Common use of OTHER CATEGORIES Clause in Contracts

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Homes & C.Ommunity Renew.i New York State Homes & Community Renewal www. xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of N ew York Mo rtgage Agency, N ew York State Afforda ble Housing Corporation, State of New York Mu nicipal Bond Bank Agency, Tobacco Settlement Fi nancing Corporation and Housing Trust Fund Corporation (i ndividually, "Agency" and collectively, "Agencies") It is the goal of the Age ncies to ensure complia nce with the federal Equal Em ployment Opportu n ity Act of 1972, as amended. Respondents with fifteen ( 15) or more em ployees responding to this solicitation, must submit a statement disclosing whether the Respondent is cu rrently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Em ployment Opportu nity Comm ission ("EEOC"); has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of a civil action brought aga inst it by the EEOC; has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of an action brought against it by the EEOC for permanent, temporary or prelimina ry relief; has operated, at some time in the last five (5) yea rs, or is cu rrently operating under an order of a cou rt to take affirmative action as a result of a civil action brought agai nst it by EEOC. Please answer the above question either in the affirmative or negative. NO Respond YES or NO. If YES, provide explanation: Respondent's Signature May 18, 2018 Date of Respondent's Signature Xxxxx X. Xxxxxxx, PE Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement�FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 0000 Xxxxxx Xxxx, Jamestown, NY 14701 Xxxxxx Engineering Architecture & Surveying PLLC Name Address 3 TBD Environmental Inspection and Permitting TBD 1100124550 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address 3 TBD Environmental Engineering and Inspection TBD 1100156945 0000 Xxxxx 000 Xxxxx 000 Xxxx Xxxxxxxxx Xxxxxxx Xxx Xxxx 00000 Xxxxxx Engineering, LLC Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) New York State Homes & Community Renewal xxx.xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of New York Mortgage Agency, New York State Affordable Housing Corporation, State of New York Municipal Bond Bank Agency, Tobacco Settlement Financing Corporation and Housing Trust Fund Corporation (individually, “Agency” and collectively, “Agencies”) It is the goal of the Agencies to ensure compliance with the federal Equal Employment Opportunity Act of 1972, as amended. Respondents with fifteen (15) or more employees responding to this solicitation, must submit a statement disclosing whether the Respondent is currently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Employment Opportunity Commission (“EEOC”); has been, at some time in the last five (5) years, or is currently the subject of a civil action brought against it by the EEOC; has been, at some time in the last five (5) years, or is currently the subject of an action brought against it by the EEOC for permanent, temporary or preliminary relief; has operated, at some time in the last five (5) years, or is currently operating under an order of a court to take affirmative action as a result of a civil action brought against it by EEOC. Please answer the above question either in the affirmative or negative. _Respond YES or NO. If YES, provide explanation: Respondent’s Signature Date of Respondent’s Signature Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement_FINAL docx PROC-8 Form HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Page 1 PROC-6 (revised 2/2012) Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) New York State Homes & Community Renewal xxx.xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of New York Mortgage Agency, New York State Affordable Housing Corporation, State of New York Municipal Bond Bank Agency, Tobacco Settlement Financing Corporation and Housing Trust Fund Corporation (individually, “Agency” and collectively, “Agencies”) It is the goal of the Agencies to ensure compliance with the federal Equal Employment Opportunity Act of 1972, as amended. Respondents with fifteen (15) or more employees responding to this solicitation, must