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/ sub-consultants must submit this form with each voucher for payment and/or periodically as the agency may require. It details the total amount paid to ALL subcontractors/subconsultants (including subcontractors/subconsultants that are not M/WBEs); the names, addresses and contact numbers of each M/WBE or non-M/WBE hired as a subcontractor/subconsultant pursuant to such plan as well as the dates and amounts paid to each M/WBE or non-M/WBE. This form must be certified under penalty of perjury.

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