OMB Control No.
0412-0520; Expiration Date: 02/28/2014
CONTRACTOR EMPLOYEE BIOGRAPHICAL DATA SHEET
1. Name (Last, First, Middle) 2. Contractor’s Name
DIAWARA CHEICKNE HAMALA AUDITECH-CONSEIL
3. Employee’s Address (include ZIP code) 4. Contract Number 5. Position Under Contract
BKO/MALI KALABAN COURA RUE 226 PORTE 600 +223 75094116/63626800 DIRECTEUR TECHNIQUE
6. Proposed Salary 7. Duration of Assignment
300 000 FCFA 3 ans
8. Telephone Number (include area code) 9. Place of Birth 10. Citizenship (If non-U.S. citizen, give visa status)
+223 73489490 Bamako Malienne
11. Names, Ages, and Relationship of Dependents to Accompany Individual to Country of Assignment
12. EDUCATION (include all college or university degrees) 13. LANGUAGE PROFICIENCY (see Instruction on Page 2)
Proficiency Proficiency
NAME AND LOCATION OF INSTITUTION MAJOR DEGREE DATE LANGUAGE
Speaking Reading
GEMINI MANAGEMENT 09/15/20
Très Bien MASTER Français 5/S 5/R
INETRNANIONAL BKO/MALI GOLF 16
GEMINI MANAGEMENT 09/30/20
Très Bien LICENCE Anglais 2/S 3/R
INTERNATIONAL BKO/MALI GOLF 14
06/16/20
LYCEE MARLIDEM Passable BAC 2/S 2/R
10
14. EMPLOYMENT HISTORY
1. Give last three (3) years. List salaries separate for each year. Continue on separate sheet of paper if required to list all employment related to
duties of proposed assignment.
2. Salary definition – basic periodic payment for services rendered. Exclude bonuses, profit-sharing arrangements, commissions, consultant fees,
extra or overtime work payments, overseas differential or quarters, cost of living or dependent education allowances.
EMPLOYER’S NAME AND ADDRESS Dates of Employment (M/D/Y) Annual Salary
POSITION TITLE
POINT OF CONTACT &TELEPHONE # From To Dollars
DIRECTEUR TECJHNIQUE AUDITECH-CONSEIL +223 75094116 06/06/2018 09/30/2020 6,458.06
RESPONSIBLE TECHNIQUE AUDITECH-CONSEIL +223 75094116 05/01/2017 05/01/2018 4,735.91
SECURIMAX INFORMATIQUE +223 6511
Administrateur Système 10/11/2015 02/12/2016 2,152.69
3976
15. SPECIFIC CONSULTANT SERVICES (give last three (3) years)
EMPLOYER’S NAME AND ADDRESS Dates of Employment (M/D/Y) Days at Daily Rate
SERVICES PERFORMED
POINT OF CONTACT &TELEPHONE # From To Rate In Dollars
Installation d'une solution VOIP et PROVEQTUS BKO/MALI GOLF +223
01/06/2018 12/08/2018
Réseau sans Fil 74316099
ETUDE ET MISE EN PLACE D'UN ECOLE SUPERIEUR DE JOURNALISME
08/03/2017 06/15/2019
RESEAU INFORMATIQUE BKO/MALI DARSALAM +223 66752852
Developpement d'une application pour ACI BKO/MAI Hamdallaye ACI 2000 +223
gestion ibolière de l'angence de cession 02/01/2019 10/06/2019
71818114
ACI
16. CERTIFICATION: To the best of my knowledge, the above facts as stated are true and correct.
Signature of Employee Date
07/15/2021
17. CONTRACTOR'S CERTIFICATION (To be signed by responsible representative of Contractor)
Contractor certifies in submitting this form that it has taken reasonable steps (in accordance with sound business practices) to verify the information
contained in this form. Contractor understands that USAID may rely on the accuracy of such information in negotiating and reimbursing personnel under
this contract. The making of certifications that are false, fictitious, or fraudulent, or that are based on inadequately verified information, may result in
appropriate remedial action by USAID, taking into consideration all of the pertinent facts and circumstances, ranging from refund claims to criminal
prosecution.
Signature of Contractor’s Representative Date
07/15/2021
AID 1420-17 (04/2007) Page 1 of 2
INSTRUCTION
Indicate your language proficiency in block 13 using the following numeric Interagency Language Roundtable levels (Foreign Service Institute
Levels). Also, the following provides brief descriptions of proficiency levels 2, 3, 4, and 5. “S” indicates speaking ability and “R” indicates
reading ability. For more in-depth description of the levels refer to USAID Handbook 28 or superseding policy directive.
2. Limited working proficiency
S Able to satisfy routine special demands and limited work requirements .
R Sufficient comprehension to read simple, authentic written material in a form equivalent to usual printing or typescript on familiar
subjects within familiar contexts.
3. General professional proficiency
S Able to speak the language with sufficient structural accuracy and vocabulary to participate effectively in most formal and informal
conversations on practical, social, and professional topics.
R Able to read within a normal range of speed and with almost complete comprehension of a variety of authentic prose material on
unfamiliar subjects.
4. Advanced professional proficiency
S Able to use the language fluently and accurately on all levels normally pertinent to professional needs.
R Able to read fluently and accurately all styles and forms of the language pertinent to professional needs.
5. Functional native proficiency
S Speaking proficiency is functionally equivalent to that of a highly articulate well-educated native speaker and reflects the cultural
standards of a country where the language is natively spoken .
R Reading proficiency is functionally equivalent to that of the well-educated native reader.
PAPERWORK REDUCTION ACT INFORMATION
The information requested by this form is necessary for prudent management and administration of public funds under USAID contracts. The
information helps USAID estimate overseas logistic support and allowances, the educational information provides an indication of
qualifications, the salary information is used as a means of cost monitoring and to help determine reasonableness of proposed salary.
PAPERWORK REDUCTION ACT NOTICE
Public reporting burden for this collection of information is estimated to average thirty minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to:
United States Agency for International Development
Office of Acquisition and Assistance
Policy Division (M/OAA/P)
Washington, DC 20523-7100;
and
Office of Management and Budget
Paperwork Reduction Project (0412-0520)
Washington, DC 20503
AID 1420-17 (04/2007) Page 2 of 2
