Form II
Omnibus Procurement Act
Standard 15 Day Notification Form
For Contracts for Goods and Services of $1 Million or More
To Out-of-State/Foreign Firms
In compliance with Section 2879 subdivision 5 of the Public Authorities Law and Section 139-i of the State Finance Law, the Commissioner of Economic Development is hereby notified that:
CONTRACTING AGENCY:______________________________________________________________
ADDRESS: __________________________________________________________________________
____________________________________________________________________________________
TELEPHONE NUMBER: _______________________________________________________________
FAX NUMBER: _______________________________________________________________________
CONTACT PERSON AT AGENCY: _______________________________________________________
is preparing to enter into a contract, on or about _________________with the following out-of-state/foreign firm: (date)
FIRM NAME:_________________________________________________________________________
ADDRESS: __________________________________________________________________________
____________________________________________________________________________________
TELEPHONE NUMBER: ________________________________________________________________
FAX NUMBER: _______________________________________________________________________
BRIEF DESCRIPTION OF GOODS OR SERVICES:__________________________________________
____________________________________________________________________________________
AMOUNT OF PROPOSED CONTRACT: ___________________________________________________
TERM OF PROPOSED CONTRACT:______________________________________________________
CONTACT PERSON AT FIRM:___________________________________________________________
DATE OF NOTICE TO DED:_____________________________________________________________
For immediate notice to DED, please fax form to:
Department of Economic Development
Division for Small Business
Procurement Unit
Telephone (518) 292-5220 FAX (518) 292-5884