Cr 442 Certification Review Form PDF Details

Ensuring a diverse and inclusive workforce is a priority for businesses today, and the Cr 442 Certification form plays a pivotal role in this process for those operating with or proposing to do business within Michigan. Issued by the Michigan Department of Civil Rights, the form is a comprehensive document designed to evaluate a contractor's adherence to equal employment standards, focusing on achieving reasonable representation of minorities and women across all levels of its workforce. By comparing the demographic makeup of a contractor's employees against that of the available employment pool derived from the latest U.S. Census data, the form aids in identifying disparities and encourages proactive engagement in diversity hiring practices. Further, it encompasses a variety of segments including company information, types of ownership, employee recruitment, current Michigan contracts, and detailed reporting of the workforce's ethnic composition. The form also outlines rigorous compliance and certification processes, underlining the Michigan Department of Civil Rights' commitment to promoting equitable employment opportunities across the state. Failure to submit the necessary information or adhere to the specified format can significantly delay the review process and negatively impact a company's eligibility for certification, emphasizing the form's critical place in the operational oversight of contractors and bidders in Michigan.

QuestionAnswer
Form NameCr 442 Certification Review Form
Form Length8 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min
Other namesCR 442_Certificate _of_Awardabilit y_08 10_348552_7 ate of awardability form

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CERTIFICATION REVIEW FORM

REVIEW NUMBER

Contractors and Biddersdoing buslnesswlth the State of Michlganandlor who propose to do businesswith the State are subjedto reviewbythe Michi~anDepartmentof Civil Rights. The contractcompliance review is a total evaluation of your actlvilles relative to the equal employment standardof reasonablerepresentation of minorities and women at all levelsof yourwork force. The slandard is determined by comparisonwith the approximate percentagesof minoritiesandwomenamongthe available employment pool establishedby Ule latest United States Census for Ule geographicalarea where the contractor recruits ils employees.

Failure to provide the requestedInformation in the format providedwill delay the review processand may adverselyimpactyour ellgibllity

COMPANY NAME

 

 

FEDERAL TAX IDENTIFICATIONNUMBER

 

 

 

STREET ADDRESS

 

 

C I M

 

 

STATE

Z1P CODE

 

COUNTY

EMAILAODRESS

TELEPHONE NUMBER

 

FAX NUMBER

 

L

 

- - -

(

1

 

(

 

1

 

 

 

 

 

 

 

 

 

NAME OF TOP OFFICAL OF THE ORGANIZUION:

N.ME OF THE EQUAL EMPLOYMENTOPPORTUNITY (EEO) COORDINATOR

NAME OF PERSONWE CAN CONTACT FORADDITIONAL INFORMATION:

CONTACT PERSON'S TELEPHONE NUMBER

 

 

 

TYPE OF OWNERSHIP or S ~ ~ U ~ ~UuCr ~p oI s iOnly)r

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0 CORPORATION

 

a PARTNERSHIP

 

 

0 PROPRIETORSHIP

1

NON-PROFIT

CERTIFIEDMINORIM BUSINESS

 

a CERTIFIED PERSONSWITH DISABILIM

 

0 CERTIFIEDWOMEN BUSINESS

 

ENTERPRISE (Attach copy ofCertlficate1

BUSINESS ENTERPRISE (Attach CODYof CerlificaU

ENTERPRISE(Attach COPYof CdliCate)

 

GENERAL1SPECALNCONSTRUCTION

0 PROFESSIONALSERVICES

 

 

MANUFACTURING

 

0 WHOLESALE

 

1 a SERVICE

 

 

1

OTHER

 

 

 

IOENTIFYSPEClALTYANDlOR SKILLEDTRADES:

EXPLAINM P E OF OPERATION(For Exa'mple, electrical, c o n s W o n , architectural, ek):

I LIST OTHER LOCATIONS: (Attachaddilfonaisneelsas needed)

LIST MICHIGANCONTRACTS ONWHICH YOU ARE CURRENTLYWORKING: (Attach addifionalaheels as needed)

-

-

-

-

---

-

UNION NAME(S) AND LOCAL NUMBER(S) WITH WHICHYOU HAVEBARGAININGAGREEMENTS):

IF NONE, CHECK BOX a NONE

-

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I

NOTE: This form is Issued under the authority of PublicA& 220 & 453, PubllcA d s of 1976, as amended. This information is required in order to be considered for awadabllltycertification.

