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Subcontractors Monthly Payment Report

VIEWS: 11 PAGES: 6

									                                                                               Howard County, Maryland
                                                                                 Office of Purchasing
                                                          SUBCONTRACTOR'S MONTHLY PAYMENT REPORT
                                                           EQUAL BUSINESS OPPORTUNITY (EBO) SUBCONTRACTOR PARTICIPATION

Howard County Office Of Purchasing                                                                                                        QUESTIONS SHOULD BE DIRECTED TO:
Attn: EBO Coordinator
6751 Columbia Gateway Drive, Suite 501                                                                                                    Equal Business Opportunity Coordinator
Columbia, MD 21046                                                                                                                        Phone: (410) 313-3694
Fax: (410) 313-6388

                                     To ensure EBO Subcontracting Participation and Compliance, you must complete this form and
                                            forward via mail, fax or email to the Office of Purchasing, Attn: EBO Coordinator

                                                               Due by the 10th of Each Month for the Preceding Month
From:                                                                                                                                     For the Period of:                           2011
Company Name:                                                    Contact Person:
Street Address:                                                  Email Address:                                                           Original Contract Amount:
City, ST, Zip:                                                   Phone Number:                                                            (issued from Howard County)                  $0.00
EBO/MBE Certification #:                                         Fax Number:
Services to be Performed:                                                                                                                 EBO Participation Goal:        0% =          $0.00
                                                                                                                                          (from the EBO Participation Form)


 Invoice# to Prime Contractor        Date of Invoice           Total Invoice Amount                 Date Payment was Received                  Amount Received from Prime Contractor




                                                                                                                                  Total                          $0.00

Prime Contractor
Company Name:                                                                         Contact Name:
Contract Number:                                                                      Email Address:
Street Address:                                                                       Phone Number:
City, ST, Zip:



                                 Authorized Signature                                                                                                     Date




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                   Howard County, Maryland
                     Office of Purchasing
SUBCONTRACTOR'S MONTHLY PAYMENT REPORT
EQUAL BUSINESS OPPORTUNITY (EBO) SUBCONTRACTOR PARTICIPATION




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