SUPERIOR COURT OF CALIFORNIA
SANTA CLARA COUNTY
SMALL BUSINESS POST-CONTRACT REPORT
The contractor identified above (Contractor) entered into the agreement identified above
(Agreement) with the JBE. As required by Government Code section 14841, Contractor
must report to the JBE the actual percentage of small/micro-business participation.
Please return this form to the JBE within sixty (60) days of receiving final
payment under the Agreement. Failure to return this form as required constitutes a
breach of the Agreement.
Total amount of money Contractor received
under the Agreement
Total amount paid by Contractor to
subcontractors that are not DGS-certified
Contractor certifies that the information above is accurate.
Contractor (Printed) Date Executed
By (Authorized Signature)
Printed Name and Title of Person Signing
Send completed form to: Superior Court of California, Santa Clara County
Attn: Procurement Division
191 North First Street
San Jose, CA 95113
GS-045 REV 2/4/14