VETS-100 FEDERAL CONTRACTOR REPORT ON VETERANS' EMPLOYMENTOM B N O :1 293-0 005 RETU RN C O M PLE TE D R EPO RT T O :
Exp ir e s: N ove m ber 3 0, 2 004 U.S. DEPARTMENT OF LABORVETERANS' EMPLOYMENT AND TRAINING SERVICEVETS-100 Reporting OfficePersons are not required to respond to this collection of 4200 Forbes Blvd., Suite 202information unless it displays a valid OMB number
Lan
ham, Maryland 20706TYPE OF REPORTING
ORGANIZATION (Check one or both, as
applicable)Single EstablishmentMult ip le E sta blis h m ent-
Headquarters
COM
PAN
Y IDENTIFICATION INFORMATION (Omit items preprinted above-ADD Company Contact Information Below)
M M D D Y Y Y Y
NAME OF HIRING LOCATION: ADDRESS (NUMBER AND STREET):CITY: COUNTY:STATE:ZIP CODE:EM PLO YE R ID
D U N
S: _ _ (IR S T A X N o.) _ EMPLOYEE DATA AND VETERAN REPORTING
REQUIREMENTS REP
ORT
ALL PERMANENT FULL-TIME OR PART-TIME EMPLOYEES AND NEW HIRES WHO ARE TARGETED VETERANS,
DATA ON NUMBER OF EMPLOYEES ARE TO BE ENTERED IN COLUMN L, M, AND N, LINES 1-9. DATA ON NEW HIRES
ARE TO BE ENTERED IN COLUMNS O, P, Q, R, AND S. ENTRIES IN COLUMNS O, P, Q, R, AND S, LINES 1 THROUGH 9,
AND COLUMNS L, M, N AND Q, LINE 10 (GRAY SHADED AREAS) ARE OPTIONAL FOR THIS REPORTING CYCLE.
INSTRUCTIONS ARE FURTHER DETAILED ON THE REVERSE OF THIS FORM.CATE G ORI
ES SPEC IA L
DIS ABLE D
VETERANS(L) VIE TN AM
ERA
VETERANS(M) O TH ER
PRO TE C TE D
VETERANS(N)SPEC IA L
DIS ABLE D
VETERANS(O) VIE TN AM
ERA
VETERANS(P) N EW LY
SEPAR ATE D
VETERANS(Q)O TH ER
PRO TE C TE D
VETERANS(R) TO TA L N EW
HIR ES, BOTH
VETERANSAND NON-
VETERANS (S) TYPE OF FORM (Check only one)Prime ContractorSubcontractor (MSC) Multiple Establishment-State
Conso lid ate d ( s p ecif y n um ber o f lo ca tio ns)ATTN: Human Resource/EEO DepartmentMultiple Establishment-Hiring
LocationCOMPANY No: TWELVE MONTH PERIOD ENDING 2 0 0 3NAME OF PARENT COMPANY: ADDRESS (NUMBER AND STREET):CITY: COUNTY:STATE:ZIP CODE:NAME OF COMPANY CONTACT:TE LE PH O NE A N D E M AIL F O R C O NTA C T: NUMBER OF EMPLOYEES NEW HIRES (PREVIOUS 12 MONTHS)
NAIC S:
JOB OFFICIALS AND
MANAGERS 1
PROFESSIONALS2TECHNICIANS3SALES WORKERS 4OFFICE AND CLERICAL 5CRAFT WORKERS (SKILLED) 6OPERATIVE (SEMI-SKILLED) 7LABORERS (UNSKILLED) 8SERVICE WORKERS 9TOTAL 10Rep ort th e to ta l m axim um a nd m in im um n um ber o f p erm anent e m plo ye es d urin g th e p erio d c o ve re d b y th is r e port.Maximum Number Minimum Number
FEDERAL CONTRACTOR VETERANS' EMPLOYMENT REPORT (VETS-100) WHO MUST FILEThe V ets -1 00 r e port is to b e c o m ple te d b y a ll n o nexe m pt fe dera l c o ntr a cto rs a nd s u bco ntr a cto rs
wit h c o ntr a cts o r s u bco n tr a cts fo r th e fu rn is h in g o f s u pplie s a nd s e rv ic e s o r th e u se o f r e al o r
