Resolutions - Jersey City

Form AA302Rev. 1/00STATE OF NEW JERSEYDivision of Contract Compliance & Equal Employment OpportunityEMPLOYEE INFORMATION REPORTFor Instructions on completing the form, go to: http://www.state.nj.us/treasury/contracccompiiance/pdf/aa302ins.pdfSECTION A, COMPANY IDENTIFICATIONI, FlO, NO OR SOCIAL SECURITY TYPE OF BUSIl'ESS ), TOTAL NO. E~1PLOYEES IN l1 ENTIRE22'37540364, COMPANY NAMETelecom Integrity Group5. STREET CITY1250 Rte 28, Ste 305 Branchburg6. NAME OF PARENT OR AFFILIATED COMPANY (IF NONE, SO INDICATE)o 4. RETAIL 0 S, OTHER 7o i. MFG i; 2 SERVICE 0 3, WHOLESALE COMPANY. COUNTYSomersetSTATE ZfPCODENJ 08876CITYSTATE ZIPCODEnoneI I7. CHECK ONE: IS THE COMPANY: o; SINGLE-ESTABLISHMNT EMPLOYER o MULTI-ESTABLISHMENT EMPLOYER8. IF MULTI-ESTABLISHMENT EMPLOYER STATE THE NUBER OF ESTABLISHMENTS IN NJ9. TOTAL !'UMBER OF EMPLOYEES AT ESTABLISHMENT \VHICH HAS BEEN AWARDED THE CONTRACT10 PUBLIC AGENCY AWARDIt'G CONTRACTCity of Jersey CityCITYJersey CityCOUNTY .HudsonOffcial Use Onlv DA TE RECEIVED NAUG.DATE ASSIGNED CERTrFlCA TlON NUMBERNJZIP CODE07306SECTION B - EMPLOYMENT DATAII. Repor all permanent, temporary and part-ume empl.oyees ON YOUR OVv'N PAYROLL. _ Enrer ihe appropriate figures on all lines and in all columns. Where ihere areno employees in a particular caiegory. enter a. zero. (Ilcludc ALL employees,. not just those in minority/non-minori(~. categores, in columns I, 2, & 3~ DO NOT SUBMITAN EEO 1 REPORT!ALL EMPLOYEESPERMANENT MINORITY/NON-MINORITY EMPLOYEE BREAKDOWNJOB COL. i COL, 2 COL. 3 ......... MALE..."'.................... ...............FEMA ..........................CATEGORIES TOTAL MALE FEMALE AlIEIt NON lAMER. NON(Col'.2 &3) BLACK HISPANIC INDlA~ ASIAN MIN. BLACK HISPANIC INmAN ASIAN MIN.Officials! Managers 1 1 0 0 0 0 0 1 0 0 0 0 0Professionals 2 1 1 0 0 0 0 1 0 0 0 0 1Technicians1 1 0 0 0 0 0 1 0 0 0 0 0Sales Workers 0 0 0 0 0 0 0 0 0 0 0 0 0Offce & Clerical 0 0 0 0 0 0 0 0 0 0, 0 0 0Craftworkers(Skiled) 0 0 0 0 0 0 0 0 0 0 0 0 0Operatives(Semi.skilled) 0 0 0 0 0 0 0 0 0,0 0 0 0Laborers(Unskilled)0 0 0 0 0 0 0 0 0 0 0 0 0Service Workers 0 0 0 0 0 0 0 0 0 0 0 0 0TOTAL 4 3 1 0 0 0 0 3 0 0 0 0 1Total employmentFrom previousReport (if any)Temporary & Part.Time EmployeesThe data below shall !'OT be included in the figures for the appropriate categories above.3 2 1 0 0 0 0 :i 0 0 0 0 1L12 HOW W.AS INFORMATION AS TO RACE OR ETHNIC GROUP IN SECTION B OBTAINED 14. IS THIS THE FIRST 15,lF NO. DATE LAST,~ i. Visual Sur..ey 02. Employment Recrd 03, Other (Specify) .Employee Information REPORT SUBMmEDReport Submit red?MO, rAY I YEAR13. DATES OF PAYROLL PERIOD USEDFrom:1/1/09To:¡YESr- 2. NOIXcurrent5EcriON C' SIGNATURE AND 100NTlfiCATION16, NAME OF PERSO~ COMPLETING FORM (Print orT),pe)I'iA h. SIGNATUREKurt Johnson7 't 'if/ I17. ADDRESS NO, & STREET CITY U, COUNTY9 15 08MO DAY YEARI member/owner TITLE I DATE . 81 261 09STATE ZIP CODE PHONE (AREA CODE, NO.,EXTNSION)1 250 Rte 28, Ste 305 Branchburg Somerset NJ 08876 908 - 231 - 1980