Common use of Required Licenses Clause in Contracts

Required Licenses. Check the box if the nature of the subcontract requires the subcontractor to be licensed and you are required to review those licenses. CITY OF NEW YORK SUBCONTRACTOR APPROVAL FORM For subcontracts to be approved before contract registration Column on left indicates whom that section is to be completed by AGENCY PRIME CONTRACT INFORMATION Agency: Unit/Div: PIN: Contract Description: PRIME CONTACTOR PRIME CONTRACTOR IDENTIFICATION Name: EIN/SSN: SUBCONTRACTOR INFORMATION Name: PIP Vendor #: *Phone: *Fax: *Address: *City: *State/Zip: *EIN/SSN: *E-Mail: Subcontract Description: Approx Subcontract Value:$ Approx Start Date / / Approx End Date / / Subcontractor is DSBS-certified as: M/WBE EBE or LBE (check all that apply & note status below) YES Application Pending Intends to Apply NO Prime Contractor Certification: I hereby affirm that the information supplied is true and correct. Signature Title Print Name Date Email Phone AGENCY AGENCY PRELIMINARY REVIEW PLEASE SEE PAGE 2 FOR INSTRUCTIONS Agency Preliminary Review Completed By: Date