submit a statement disclosing whether the Respondent is currently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Employment Opportunity Commission (“EEOC”); has been, at some time in the last five (5) years, or is currently the subject of a civil action brought against it by the EEOC; has been, at some time in the last five (5) years, or is currently the subject of an action brought against it by the EEOC for permanent, temporary or preliminary relief; has operated, at some time in the last five (5) years, or is currently operating under an order of a court to take affirmative action as a result of a civil action brought against it by EEOC. Please answer the above question either in the affirmative or negative. NO _Respond YES or NO. If YES, provide explanation: 5/18/2018 Respondent’s Signature Date of Respondent’s Signature Xxxxxx Xxxxxx Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement_FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 00 Xxxxxx Xxxxxx | Boonton, NJ 07005 First Environment Name Address ~6% 201803_066 TBD 171392 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Page 1 PROC-6 (revised 2/2012) Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: TBD Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address XXX Xxxxxxx # Xxxxxxxx # Xxxxx % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 00 Xxxx 00xx xxxxxx, Xxx Xxxx, XX 00000 Front Line Consulting, LLC Name Address Project management and analytics, inspection, quality control TBD >6% Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Homes & C.Ommunity Renew.i New York State Homes & Community Renewal www. xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of N ew York Mo rtgage Agency, N ew York State Afforda ble Housing Corporation, State of New York Mu nicipal Bond Bank Agency, Tobacco Settlement Fi nancing Corporation and Housing Trust Fund Corporation (i ndividually, "Agency" and collectively, "Agencies") It is the goal of the Age ncies to ensure complia nce with the federal Equal Em ployment Opportu n ity Act of 1972, as amended. Respondents with fifteen ( 15) or more em ployees responding to this solicitation, must submit a statement disclosing whether the Respondent is cu rrently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Em ployment Opportu nity Comm ission ("EEOC"); has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of a civil action brought aga inst it by the EEOC; has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of an action brought against it by the EEOC for permanent, temporary or prelimina ry relief; has operated, at some time in the last five (5) yea rs, or is cu rrently operating under an order of a cou rt to take affirmative action as a result of a civil action brought agai nst it by EEOC. Please answer the above question either in the affirmative or negative. NO Respond YES or NO. If YES, provide explanation: Respondent's Signature May 18, 2018 Date of Respondent's Signature Xxxxx X. Xxxxxxx, PE Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement�FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 0000 Xxxxxx Xxxx, Jamestown, NY 14701 Xxxxxx Engineering Architecture & Surveying PLLC Name Address 3 TBD Environmental Inspection and Permitting TBD 1100124550 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address 3 TBD Environmental Engineering and Inspection TBD 1100156945 1010 Xxxxx 000 Xxxxx 000 Xxxx Xxxxxxxxx Xxxxxxx Xxx Xxxx 00000 Xxxxxx Engineering, LLC Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) New York State Homes & Community Renewal xxx.xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of New York Mortgage Agency, New York State Affordable Housing Corporation, State of New York Municipal Bond Bank Agency, Tobacco Settlement Financing Corporation and Housing Trust Fund Corporation (individually, “Agency” and collectively, “Agencies”) It is the goal of the Agencies to ensure compliance with the federal Equal Employment Opportunity Act of 1972, as amended. Respondents with fifteen (15) or more employees responding to this solicitation, must submit a statement disclosing whether the Respondent is currently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Employment Opportunity Commission (“EEOC”); has