Forms

For assistance on completing these forms, contact us here.

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Background Information

• Non-Profit Reimbursement Program Information Forum Presentation 3-1-21
• DDC Non-Profit Reimbursement Program Handbook – Start Here!
• Guidelines for Capital Funding Requests For Not-for-Profit Organizations NYC Comptroller's Directive # 10 – (February 2023 version) 
• Workflow Chart
• List of Ineligible Items
• Directly book an appointment with DDC Law's NRP Unit^New!

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Not-For-Profit Program (NRP) Video Training Modules

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City Questionnaire/Intake Form

Instructions and applications are available at nyc.gov.

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Checklists

These checklists provide details on what is needed for each stage of the registration and reimbursement process: (check back for updates)

Step 1: Budget Review

• Budget & Pre-CP Checklist

Step 2: Registration:

• Registration Checklist

Step 3: Reimbursements:

• Payment Checklist for Equipment
• Payment Checklist for Vehicles

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Legal Documents (Check back for updates)

Funding Agreements

• Equipment and Vehicle(s)
• Equipment
• Vehicle(s)

Security Agreements
(Only applicable for equipment and vehicle purchases)

• Equipment and Vehicle(s)
• Equipment
• Vehicle(s)

Parent & Subsidiary Agreements

• Equipment and Vehicle(s) - Funding Agreement
• Equipment and Vehicle(s) - Security Agreement
• Equipment - Funding Agreement
• Equipment - Security Agreement
• Vehicles - Funding Agreement
• Vehicles - Security Agreement

Other Agreements

• Subordination Agreement
• Equipment Budget Amendment for Quantity Increases
• Equipment Budget Amendment for Change in Software Licensors

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Step 1: Forms Required for the Budget & Pre-CP Review

Required Forms for all Awards

• Schedule A Budget Spreadsheet
  • Notes on Schedule A Budget Spreadsheet
• Organization's Hours of Operation & Frequency of Use of the Equipment/Vehicles
  • Notes on Organization’s Hours of Operation & Frequency of Use of the Equipment/Vehicles
• Useful Life Statement: General
• Useful Life Statement: Items With Different Useful Life Expectancies
• Useful Life Statement: For Awards That Include IT Equipment
  • Notes on the Useful Life Statement
• Non-discrimination Affirmation

Required Forms for Specific Awards

• Information Systems Management (ISM) Questionnaire
  • Statement on Equipment Owned by the Organization in Relation to the Capital Award
• Initial Outfitting Affirmation
• Major Medical Systems Letter
• Software Checklist
  • Notes on the Software Checklist
• Preliminary Approval Letter of the NYC Software License Agreement
• Preliminary Approval Letter of the NYC Software License Agreement (For 3rd Party Purchases)
• Confirmation Letter for Firmware Purchases
• Minimally Attached Moveable Property Questionnaire
• Personalty Agreement for Landlords
• Personalty Agreement for Lenders

Step 2: Forms Required for Registration

For MOCS PASSPort Information, please visit here.

• Doing Business Data Form
• Insurance Checklist (includes samples of submission certificates)
• Tax Affirmation (Funding agreement exhibit)
• Opinion of Counsel Letter (Funding agreement exhibit)

DLS Supply & Services Employment Report (for awards $100,000 or greater)

• DLS Employment Report Instructions
• Less than 50 Employees
• More than 50 Employees
• DLS Employment Report Fillable Employee Data Tables (Required for 150 or more employees)
• Index of Industry Codes
• Index of Occupation Codes

Step 3: Forms Required for Reimbursement

Payment Requisition Forms (Required for all awards)

• Procurement Affirmation
• Procurement Affirmation List of Bids
• Payment Requisition Form A
• Notes on Payment Requisition Form A
• Payment Requisition Form C
• Notes on Proofs of Payment for Invoices

Lien Recording Documents (for Vehicle Awards)

• Department of Motor Vehicles Form MV-900 (Notice of Lien)
  This form must be accompanied by an original Certificate of Title for each vehicle.
• Notes on recording the DDC Lien on a City-Funded Vehicle
• DMV - Lien Removal Guidelines (only applicable if City Purpose Period and Contractual requirements have been met.)

Legal, Insurance, & Licensing Forms (for Equipment Awards)

• Attorney Equipment Lien Attestation Form
  • UCC Guidelines (To aid in the completion of the Attorney Equipment Lien Attestation Form)

• Acord 25 - Certificate of Liability Insurance
• Acord 27 - Evidence of Property Insurance
• Acord 28 - Evidence of Commercial Property Insurance
  • Acord 101 - Additional Remarks Schedule
    
• Certification by Insurance Broker
  
• Software License Agreement
  

UCC-1 Financing Statement Forms

• UCC-1 Financing Statement
(NYSDOS Form)
• UCC-1 Addendum
  (NYSDOS Form)
• UCC-1 Exhibit A
  (Required DDC Attachment)
• UCC-1 Filing Acknowledgment Letter
  (To be completed by the FR filing attorney)

UCC-3 Amendment Statement Forms

• UCC-3 Financing Statement Amendment
  (NYSDOS Form)
• UCC-3 Exhibit A & Schedule I
  (Required DDC attachment)
• UCC-3 Filing Acknowledgment Letter
  (To be completed by the FR filing attorney)

Contract Compliance for Reimbursed Awards

Contract Compliance Information and Forms

• Introduction to OMB’s Capital Funding Compliance Process
• Compliance Report for Equipment and Vehicle(s)
• Inventory of all City-Funded Equipment

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