CR-442(Rev. 08/10)

Page 1of 8

I COMPANY NAME

 

I COUNTY

IADDRESS (STREET)

 

 

I a STATE EMPLOYMENTAGENCY (Provide Name)

1 a UNIONS

( 0 PRIVATEEMPLOYMENTAGENCIES

0 WORD OF MOUTH

a EQUAL OPPORTUNITYEMPLOYMENT

 

USED INADS

1 0

0

NEWSPAPERAWE-NO (Please List Below)

INTERNETa OTHER SOURCES

(Please Us1Below)

DO YOU USETARGETING RECRUITINGTECHNIQUESTO INCREASETHE NUMBER OF WOMEN, MINORITY GROUP PERSONS. AND PERSONSWIM DlSABlLmESWHO

APPLY FOR EMPLOYMENT? (Please specifically identityeach reccultmenltechnfque, 8.g.. name the newspapem Inwhich you will adveltlae, or the schoolsor organtzellonsyou will

 

contad) (Attach addifonalsheelsas needed.)

 

 

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WRITTENAPPLICATION

(Send a copy of current ..application If not ~rovlded~revlouslv.

 

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0 RESUME

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Teatlng Methods You Use: (Check allthat apply) -

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OTHER (OESCRIBE):

 

 

 

 

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NAME:

I TITLE:

 

 

 

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TRAINING PROGRAMS

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ON-THE-JOB PROGRAMS (DESCRIBE):

 

 

 

 

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FORMALIINFORMAL:

 

 

 

 

 

W W N :

I MANAGEMENT OR COLLEGETRAINEE PROGRAMSI HIGH SCHOOL CO-OP PROGRAMS:

EXPLAIN:

Pages 3 through 8 require lnformatlonregarding the raceof personsyou currenUy employ or who you haveemployed. Pleaseuse the following definltlons of racelethnlclty groups when enterlng lnformatlon on these pages:

Amerlcan lndlan (Al) or Alaska NaUve. A person having originsInany of the origlnalpeopleof NorthandSouthAmerica (Indudlng CenlralAmerica), andwho maintains trlbal affiliatfonor community attachment VedtlcatfonofAmerlcanlndlanstatus, such as tribalcard, a blrth cerlltlcateorsomedher writtensfatusverlflcallon, is requlredfor all employees llstedas Amedcan Indlan andmusf besubmlmdwlth fhe completedcertlflcatlon revlewfonn.

Asian (A). A person havlng orlgins h any of the orlginal peopleof the Far East, Southeast Asla, or the IndiansubconUnent Including, for example, Cambodia. Indla, Japan. Korea. Thailand, and Vietnam.

Black (B) or Afrlcan Amerlcan. A person havlng origins in any of Ule black racialgroups of Africa.

Hispanic (H) or Latlno. Aperson of Cuban, Mexican, PuertoRican, Southor CentralAmerica, or otherSpanishculture or origin, regardlessofrace. Thetem,'SpanM origin,' can be used Inaddition to 'Hispanic or Latino.'

Native Hawallan(NH) or Other Paclflc Islander. A person havlng origins in any of the origlnal peoples of Hawaii, Guam, Samoa, or dher PadficIslands.

Muitlraclal (MR). A person having parents of one or more minority racialgroups. This classifition and deflnitton Is provided under Michlgan law.

White 0.A person havlng orlgins Inany of Ule odglnal peoplesof Europe. Ule Middle East, or NorthAfrica.

PLEASE NOTE: WHEN USINGAllACHMENTS FOR PAGES 3 THROUGH 7, FOLLOWTHE FXAC'I: FORMAT AS THE CERTIFICATDN REVIEWFORM.

CR-442(Rev. 08110)

Page2 of 8

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NEW HIRES SINCE (Month, day. year) (Date of last woikforcesnapshot. or last

(For example: New hlres, rehlres, return from lay-off, temporary hlree, return from leave of abeence, 12 monthslor an IniUalcediticalion) interns, etc.)

Note: Raclalcategoryabbrevlatlonsere deflnedat the bottom of thls page.

PERSONSWITH

OFFlClALS &

MANAGERS

PROFESSIONALS

TECHNICIANS

SALES WORKERS

FOREPERSONSI

SUPERVISORS

SKILLED CRAFT

WORKERS

OFFICE &

CLERICAL

OPERATNES (Seml-skilled)

LABORERS (Unskilled)

SERVICE

WORKERS

APPRENTICES

TOTAL

SEPARATIONS SINCE (Month, day, year)

(Date of last workforcesnapshot, or last 12 monthsfor the initial certiflcatlon)

OFFICIALS &

MANAGERS

PROFESSIONALS

TECHNICIANS

SALESWORKERS

FOREPERSONS/

SUPERVISORS

SKILLED CRAFT

WORKERS

OFFICE &

CLERICAL

OPERATIVES (SemCskllled)

LABORERS (Unskilled)

SERVICE

WORKERS

APPRENTICES

TOTAL

W - Whlte

B - Black

-

A -Aslan

H - Hlspanlc

(For example: Discharges, lay-offs, leave of absence, voluntary terminations, etc.)

