(a) Each owner of a video lottery gaming facility is required to be licensed by the commission as a video lottery gaming agent. A video lottery gaming agent application and disclosure form shall be filed with the commission for each of the following:

1. (1) the video lottery gaming agent license applicant; and
2. (2) each parent company or holding company of the applicant.

(b) Each person who is a principal of a video lottery gaming agent or the operator of a video lottery gaming facility on behalf of such an agent is required to be licensed by the commission. A video lottery gaming agent principal application and disclosure form shall be filed with the commission for each of the following:

1. (1) each person required to be licensed as a principal of the applicant; and
2. (2) each person required to be licensed as a principal of a parent or holding company of such agent; and
3. (3) where the video lottery gaming agent principal is other than a natural person, each person(s) exercising control as principals over the video lottery gaming agent principal applicant.

(c) In addition to the information submitted on or required by the application or disclosure form, any applicant for a video lottery gaming agent or principal license shall submit the following additional documents, which shall be dated, signed and notarized by either the president, chief executive officer, member(s), any general partner(s), sole proprietor(s) or other authorized person:

1. (1) a statement of truth;
2. (2) release authorizations as requested by the commission directing all courts, probation departments, selective service boards, employers, educational institutions, financial and other institutions and all governmental agencies to release any and all information pertaining to the applicant as requested by the commission; and
3. (3) an acknowledgment of receipt of notice regarding confidentiality, consent to search and non-refundable filing fees, with a waiver of liability as to the State and the instrumentalities and agents of the State, including the commission, for any damages resulting to the video lottery gaming agents, such agents’ principals, servants, agents and employees, from any disclosure or publication of information acquired during the license or investigation process;

4. (4) such other and further information and documentation as may be required by the commission to establish compliance with all relevant facilities requirements of the commission including, without limitation, the following:

   1. (i) a certified copy of the local law authorizing the applicant’s participation in video lottery gaming, if applicable;
   2. (ii) a certified copy of the certificate of occupancy or a certificate of compliance issued by the appropriate governmental body demonstrating that the facility to be licensed is in compliance with all State and local fire and safety codes;
   3. (iii) certified payroll records showing that all workers engaged or to be engaged in the construction, reconstruction, development, rehabilitation or maintenance of any area utilized or to be utilized for video lottery gaming have been paid prevailing wages in accordance with articles 8 and 9 of the State Labor Law and regulations promulgated by the State Department of Labor to the extent provided in such articles;
   4. (iv) a description of the proposed video lottery gaming facility site, including site plans, total acreage, total square footage, frontages and elevation;
   5. (v) certificates of insurance to comply with section 5103.8 of this Part;
   6. (vi) the construction program for the video gaming facility, including estimated construction time and anticipated date of opening; the status of all required governmental and regulatory approvals and any conditions thereto, including, but not limited to, the results of any review pursuant to the New York State Environmental Quality Review Act and all necessary demolition and construction permits; the project budget; and the architect, general contractor, construction manager and primary subcontractors, environmental consultant and interior designer and proof of insurance of all phases of the construction process;
   7. (vii) certified copies of any agreement(s) with the organization authorized to represent its horsemen; and
   8. (viii) any other information or documentation that the commission may deem material to the licensing of the applicant, or of any person required to be licensed pursuant to the regulations of the commission.