The U.S. Environmental Protection Agency (EPA) has established a standardized method for tracking and promoting the utilization of Minority Business Enterprises (MBEs) and Women's Business Enterprises (WBEs) under federal grants, cooperative agreements, and interagency agreements through the EPA Form 5700-52A. This form, under OMB Control No. 2030-0020, serves a critical role in ensuring transparency and accountability in how federally funded projects engage with diverse businesses. By requiring reporting on MBE/WBE procurement activity for each federal fiscal quarter, the EPA emphasizes the importance of supporting minority and women-owned businesses in environmental projects. The form includes sections for detailing federal financial assistance, the recipient's information, procurement amounts, and actual MBE/WBE procurement accomplished within the reporting period. Notably, it mandates reporting even if no procurements are made, highlighting the continuous effort to foster diversity in government contracts and projects. With deadlines set for 30 days after the end of each federal fiscal quarter, the form ensures timely submission of procurement activities. This diligent reporting process not only aligns with the EPA’s mission to promote environmental protection inclusively but also encourages the broader integration of diverse businesses into federal initiatives.
| Question | Answer |
|---|---|
| Form Name | Epa Form 5700 52A |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | 5700 52a epa form, MBE, 5700-52A, Kleen |
OMB CONTROL
APPROVED: 12/30/02
APPROVAL EXPIRES: 12/31/05
U.S. ENVIRONMENTAL PROTECTION AGENCY
MBE/WBE UTILIZATION UNDER FEDERAL GRANTS, COOPERATIVE
AGREEMENTS, AND INTERAGENCY AGREEMENTS
PART 1. (Reports are required even if no procurements are made during the reporting period.)
1A. FEDERAL FISCAL YEAR |
1B. REPORTING QUARTER (Check appropriate box) |
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200_______ |
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9 1st |
9 2nd |
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9 3rd |
9 4th |
9 Annual |
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1C. REVISION |
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HIGHLIGHT ITEMS TO BE REVISED AND PROVIDE EXPLANATION IN BLOCK No. 6 |
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Year: _________ |
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Quarter: _________ |
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2A. FEDERAL FINANCIAL ASSISTANCE AGENCY |
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3A. REPORTING RECIPIENT (Name and Address) |
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(EPA Office Address - ATTN: DBE Coordinator) |
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2B. REPORTING CONTACT |
2C. PHONE: |
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3B. REPORTING CONTACT (Recipient) |
3C. PHONE: |
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(EPA DBE Coordinator) |
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4A. FINANCIAL ASSISTANCE AGREEMENT ID NUMBER |
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4B. FEDERAL FINANCIAL ASSISTANCE PROGRAM |
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(SRF State Recipients, Refer to Instructions for Completion of 4A, 5A, and 5C) |
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5A. TOTAL ASSISTANCE AGREEMENT |
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5B. Check and skip to Block |
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5C. TOTAL PROCUREMENT AMOUNT THIS REPORTING |
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AMOUNT |
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No. 7 if no procurements |
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PERIOD (ONLY include the amount not in any prior reporting |
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and accomplishments |
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period and procurements made by SRF Loan Recipients and Sub- |
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EPA Share: |
$_______________________ |
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were made this reporting |
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Recipients) |
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period. |
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$______________________________ |
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9 |
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(Exclude procurement amounts reported by Prime Contractors) |
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Recipient Share: $_____________________ |
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5D. ACTUAL MBE/WBE PROCUREMENT ACCOMPLISHED THIS |
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5E. ACTUAL MBE/WBE PROCUREMENT ACCOMPLISHED THIS |
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REPORTING PERIOD BY RECIPIENT (SRF State Recipients, Report |
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REPORTING PERIOD BY LOAN RECIPIENTS, |
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State Procurement Activities Here) |
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AND PRIME CONTRACTORS |
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$ MBE |
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$ WBE |
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$ MBE |
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$ WBE |
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Construction |
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Construction |
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Equipment |
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Equipment |
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Services |
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Services |
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Supplies |
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Supplies |
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TOTAL |
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TOTAL |
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6. COMMENTS: |
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7. NAME OF AUTHORIZED REPRESENTATIVE |
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TITLE |
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8. SIGNATURE OF AUTHORIZED REPRESENTATIVE |
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DATE |
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EPA FORM
NOTE: THIS REPORT IS DUE 30 DAYS AFTER THE END OF EACH FEDERAL FISCAL QUARTER OR ANNUAL:
SUBMISSION DATES ARE: January 30, April 30, July 30, and October 30*
*ANNUAL REPORT
MBE/WBE PROCUREMENTS MADE DURING REPORTING PERIOD EPA Financial Assistance Agreement Number: _______________
1. Procurement Made By |
2. Business Enterprise |
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Recipient |
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Other |
Minority |
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Women |
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3.$ Value of Procurement
4.Date of Award
MM/DD/YY
5.Type of Product or ServicesA
(Enter Code)
6.Name/Address/Phone Number of MBE/WBE Contractor or Vendor
AType of product or service codes:
1 = Construction |
2 = Supplies |
3 = Services |
4 = Equipment |
A = Business Services
B = Professional Services
C = Repair Services
D = Personal Services
EPA FORM