pe rs o nal p ro perty fo r $ 25,0 00 o r m ore . S erv ic e s in clu de b ut a re n ot lim it e d to th e fo llo w in g
serv ic e s: U tilit y , c o nstr u ctio n, tr a nsp orta tio n, r e se arc h , in su ra nce , a nd fu nd d eposit o ry , ir re sp ectiv e
of w he th er th e g ove rn m ent is th e p urc h ase r o r s e lle r. T he e xis te nce o f $ 25,0 00 o r m ore in fe dera l
co ntr a cts o r s u bco ntr a cts d urin g a g iv e n c a le ndar y e ar e sta blis h es th e r e quir e m ent to file a V E TS -
100 R eport d urin g th e fo llo w in g c a le ndar y e ar.WHEN TO FILEThis a n nual r e port m ust b e file d n o la te r th an S epte m ber 3 0. M ail to th e a ddre ss p re -p rin te d o n
th e fr o nt o f th e fo rm .LEGAL BASIS FOR REPORTING REQUIREMENTSTit le 3 8 , U nit e d S ta te s C ode, S ectio n 4 212(d ) a nd P L 1 05-3 39, r e quir e th at fe dera l c o ntr a cto rs
re p ort a t le ast a nnually th e n um bers o f e xis tin g e m plo ye es w ho a re : 1 ) s p ecia l d is a ble d
vete ra n s, 2 ) v e te ra ns o f th e V ie tn am e ra , a nd 3 ) o th er p ro te cte d v e te ra ns ( th at is , w ho s e rv e d o n
activ e d uty d urin g a w ar o r in a c a m paig n o r e xp edit io n fo r w hic h a c a m paig n b adge h as b ee n
au th o riz e d). F or th e e xis tin g e m plo ye es, th e n um bers o f v e te ra ns w it h in th ese th re e g ro ups a re
to b e b ro ke n o ut b y jo b c a te gory . N ew h ir e s a re to b e r e porte d o ve r a tw elv e -m onth r e portin g
pe rio d. T he to ta l n um ber o f v e te ra n n ew h ir e s in e ach o f th e th re e g ro ups a bove is to b e
re p orte d, a lo ng w it h th e to ta l n um ber o f n ew ly s e para te d v e te ra ns ( i. e . h ir e d w it h in tw elv e
mo n th s o f s e para tio n). In a ddit io n, o ve r th e s a m e tw elv e -m onth p erio d, th e to ta l n um ber o f n e w
hir e s, b oth v e te ra ns a nd n on-v e te ra ns, is r e quir e d to b e r e porte d, a lo ng w it h th e m in im um a nd
ma xim um to ta l e m plo ym ent. T his r e portin g is r e quir e d b y h ir in g lo ca tio n.HOW TO SUBMIT THE VETS-100 REPORTSSin gle -e sta b lis h m ent e m plo ye rs m ust file o ne c o m ple te d fo rm . A ll m ult i- e sta blis h m ent e m plo ye rs ,
i. e ., th ose d o in g b usin ess a t m ore th an o ne h ir in g lo ca tio n, m ust file ( A ) o ne fo rm c o ve rin g th e
prin cip al o r h eadquarte rs o ffic e : ( B ) a s e para te fo rm fo r e ach h ir in g lo ca tio n e m plo yin g 5 0 o r m ore
pe rs o ns: a nd ( C ) E IT H ER , ( I) a s e para te fo rm fo r e ach h ir in g lo ca tio n e m plo yin g fe w er th an 5 0
pe rs o ns, O R ( ii) c o nso lid ate d r e ports th at c o ve r h ir in g lo ca tio ns w it h in o ne S ta te th at h ave fe w er
