5700-52A MBE/WBE Utilization Under Federal Grants and Cooperative

OMB CONTROL NO.: 2030-0020
APPROVAL EXPIRES: MM/DD/YYYY

U.S. ENVIRONMENTAL PROTECTION AGENCY MBE/WBE UTILIZATION
UNDER FEDERAL GRANTS AND COOPERATIVE AGREEMENTS
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2030-0020). Responses to this collection of information are
required to obtain an assistance agreement (40 CFR Part 30, 40 CFR Part 31, and 40 CFR Part 33 for awards made prior to December 26, 2014, and 2 CFR 200, 2 CFR 1500, and 40 CFR Part 33
for awards made after December 26, 2014). 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. The public reporting and recordkeeping burden for this collection of information is estimated to be 1 hour per response. 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 to the Regulatory Support Division Director, U.S. Environmental Protection Agency
(2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

1A. REPORTING PERIOD
October 1,

1B. REPORT TYPE
_

1C: Revision of a Prior Year Report?

September 30,

Annual

Final Report (Project completed)

Yes

No

If yes, what reporting period is being revised and briefly
describe the changes made. Note: The revised report will
replace the associated original report in its entirety.
2A. RECIPIENT UNIQUE ENTITY IDENTIFIER

2B. RECIPENT REPORTING CONTACT
Name:
Email:
Phone:
3. FEDERAL AWARD IDENTIFICATION NUMBER (FAIN)
(For SRF state recipients, please include all numbers for all open assistance agreements being reported on this form.

4A. If NO procurements were made this reporting period (by the recipient, sub-recipient(s), loan recipient(s), and prime contractor(s)), CHECK and
SKIP to Block No. 6. (Procurements are all expenditures through contract, order, purchase, lease or barter of supplies, equipment, construction, or
services needed to complete Federal assistance programs.)

Total Procurements & MBE/WBE Accomplishments This Reporting Period (in dollars)

4B.

Construction

Total

Non-Construction

$

$

$

MBE/WBE Combined Procurement: $

$

$

Total Procurement:

5A. Good Faith Efforts: If procurements were made, indicate whether
your organization has followed the six Good Faith efforts found in 40
CFR Part 33, Subpart C, 40 CFR 33.501 and 2 CFR 200.321.

5B. If procurements were made, but no MBE/WBE
procurements are being reported, then check the applicable
box(es) for the reason(s) why no MBE/WBE procurements were
made.

Yes, my organization has implemented and documented each of
the six Good Faith Efforts on the procurements made during this
reporting period.

No MBE/WBE(s) applied

No, my organization has not implemented and documented each
of the six Good Faith Efforts on the procurements made during this
reporting period.
6.

No MBE/WBE(s) were
qualified

Other:

NAME OF RECIPIENT'S AUTHORIZED REPRESENTATIVE

TITLE

7. SIGNATURE OF RECIPIENT’S AUTHORIZED REPRESENTATIVE

DATE

EPA FORM 5700-52A available electronically at: https://www.epa.gov/grants/epa-form-5700-52a-united-states-environmental-protection-agency-minority-

business

Instructions:
A. General Instructions:
MBE/WBE utilization is based on 40 CFR Part 33 and 2 CFR
Parts 200 and 1500. The reporting requirement reflects the
change in the reporting threshold described in Recipient/
Applicant Information Notice-2018-G04 issued by EPA's
Office of Grants and Debarment on September 7, 2018
(https://www.epa.gov/grants/rain-2018-g04). EPA Form
5700-52A must be completed annually by recipients of
financial assistance agreements where the combined total
of funds budgeted for procuring supplies, equipment,
construction and services exceeds the current Simplified
Acquisition Threshold as set by the Federal Acquisition
Regulation at 48 CFR Subpart 2.1. This reporting
requirement applies to all new and existing awards and
voids all previous reporting requirements.
In determining whether the threshold is exceeded for a
particular assistance agreement, the analysis must focus on
funds budgeted for procurement under the supplies,
equipment, construction, services or “other” categories,
and include funds budgeted for procurement under subawards or loans.
Reporting will also be required in cases where the details
of the budgets of sub-awards/loans are not clear at the
time of the grant awards and the combined total of the
procurement and sub-awards and/or loans exceeds the
Simplified Acquisition Threshold.
For example, if the Simplified Acquisition Threshold is
$250,000, then if a recipient has $300,000 budgeted under
procurement, then completion of this report is required.
When reporting is required, all procurement actions are
reportable, not just the portion which exceeds the
Simplified Acquisition Threshold.
If at the time of award the budgeted funds exceed
the Simplified Acquisition Threshold but actual
expenditures fall below, a report is still required.
If at the time of award, the combined total of funds
budgeted for procurements in any category is less than or
equal to the Simplified Acquisition Threshold and is

