
T / VENDOR INFORMATION NAME: PROJECT# ADDRESS: CITY, STATE ZIP: CONTACT PERSON: (person completing form) FEDERAL ID# - TELEPHONE# EMAIL: - Please check here if you were granted a Total Waiver of the M/WBE Goals by receipt of letter dated: / / Please check here if you are a Construction Contractor and the original contract amount is under $100,000. SUBCONTRACTOR/SUBCONSULTANT and SUPPLIER PAYMENT INFORMATION Name: Address: Work Description: Name: Address: Work Description: Name: Address: W.
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How to fill out the NY DASNY Compliance Report online
Filling out the NY DASNY Compliance Report is a crucial process for ensuring compliance with contract requirements. This guide will provide clear, step-by-step instructions to help users complete the form accurately and efficiently.
Follow the steps to complete the NY DASNY Compliance Report.
- Press the ‘Get Form’ button to access the Compliance Report form and open it in the editing interface.
- Complete the Prime Contractor, Consultant, or Vendor Information section. Provide your name, project number, address, city, state, zip code, contact person, federal ID number, telephone number, and email address.
- Indicate if you were granted a Total Waiver of the M/WBE Goals by checking the appropriate box and providing the date of the letter received.
- If applicable, indicate if the original contract amount is under $100,000 by checking the relevant box.
- Provide information for the Subcontractor, Subconsultant, and Supplier Payment section. List each entity's name, address, and work description as required.
- Check applicable boxes indicating if you are a Professional Service Consultant or Commodity Vendor if the original contract or purchase order amount is under specified limits.
- Ensure that all M/WBE firms and Non-M/WBE firms with a total value of subcontract or purchase order over $10,000 are listed, even if no payment is being made.
- Fill in the Company Information section with the Work Authorization number, contract number, institution name, amount to be paid, and the federal tax ID number.
- In the Amount to be Paid section, indicate the total amounts for MBE, WBE, and Non-M/WBE classifications. Provide the total value of all subcontract agreements and purchase orders issued.
- Sign and date the form where indicated, ensuring that the principal’s signature is included to validate the report.
- Review the completed report for accuracy before saving changes, downloading, printing, or sharing the form.
Complete your NY DASNY Compliance Report online today to ensure timely processing of your payments.
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