th an 5 0 e m plo ye es. E ach s ta te c o nso lid ate d r e port m ust a ls o lis t th e n am e a nd a ddre ss o f th e
hir in g lo ca tio ns c o ve re d b y th e r e port. C om pan y c o nso lid ate d r e ports s u ch a s th ose r e quir e d b y
EE O -1 r e portin g p ro ce du re s a re N O T r e quir e d fo r th e V ETS -1 00 r e port. C om ple te d r e ports fo r
th e h ea dquarte rs lo ca tio n a nd a ll o th er h ir in g lo ca tio ns fo r e ach c o m pany s h ould b e m aile d in o ne
pa cka ge to th e a ddre ss in dic a te d o n th e fr o nt o f th e fo rm .RECORD KEEPINGEm plo ye rs m ust k e ep c o pie s o f th e c o m ple te d a nnual V ETS -1 00 r e port s u bm it te d to D O L fo r a
pe rio d o f th re e y e ars .HOW TO PREPARE THE FORMSShade d a re as d esig nate o ptio nal in fo rm atio n.
An sw ers to q uestio ns in a ll o th er a re as o f th e fo rm a re m andato ry .M ult i- e sta blis h m ent e m plo ye rs s u bm it tin g h ard c o py r e ports s h ould p ro duce fa csim ile c o pie s o f
th e h ea dquarte rs fo rm fo r r e portin g d ata o n e ach lo ca tio n.T yp e o f R eportin g O rg aniz a tio n In dic a te th e ty p e o f c o ntr a ctu al r e la tio nsh ip ( p rim e c o ntr a cto r o r s u bco ntr a cto r) th at th e o rg aniz a tio n h as w it h th e F edera l G ove rn m ent. If th e o rg aniz a tio n s e rv e s
as b oth a p rim e c o ntr a cto r a nd a s u bco ntr a cto r o n v a rio us fe dera l c o ntr a cts , c h eck b oth b oxe s.T yp e o f F orm If a r e portin g o rg aniz a tio n s u bm it s o nly o ne V ETS -1 00 R eport fo rm fo r a s in gle lo ca tio n, c h e ck th e S in gle E sta blis h m ent b ox. If th e r e portin g o rg aniz a tio n s u bm it s m ore th an
on e fo rm , o nly o ne fo rm s h ould b e c h ecke d a s M ult ip le E sta blis h m ent- H eadquarte rs . T he
re m ain in g fo rm s s h ould b e c h ecke d a s e it h er M ult ip le E sta blis h m ent- H ir in g L oca tio n o r M ult ip le
Esta b lis h m ent- S ta te C on so lid ate d. F or s ta te c o nso lid ate d fo rm s, th e n um ber o f h ir in g lo ca tio ns
in clu de d in th at r e port s h ould b e e nte re d in th e s p ace p ro vid ed. F or e ach fo rm , o nly o ne b ox
sh ould b e c h ecke d w it h in th is b lo ck.COMPANY IDENTIFICATION INFORMATIONCom pa ny N um ber D o n ot c h ange th e C om pany N um ber th at is p rin te d o n th e fo rm . If th ere a re a ny q uestio ns re g ard in g y o ur
Co m pany Num ber, ple ase ca ll th e VETS -1 00 sta ff at (3 01) 306-6 752 or e-m ail
HE LP D ESK@ VETS 100.C O M . Tw elv e M onth P erio d E ndin g E nte r th e e nd d ate fo r th e tw elv e m onth r e portin g p erio d u se d a sth e b asis fo r filin g th e V ETS -1 00 R eport. T o d ete rm in e th is p erio d, s e le ct a d ate in th e c u rr e nt
