Fillable STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY (NJ Department of Treasury)

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STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY (NJ Department of Treasury)

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STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY
Division of Purchase & Property Contract Compliance Audit Unit EEO Monitoring Program
VENDOR ACTIVITY SUMMARY REPORT
___NEW HIRES ___PROMOTIONS ___TRANSFERS ___TERMINATIONS (CHECK (X) APPROPRIATE ACTIVITY)
CERTIFICATE NO._____________ DATES OF PAYROLL PERIOD USED: FROM________________ TO_____________
===================================================================================================================================
NAME OF FACILITY:
___________________________________________________________________________________________________________________________________
City
County State Zip Code
___________________________________________________________________________________________________________________________________
===================================================================================================================================
JOB MALE FEMALE
CATAGORIES
===================================================================================================================================
OFFICIALS & MANAGERS
___________________________________________________________________________________________________________________________________
PROFESSIONALS
___________________________________________________________________________________________________________________________________
TECHNICIANS
___________________________________________________________________________________________________________________________________
SALES WORKERS
___________________________________________________________________________________________________________________________________
OFFICE & CLERICAL
___________________________________________________________________________________________________________________________________
CRAFTWORKERS
___________________________________________________________________________________________________________________________________
OPERATIVES
___________________________________________________________________________________________________________________________________
LABORERS
___________________________________________________________________________________________________________________________________
SERVICE WORKERS
___________________________________________________________________________________________________________________________________
TOTAL
===================================================================================================================================
I certify that the information on this Form is true and correct.
NAME OF PERSON COMPLETING FORM (Print or Type) SIGNATURE DATE SUBMITTED
LAST FIRST MI
___________________________________________________________________________________________________________________________________
ADDRESS(NO. & STREET) (CITY) (STATE) (ZIP) PHONE(AREA CODE,NO.,EXTENSION)
___________________________________________________________________________________________________________________________________
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Black
Hispanic
AM.Indian Asian Non-Min.
Total
Non-Min.Asian
AM.Indian
Hispanic
BlackTotal
Street
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STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY (NJ Department of Treasury)

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Completed 13 August 2020

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