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Contract and Subcontract Activity U.S. Department of Housing and Urban Development OMB Approval No.: 2535-0117 (exp. 12/31/2006) Public Reporting Burden for this collection of information Is estimated to average 50 hours per response, including the time for reviewing Instructions, searching existing data sources, gathering and maintu ing the data needed, and completing and reviewing the collection of information. This information is voluntary. HUD may not collect this information, and you are not required to complete this form, unless it displays a currentN valid OMB Control Number. Executive Order 12421 dated July 14, 1983, directs the Minority Business Development Plans shall be developed by each Federal Agency and that these annual plans shall establish minority business development objectives. The information is used by HUD to monitor and evaluate MBE activities against the total program activity and the designated minority business enterprise (MBE) goals. The Department requires the information to provide guidance. and oversight for programs for the development of minority business enterprise concerning Minority Business Development. If the information is not collected HUD would not be able to establish meaningful MBE goals nor evaluate MBE performance against these goals. While no assurances of confidentiality is pledged to respondents, HUD generally discloses this data only in response to a Freedom of Information request. Privacy Act Notice - The United States Department of Housing and Urban Development, Federal Housing Administration, is authorized to solicit the information requested in this form by virtue of Title 12, United States Code, Section 1701 at seq., and regulations promulgated thereunder at Title 12, Code of Federal Regulations. It will not be disclosed or released outside the United States Department of Housing and Urban Development without your consent, except as required or permitted by law. 1 . Grantee/ProjectOwner/Developer/Sponsor/Builder/Agency Check it 2. lncation (city. State. ZIP Code) PHA n RA LTJ 3a. Name at Contact Person 3b. PM1ona Number limed iArea Code) 4. Repotting Periotl 5. Program Code (Not applicable for CPU programs) 6. Date Submittetl to Field Office E] Oct. 1 - Sept. 30 (Annuali See explanation of codes at bottom of page. Use a separate sheet for each program code. T Contractof or __. . _. G rantlProject Number or Amount of Typsof Subcontractor , Woman Prime Contractor Sec. Subconi Sec ConlractorlSubconawtor Name and Address HUD Case Numberor Contract Trade Business Owned Identification (ID) 3 Identification ID) 3 71 other 'idenutication of property, or Subcontract Code Raciald7thnic Business Number Number subdivision. dwen'ngunitetc (See Code (Yes or - - below) (See below) No) Name Street city State Zip code 7a. 7b. 7c, 7d, 7e. 7f. 7g. m. 71. 7e: Type of Trade Codes: 7d: RaciagEthnic Codes; 5: Program Codes (complete for Housing and Public and radian Housingams only) CPD: Houaing/Publlc Housing: 1 = White Americans progr 1 = New Construction 1 = New Construction 6 = Professional 2 = Black Americans 1 = All insured, including Section a 5 = Section 202 2 = Education/Traming 2 = Substantial Rehab. 7 = Tenant Services 3 = Native Americans 2 = Flexible Subsidy 6 = HUD-Held (Management) 3 = Other 3 = Repair 8 = Education/framing 4 = Hispanic Americans 3 = Section B Noninsured, Non-RPDA 7 = Public/lndian Housing 4 = Service 9 = Arch./Engrg. Appraisal 5 = Asian/Pacific Americans 4 = Insured (Management 5 = Protect Mani 0 = Other 6 = Hasidic Jews Previous editions are obsolete. form HUD--2516 (8/96)