Vendor Responsibility Questionnaire

AC 3294-S (4/12)

New york state

vendor responsibility questionnaire

Attachment A – completed construction contracts

Vendor Name: / NYS Vendor ID: /
Question 3.0: List the ten most recent construction contracts the Business Entity has completed. If less than ten, include most recent subcontracts on projects up to that number: /
1. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
2. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
3. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
4. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
5. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
6. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
7. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
8. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
9. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable
10. / Agency/Owner / Award Date / Amount / Date Completed
Contact Person / Telephone No. / Designer Architect and /or Design Engineer
Contract No. / Prime or Sub
PrimeSub / Joint Venture (JV) Name, if applicable / EIN of JV, if applicable

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