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Get NJ AA302 2011

STATE OF NEW JERSEY Form AA302 Rev. 11/11 Division of Purchase Property Contract Compliance Audit Unit EEO Monitoring Program EMPLOYEE INFORMATION REPORT IMPORTANT-READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORM. Other Specify 13. DATES OF PAYROLL PERIOD USED From 14. IS THIS THE FIRST Employee Information Report Submitted To 1. DO NOT SUBMIT AN EEO-1 REPORT. JOB CATEGORIES ALL EMPLOYEES COL. 1 COL. 2 TOTAL MALE Cols. 2 3 COL. 3 FEMALE PERMANENT MINORITY/NON-MINORITY EMPLOYEE BREAKDOWN MALEFEMALE AMER. NON BLACK HISPANIC INDIAN ASIAN MIN. ASIAN MIN. Officials/ Managers Professionals Technicians Sales Workers Office Clerical Craftworkers Skilled Operatives Semi-skilled Laborers Unskilled Service Workers Total employment From previous Report if any Temporary PartTime Employees The data below shall NOT be included in the figures for the appropriate categories above. 12. HOW WAS INFORMATION AS TO RACE OR ETHNIC GROUP IN SECTION B OBTAINED 1. Visual Survey 2. Employment Record 3. FAILURE TO PROPERLY COMPLETE THE ENTIRE FORM AND TO SUBMIT THE REQUIRED 150. 00 FEE MAY DELAY ISSUANCE OF YOUR CERTIFICATE* DO NOT SUBMIT EEO-1 REPORT FOR SECTION B ITEM 11. For Instructions on completing the form go to http //www. state. nj. us/treasury/contractcompliance/pdf/aa302ins. pdf SECTION A - COMPANY IDENTIFICATION 1. FID. NO. OR SOCIAL SECURITY 2. TYPE OF BUSINESS 1. MFG 2. SERVICE 4. RETAIL 5. OTHER 3. WHOLESALE 3. TOTAL NO. EMPLOYEES IN THE ENTIRE COMPANY COUNTY STATE 4. COMPANY NAME 5. STREET CITY 6. NAME OF PARENT OR AFFILIATED COMPANY IF NONE SO INDICATE 7. CHECK ONE IS THE COMPANY ZIP CODE SINGLE-ESTABLISHMENT EMPLOYER MULTI-ESTABLISHMENT EMPLOYER 8. IF MULTI-ESTABLISHMENT EMPLOYER STATE THE NUMBER OF ESTABLISHMENTS IN NJ 9. TOTAL NUMBER OF EMPLOYEES AT ESTABLISHMENT WHICH HAS BEEN AWARDED THE CONTRACT 10. PUBLIC AGENCY AWARDING CONTRACT Official Use Only DATE RECEIVED INAUG*DATE ASSIGNED CERTIFICATION NUMBER SECTION B - EMPLOYMENT DATA 11. Report all permanent temporary and part-time employees ON YOUR OWN PAYROLL* Enter the appropriate figures on all lines and in all columns. Where there are no employees in a particular category enter a zero. Include ALL employees not just those in minority/non-minority categories in columns 1 2 3. DO NOT SUBMIT AN EEO-1 REPORT. JOB CATEGORIES ALL EMPLOYEES COL* 1 COL* 2 TOTAL MALE Cols. 2 3 COL* 3 FEMALE PERMANENT MINORITY/NON-MINORITY EMPLOYEE BREAKDOWN MALEFEMALE AMER* NON BLACK HISPANIC INDIAN ASIAN MIN* ASIAN MIN* Officials/ Managers Professionals Technicians Sales Workers Office Clerical Craftworkers Skilled Operatives Semi-skilled Laborers Unskilled Service Workers Total employment From previous Report if any Temporary PartTime Employees The data below shall NOT be included in the figures for the appropriate categories above. 12. HOW WAS INFORMATION AS TO RACE OR ETHNIC GROUP IN SECTION B OBTAINED 1. Visual Survey 2. Employment Record 3. YES 15. IF NO DATE LAST REPORT SUBMITTED MO. DAY YEAR 2. NO SECTION C - SIGNATURE AND IDENTIFICATION 16. .

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