been, at some time in the last five (5) years, or is currently the subject of a civil action brought against it by the EEOC; has been, at some time in the last five (5) years, or is currently the subject of an action brought against it by the EEOC for permanent, temporary or preliminary relief; has operated, at some time in the last five (5) years, or is currently operating under an order of a court to take affirmative action as a result of a civil action brought against it by EEOC. Please answer the above question either in the affirmative or negative. _Respond YES or NO. If YES, provide explanation: Respondent’s Signature Date of Respondent’s Signature Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement_FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) New York State Homes & Community Renewal xxx.xxxxxx.xxx EEOC Statement of the Division of Housing and Community Renewal, New York State Housing Finance Agency, State of New York Mortgage Agency, New York State Affordable Housing Corporation, State of New York Municipal Bond Bank Agency, Tobacco Settlement Financing Corporation, Housing Trust Fund Corporation (individually, “Agency” and collectively, “Agencies”) It is the goal of the Agencies to ensure compliance with the federal Equal Employment Opportunity Act of 1972, as amended. Respondents with fifteen (15) or more employees responding to this solicitation, must submit a statement disclosing whether the Respondent is currently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Employment Opportunity Commission (“EEOC”); has been, at some time in the last five (5) years, or is currently the subject of a civil action brought against it by the EEOC; has been, at some time in the last five (5) years, or is currently the subject of an action brought against it by the EEOC for permanent, temporary or preliminary relief; has operated, at some time in the last five (5) years, or is currently operating under an order of a court to take affirmative action as a result of a civil action brought against it by EEOC. Please answer the above question either in the affirmative or negative. No Respond YES or NO. If YES, provide explanation: 5/18/2018 Respondent’s Signature Date of Respondent’s Signature Xxxxxx X. Xxxxxxxx, PE Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement_FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 000 Xxxx Xxxx, Xxxxxxxxxx, XX 00000 Eastern Environmental Solutions, Inc Name Address Drilling Services TBD 6% Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Homes & C.Ommunity Renew.i New York State Homes & Community Renewal www. xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of N ew York Mo rtgage Agency, N ew York State Afforda ble Housing Corporation, State of New York Mu nicipal Bond Bank Agency, Tobacco Settlement Fi nancing Corporation and Housing Trust Fund Corporation (i ndividually, "Agency" and collectively, "Agencies") It is the goal of the Age ncies to ensure complia nce with the federal Equal Em ployment Opportu n ity Act of 1972, as amended. Respondents with fifteen ( 15) or more em ployees responding to this solicitation, must submit a statement disclosing whether the Respondent is cu rrently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Em ployment Opportu nity Comm ission ("EEOC"); has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of a civil action brought aga inst it by the EEOC; has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of an action brought against it by the EEOC for permanent, temporary or prelimina ry relief; has operated, at some time in the last five (5) yea rs, or is cu rrently operating under an order of a cou rt to take affirmative action as a result of a civil action brought agai nst it by EEOC. Please answer the above question either in the affirmative or negative. NO Respond YES or NO. If YES, provide explanation: October 23, 2019 Respondent's Signature Date of Respondent's Signature Xxxxxxx Xxxxxxxx Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement�FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: X X Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: Xxx 00, Xxxx Xxxxx, XX 00000 DDCues, LLC Name Address TBD investigative support TBD 1100188458 