maintained below the threshold, no DBE report is
required to be submitted.
Recipients are required to report 30 days after the
end of each federal fiscal year (i.e. October 30th),
per the terms and conditions of the financial
assistance agreement.
Final reports are due October 30th or 120 days after
the end of the project period, whichever comes
first.
MBE/WBE program requirements, including
reporting, are material terms and conditions of the
financial assistance agreement. Failure to comply
may lead to termination of the financial assistance
agreement which is then reported to the OMBdesignated integrity and performance system
accessible through SAM (currently FAPIIS) pursuant
to 2 CFR 200.339(b).
B. Submission:
Recipients must submit completed forms to the
point of contact associated with the awarding office
for the applicable assistance agreement.
Information on specific points of contact for EPA's
Headquarters and ten Regional Offices is located at:
https://www.epa.gov/grants/frequently-askedquestions-disadvantaged-business-enterprises
Questions regarding the completion of this form
should be directed to the DBE Coordinator
associated with the awarding office for the
applicable assistance agreement. A list of the DBE
Coordinators for each awarding office can be
located here:
https://www.epa.gov/grants/epa-dbe-programcoordinators

C. Instructions:
1A. Specify Federal fiscal year this report covers.
The Federal fiscal year runs from October 1st
through September 30th (e.g. November 29, 2020
falls within Federal fiscal year 2021)
1B. Specify report type. Check the annual
reporting box if this is an annual report. If it is a
final report, check the final report box to indicate if
the project is completed.
1C. Indicate if this is a revision to a previous year
and provide a brief description of the revision you
are making including what reporting period is being
revised. The revised report will replace the
associated original report in its entirety.
2A. Provide your organization's Unique Entity
Identifier. More information about Unique Entity
Identifier, including its meaning, can be found in 2
CFR Part 25.
2B. Identify the name and contact information for
the person located within the recipient organization
that can be contacted if questions arise from this
report.
3. Provide the Federal Award Identification Number
(FAIN) assigned by EPA. A separate report must be
submitted for each Assistance Agreement.
*For SRF recipients: In box 3 list numbers for ALL
OPEN Assistance Agreements being reported on
this form.
4A. Self-explanatory. Note: Procurement means
expenditures under the supplies, equipment,
construction, services or “other” categories, and
include funds expended for procurement under subawards or loans.

4B. Provide the total dollar amount (in dollars) of
ALL procurements awarded this reporting period by
construction, non-construction, and grand total by
the recipient, sub-recipients, and SRF loan
recipients, including MBE/WBE expenditures, not
just the portion which exceeds the threshold. For
example: Actual dollars for procurement from the
procuring office; actual contracts let from the
contracts office; actual goods, services, supplies,
etc., from other sources including the central
purchasing/ procurement centers).
Provide the total dollar amount (in dollars) of MBE/
WBE procurements ONLY awarded this reporting
period by construction, non-construction, and grand
total by the recipient, sub-recipients, SRF loan
recipients, and prime contractors not just the
portion which exceeds the threshold.
*For SRF recipients only: In 4B, please enter the
total annual procurement amount under all of your
SRF Assistance Agreements. The figure reported in
this section is not directly tied to an individual
Assistance Agreement identification number. (SRF
state recipients report state procurements in this
section)
5A. Self-explanatory.
5B. If procurements were made during this reporting
period, but no procurements with
MBE(s) or WBE(s) are being reported, then select
the reason why. If "Other" is chosen, please fill in
with the reason.
6. Self-explanatory.
7. Self-explanatory.

**This data is requested to comply with provisions mandated by: statute or regulations (40 CFR Part 33 and/or 2
CFR Parts 200 and 1500); OMB Circulars; or added by EPA to ensure sound and effective assistance
management. Accurate, complete data are required to obtain funding, while no pledge of confidentiality is
provided.