Common use of Management, Ownership Clause in Contracts

Management, Ownership. (Proprietor, partners, officers, directors, all holders of outstanding stock/equity -- 100% of ownership must be shown below). Use separate sheet if necessary. 1. Owned: *Veteran: Yes No *Service Disabled: Yes No *Gender: Male Female *Race: American Indian / Alaska Native Black / African American Asian Native Hawaiian / Pacific Islander White *Ethnicity: Hispanic / Latino Not: Hispanic / Latino Name, Soc. Sec. No., Position / Title Complete Address & Telephone 2. Owned: *Veteran: Yes No *Service Disabled: Yes No *Gender: Male Female *Race: American Indian / Alaska Native Black / African American Asian Native Hawaiian / Pacific Islander White *Ethnicity: Hispanic / Latino Not: Hispanic / Latino *This data is collected for statistical purposes only. It has no bearing on the credit decision. Disclosure is voluntary. One or more boxes for race may be selected. Applicant: is is not a participant in SBA’s 8 (a) Business Development Program. Applicant: has has not received SBA Surety Bond Guarantee is has is not an SBA certified HUB Zone small business concern. Assistance under any other business name. has not defaulted on any contracts. If so, provide Business Name: has not had an SBA loan. If so, Loan# and, provide Tax ID or SSN: does not have a current signed General Applicant is is not presently debarred, suspended, proposed for Indemnity Agreement (GIA) with the Surety Company identified on this form. debarment, declared ineligible, or voluntarily excluded from transactions with any Federal department or agency.

Management, Ownership. (Proprietor, partners, officers, directors, all holders of outstanding stock/equity -- 100% of ownership must be shown below). Use separate sheet if necessary. 1. Owned: *Veteran: Yes No *Service Disabled: Yes No *Gender: Male Female *Race: American Indian / Alaska Native Black / Asian Black/African American Asian Native Hawaiian / Pacific Islander White *Ethnicity: Hispanic / Latino Not: Hispanic / Latino Name, Soc. Sec. No., Position / Title Complete Address & Telephone 2. Owned: *Veteran: Yes No *Service Disabled: Yes No *Gender: Male Female *Race: American Indian / Alaska Native Black / African American Asian Native Hawaiian / Pacific Islander White *Ethnicity: Hispanic / Latino Not: Hispanic / Latino *This data is collected for statistical purposes only. It has no bearing on the credit decision. Disclosure is voluntary. One or more boxes for race may be selected. Applicant: is is not a participant in SBA’s 8 (a) Business Development Program. Applicant: has has not received SBA Surety Bond Guarantee is has is not an SBA certified HUB Zone small business concern. Assistance under any other business name. has has not defaulted on any contracts. If so, provide Business Name: ______________________________ has has not had an SBA loan. If so, Loan# ________ and, provide Tax ID or SSN: _____________________________ does does not have a current signed General Applicant is is not presently debarred, suspended, proposed for Indemnity Agreement (GIA) with the Surety Company identified on this form. debarment, declared ineligible, or voluntarily excluded from transactions with any Federal department or agency.. Project Type: Construction ____ Service____ Supply____ Other____ Liquidated Damages: $______________ Weekdays Calendar Days Project Description: Project Location: Project’s NAICS Code: # of Employees before this project was awarded: # Existing jobs retained due to this project (same job cannot be reported as new): Name and Address of Obligee: # New jobs due to project (same job cannot be reported as retained-above):

Management, Ownership. (Proprietor, partnerspa rtners, officers, directorsdir ectors, all holders of outstanding outst xxxxxx stock/equity eq uity -- 100% of ownership ow nership must be shown below). Use separate sheet if necessary. 1. Owned: *Veteran: Yes No *Service Disabled: Yes No *Gender: Male Female *Race: American Indian / Alaska Native Black / Asian Black/African American Asian Native Hawaiian / Pacific Islander White Whit *Ethnicity: Hispanic / Latino Not: Hispanic / Latino Name, Soc. Sec. No., Position / Title Complete Address & Telephone 2. Telephone % Owned: *Veteran: Yes No *Service Disabled: Yes No *Gender: Male Female *Race: American Indian / Alaska Native Black / African American Asian Native Hawaiian / Pacific Islander White Whit *Ethnicity: Hispanic / Latino Not: Hispanic / Latino *This data is collected for statistical purposes only. It has no bearing on the credit decision. Disclosure is voluntary. One or more boxes for race may be selected. Applicant: is is not a participant in SBA’s 8 (a) Business Development Program. Applicant: has has not received SBA Surety Bond Guarantee is has is not an SBA certified HUB Zone small business concern. Assistance under any other business name. has has not defaulted on any contracts. If so, provide Business Name: has has not had an SBA loan. If so, Loan# and, provide Tax ID or SSN: does does not have a current signed General Applicant is is not presently debarred, suspended, proposed for e Indemnity Agreement (GIA) with the Surety Company identified on this form. debarment, declared ineligible, or voluntarily excluded from transactions with any Federal department or agency.