WIXLIB

The City of New YorkBUSINESS INTEGRITY COMMISSION100 Church Street 20th FloorNew York New York 10007Tel. (212) 437-0500 Fax (646) 500-7096INSTRUCTIONSAPPLICATION FOR CLASS 1 SELF HAULER REGISTRATIONPLEASE READ THESE INSTRUCTIONS AND ALL QUESTIONS CAREFULLYAS THE APPLICATION HAS RECENTLY BEEN REVISEDDefinitions of terms used in the application are set forth in Title 16-A, Chapter 1 of theAdministrative Code of the City of New York (“Local Law 42”) and in Title 17, Chapter 1 of theRules of the City of New York. Certain of these definitions have been excerpted and attached asAppendix A to the application. Before completing this application, the principals of the applicantshould read and familiarize themselves with all of Local Law 42 and the related rules. Theseinstructions are not a substitute for such a complete review and may not be relied on in lieu ofthe law and rules. Copies of Local 42 and the rules are available at the office of the New YorkCity Business Integrity Commission (“Commission”) or from the Commission’s website,www.nyc.gov/bic.Attached is the application for a Class 1 Self Hauler’s Registration for removal,collection, or disposal of trade waste that is generated in the course of operating of one’sbusiness. To apply for registration, the applicant must complete each and every question setforth therein. If a question is not applicable, write "not applicable" or "N.A." Applications thathave not been completed properly may be denied, or the application may be returned to theapplicant without being processed. An application returned as incomplete will not be deemedsubmitted.Tax ID or SSN:Page of PagesRev. 10/30/19

DOCUMENTS TO BE SUBMITTED FOR ACLASS I SELF HAULER REGISTRATION APPLICATIONIn addition to the application form, a number of documents must be submitted to theCommission in order for the application to be considered. The applicant must submit thefollowing documents (to the extent applicable), some of which are described in theseinstructions, some in the body of the application and attachments, and some in the applicablerules: Registration Application; Signed and Notarized Certifications (on behalf of applicant business and by each principal); Signed and Notarized Releases (on behalf of applicant business and by each principal); Documents related to the organization of the applicant business;1 Photographs (Each Principal): A notice will be emailed to the company with instructions onhow to submit digital photographs to the Commission’s Licensing Unit. Payment by credit card,2 money orders, or checks made payable to the “New York CityBusiness Integrity Commission” to cover the registration fee of 1,000.00ALL FEES NON-REFUNDABLETHE APPLICANT MUST SUBMIT AN ORIGINAL PLUS ONE COPY OF THEAPPLICATION AND ALL ATTACHED DOCUMENTS.NOTE: REQUEST(S) TO WITHDRAW AN APPLICATION WILL BE EVALUATEDON A CASE BY CASE BASIS AND WILL NOT NECESSARILY BE APPROVED.1If a sole proprietorship, a certified copy of the Certificate of Doing Business filed with the County Clerk. If a partnership, acertified copy of the Certificate of Partnership filed with the County Clerk and a copy of the current partnership agreement. If acorporation, a certified copy of the Certificate of Incorporation and copies other current bylaws and last annual report, includingfinancial statement.2Effective Monday, October 15, 2018, due to City-wide policy, all credit card and debit card transactions will be charged a fee of2% of the payment amount.2Rev. 10/30/19

CLASS I SELF HAULER REGISTRATION APPLICATIONEach page submitted by the applicant must contain in the lower left hand corner theapplicant's social security number or tax identification number and each page must be numberedsequentially as "Page of pages" (e.g., if a twenty-five page application is submitted, thefirst page should be marked: "Page 1 of 25 pages").If additional space is required to complete any answer, the applicant may attachadditional pages to the application. The top of each such additional page must indicate the Partand question number to which the additional page relates. The Schedules in the application alsomay be copied if additional schedule pages are needed. All additional pages and Schedules alsomust be identified in the lower left-hand corner with the applicant's social security or taxidentification number. Each added page must be numbered sequentially like the rest of theapplication (e.g., "Pageofpages").In addition to the information required on this application, an applicant may submit anymaterials or explanations relevant to the application. If the explanations or materials relate to aquestion on the application, the applicant should identify the Part(s) and question(s) to which ithas provided additional materials or explanations.The applicant is under a continuing obligation to update answers to application questionsmarked with an asterisk (*). Any change in the answer to such a question, must be provided tothe Commission in writing, no later than ten (10) calendar days after the change occurs. Theapplicant's continuing obligation begins upon submission of the registration application andextends throughout the processing period and any registration term.NOTARIZED CERTIFICATIONSUpon completion of the application and all of its Schedules and attachments, theapplicant business and each principal must complete and sign a notarized certification form andsign a notarized release form.3Rev. 10/30/19