yea r b etw een J u ly 1 a nd A ugust 3 1 th at r e p re se nts th e e nd o f a p ayro ll p erio d. T hat p ayro ll
pe rio d w ill b e th e b asis fo r r e portin g N um be r o f E m plo ye es, a s d escrib ed b elo w . T hen th e
tw elv e -m onth p erio d p re ce din g th e e nd d ate o f th at p ayro ll p erio d w ill b e y o ur tw elv e -m onth
pe rio d c o ve re d. T his p erio d is th e b asis fo r r e portin g N ew H ir e s, a s d escrib ed b elo w . A ny
fe dera l c o ntr a cto r o r s u bco ntr a cto r w ho h as w rit te n a ppro va l fr o m th e E qual E m plo ym ent
Opp ortu nit y C om mis s io n to u se D ece m ber 3 1 a s th e e ndin g d ate fo r th e E EO -1 R eport m ay
als o u se th at d ate a s th e e ndin g d ate fo r th e p ayro ll p erio d s e le cte d fo r th e V ETS -1 00 R epo rt.N am e a nd A ddre ss fo r M ult i E sta blis h m ent E m plo ye rs F or p are n t c o m pan y h ead quarte rs lo catio n, C O M PLE TE th e n am e a nd a ddre ss fo r th e p are nt c o m pany h eadquarte rs , L E AVE
BLA N K th e n am e a nd a ddre ss o f th e H ir in g L oca tio n. F or h ir in g lo catio ns o f a p are n t
co m pan y, C O M PLE TE th e n am e a nd a ddre ss fo r th e P are nt C om pany lo ca tio n, C O M PLE TE th e
nam e a nd a d dre ss fo r th e H ir in g L oca tio n.N AIC S C ode , D UNS N um ber, a nd E m plo ye r ID N um ber S in gle E sta blis h m ent a nd M ult i E sta b lis h m ent E m plo ye rs m ust C O M PLE TE th e N AIC S C ode, E m plo ye r ID N um ber, a nd th e
DU NS n um ber if th e c o ntr a cto r h as a D UNS n um ber, a s d escrib ed b elo w .N AIC S C ode E nte r th e s ix ( 6 ) d ig it N AIC S C ode a pplic a ble to th e h ir in g lo ca tio n fo r w hic h
th e r e p ort is file d. If th ere is n ot a s e para te N AIC S C ode fo r th e h ir in g lo ca tio n, e nte r th e
NA IC S C ode fo r th e p are nt c o m pany.D un a nd B ra dstr e et I.D . N um ber ( D UNS) If th e c o m pany o r a ny o f it s e sta blis h m ents h as a D un a nd B ra dstr e et Id en tif ic a tio n N um ber, p le ase e nte r th e n in e ( 9 ) d ig it n um ber in th e
space p ro vid ed. If th ere is a s p ecif ic D UNS N um ber a pplic a ble to th e h ir in g lo ca tio n fo r
wh ic h th e r e p ort is file d, e nte r th at D UNS N um ber. O th erw is e , e nte r th e D UNS n um ber fo r
th e p are nt c o m pany.E m plo ye r I.D . N um ber ( E IN ) E nte r th e n in e ( 9 ) d ig it n um bers a ssig ned b y th e I.R .S . to th e co ntr a cto r. If th ere is a s p ecif ic E IN a pplic a ble to th e h ir in g lo ca tio n fo r w hic h th e r e port is
file d, e n te r th at E IN . O th e rw is e , e nte r th e E IN fo r th e p are nt c o m pany.
