The EPA Form 6100-3 is a document used to report on the results of an environmental assessment (EA). This form is used by both federal and state agencies, and can be completed by either the governmental agency or the developer. The EPA Form 6100-3 must be submitted to the appropriate agency within 30 days of completion of the EA. The purpose of this blog post is to provide an overview of the EPA Form 6100-3, including what information is required and when it must be submitted. We will also discuss some potential penalties for not submitting this form on time.
| Question | Answer |
|---|---|
| Form Name | Epa Form 6100 3 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | form 6100 3, subcontractor performance fifteen, 6100 dbe form, form dbe environmental |
OMB Control No:
Approved: 05/01/2008
Approval Expires: 01/31/2011
Environmental
Protection Agency
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
NAME OF SUBCONTRACTOR1
PROJECT NAME
ADDRESS
BID/PROPOSAL NO.
TELEPHONE NO.
PRIME CONTRACTOR NAME
CONTRACT ITEM NO.
ITEM OF WORK OR DESCRIPTION OF SERVICES BID TO PRIME
PRICE OF WORK
SUBMITTED TO PRIME CONTRACTOR
Currently certified as an MBE or WBE under EPA’s DBE Program? ______ Yes ______ No Signature of
Prime Contractor Date Print Name Title ___________________________________________
__________________________________________ Signature of Subcontractor Date
___________________________________________ __________________________________________ Print
Name Title
1Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance.
EPA FORM
OMB Control No: |
|
Approved: |
05/01/2008 |
Approval Expires: |
01/31/2011 |
Environmental
Protection Agency
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
The public reporting and recordkeeping burden for this collection of information is estimated to average fifteen
(15)minutes. Burden means the total time, effort, or financial resources expended by persons to generate, maintain, retain, or disclose or provide information to or for a Federal agency. This includes the time needed to review instructions; develop, acquire, install, and utilize technology and systems for the purposes of collecting, validating, and verifying information, processing and maintaining information, and disclosing and providing information; adjust the existing ways to comply with any previously applicable instructions and requirements; train personnel to be able to respond to a collection of information; search data sources; complete and review the collection of information; and transmit or otherwise disclose the information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed EPA DBE Subcontractor Performance Form to this address.
EPA FORM