Appendix A (Separate Agreement)_FORM_VENDOR.pdf

This is a vendor acknowledgment form for the New York State Department of Transportation (NYSDOT) Administrative Services Division/Purchasing, confirming receipt and understanding of Appendix A (Standard Clauses for NYS Contracts) dated June 2023. The form requires the contractor to provide company name and Federal Employer Identification Number (FEIN), then sign and date to acknowledge receipt and full comprehension of the updated Appendix A, with the understanding that this version supersedes all previous versions. The completed form must be returned to NYSDOT ASD/Purchasing at 50 Wolf Road, Suite 1PC, Albany, NY 12232, addressed to the Contract Management Specialist.

The associated contract opportunity is a One-Time Purchase Contract for Region 8 Traffic Signs covering Columbia, Dutchess, Putnam, Orange East, Orange West, and Ulster counties in New York. The procurement involves traffic signs and related materials, with no business enterprises having been awarded identical or substantially similar contracts within the past five years. The contract includes specific contracting goals: 6.00% for Service-Disabled Veteran-Owned Business (SDVOB), 1.00% for Minority Business Enterprise (MBE), 8.00% for Women Business Enterprise (WBE), and 0.00% for Disadvantaged Business Enterprise (DBE).