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Get NY OTDA-4938 2013

Federal ID Number: (Name of Contractor) Proposal / Contract number: Contract Scope of Work: The undersigned intends to perform services or provide material, supplies or equipment as follows: At the following price: $ Name of MWBE: Address: Federal ID Number: Telephone Number: Ethnicity (see page 2 for definition) Gender (Male or Female): Designation: MBE - Subcontractor Joint venture with: Name: WBE – Subcontractor MBE – Supplier WBE - Supplier Address Fed ID Number: MBE WBE Are yo.

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