Subcontractor Disclosure Form
Committee Name:
Friends of Alice Slattery
SA
I am required to report information about subcontractors who are paid more than $5,000. A subcontractor is anyone who a vendor pays for goods or services provided through the vendor for my campaign.
MP
LE
Vendor Name: Vendor Address:
NYC Media and Graphics 212 West 57th Street New York, NY 10016
Did you use subcontractors?
Yes
✓
No ________ Yes
If yes, was there more than $5,000 worth of goods or services subcontracted? If yes, please complete the following information:
✓
No ________
Subcontractor Name: Subcontractor Address:
J and Z Printing Co. 754 West Street New York, NY 10021
Services Provided: Cost of Services Provided:
Printed Palm Cards $8,300
Subcontractor Name: Subcontractor Address:
ABC Television 417 East 38th Street New York, NY 10011
Services Provided: Cost of Services Provided:
TV Commercial $20,000
Vendor Signature: Name: Title:
Date: ____________________
Ethan Mitchell CEO and President