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address TBD compliance and financial support services TBD 1100171537 00 Xxxxxx Xxxx Xxxx, Xxxxxx Xxxxx, XX 00000 Xxxxx Advisors, LLC Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Page 1 PROC-6 (revised 2/2012) HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) /P December 20, 2017 Xxxxx Xxxxxx HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) No December 20, 2017 Xxxxx Xxxxxx HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) New York State Homes & Community Renewal xxx.xxxxxx.xxx EEOC Statement of the Division of Housing and Community Renewal, New York State Housing Finance Agency, State of New York Mortgage Agency, New York State Affordable Housing Corporation, State of New York Municipal Bond Bank Agency, Tobacco Settlement Financing Corporation, Housing Trust Fund Corporation (individually, “Agency” and collectively, “Agencies”) It is the goal of the Agencies to ensure compliance with the federal Equal Employment Opportunity Act of 1972, as amended. Respondents with fifteen (15) or more employees responding to this solicitation, must submit a statement disclosing whether the Respondent is currently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Employment Opportunity Commission (“EEOC”); has been, at some time in the last five (5) years, or is currently the subject of a civil action brought against it by the EEOC; has been, at some time in the last five (5) years, or is currently the subject of an action brought against it by the EEOC for permanent, temporary or preliminary relief; has operated, at some time in the last five (5) years, or is currently operating under an order of a court to take affirmative action as a result of a civil action brought against it by EEOC. Please answer the above question either in the affirmative or negative. Yes Respond YES or NO. If YES, provide explanation: As a large firm with greater than 2,700 employees, CohnReznick is occasionally subject to a civil brought against it by the EEOC Please see below list of the relevant incidents from the previous 5_years 2/2/2018 Respondent’s Signature Date of Respondent’s Signature Xxx Xxxxxx Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement_FINAL.docx PROC-8 Form HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) HOUSING TRUST FUND CORPORATION 0038-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 0000 Xxxxxx Xxxxxx, Bronx, NY 10469 W Xxxxx Engineering PLLC Name Address 10% 201712_063 Construction Audits TBD 161235 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXXUse the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., XXXXXXall forms of landscaping services) B Mining (e.g., XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (Instructions on Reverse Sidee.g., highway, pipe laying) Homes & Community Renewal Office C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of Fair Housing goods) E Transportation, Communication and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name Sanitary Services (e.g., Delivery services, warehousing, broadcasting and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARScable systems) F/Project # Work Location Name G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of Firm equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and Address related services PROC-6 (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancerevised 2/2012)

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 0000 Xxxxxx Xxxxxx, Bronx, NY 10469 W Xxxxx Engineering PLLC Name Address 10% 201712_063 Construction Audits XXX 000000 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Page 1 PROC-6 (revised 2/2012) Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Homes & C.Ommunity Renew.i New York State Homes & Community Renewal www. xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of N ew York Mo rtgage Agency, N ew York State Afforda ble Housing Corporation, State of New York Mu nicipal Bond Bank Agency, Tobacco Settlement Fi nancing Corporation and Housing Trust Fund Corporation (i ndividually, "Agency" and collectively, "Agencies") It is the goal of the Age ncies to ensure complia nce with the federal Equal Em ployment Opportu n ity Act of 1972, as amended. Respondents