Form AAP22 "Dbe/Mbe/Wbe/Sdvob Material Supplier Commitment Information" - New York

What Is Form AAP22?

This is a legal form that was released by the New York State Department of Transportation - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2020;
  • The latest edition provided by the New York State Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AAP22 by clicking the link below or browse more documents and templates provided by the New York State Department of Transportation.

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Download Form AAP22 "Dbe/Mbe/Wbe/Sdvob Material Supplier Commitment Information" - New York

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DBE/MBE/WBE/SDVOB Material Supplier Commitment Information
AAP 22
(5/2020)
This form identifies how the DBE/MBE/WBE/SDVOB Material Supplier commitment was established. The Prime Contractor
is responsible for ensuring that the form is completed accurately.
Pre-Award
Post Award
Region:
Contract #:
Date Submitted:
Prime Name:
DBE/MBE/WBE/SDVOB Supplier:
Contact Information
DBE/MBE/WBE/SDVOB:
Owner's Name:
Phone #:
Address:
E-mail:
Associated Contract NYSDOT
Material Work Code/Type of Material:
Pay Item (3 digit code)
Description of Materials:
If Special Order, does the Supplier also sell these
Stockpiled
Special Ordered
Yes
No
OR
OR
Are these materials?
items on a retail basis?
Yes OR
No
Will these materials be delivered to the contract site?
If Yes, how will the materials be
By Material Supplier via
By Material Supplier via Transportation Company with whom
delivered to the contract site?
Owned or Leased Trucks
the Material Supplier has an executed long term lease.
If No, who will be picking up the items?
Associated Contract NYSDOT
Material Work Code/Type of Material:
Pay Item (3 digit code)
Description of Materials:
If Special Order, does the Supplier also sell these
Stockpiled
Special Ordered
No
Yes
OR
OR
Are these materials?
items on a retail basis?
Yes OR
No
Will these materials be delivered to the contract site?
If Yes, how will the materials be
By Material Supplier via
By Material Supplier via Transportation Company with whom
delivered to the contract site?
Owned or Leased Trucks
the Material Supplier has an executed long term lease.
If No, who will be picking up the items?
Total Commitment Dollar Amount for Materials Identified Above:
Post Award Only
For Special Order, Identify Supplier
Identify Prime to Supplier Purchase Order #:
to Manufacturer Purchase Order #:
*attach copy of P.O.
*attach a copy of P.O.
Notes/Comments
Do not click the "Make Form Read-Only" button until data entry is complete.
Make Form Read-Only
Read-Only locks the data entered and cannot be undone.
(Cannot be undone)
DBE/MBE/WBE/SDVOB Material Supplier Commitment Information
AAP 22
(5/2020)
This form identifies how the DBE/MBE/WBE/SDVOB Material Supplier commitment was established. The Prime Contractor
is responsible for ensuring that the form is completed accurately.
Pre-Award
Post Award
Region:
Contract #:
Date Submitted:
Prime Name:
DBE/MBE/WBE/SDVOB Supplier:
Contact Information
DBE/MBE/WBE/SDVOB:
Owner's Name:
Phone #:
Address:
E-mail:
Associated Contract NYSDOT
Material Work Code/Type of Material:
Pay Item (3 digit code)
Description of Materials:
If Special Order, does the Supplier also sell these
Stockpiled
Special Ordered
Yes
No
OR
OR
Are these materials?
items on a retail basis?
Yes OR
No
Will these materials be delivered to the contract site?
If Yes, how will the materials be
By Material Supplier via
By Material Supplier via Transportation Company with whom
delivered to the contract site?
Owned or Leased Trucks
the Material Supplier has an executed long term lease.
If No, who will be picking up the items?
Associated Contract NYSDOT
Material Work Code/Type of Material:
Pay Item (3 digit code)
Description of Materials:
If Special Order, does the Supplier also sell these
Stockpiled
Special Ordered
No
Yes
OR
OR
Are these materials?
items on a retail basis?
Yes OR
No
Will these materials be delivered to the contract site?
If Yes, how will the materials be
By Material Supplier via
By Material Supplier via Transportation Company with whom
delivered to the contract site?
Owned or Leased Trucks
the Material Supplier has an executed long term lease.
If No, who will be picking up the items?
Total Commitment Dollar Amount for Materials Identified Above:
Post Award Only
For Special Order, Identify Supplier
Identify Prime to Supplier Purchase Order #:
to Manufacturer Purchase Order #:
*attach copy of P.O.
*attach a copy of P.O.
Notes/Comments
Do not click the "Make Form Read-Only" button until data entry is complete.
Make Form Read-Only
Read-Only locks the data entered and cannot be undone.
(Cannot be undone)