INFORMATION ON EMPLOYEESC ountin g V ete ra ns S om e v e te ra ns w ill fa ll in to m ore th an o ne o f th e p ro te cte d v e te ra n c a te gorie s. F or e xa m ple , a v e te ra n m ay b e b oth a
sp ecia l d is a ble d v e te ra n a nd a V ie tn am e ra v e te ra n . In s u ch c a se s th e v e te ra n m ust b e
co unte d in e ach c a te g ory . N ew ly s e para te d v e te ra n s w ill b e c o unte d in th e N ew H ir e s s e ctio n
of th e V ETS -1 00 R ep ort o nly . In s u bse quent y e ars , th ese v e te ra ns w ill n o lo nger b e
co nsid ere d n ew ly s e p ara te d v e te ra ns. N um be r o f E m plo ye es S ele ct a ny p ayro ll p erio d e ndin g b etw een J u ly 1 a nd A ugust 3 1 o f th e cu rre nt y e ar. P ro vid e a ll d ata fo r p erm anent fu ll- tim e a nd p art- tim e e m plo ye es w ho w ere s p e cia l
dis a ble d v e te ra ns, V ie tn a m -e ra v e te ra ns, o r o th er p ro te cte d v e te ra ns e m plo ye d a s o f th e e n din g
date o f th e s e le cte d p ayro ll p erio d. D o n ot in clu de e m plo ye es s p ecif ic a lly e xclu ded a s in dic a te d
in 4 1 C FR 6 1 -2 50.2 (b )(2 ). E m plo ye es m ust b e c o unte d b y v e te ra n s ta tu s fo r e ach o f th e n in e
occu p atio nal c a te gorie s ( L in es 1 -9 ) in c o lu m ns L , M , a nd N . T he d escrip tio n o f jo b c a te gorie s
ca n b e fo und in 4 1 C FR 6 1-2 50.2 (b )(3 ). B la nk s p ace s w ill b e c o nsid ere d z e ro s.N ew H ir e s R eport th e n um ber o f p erm anen t fu ll- tim e a nd p art- tim e e m plo ye es b y v e te ra n
sta tu s w ho w ere h ir e d ( b oth v e te ra ns a nd n on -v e te ra ns) a nd w ho w ere in clu ded in th e p ayro ll
fo r th e fir s t tim e d urin g th e 1 2-m onth p erio d e ndin g b etw een J u ly 1 th ro ugh A ugust 3 1 o f th e
curr e nt y e ar. T he to ta ls in c o lu m ns O , P , R , a nd S ( L in e 1 0) a re r e quir e d. T he to ta l in c o lu m n
Q ( L in e 1 0) is o ptio nal fo r 2 003 r e portin g c ycle . E nte r a ll a pplic a ble n um bers , in clu din g z e ro s.M axim um /M in im um E m plo ye es R eport th e m axim um a nd m in im um n um ber o f p erm anent e m plo ye es o n b oard d urin g th e p erio d c o ve re d a s in dic a te d b y 4 1 C FR 6 1-2 50.1 0(a )(3 ).
Co ntr a cto rs m ay u se a n y r e aso nable m eth od fo r c a lc u la tin g a nd d ete rm in in g th e m axim um
and m in im um n um ber o f e m plo ye es d urin g th e r e portin g p erio d.D EFIN IT IO NS:'
Hir in g lo ca tio n'
m eans a n e sta blis h m ent a s d efin ed a t 4 1 C FR 6 1 2 50.2 (b ).'
