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4. Program Subrecipient Information <br />Complete the following information for each Subrecipient organization providing HOPWA-funded services to client households. <br />These organizations would hold a contract/agreement with a project sponsor(s) to provide these services. For example, a <br />Subrecipient organization may receive funds from a project sponsor to provide nutritional services for clients residing within a <br />HOPWA facility-based housing program. Please note that subrecipients who work directly with client households must provide <br />performance data for the grantee to include in Parts 2-7 of the CAPER. <br />Note: Please see the definition of a subreeipient for more information. <br />Note: Types of contracts/agreements may include: grants, sub-grants, loans, awards, cooperative agreements, and otherfornrs <br />offinancial assistance; and contracts, subcontracts, purchase orders, task orders, and delivery orders. <br />Note: If any information is not applicable to the organization, please report N/A in the appropriate box. Do not leave boxes <br />blank. <br />Sub-recipient Name Parent Company Name, ifapplicable <br />Name and Title of Contact at Contractor/ <br />Sub-contractor Agency <br />Email Address <br />Business Address <br />City, County, State, Zip <br /> <br />Phone Number (included area code) Fax Number (include area code) <br />Employer Identification Number (EIN) or <br />Tax Identification Number (TIN) <br />DUN & Bradstreet Number (DUNS) <br />North American Industry Classification <br />System (NA1CS) Code <br />Congressional District of the Sub-recipient's <br />Business Address <br />Congressional District(s) of Primary Service <br />Area <br />City(ies) and County(ies) of Primary Service <br />Area Cities: Counties: <br />Total HOPWA Subcontract Amount of this <br />Organization for the operating year <br />Previous editions are obsolete Page 4 form HUD-40110-D (Expiration Date: 10/31/2014) <br />25D-19