NOTE: Please compose your submission offline before submitting through the website and keep a copy for your records. We will send you a confirmation email once we have received your submission.

1. Job Location

Street Address

City:	State:	Zip:	County:
	NY AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY

---

2. Job Description

Size:	Choose one:	This Job is:
Square Feet	Commercial Residential Cultural Educational (private universities, etc.) Other	Exterior Work Interior Work Both
Floors

Is this job new construction? Yes No

Is the Job a portion of a larger project? Yes No

Please provide details below, include the Scope of Work:


General Description of Job and if an existing job, include what has been completed so far:

---

3. Applicant (CM/GC)

Name


Relationship to Job


Contact Person, Title


Street Address

City:	State:	Zip:
	NY AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY

Phone:	Fax:

Email

---

4. Owner/Developer

Name


Contact Person, Title


Street Address

City:	State:	Zip:
	NY AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY

Phone:	Fax:

---

5. Is this an existing job?
Yes (if yes answer question 6) No (if no answer question 7)

---

6 Date Project started: (See attached certification regarding existing jobs)

7. Estimated date of commencement of bidding process:

---

8(a) Estimated total job costs: $

8(b) Estimated dollar value of remaining work for existing job or percentage of work completed: $ OR %

---

9. Complete Bidders List

Have subcontractors been terminated? Yes No

Have the subcontracts been re-opened for competitive bid? Yes No

Have the subcontracts been re-priced by existing contractors? Yes No

List all bidders if this is an existing job. For new jobs, please provide a list of any known bidders.

---

10. Estimated man hours per trade*
*Note: Provide the number of hours and jobs that remain for existing jobs.

	Trade		Hours		Jobs
	Boilermakers
	Bricklayers
	Carpenters
	Cement/Concrete workers
	Derrickmen/Riggers
	Drywall Tapers
	Electricians
	Elevator Constructors
	Glaziers
	Insulators
	Iron Workers (Structural)
	Iron Workers (Ornamental)
	Laborers
	Maintenance Division
	Metal Polishers
	Metal Lathers
	Painters Pavers and Road Builders
	Plasterers
	Plumbers
	Private Sanitation
	Operating Engineers
	Roofers/Waterproofers
	Sheet Metal Workers
	Steamfitters
	Teamsters
	Tile, Marble, Terrazzo
	Window Cleaners
	Total Estimated Number of Jobs on Projects
	Total Estimated Man Hours for Project

---

11.
In the space below, please provide a detailed explanation of why the Economic Recovery PLA is appropriate for this project, I.e; was the project cancelled; delayed; modified to significantly reduce the size and scope of the project?

Please select one: cancelled delayed modified

Explain:

---

12. Authorization and Signature

I declare under penalty of perjury under the laws of the United States of America that the information in this Application is true and correct.

Name


Title

---

Certification for Existing Jobs

If you answered "YES" to question number 5, you must complete and sign either one or two below.

(1)	I hereby certify that i have submitted an application for the Economic Recovery Plan is an existing job that has been re-bid. The job was re-bid as of and the list of bidders i provided in box 5 represents the bids submitted as a result of the re-bidding process.

I declare under penalty of perjury under the laws of the United States of America that the information in this Application is true and correct.

-OR-

(2)

I hereby certify that by submitting this application for the Economic Recovery PLA and by clicking below that i understand that this existing job will have to be re-bid. If the job is not re-bid, hereby agrees to indemnify. defend and hold harmless the BCTC or any of its affiliated unions, officers or representatives of same against any and all liabilities, claims, losses, lawsuits, judgments, and/or expenses, including attorneys fees, arising either directly or indirectly from any act or failure to act by the Construction Manager / General Contractor or any subcontractor with respect to the rebidding process on existing jobs

I declare under penalty of perjury under the laws of the United States of America that the information in this Application is true and correct.

---