Form FR 1400D FR 1400D Subcontracting Report

OMB Number 7100-0180
Approval expires May 31, 2022

Subcontracting Report
Board of Governors of the Federal Reserve System

FR 1400D

This form collects subcontract data and should be completed in accordance with Section M of the
prime contract. Submit the completed form via email to the Board's Procurement Office.

Date Submitted (MM/DD/YYYY)

Prime Contractor
Contract Number:

Contract Amount:

Reporting Period From:

To:
(MM/DD/YYYY)

Vendor Name:

DUNS Number:

Contact Name:

Phone Number:

(MM/DD/YYYY)

(including area code)

Street Address:

Fax Number:
(including area code)

Zip Code:

State:

City:

Email:
(5-digits)

TOTAL SUBCONTRACTOR AWARDS
Provide details regarding the subcontractor awards for small and/or large business concerns. Cumulative values represent the actual dollar amounts
subcontracted. Goal values represent the anticipated dollar amounts outlined in the contractor's proposal. Percentages are auto populated.

Goals

Cumulative
Type

Whole Dollars

Whole Dollars

%

%

Small Business Concerns
Large Business Concerns
Total Subcontract Value
Remarks

DETAILED SUBCONTRACTOR CLASSIFICATION INFORMATION
Provide detailed subcontractor information below. The percent field for each subcontractor is calculated from the whole dollars field compared to
the Total Subcontract Value above. This represents the percentage of the total subcontract dollars the subcontractor is receiving.
Name

Business Type (select all that apply)
Women-Owned
Small Disadvantage

DUNS Number

Size

Whole Dollars

Percent

Business Classification
HubZone

Veteran or Service-Disabled Veteran Owned

Description of Services

Add

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Subcontracting Report—(continued)
This table acts as a record to show the diversity breakdown of subcontractors. Percentages are auto populated and based off business type and
classification selections. Note: Outcome may not equal 100%.

CLASSIFICATION SUMMARY
Women-Owned
Small Disadvantaged Business Owned
HubZone
Veteran or Service-Disabled Veteran Owned
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian
Pacific Islander
Non-Minority

Total
Percentage

By typing my name in the indicated field. 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.

Vendor Contact Name

Date (MM/DD/YYYY)

Privacy Act Statement
PURPOSES. Information from the Subcontracting Report is used to assist the Board in fulfilling Congressional reporting requirements in the Board's annual report
regarding the fair inclusion of minorities and women in contracting. AUTHORITY. Sections 10 and 11 of the Federal Reserve Act (12 USC 244 and 248).
EFFECTS OF NONDISCLOSURE. For prospective vendors that decide to submit proposals to the Board, the FR 1400D is required to obtain a benefit, in order to
be eligible for the award and fulfillment of a contract at certain contract income thresholds. However, the failure to provide any requested information may impact
the continuation of an official Board contract. ROUTINE USES. The information you provide will be stored in the system of records entitled BGFRS-9, “FRB—
Supplier Files," located at https://www.federalreserve.gov/files/BGFRS-9-supplier-files.pdf and published at 73 FR 24984 at 24994-95 (May 6, 2008). All or part of
the information may be disclosed outside of the Board in accordance with routine uses, A, C, D, G, I, and J, and records may also be used to disclose information
to the Internal Revenue Service to report payments that may be considered income to the suppliers. See "General Routine Uses of Board Systems of Records"
located at https://www.federalreserve.gov/files/SORN-page-general-routine-uses-of-board-systems-of-records.pdf and published in the Federal Register at
83 FR 43872 (August 28, 2018) at 43873-74.

FR 1400D

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