NYC DEPARTMENT OF EDUCATION
SUBCONTRACTOR APPLICATION
PRIME CONTRACTOR INFORMATION:
THE PRIME CONTRACTOR IS RESPONSIBLE FOR THE TIMELY SUBMISSION OF THIS APPLICATION PRIOR TO THE
START OF A SUBCONTRACTOR WORKING ON SITE. SUBCONTRACTOR APPROVAL STATUS IS TRADE SPECIFIC.
1. PRIME CONTRACTOR’S NAME __________________________________________________________
2. TEL. NO. _______________________ FAX___________________ EMAIL ________________________
3. FEDERAL TAX I.D. NUMBER ____________________________________________________________
4. CONTRACT DESCRIPTION ______________________________________________________________
5. BOE CONTRACT MANAGER _____________________________________________________________
6. CONTRACT NO. _____________________ SPECIFICATION NO. _______________________________
7. DESCRIPTION OF SUBCONTRACT WORK __________________________________________________
SUBCONTRACTOR BUSINESS INFORMATION:
1. NAME OF COMPANY _____________________________________________________________________
2. TEL. NO. _______________________ FAX__________________ EMAIL ____________________________
3. FEDERAL TAX I.D. NUMBER (FEIN) / SS NUMBER______________________________________________
[IF YOU DO NOT HAVE A FEDERAL TAX NUMBER ISSUED BY THE IRS, PROVIDE YOUR SOCIAL SECURITY NUMBER]
4. ADDRESS _______________________________________________________________________________
CITY _______________________________ STATE __________________ ZIP ________________________
5. OFFICER / OWNER NAME __________________________________________________________________
TITLE ___________________________________________________________________________________
6. TRADE(S) _____________________________________________ CURRENT LICENSE □ YES
[COPIES OF ALL APPLICABLE LICENSES AND CERTIFICATES MUST BE ATTACHED]
7. COMPANY IS ONE OR MORE OF THE FOLLOWING: PLEASE CHECK BOX AND ATTACH DOCUMENTATION
□ MBE □ LBE □ WBE □ SOLE PROPRIETORSHIP □ PARTNERSHIP □ CORPORATION
SUBCONTRACTOR CERTIFICATION:
I CERTIFY THE INFORMATION STATED IN THIS APPLICATION IS IN ALL RESPECTS TRUE
NAME OF BUSINESS ___________________________________________________________________________________________
BY _______________________________________________ ______________________________________________________
(SIGNATURE OF AUTHORIZED OFFICIAL) (TYPE OR PRINT NAME)
TITLE OF AUTHORIZED OFFICIAL ____________________________________
(TYPE OR PRINT)
DATE _______________________
SWORN TO ME THIS ________ DAY OF __________________ 20___________
____________________________________________
NOTARY PUBLIC
APPLY CORPORATE SEAL HERE
I certify that I pay and will continue to pay the prevailing rate of wages including all supplemental benefits as required by the
New York State Labor Law Section 220 and /or Section 230 and as prescribed by the Comptroller of the City of New York to all
labor employed by me on New York City Department of Education contracts, and that I am ready to provide evidence on
prevailin
g wages and supplemental benefit payments at any time upon request from the New York City Department of
Education.
I certify that I will pay supplemental benefits to all labor employed by me in accordance with the category checked below.
1. □ Benefits paid through Union, Local Number ____________ (attach copy of agreement).
2. □ Approved welfare/pension plan (attach copy).
3. □ No work on site. Law not applicable.
4. □ Section 230 applies (check other appropriate category).
5. □ Cash payments in form of checks at Comptroller approved rates.
ALL CONTRACTORS AND SUBCONTRACTORS MUST SUBMIT A VENDEX BOOK TO THE MAYOR’S OFFICE OF CONTRACTS
AND A VENDEX MEMO TO THE DIVISION OF SCHOOL FACILITIES - GO TO WWW.NYC.GOV/VENDEX FOR INSTRUCTIONS