PERSONSWITH

Al --Amerlcan lndlan

NH - Natlve Hawalian

MR -Multi-racfal

CR-442 (Rev. 08/10)

Page 8 of 8

PROVIDE THE FOLLOWING INFORMATION FOR MINORITY EMPLOYEES, FEMALE EMPLOYEES AND EMPLOYEES WITH DISABILITIES WHO WERE PROMOTED IN THE PER100 SINCE YOUR LAST WORKFORCE SNAPSHOP (OR IN THE LAST 12 MONTHS FOR AN INlTlAL CERTIFICATION) :

(Attach additional sheets as needed.)

W - Whlte

B - Black

H - Hlepanlc

A -Aslan

Al -Amerlcanlndlan

NH -Natlve Hawalbn

MR -Multbraclal

CR442 (Rev. OUIO)

Page 7 of 8

I .

Is contractor aware of laws that prohibit discrimination based on religion or national origin?

0yes

0No

2.

Is contractor aware of laws that prohibits discrimination based on age?

a yes

0No

3.

Is contractor aware of current requirements for equal employment opportunity for persons

yes

0No

 

with disabilities?

 

 

4.

Has contractor either solicited or assisted businesses that are minority-owned, woman-owned

a Yes

0No

 

or owned by persons with disabilities to perform work for the State of Michigan?

 

 

5.

List Name, Address, and Telephone number of Minorityand/or Woman-Owned Subcontractors,Suppliersand JointVentures, that

 

you contracted with over the past twelve (12) months. (Aftach additional sheets as needed)

 

 

Include estimated dollar value of the Subcontracts andlor Joint Venture Projects.

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6 .

Does the company agree to use, on state contracts, only those subcontractors, vendors or suppliers who are reported to the

 

company to be in compliance or awardable by the Contract Compliance Team of the Michigan Department of Civil Rights?

 

 

r;ll Yes

No

7.

Has the contractor received a copy of the Directive fo Stafe Contractors and Bidders?

0 Yes

a No

8.List all open clvil rights employment complaints against your company by any state, local or federal clvil rights agency in any locationwhere you do business. (Aftach additional sheets as needed.)

PLEASE READTHIS CHECK LIST BEFORE SIGNINGAND RETURNINGYOUR CERTIFICATION REVIEW FORM. DIDYOU REMEMBERTO:

0Includeworkforce dates in the format requested (Monlh/DaylYear) on pages 3,6 and 7.

0Provide row and column totals ON page 3 and column totals on pages 6 and 7.

O Provide tribal cards, birth certificate, or wrilten verification for those listed as American Indians. Provlde employee ID numbers (if using Social Security numbers, only use the last four dlgits).

0Provide correct New Hire and Separationdales on page 5: (I)For those reapplying, start wllh the date of your previousworkforce snapshol,

endingwithyour current workforce snapshot (Example: 02-10-03 - 02-10-04. (2) For initialcertifications, your hiresand separalionswilhin lhe last belve (12) months.

0For re-certifications, dld you reconcile your reported hires and separations with your prior workforce snapshot. (Formula: Prior workforce snapshot + Hires - Separations = Current workforce snapshot.)

R When using attachments for pages 3 through 7, follow the EXACT format as the Certification Review Form.

R Out-of-Slate contraclors: Also provide copies of pages 3 through 7 for your Michiganworkforce, andlor call for instruclions.

On behalf of this business, Icertify that it Is an equal opportunity employer and does not discriminate based on race, sex, age, color, reiiglon, natlonai origln, marltal status, dlsablllty, weight, height and misdemeanor arrest record Inany employment ptactlces.

Icertlfy that the Information Ihave provlded on pages 4 through 8 of this form is correct, to the best of my knowledge.

Slgn and date:

 

 

(Corporate Officer)

(Title)

(Date)

Prlnt Name of Signer:

 

Please retain a copy of the CertlflcaUon

 

 

Revlew Form for company file.

CR442 (Rev. 06/10)

Page 8 of 8

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