Fillable Erie County Department of Social Services Vendor List (County of Erie, New York)

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Erie County Department of Social Services Vendor List (County of Erie, New York)

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U.S.A. forms for County of Erie, New York

BROWSE COUNTY OF ERIE, NEW YORK (NY) FORMS

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Erie County Department of Social Services Vendor List
To add your name to the Erie County Department of Social Services (ECDSS)’ vendor list please
fill out the ECDSS Vendor Application. The application asks general information, including what
products or services you may have for ECDSS customers. Please review the list carefully and
indicate which products and/or services you would be interested in supplying. Send the completed
application by email to DSSVendorApps@erie.gov, fax it to 858-6956 or mail to 95 Franklin Street
Room 406, Buffalo NY 14202. Applications received will be reviewed by DSS Administration.
HEAP Vendor Participation
All vendors providing HEAP Clean and Tune service vendors and/or CAC services must have a
signed agreement on file with the New York State Office of Temporary and Disability Assistance
(OTDA) HEAP Bureau. This legally binding document provides both OTDA and participating
vendors with assurances that vendors understand the scope of the work to be performed. In
addition, it requires participating vendors to abide by the provisions set forth in the document.
Vendors must be directed to contact the OTDA HEAP Bureau at: (518) 473-0332 or 1-866-270-
HEAP (4327) to become a provider.
A list of HEAP participating vendors is updated on a daily basis and districts must confirm
vendor participation using this list prior to authorizing a benefit.
http://otda.ny.gov/programs/heap/documents/Vendor-Agreement-Repair-Replacement.pdf
Erie County Department of Social Services Vendor Application
Name
Street Address
City
State
Zip
Contact Person
Telephone Number
Fax Number
Email Address
Federal ID# or Social Security Number
Certified Minority Business Classified as Follows:
Black
Asian American
American Indian
Eskimo or Aleut
Veterans
Other:
Received Minority Certification From:
I hereby certify that the information supplied herein is correct.
Print or Type Name
Signature
Date
Service Maximum Payment
Appliance Repair Estimate Stove/Refrigerator Repair Estimate: $12.50
Appliance Repair Stove/Refrigerator Repair: less than $182.00
Appliance Replacement Stove: $182.00; Refrigerator: $182.00/$258.00(household of 4 or more)
Extermination As per sealed bids
Property Repairs As per sealed bids
Moving As per sealed bids
Storage As per sealed bids (storage size relative to household size)
Household Establishment
(used or new)
As per Initial or Replacement Cost of Essential Household Furniture,
Furnishings, Equipment and Supplies (Schedule SA-4a):
Living Room
$182
Bedroom
with single bed
$145
with two single beds
$205
with double bed
$184
Kitchen
(excluding appliances)
$142
(plus $12 for each additional person)
Range
$182
Refrigerator
$182
(or $258 for four or more persons)
Bathroom
$ 6
(plus $4 for each additional person)
Other Equipment
Cabinet for linens
$ 22
Stove for heating
$ 72
(or $82 for five or more persons)
This list is subject to change
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Erie County Department of Social Services Vendor List (County of Erie, New York)

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Completed 17 July 2020

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