Sp ecia l D is a ble d V ete ra n=
m eans ( i) a v e te ra n o f th e U .S . m ilit a ry , g ro und, n ava l o r a ir s e rv ic e w ho is e ntit le d to c o m pe nsa tio n ( o r w ho b ut fo r th e r e ce ip t o f m ilit a ry r e tir e d p ay w ould b e
en tit le d to c o m pensa tio n ) u nder la w s a dm in is te re d b y th e D epartm ent o f V ete ra ns'
A ffa ir s fo r a
dis a bil it y ( A ) r a te d a t 3 0 p erc e nt o r m ore , o r ( B ) r a te d a t 1 0 o r 2 0 p erc e nt in th e c a se o f a v e te ra n
wh o h as b een d ete rm in ed u nder S ectio n 3 8 U .S .C . 3 106 to h ave a s e rio us e m plo ym ent
ha ndic a p o r ( ii) a p ers o n w ho w as d is ch arg ed o r r e le ase d fr o m a ctiv e d uty b eca use o f a s e rv ic e -
conne cte d d is a bilit y .>
Ve te ra n o f th e V ie tn am -e ra=
m eans a p ers o n w ho: ( i) s e rv e d o n a ctiv e d uty in th e U .S . m ilit a ry ,
gr o un d, n ava l o r a ir s e rv ic e fo r a p erio d o f m ore th an 1 80 d ays, a nd w ho w as d is ch arg ed o r
re le ase d th ere fr o m w it h o th er th an a d is h onora ble d is ch arg e, if a ny p art o f s u ch a ctiv e d uty w as
pe rfo rm ed: ( A ) in th e R epublic o f V ie tn am b etw een F ebru ary 2 8, 1 961, a nd M ay 7 , 1 975; o r ( B )
be tw een A ug ust 5 , 1 964, a nd M ay 7 , 1 975, in a ll o th er c a se s; o r ( ii) w as d is ch arg ed o r r e le ase d
fro m a ctiv e d uty in th e U .S . m ilit a ry , g ro und, n ava l o r a ir s e rv ic e fo r a s e rv ic e -c o nnecte d d is a b ilit y
if a ny p art o f s u ch a ctiv e d uty w as p erfo rm ed ( A ) in th e R epublic o f V ie tn am b etw een F ebru ary
28 , 1 96 1, a nd M ay 7 , 1 975; o r ( B ) b etw een A ugust 5 , 1 964, a nd M ay 7 , 1 975, in a ny o th er
lo ca tio n.‘
New ly S epara te d V ete ra ns’
m eans a ny v e te ra n w ho s e rv e d o n a ctiv e d uty in th e U .S . m ilit a ry , g ro un d, n ava l o r a ir s e rv ic e d urin g th e o ne-y e ar p erio d b egin nin g o n th e d ate o f s u ch v e te ra n’
s
dis ch arg e o r r e le ase fr o m a ctiv e d uty .‘
Oth er P ro te cte d V ete ra ns’
m eans v e te ra ns w ho s e rv e d o n a ctiv e d uty in th e U .S . m ilit a ry ,
gro un d, n ava l o r a ir s e rv ic e d urin g a w ar o r in a c a m paig n o r e xp edit io n fo r w hic h a c a m pa ig nbadge h as b e en a uth oriz e d. F or th ose w it h In te rn et a cce ss, th e in fo rm atio n r e quir e d to m ake
this d ete rm in atio n is a va ila ble a t h ttp ://w ww.o pm .g ov/v e te ra ns/h tm l/ v g m e dal2 .h tmN am e a nd A ddre ss fo r S in gle E sta blis h m ent E m plo ye rs C O M PLE TE th e id entif y in g in fo rm atio n u nder th e P are nt C om pany n am e a nd a ddre ss s e ctio n. L E AVE B LA N K a ll o f th e id entif y in g
info rm atio n fo r th e H ir in g L oca tio n.Public reporting burden for this collection is estimated to average 45 minutes per response,
including the time for reviewing instructions, searching existing data source, gathering and m ain ta in in g th e d ata n eeded, a nd c o m ple tin g a nd re vie w in g th e c o lle ctio n o f in fo rm atio n.
Se n d c o m m ents r e gard in g th is b urd en e stim ate o r a ny o th er a sp ect o f th is c o lle ctio n of information, including suggestions for reducing the burden to the Department of Labor, Office of
Information Management, Room N-1301, 200 Constitution Avenue, NW,Washington D.C. 20210. All completed VETS-100 Reports should be sent to the address indicated on the front of the form.. A c o py o f th e lis t a ls o m ay b e o bta in ed b y c a llin g ( 3 01) 3 06-6 752 a nd r e questin g th at a c o py o f th e lis t b e
ma ile d to y o u .