Form CC-257

Monthly Employment Utilization Report

U.S. Department of Labor

Employment Standards Administration
Office of Federal Contract Compliance Programs
This report is required by Executive Order 11246, Sec. 203. Failure to report can result in contracts
1. Covered Area (SMSA or EA)
2. Employers I.D. No.
being cancelled, terminated or suspended in whole or in part and the contractor may be declared
ineligible for further Government contracts of federally assisted construction contracts.
3. Current Goals
4. Reporting Period
Name and Location of Contractor
Minority
From
Female

6.9%

Federal
Funding
Agency

To

6. TOTAL FEDERAL & NON-FEDERAL CONSTRUCTION WORK HOURS

5.
CONSTRUCTION
TRADE

OMB No. 1215-01633
Expires: 12/13/92

Classifications

6a.
Total All
Employees
By Trade

M

6b.
Black
(Not of Hispanic
Origin)

F

M

F

6c.

6d.
Asian or
Pacific
Islander

Hispanic

M

F

M

6e.
American
Indian or
Native American

F

M

F

7,

8.

Minority
Percentage

Female
Percentage

9.

10.

Total
Number of
Employees

Total Number of
Minority Employees

M

F

M

F

Journey Worker
Apprentice
Trainee
Sub-Total
Journey Worker
Apprentice
Trainee
Sub-Total
Journey Worker
Apprentice
Trainee
Sub-Total
Journey Worker
Apprentice
Trainee
Sub-Total
Journey Worker
Apprentice
Trainee
Sub-Total
Total Journey Worker
Total Apprentices
Total Trainees
Grand Total
11. Company Official’s Signature and Title

12. Telephone Number
(Include area code)
(

13. Date Signed

Page
of
Form CC-257
Rev. Jan. 1992