Common use of Reporting Period From Clause in Contracts

Reporting Period From. Reporting Period To: This report is to be mailed directly to the Supplier Diversity & Outreach Program. Design Professional Information ADDRESS OF DESIGN PROFESSIONAL Additional services listing Current Totals CONTRACT AMOUNT (if applicable) LENGTH OF CONTRACT CONTRACT START DATE CONTRACT END DATE Contract M/WBE Goal % SUPPLIER DIVERSITY & OUTREACH PROGRAM VENDOR INFORMATION NAME OF CERTIFIED M/WBE CONSULTANT WORK DESCRIPTION AMOUNT DRAWN/PAID TO VENDOR AMOUNT FOR WORK PERFORMED DURING MONTH AMOUNT PAID TO DATE % of TOTAL PAID TO CONTRACT AMOUNT CurrentTotals Company Official’s Signature & Title: Phone # ( ) Date: The School Board of Broward County M/WBE Report Form Revised 12/1/15 Page 1 of 1 This page intentionally left blank

Reporting Period From. Reporting Period To: This report is to be mailed directly to the Supplier Diversity & Outreach Program. Design Professional Information ADDRESS OF DESIGN PROFESSIONAL Additional services listing Current Totals CONTRACT AMOUNT (if applicable) LENGTH OF CONTRACT CONTRACT START DATE CONTRACT END DATE Contract M/WBE Goal % SUPPLIER DIVERSITY & OUTREACH PROGRAM VENDOR INFORMATION NAME OF CERTIFIED M/WBE CONSULTANT WORK DESCRIPTION AMOUNT DRAWN/PAID TO VENDOR AMOUNT FOR WORK PERFORMED DURING MONTH AMOUNT PAID TO DATE % of TOTAL PAID TO CONTRACT AMOUNT CurrentTotals Company Official’s Signature & Title: Phone # ( ) Date: The School Board of Broward County M/WBE Report Form Revised 12/1/15 Page 1 of 1 This page intentionally left blankblank PSA Attachment 11 The School Board of Broward County IRS Form W‐9