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Click ‘Get Form’ to open the MBE Attachment D-5 in the editor.
Begin by entering the Report Number and Reporting Period (Month/Year) at the top of the form. Ensure these details are accurate as they are crucial for tracking your submissions.
Fill in the MBE Subcontractor Name, MDOT Certification Number, and Contact Person details. Include your address, city, phone number, and email for effective communication.
In the 'Subcontractor Services Provided' section, detail the services you have rendered along with Contract Number and Contracting Unit information.
List all payments received from the Prime Contractor during the reporting period. For each payment, include the Invoice Amount and Date.
Document any unpaid invoices over 30 days old in a similar format under 'List dates and amounts of any unpaid invoices'.
Calculate and enter Total Dollars Paid and Total Dollars Unpaid at the bottom of the form.
Finally, provide your signature and date before submitting. You can return this form electronically for convenience.
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Baltimore City Community College Implementation Plan
Oct 8, 2018 G-6 Subcontractor Paid/Unpaid MBE Invoice Report (due by the 15 th of the month following the month the services were provided). 50. Page 417
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