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City of Decatur <br /> CITY OF DECATUR Minority Participation Worksheet <br /> PUBLIC WORKS DEPARTMENT <br /> ENGINEERING DIVISION Return with Pay Estimate <br /> Check Appropriate Block <br /> Prime Contractor Pay Estimate Period: <br /> SuuF VVbco�nnt_ractor r <br /> Company: i7f da tree l..L a i:.td h./� <br /> Coic i xI 1.LC <br /> Address: fgb45 6, 429 ji'1yl , 31t4,4ift�✓[ it.Li V7 <br /> Project Title: Tee ;vu „Ai 114,41'43 ccat <br /> 43 1:1i�t� LibAh <br /> Project Number: — 22L.yt—c)/ <br /> Current Previous To Date <br /> Male Female Current Totals Totals From Previous Totals To Date <br /> Job Categories Pay Periods <br /> Count Hours Worked Count Hours Worked Count Hours Worked PCounts Previous Hours Worked Count DateTo Hours Worked To Date % <br /> Black or African American <br /> Asian <br /> American Indian 1 Alaskan Native <br /> Hispanic or Latino <br /> Native Hawaiian or other Pacific <br /> Islander <br /> White 2 <br /> Total 7 I U <br /> (. <br /> Total Minority <br /> Prepared by,(Signature and Title of Copfra ors Representative) Date: <br /> \.\ /C 2/2C 2 6 <br /> Reviewed by: (Signature of City Projecf�Manager) Dale: <br /> Printed 7r29/2O22 Page 1 of 1 Minority Participation Worksheet(Rev.07/29/22) <br />