with fifteen ( 15) or more em ployees responding to this solicitation, must submit a statement disclosing whether the Respondent is cu rrently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Em ployment Opportu nity Comm ission ("EEOC"); has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of a civil action brought aga inst it by the EEOC; has been, at some time in the last five (5) yea rs, or is cu rrently the su bject of an action brought against it by the EEOC for permanent, temporary or prelimina ry relief; has operated, at some time in the last five (5) yea rs, or is cu rrently operating under an order of a cou rt to take affirmative action as a result of a civil action brought agai nst it by EEOC. Please answer the above question either in the affirmative or negative. Respond YES or NO. If YES, provide explanation: Date of Respondent's Signature GeorgePenesis,P.E.,AICP Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement�FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 000 Xxxx Xxxx, Xxxxxxxxxx, XX 00000 Eastern Environmental Solutions, Inc. Name Address XXX XXX Environmental Management Consulting Services TBD 161287 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract on a semi-annual basis to the Office of General Services Division of Service-Disabled Veterans’ Business Development. See xxxx://xxx.xx.xxx NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: HOUSING TRUST FUND CORPORATION 00Page 1 PROC-6 (revised 2/2012) Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) }Òɽ & lËãß ¾ 3Fm =]aW 8g>gF 5 ,)9/ • C,))3*"15 R9*946' mmmu \oe MAau]aK ]G gMF 3 Fm =]aW 8g>gF ,]ieP\K (P\>\AF KF\Ao, 8g>gF ]G 3 Fm =]aW 2 ] agK>KF KF\Ao, 3 Fm =]aW 8g>gF J]aD> ?XF -]ieP\K #]a^]a>gP]\, 8g>gF ]G 3 Fm =]aW 2 i \PAP^>X "]\D ">\W KF\Ao, -]ieP\K 9aieg ( i\D #]a^]a>gP]\ ( P \DPkPDi>XXo, ” KF\Ao" >\D A]YYFAgPkFXo, ” KF\APFe") .g Pe gMF K]>X ]G gMF KF\APFe g] F \eiaF A][^XP>\AF mPgM gMF GFDFa> X '`i>X ' [^Y]o[F\g 4^^]agi \ Pgo Ag ]G Fǘǎƣð >e >[F\D FDu 7Fe^]\DF\ge mPgM GPGgFF\ ( F^) ]a [] aF F[ ^Y]oFFe aFe^]\DP\K g] g MPe e]XPAPg>gP]\, [ ieg ei?[Pg > eg>gF[ F\g D PeAX]eP\K mMFgMFa gMF 7Fe^]\DF\g Pe Ai aaF\gXo ]^Fa>gP\K i\DFa ] a \FK]gP>gP\K, ] a M>e >g e][F gP[F P\ gMF X>eg GPkF (^) oF>ae ]^Fa>gFD i\DFa ]a \FK]gP>gFD, > A]\APXP>gP]\ >KaFF[F\g mPgM gMF '`i>X '[ ^X]o[F\g 4 ^^]agi \Pgo #][ [ PeeP]\ (”''4#"); M>e ?FF\, >g e][F gP[F P\ gMF X>eg GPkF (^) oF> ae, ]a Pe AiaaF\gYo gMF ei?TFAg ]G > APkPX >AgP]\ ?a]iKMg >K> P\eg Pg ?o gMF ''4#; M>e ?FF\, >g e][F gP[F P\ gMF Y>eg GPkF (^) oF> ae, ]a Pe Ai aaF\gXo gMF ei?T FAg ]G >\ > AgP]\ ?a]iKMg >K>P\eg Pg ?o gMF ''4# G] a ^Fa[>\F\g, g F[^]a>ao ]a ^aFYP[P\> ao aFXPFG; M>e ]^Fa>gFD, >g e][F gP[F P\ gMF Y>eg GPkF (^) oF> ae, ]a Pe Ai aaF\gXo ]^Fa>gP\K i \DFa >\ ] aDFa ]G > A]i ag g] g> WF >GHPa[>gPkF >AgP]\ >e > aFei Xg ]G > APkPX >AgP]\ ?a]iKMg >K>P \eg Pg ?o ' '4#u 5XF>eF > \emFa gMF > ?]kF `iFegP]\ FPgMFa P \ gMF >GHPa[>gPkF ]a \FK>gPkFu No 7Fe^]\D ='8 ] a 34u .G ='8, ^a]kPDF Fn^X>\>gP]\: January 30, 2018 7Fe^]\DF\g’e 8PK\>giaF %>gF ]G 7Fe^]\DF\g’e 8PK\>giaF Xxxxx X. Xxxxxxt 5 aP\g 3>[F ]G 7Fe^]\DF\g F:\t %a)8-C0-;4as:\F04*8 a/d R!)a; d G.$15+a;'0.\UV8E FORUG > 80()!43)a: La-&<a%!\ ROC⁄8 ⁄ ßßOC G;a:!,!/;?FGKAL.d0c> 574#×8 )]a[ SDVOB UTILIZATION PLAN X Initial Plan Revised plan Contract/Solicitation # INSTRUCTIONS: This Utilization Plan must contain a detailed description of the supplies and/or services to be provided by each NYS Certified Service-Disabled Veteran-Owned Business (SDVOB) under the contract. By submission of this Plan, the Bidder/Contractor commits to making good faith efforts in the utilization of SDVOB subcontractors and suppliers as required by the SDVOB goals contained in the Solicitation/Contract. Making false representations or providing information that shows a lack of good faith as part of, or in conjunction with, the submission of a Utilization Plan is prohibited by law and may result in penalties including, but not limited to, termination of a contract for cause, loss of eligibility to submit future bids, and/or withholding of payments. Firms that do not perform commercially useful functions may not be counted toward SDVOB utilization. Attach additional sheets if necessary. BIDDER/CONTRACTOR