Attachment 7

DBE/SS Accomplishment Report

1. Project Name:

2. Funding Amount:

3. Project Start and Completion Date:

4. Project Goals and Objectives:

5. Accomplishments to Date (Include data and information for the length of the project. Provide a discussion or explanation of any measurable outcomes):

6. Service Provider (In-house administered by the State or Outside consultant):
   Name:
   Agency/Organization:
   Address:
   Phone no.:
   Fax:
   Email address:

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