Resolution of the City of Jersey City, N.J.
Resolution of the City of Jersey City, N.J.
Resolution of the City of Jersey City, N.J.
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Fonn AA302Rev, 10/08STATE OF NEW JERSEYDivision <strong>of</strong> Public Contracts Equal Employnent Opportunity ComplianceEMPLOYEE INFORMATION REPORT,IMPORTANT. READ INSTRUCTIONS ON BACK OF FORM CAREFULLY BEFORECOMPLEnNG FORM. TYPE OR PRINT IN SHARP BALLPOINT PEN.FAlLURETO PROPERLY COMPLETE THE ENTIRE FORM AND SUBMIT THE REQUIRED 5150.00 NON-REFUNDABLE FEE MAY DELAY ISSUANCE OF YOUR CERTIFICATE.DO NOT SUBMIT EED-i REPORT FOR SECTION B,ITEM 11. For Instructions on completin9 <strong>the</strong> Form, go to: www..tate.nJ.u.ltreasu~/contract_compliance/pdflaa302in..pdfSECTION A. COMPANY IDENTIFICATIONi. FlO, KO, OR SOCIAL SECURITY 2, TYPE OF BUSINESS), TOTAL NO~ EMPLOYEES N THE EKTIRE01. MFG i; 2, SERVICE 0 3_ WHOLESALECOMPANY52-2190781 o 4, RETAIL 05_ OniR1994, COMPANY NAMEOffCial Payments Corporation5, STREET CITY10780 Parkridge Blvd. #400 Reston6, NAME OF PARNT OR AFFILIATED COMPANY (IF NONE. SO INDICATE)TIer Technologies7, CHECK ONE: IS THE COMPANY:o SINGLE-EST ABLISHMEKT EMPLOYERCOUNTYFairfaxCITYsame8, IF MVLTI-E TABLlSHiIENT E~IPLOYER STATE THE NUMBER OF ESTAlll.SHMENTS IN J9, TOTAL NUMBER OF EMPLOYEES AT ESTABLISHMENT WHICH HAS BEEN AWARDED THE CONTRACT10 PHIlLlC AGENCY ,~WARJ)ING CONTRACTCITYCOUNTYSTATE ZIP CODEVA 20191STATE zip10 ICODEii MULTI-ESTABLlSI'¡IENT EMPLOYERSTATEZU'CODEOffcial Use Onl DATE RECEIVED NAUG,DATE AS I NED CERTIFICA no:' NU\fß.RSECTION B - EMPLOYMENT DATA11. Report all pcnnanenl, tempoliuy and pan-time employees ON YOUR OWN PAYROLL. Enter <strong>the</strong> appropriate figures on all lines and in all columns. Where <strong>the</strong>re areno employees in a panic:ular category, enier a zero. Include ALL emplorees. not just those in iniiiority/non-minorit)' caiegories, in columns 1,2, & 3. DONOTSUBMfTAN EEO-' REPORT.LL EMPLOYEES -JOB COL_I COL 2 COL,) ."'''....... MALE..,................."'....... .................FEMA ................."."'''.......CATEGORIES TOTAL MALE FEMALE AMER, NON ,\MER- NON(Col.,2 &3) BLACK HISPANIC INDlA~ ASIAN MIN_ ßLACK HISPANIC INDIAN ASIA;- MINOffcialsl Managers 63 39 24 0 1 0 4 34 1 0 0 7 16Pr<strong>of</strong>essionals 125 55 70 4 6 0 11 34 lß 11 0 7 34Technicians 1 1 0 0 0 0 0 1 0 0 0 0 0Sales Workers 7 3 0 0 0 0 4 1 0 0 0 2Orrce & Clerical 3 2 1 1 0 0 0 1 1 0 P 0 0Craftworkers(Skiled)Operatives(Semi-.kiled)0 0 0 0 0 0 0 0 0 0 p 0 00 0 0 0 0 0 0 0 0 0 p 0 0Laborers(Un. killed)0 0 0 0 0 p 0 0 0 0 0 0 0Service Workers 0 0 0 0 0 p 0 0 0 0 0 0 0TOTAL 199 101 98 5 7 ~ 15 74 21 11 0 14 52Total employmentFrom pre.viousReport (If any)Temporary &i Part-The dala below shall NOT be included in <strong>the</strong> figures ror <strong>the</strong> appropriate categories above,Time Employees ,I12, HOW WAS INFORMATION AS TO RACE OR ETHNIC GROUP IN SECTION BOBTAINED' 14, IS THIS THE FIRST I S_ IF NO. DATE LASTo 1. Visual SurvC)' Employee InformaiionREPORT SUBMITTED~J.. Employment Record 0), O,hcr (Spcciry)Rcpon Submiued?MO_1DAY1YEAR13, DATES OF PAYROLL PERJOD USEDFrom: 10/03/200916, NA~"iE OF PERSON COMPLETING FORM (Prin' or Type) IGitaGarman17 ADDRESS NO, &. STREET CITYTo:10/16/2009SECTON C- SIGNATUREAND IDENTIFICATIONSIGNATUREi. YES !X 2NOI:'10 DAY YEARI Human TITLE Resources I DATE 10 11512009STATE ZIP CODE PI-IOKE (AREA CODE, NO,.EXTENSION)10780 Parkridge Blvd. #400 Reston Fairrax VA- 20191 571 - 382 - 1000I certify that <strong>the</strong> information on this Form is true and correct.
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