U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

CERTIFICATION BY PROPOSED SUBCONTRACTOR REGARDING

EQUAL EMPLOYMENT OPPORTUNITY

INSTRUCTIONS

This certification is required pursuant to Executive Order 11246 (30 F.R. 12319-15). The implementing rules and regulations provide that any bidder or prospective contractor, or any of their proposed subcontractors, shall state as an initial part of the bid or negotiations of the contract whether it has participated in any previous contract or subcontract subject to the equal opportunity clause; and, if so, whether it has filed all compliance reports due under applicable instructions.

Where the certification indicates that the subcontractor has not filed a compliance report due under applicable instructions, such subcontractor shall be required to submit a compliance report before the owner approves the subcontract or permits work to begin under the subcontract.

SUBCONTRACTOR'S CERTIFICATION

NAME AND ADDRESS OF BIDDER (Including ZIP Code)

1. Bidder has participated in a previous contract or subcontract subject to the Equal Opportunity Clause.

___ Yes ___ No

2. Compliance reports were required to be filed in connection with such contract or subcontract.

___ Yes ___ No

3. Bidder has filed all compliance reports due under applicable instructions, including SF-100.

___ Yes ___ No ___ None Required

4. Have you ever been or are you being considered for sanction due to violation of Executive Order 11246, as amended?

___ Yes ___ No

NAME AND TITLE OF SIGNER (Please type)

SIGNATURE DATE

H-1