SECTION 3 BUSINESS UTILIZATION REPORT City of Cleveland Department of Community Development Project Name

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SECTION 3 BUSINESS UTILIZATION REPORT City of Cleveland Department of Community Development Project Name Powered By Docstoc
					                                    SECTION 3 BUSINESS UTILIZATION REPORT
                               City of Cleveland, Department of Community Development

Project Name:                                                                           Project Number:                 Contract Number:


Company Name:                                                                                                              Date Completed:
Address:
City & State:
Zip:
Person Completing This Form:                             Telephone Number:         FAX Number:               Email Address:


                                                 Check () Quarterly (This) Report Period
Jan. – March                     April – June                          July – Sept.                          Oct. – Dec.

                         (A)                                               (B)             (C)                (D)                     (E)
      LIST ALL BUSINESSES AWARDED CONTRACTS                               CHECK           TOTAL              CHECK                *Section 3
                (THIS REPORT PERIOD)                                                     DOLLAR                                    Business
                   NAME & ADDRESS                                       If Sec. 3        AWARD           Project Work            Performance
                                                                        Certified                            Force                  Rating
                                                                        Business                          Utilization            1=Excellent-
                                                                                                            Report                 5=Poor
                                                                                                          Submitted
Name:
Address:
City/Zip:
Name:
Address:
City/Zip:
Name:
Address:
City/Zip:
Name:
Address:
City/Zip:
Name:
Address:
City/Zip:
Name:
Address:
City/Zip:
Name:
Address:
City/Zip:
Name:
Address:
City/Zip:
OPTIONAL: Enter problem(s) found, action taken to resolve concern(s), positive experiences/suggestions. *Use back of page if needed
or utilize the Section 3 Business Performance Evaluation Form.




                          Total Dollar                        Total Section 3                         Percent of Section
 For Departmental
       Use:                 Amount                                Dollars                             3 Dollars Awarded:                 %%
                           Awarded:                             Awarded:

                  Download a complete packet of Section 3 Report Forms at:   http://cd.city.cleveland.oh.us/quicklinks
                                                       For Further Information Contact:
                           Department of Community Development; 601 Lakeside Ave., Rm. 320; Cleveland, Ohio 44114
                                         Phone: (216) 664-4048: Email: lmartinez@city.cleveland.oh.us
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                                                                                                Compliance Section: Sec. 3 Business Utilization Report
                                                                                                 Rev 30 November 2010 Previous Versions Obsolete

				
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