INFORMATION SDVOB Goals In Contract Bidder/Contractor Name: Deloitte Financial Advisory Services LLP NYS Vendor ID: 6% Xxxxxx/Xxxxxxxxxx Xxxxxxx (Xxxxxx, Xxxx, Xxxxx and Zip Code): 00 XXXXX XXXXXXXxxxxxxxxxx Xxxxx, XXXXXXXxx Xxxx, XXX XXXX XX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing Bidder/Contractor Telephone Number: Contract Work Location/Region: Contract Description/Title: NYS GOSR CDBG-DR Monitoring and Equal Opportunity Web SiteCompliance Services II CONTRACTOR INFORMATION Email Address: xxx.xxxxxx.xxx Contractors xxxxxxxx@xxxxxxxx.xxx Name and AddressTitle of Preparer: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-complianceXxxxx Xxxxxxt – Advisory Partner Telephone Number: Date:

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: New York State Homes & Community Renewal xxx.xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of New York Mortgage Agency, New York State Affordable Housing Corporation, State of New York Municipal Bond Bank Agency, Tobacco Settlement Financing Corporation and Housing Trust Fund Corporation (individually, “Agency” and collectively, “Agencies”) It is the goal of the Agencies to ensure compliance with the federal Equal Employment Opportunity Act of 1972, as amended. Respondents with fifteen (15) or more employees responding to this solicitation, must submit a statement disclosing whether the Respondent is currently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Employment Opportunity Commission (“EEOC”); has been, at some time in the last five (5) years, or is currently the subject of a civil action brought against it by the EEOC; has been, at some time in the last five (5) years, or is currently the subject of an action brought against it by the EEOC for permanent, temporary or preliminary relief; has operated, at some time in the last five (5) years, or is currently operating under an order of a court to take affirmative action as a result of a civil action brought against it by EEOC. Please answer the above question either in the affirmative or negative. _Respond YES or NO. If YES, provide explanation: Respondent’s Signature Date of Respondent’s Signature Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement_FINAL docx PROC-8 Form HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliancecompliance INSTRUCTIONS FOR FILING CUMULATIVE PAYMENT STATEMENT Quarter Reporting Period Due Date 1st April 1 – June 30 July 10 2nd July 1- September 30 October 10 3rd October 1 - December 31 January 10 4th January 1 – March 31 April 10 This document pertains to HCR funding only: The form is to be completed and signed by the Company Official and submitted by the 10th of each quarter. The form must include ALL (e.g. MBE, WBE and non-M/WBE) subcontractors or suppliers assigned to this contract. The Affirmation of Income Payments to MBE/WBE (ADM-146) must accompany this form for each MBE/WBE firm who has received payment. Contractor’s Name & Address: Indicate name, address, city, state and zip code. Contractor’s Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Goals: Indicate HCR’s assigned MBE and WBE participation goals. Reporting Period: Indicate reported month and year. SHARS/Project #: Indicate HCR’s SHARS #/Project #. Subcontractor or Supplier Name & Address Indicate the name, address, city, state and zip code. Federal ID #: If Federal ID # not assigned, provide Social Security # of the owner. Description of Work: Check the box that best describes the work performed. (CHECK ONE BOX ONLY) NYS Certified Indicate if MBE or WBE. (CHECK ONE BOX ONLY) Only firms certified by NYS will be counted towards goals Payments This Period: Indicate amount paid to each subcontractors or suppliers this reporting period. NOTE: IF THERE WAS NO PAYMENT THIS PERIOD, PLEASE CHECK THE BOX. Contract Amount: Indicate total contract amounts or purchase agreement(s) for each subcontractor or supplier. ADM-123 (rev. 3/12) New York State Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Affirmation of Income Payments to MBE/WBE Each MBE and WBE FIRM must sign and submit this form to the Contractor. The Contractor/Vendor must submit this form to the Office of Fair Housing and Equal Opportunity by the 10th of each Quarter.

