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Office of Temporary and Disability Assistance 40 North Pearl Street, Albany, NY 12243 www.otda.ny.gov TDA 4969 (Rev. 1/2016) REQUEST FOR WAIVER FORM
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The otda-4969-mwbe waiver request form is a document used to request a waiver from MWBE requirements for contracts with the Office of Temporary and Disability Assistance (OTDA).
Entities seeking to be exempt from MWBE requirements when contracting with OTDA are required to file the otda-4969-mwbe waiver request form.
The otda-4969-mwbe waiver request form must be completed with all relevant information and supporting documentation to justify the waiver request.
The purpose of the otda-4969-mwbe waiver request form is to provide a mechanism for entities to request an exemption from MWBE requirements for contracts with OTDA.
The otda-4969-mwbe waiver request form requires information about the contracting entity, the contract in question, the rationale for the waiver request, and any supporting documentation.
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