Form SR Subcontractor Report

Board of Governors
of the Federal Reserve System

Subcontracting Report
Submit the completed form via email (preferred submission method) to Procurement.
Click the "Submit" button once all required fields are complete.

FRB Contract Specialist:
Contract Specialist Email:
Date sent to Prime Contractor:

If you are unable to save the form, print, sign and scan the completed form for email to
Complete the contract information below, then click here to send to Prime Contractor.
the FRB Contract Specialist’s email listed to the right.
Prime Contractor
Information

Contract Number:

Contract Amount:

Reporting Year Period From:

To:

Vendor Name:
Contact Name:

Duns Number:

FR 14-700-02

Phone Number:

Email Address:

Street Address:
City:

State:

Zip:

Basic Subcontractor Information
Owner Classification (select all that apply)

Subcontractor Name
(Address and Description of Services
REQUIRED on page 2.)

CLASSIFICATION SUMMARY
Woman Owned
Veteran-Owned

Business
Size

Total
Percentage

Woman

Veteran

Service Disabled
Veteran

Business
Classification

Dollar Amount
per year

Award
%

By typing my name in the indicated fields, I am signing this document and affirming the truth of the information
submitted. I understand that signing the document in this manner is the legal equivalent of having placed my
handwritten signature on the document.

Service Disabled Veteran-Owned
American Indian or Alaska Native
Asian
Black or African-American

______________________________________ _____________
Vendor Contact’s Printed Name

Date

Hispanic or Latino
Native Hawaiian
Pacific Islander
Non-Minority
Page 1 of 2

02/2014

Subcontracting Report—continued
Prime Contractor
Detailed Subcontractor Information
Subcontractor Name

FR 14-700-02

Street Address
City, State, Zip

Description of Services

Page 2 of 2

02/2014