Certificate Of No Change Form - Nyc Page 2

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Principal Questionnaire
This section refers to the most recent principal questionnaire submissions.
Date of signature
Date(s) of signature on
Principal Name
on last full Principal
submission of change
Questionnaire
1
2
3
4
5
6
Check if additional changes were submitted and attach a document with the date of additional submissions.
Certification
This section is required.
This form must be signed and notarized. Please complete this twice. Copies will not be accepted.
Certified By:
____________________________________________________________________________
Name (Print)
____________________________________________________________________________
Title
____________________________________________________________________________
Name of Submitting Entity
____________________________________________________________ ______________
Signature
Date
Notarized By:
______________________________
____________________
____________________
Notary Public
County License Issued
License Number
Sworn to before me on: ________________________
Date
Mayor’s Office of Contract Services
2
253 Broadway, 9th Floor New York, NY 10007
Phone: 212 788 0018 Fax: 212 788 0049

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