Less than (LT) form

As per E050, City/State funded Construction Contracts less than $750k and ICAP Subcontracts less than $1M contract value are not required to submit an employment report but are required to submit business and contract related information. Please use the form below to submit the information for the records of DLS/SBS.

Type of Submission

Select the type of submission/contract*

Select or enter value

Identification Numbers

DLS file number*

ICAP Application Number*

EIN/Tax Id Number*

Procurement Identification Number (PIN)

Contract Registration Number (CT)

Business/Contract Information

Business Name*

Business Address (street name)*

Business Address (city)*

Business Address (state)*

Business Zipcode*

Lot Number*

Block Number*

Contract Amount*

Select the Construction NAICS code*

use the dropdown to select the construction NACIS code for your proposed project. If you do not have a code, please select none of the above.

Select or enter value

Project Description*

Proposed Project Location (street name)

Proposed Project Location (borough)

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Proposed Project Location (zipcode)

Do you have any of the following Certifications? (use the dropdown)*

Select or enter value

Do you want Information on any of the following Certifcations? (use the dropdown)*

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Are you a Union Contractor*

Select or enter value

If yes, list which locals you are affiliated with

Are you a Veteran owned company?

Select or enter value

Contact Information

Your contractual relationship in this contract is:*

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Authorized Official Full Name*

Authorized Official Job Title*

Contact Email*

Contact Phone*

Phone

Affirmation of Understanding

I understand and agree that: 1. I am affirming that I have told the truth on this Application 2. This affirmation is made in accordance with NYC Charter Chapter 56, Executive Order No. 50 (1980) and the implementing Rules . 3. Willful or fraudulent falsifications of any data or information submitted herewith may result in the termination of the contract between the City and the bidder or contractor and in disapproval of future contracts for a period of up to five years. Further, such falsification may result in civil and/and or criminal prosecution.*

To affirm, please type your full name below:

Affirmation Date*

Send me a copy of my responses

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