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Page 1 PROC-6 (revised 2/2012) Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) New York State Homes & Community Renewal xxx.xxxxxx.xxx EEOC Statement of the New York State Housing Finance Agency, State of New York Mortgage Agency, New York State Affordable Housing Corporation, State of New York Municipal Bond Bank Agency, Tobacco Settlement Financing Corporation and Housing Trust Fund Corporation (individually, “Agency” and collectively, “Agencies”) It is the goal of the Agencies to ensure compliance with the federal Equal Employment Opportunity Act of 1972, as amended. Respondents with fifteen (15) or more employees responding to this solicitation, must submit a statement disclosing whether the Respondent is currently operating under or negotiating, or has at some time in the last five (5) years operated under or negotiated, a conciliation agreement with the Equal Employment Opportunity Commission (“EEOC”); has been, at some time in the last five (5) years, or is currently the subject of a civil action brought against it by the EEOC; has been, at some time in the last five (5) years, or is currently the subject of an action brought against it by the EEOC for permanent, temporary or preliminary relief; has operated, at some time in the last five (5) years, or is currently operating under an order of a court to take affirmative action as a result of a civil action brought against it by EEOC. Please answer the above question either in the affirmative or negative. NO _Respond YES or NO. If YES, provide explanation: 5/18/2018 Respondent’s Signature Date of Respondent’s Signature Xxxxxx Xxxxxx Print Name of Respondent F:\Legal8-Contract\Forms and Related Information\MWBE FORMS & Boilerplate Language\PROC-8 - EEOC Statement_FINAL.docx PROC-8 Form Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 00 Xxxxxx Xxxxxx | Xxxxxxx, XX 00000 First Environment Name Address ~6% 201803_066 TBD 171392 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXXPage 1 PROC-6 (revised 2/2012) Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., XXXXXXall forms of landscaping services) B Mining (e.g., XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (Instructions on Reverse Sidee.g., highway, pipe laying) Homes & Community Renewal Office C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of Fair Housing goods) E Transportation, Communication and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name Sanitary Services (e.g., Delivery services, warehousing, broadcasting and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARScable systems) F/Project # Work Location Name G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of Firm equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and Address related services PROC-6 (List All Firmsrevised 2/2012) Type of Service Provided (Select only one}Òɽ lËãß ¾ 3Fm =]aW 8g>gF ,) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance/ • ,))3*"15 * 4 ' mmm \oe MAa ]aK

OTHER CATEGORIES. DISABLED INDIVIDUAL • VIETNAM ERA VETERAN • GENDER any person who: - has a physical or mental impairment that substantially limits one or more major life activity(ies) - has a record of such an impairment; or - is regarded as having such an impairment. a veteran who served at any time between and including January 1, 1963 and May 7, 1975. Male or Female Failure to submit this form will result in non-compliance Is this a final report? Check one. Yes No M/WBE Quarterly Report of NYS AGENCY/AGENCIES Contract No. Project No. The following information indicates the payment amounts made by the grantee/contractor to the NYS Certified M/WBE subcontractor on this project. The payments as shown are in compliance with contract documents for the above reference project. Contractor’s Name and Address Federal ID# Goals/Dollar Amount MBE % = $ WBE % = $ Contract Type: Paid to Contractor this Quarter: Total Paid to Contractor to Date: Project Completion Date Work Location Reporting Period: 1st Quarter (4/1-6/30) 3rd Quarter (10/1-12/31) 2nd Quarter (7/1-9/30) 4th Quarter (1/1-3/31) M/WBE Subcontractor/Vendor Product Code* Work Status this Report Total Subcontractor Contract Amount Payments this Quarter Previous Payments Total Payments Made to Date MBE WBE MBE WBE MBE WBE MBE WBE Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Name: Fed ID#: Active Inactive Complete Total: *See Next Page for Product Codes Date: Name: Title: Signature: Use the following codes in the Product Code column to indicate the category of work for which the M/WBE was utilized: PRODUCT CODE KEY: A Agriculture/Landscaping (e.g., all forms of landscaping services) B Mining (e.g., Geological Investigation) C Construction C15 Building Construction – General Contractors C16 Heavy Construction (e.g., highway, pipe laying) C17 Special Trade Contractors (e.g., plumbing, heating, electrical, carpentry) D Manufacturing (production of goods) E Transportation, Communication and Sanitary Services (e.g., Delivery services, warehousing, broadcasting and cable systems) F/G Wholesale/Retail Goods (e.g., gravel, hospital