthroughtribal

AMERICAN/ALASKAN affiliationorcommunityrecognition.

NATIVE)

OTHERCATEGORIES

  • DISABLEDINDIVIDUALany personwho:-hasaphysicalormentalimpairmentthatsubstantially limitsoneormoremajorlifeactivity(ies)

hasarecordofsuchanimpairment;or

-isregardedashavingsuchanimpairment.

  • VIETNAMERAVETERANaveteranwhoservedatanytimebetweenandincludingJanuary1,1963andMay7,1975.

GENDERMaleorFemale