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Procurement Form

Procurement Form

We are grateful for the support of New York’s COVID19 response efforts. Please submit one product per form submission. All required fields must be properly completed in order to advance an offer through procurement.  

If you are interested in providing supplies specific to COVID-19 testing, please fill out this dedicated form.
Proof of certifications must be provided for regulated supplies.  FDA/CE/NIOSH certifications must be provided without redaction. 

Brokers must provide written confirmation from the manufacturer confirming supply and delivery, as well as, an official quote on letterhead.

Please note for information on adapting your business, you should visit https://esd.ny.gov/sourcing-covid-19-products-nys and select the ‘WILL REPURPOSE PRODUCTION’ option. 

For information on making a donation of goods, services, and space, please click here.
Basic Product Information
(eg. 12 ounces, 1 gallon, etc)
This question requires a valid currency format.
(note: delivery to an airport will not be accepted)
This question requires a valid number format.
4. Can you continue to provide equal or greater units each month until the end of 2020? *This question is required.
5. Are there any items that are already produced and ready to be shipped? *This question is required.
This question requires a valid number format.
This question requires a valid number format.
Point of Contact and Company/Manufacturer Information
as shown on your income tax return where applicable
as shown on your income tax return where applicable
This question requires a valid email address.
15. Are you working directly with the manufacturer?  *This question is required.
16. If you are not working directly with the manufacturer, are you working with a distributor? *This question is required.
FDA CERTIFICATION QUESTIONS
18. Is the manufacturer registered with the FDA? *This question is required.
19. Do you have unredacted copies of the FDA certificates?
20. Is the device listed with the FDA? *This question is required.
Location of Manufacturing
21. Will all the manufacturing take place in New York State? *This question is required.
22. Will all the manufacturing take place in the United States? *This question is required.
22. Will all manufacturing be done within North America? *This question is required.
22. Will manufacturing be done in a country overseas? *This question is required.
References
22. Have you sold PPE to another state or private entity? *This question is required.
23. Has the product that you have sold to another state or private entity already been delivered? *This question is required.