supplies and equipment, food stores, computer stores, office supplies) G52 Construction Materials (e.g., lumber, paint, lawn supplies) H Financial, Insurance and Real Estate Services I Services I73 Business Services (e.g., copying, advertising, secretarial, janitorial, rental services of equipment, computer programming, security services) I81 Legal Services I82 Educational Services (e.g., AIDS education, automobile safety, tutoring, public speaking) I83 Social Services (e.g., counselors, vocational training, child care) I87 Engineering, architectural, accounting, research, management and related services PROC-6 (revised 2/2012) Attachment Use of Service-Disabled Veteran-Owned Business Enterprises in Contract Performance Article 17-B of the Executive Law enacted in 2014 acknowledges that Service-Disabled Veteran-Owned Businesses (SDVOBs) strongly contribute to the economies of the State and the nation. As defenders of our nation and in recognition of their economic activity in doing business in New York State, bidders/proposers for this contract for commodities, services or technology are strongly encouraged and expected to consider SDVOBs in the fulfillment of the requirements of the contract. Such partnering may be as subcontractors, suppliers, protégés or other supporting roles. SDVOBs can be readily identified on the directory of certified businesses at: xxxx://xxx.xx.xxx/Core/docs/CertifiedNYS_SDVOB.pdf Bidders/proposers need to be aware that all authorized users of this contract will be strongly encouraged to the maximum extent practical and consistent with legal requirements of the State Finance Law and the Executive Law to use responsible and responsive SDVOBs in purchasing and utilizing commodities, services and technology that are of equal quality and functionality to those that may be obtained from non-SDVOBs. Furthermore, bidders/proposers are reminded that they must continue to utilize small, minority and women-owned businesses consistent with current State law. Utilizing SDVOBs in State contracts will help create more private sector jobs, rebuild New York State’s infrastructure, and maximize economic activity to the mutual benefit of the contractor and its SDVOB partners. SDVOBs will promote the contractor’s optimal performance under the contract, thereby fully benefiting the public sector programs that are supported by associated public procurements. Public procurements can drive and improve the State’s economic engine through promotion of the use of SDVOBs by its contractors. The State, therefore, expects bidders/proposers to provide maximum assistance to SDVOBs in their contract performance. The potential participation by all kinds of SDVOBs will deliver great value to the State and its taxpayers. Bidders/proposers can demonstrate their commitment to the use of SDVOBs by responding to the questions below and including the responses with their bid/proposal: Are you a bidder/proposer that is a NYS-certified SDVOB? Yes No If yes, what is your DSDVBD Control #? Will NYS-certified SDVOBs be used in the performance of this contract? Yes No 171392 If yes, identify the NYS-certified SDVOBs that will be used below (if more than 4 identified, please attach an additional form): NYS-Certified SDVOB 1: NYS-Certified SDVOB 2: 00 Xxxxxxx Xxxxxx 0xx Xxxxx, Xxx Xxxx, XX 00000 First Environment, Inc. Name Address 201803_066 Conduct environmental reviews, phase I & II, wetland delineation TBD 171392 Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation NYS-Certified SDVOB 3: NYS-Certified SDVOB 4: Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Name Address Control # Contract # Total % Work Performed $ Amount Nature of Participation Contractor will report on actual participation by each SDVOB during the term of the contract to the contracting agency/authority on a quarterly basis according to policies and procedures set by the contracting agency/authority. NOTE: Information about set asides for SDVOB participation in public procurement can be found at: xxxx://xxx.xxx.xx.xxx/Core/ SDVOBA.asp, which provides guidance for State agencies in making determinations and administering set asides for procurements from SDVOBs. HOUSING TRUST FUND CORPORATION 00-00 XXXXX XXXXXX, XXXXXX, XXX XXXX 00000 APPENDIX IV CONSTRUCTION REQUIREMENTS AND PROCEDURES FOR CONTRACTS WITH HOUSING TRUST FUND CORPORATION New York State CUMULATIVE PAYMENT STATEMENT (Instructions on Reverse Side) Homes & Community Renewal Office of Fair Housing and Equal Opportunity Web Site: xxx.xxxxxx.xxx Contractors Name and Address: Federal ID # Goals Reporting Period MBE % WBE % Quarter Year SHARS/Project # Work Location Name of Firm and Address (List All Firms) Type of Service Provided (Select only one) NYS Certified MBE WBE Payment This period Contract Amount Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Federal ID# • Construction • Supplier • Consultant Service • Service/Commodity • Section 3 No Payment Signature of Company Official Print Name of Company Official Date ADM-123 (rev. 3/12) Failure to submit this form will result in non-compliance