304-428-6889

Monthly Report Form

As a recipient of federal funding, we must document our support to you. In order for us to continue to receive that support and continue to provide you with free services, it is necessary for us to collect certain data each month. If you have more than one Prime Contract and/or more than one Subcontract, you must complete a form for each contract.

Name of Company
E-Mail Address
Telephone Number (xxx) xxx-xxxx
Month Reporting (MM/YY)

Please Select Appropriate Agency
Prime Contract # Subcontract #
Dollar Value $ Dollar Value $
Award Date (MM/DD/YY) Award Date (MM/DD/YY)
Buying Activity Buying Activity
Point of Contact Point of Contact
Telephone # (xxx) xxx-xxxx Telephone # (xxx) xxx-xxxx

The PTAC • Services • Help • Contact Us

Send email or call 304-428-6889.

Copyright © 2000-05 Procurement Technical Assistance Center.