U.S. Census Bureau
1201 East 10th Street
Jeffersonville, IN 47132-0001
NOTICE – Your report to the Census Bureau is confidential by law (title 13, U.S. Code). It may be seen only
by persons sworn to uphold the confidentiality of Census Bureau information and may be used only for
statistical purposes. The law also provides that copies retained in your files are immune from legal process.
In any correspondence pertaining to this report,
refer to the control number shown below.
Please refer to the Reporting Instructions
on the back of the form.
Section A PROJECT IDENTIFICATION
The construction project described below is associated with your
organization according to published sources. Please correct any errors or
fill in any blanks in items 1 and 2. If necessary, make your corrections in
item 10, Remarks, or use a separate sheet. IF YOU HAVE ANY QUESTIONS
CONCERNING THIS FORM, PLEASE CALL 1–800–845–8246.
1. PROJECT DESCRIPTION
2. PROJECT LOCATION
Section B OWNERSHIP AND START DATE
Section C COST ESTIMATES
3. TYPE OF OWNERSHIP – Mark (X) one box.
Will this project be privately or government owned during construction?
Government owned – Skip to section F
4. START DATE OF CONSTRUCTION
When did actual construction work on the
site start, or when do you estimate it will
start? Enter month and year.
Site preparation and outside construction such as sidewalks
Mechanical and electrical installations which are integral parts
of the structures, such as elevators, heating equipment, etc.
Land and pre-existing structures
Architectural, engineering, and owner’s overhead and
miscellaneous costs – See item 6
• Furniture, furnishings, and other movable equipment
• Contingency funds
NOTE: If project is on a "cost plus" basis, enter your best estimate of the final cost.
Month and year of actual
or expected start date
5a. CONTRACT CONSTRUCTION COST