THE COMMISSION WILL NOTIFY THE APPLICANT BUSINESS WHEN THEAPPLICATION IS APPROVED AND WILL SCHEDULE AN APPOINTMENT FOR APRINCIPAL OF THE APPLICANT BUSINESS TO APPEAR AT THE OFFICES OFTHE COMMISSION TO SIGN A REGISTRATION ORDER AND REGISTERVEHICLES TO BE USED FOR WASTE REMOVAL. AT THAT TIME THEPRINCIPAL MUST BRING ONE COPY OF THE FOLLOWING INSURANCECERTIFICATES AND DOCUMENTS:1.Current vehicle registration and insurance cards for each vehicle that will operate underthe registration.2.Proof of Automobile Liability insurance (certificate of liability) covering vehicles withlimits of no less than 2,000,000 combined single limit per accident for bodily injuryand property damage naming the Business Integrity Commission as the certificateholder.3.Current New York State Department of Environmental Conservation Waste TransporterPermit, if applicable.4.Proof of Workers’ Compensation/Employer’s Liability insurance coverage for youremployees naming the Business Integrity Commission as the certificate holder or proofof exemption from coverage.5.A clear copy of each vehicle operator’s driver’s license. For all vehicle operators whosedriver’s licenses are not issued by New York State, you must provide an official drivingrecord (abstract) from the state of issuance.6.Payment by credit card,3 money orders, or checks made payable to the “New YorkCity Business Integrity Commission” to cover the following fees: 400 for eachtruck used to remove and transport trade waste.All applications may be submitted in person or mailed to:NYC Business Integrity Commission100 Church Street, 20th FloorNew York, 10007If you have any questions about this application, please call 212-437-0555.3Effective Monday, October 15, 2018, due to City-wide policy, all credit card and debit card transactions will becharged a fee of 2% of the payment amount.4Rev. 10/30/19

The City of New YorkBUSINESS INTEGRITY COMMISSION100 Church Street 20th FloorNew York New York 10007Tel. (212) 437-0500 Fax (646) 500-7096www.nyc.gov/bicNoah D. GenelCommissioner and Chair2019Local Law 145 of 2013: Vehicle Emission LawNew York City’s vehicle emission law (also known Local Law 145 of 2013) was passed in December2013 to address pollutant reduction of heavy duty trade waste vehicles. The law requires that byJanuary 1, 2020, all “heavy duty trade waste hauling vehicles,” as defined in the law, must beequipped with either an EPA certified 2007 (or later) engine or utilize “Best Available RetrofitTechnology,” as defined by the New York City Department of Environmental Protection. See Title24, Chapter 1, Subchapter 7, of the New York City Administrative Code Section 24-163.11.Under the law, the Commission may exempt companies temporarily from compliance with thelaw based on financial hardship. To be considered for this exemption, a company must applyfor a financial hardship waiver with this application.Please contact BIC at (212) 437-0555 to request a financial hardship waiver application.For additional information visit our website at www.nyc.gov/bic. Click on the “Industries” tabthen view the “Vehicle Emissions Law” tab on the left hand side.

The City of New YorkBUSINESS INTEGRITY COMMISSION100 Church Street 20th FloorNew York New York 10007Tel. (212) 437-0500 Fax (646) 500-7096APPLICATION FOR CLASS 1 SELF HAULER ------------------OFFICE USE --------------------------APPLICATION #:DATE RECEIVED:RECEIVED ---------PART I – APPLICANT BUSINESS IDENTIFYING INFORMATION*1. Name of applicant business. Also list trade name and registration application name, if different:Business Name:Trade Name:*2. Main Office Address:*3. Mailing Address:*4. Garage Address:*5. Business telephone number(s):Fax Number:*6. Cellular Number(s):*7. Electronic Addresses:*Website:*E-mail Address:* (Asterisk) denotes material information on the application. Any change in material information must bereported to the Business Integrity Commission, in a notarized writing, within ten (10) business days of thechange.Tax ID or SSN:Page of Pages1Rev. 10/30/19

8. Agent for Service of Process in New York City. State the name, address, and telephone number of the personof suitable age and discretion who shall be designated as the applicant business’ agent for service of process in NewYork City. In order for the Commission to serve documents official documents regarding a license orregistration, the agent for service of process must be located within the five boroughs of New York City. Theagent for service of process may be a principal of the applicant business if the principal is located within thefive boroughs of New York City. If the applicant business is located within the five boroughs of the NewYork City, no agent of service of process need be designated.Name:Address:Telephone Number:Fax Number:9(a). Type of Organization (check one):a. Sole Proprietorship (i.e., company is not incorporated and does business under the name of aperson having ownership interest or under an assumed name, doing business as name, or trade name).Attach a certified copy of the Certificate of Doing Business filed with the County Clerk in the countyin which the business is located.b. Partnership. (Check one). Attach a copy of current partnership agreement and Certificateof Partnership, certified by the County Clerk in the county in which the business is located.General PartnershipLimited Partnership (L.P.)Limited Liability Partnership (L.L.P.)c. Corporation. Attach a copy of the Certificate of Incorporation filed with the Secretary ofState. If the applicant business is not incorporated in New York State, also attach a certified copy ofthe Authority to Do Business certificate issued by the New York Secretary of State.d. If not one of the above, describe the applicant business9(b). Is the Applicant business a Not-For-Profit corporation?Yes NoNote: A not-for-profit corporation is a corporation formed pursuant to the Not-for-Profit Corporation Law. See NPC§ 1029(c). Is the applicant business a New York City-certified M/WBE (Minority and Women-owned BusinessEnterprise)?Yes No10. If the applicant business is a corporation, provide the tax identification number(s). If the applicant business is apartnership or sole proprietorship, provide the social security numbers of all principals.Tax ID or SSN:Page of Pages2Rev. 10/30/19