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SU NY Stony Brook3320215
FORMS OSC Use Only: Reporting Code: Category Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: Dec 4, 2019 to March 31,2020
Contracting State Agency Name; state university Hospital or New York at stony Brook university Hospital Agency Codei Contract Number: C011125Contract Term: 12/04/2019 to 06/04/2023 Contractor Name: GE Healthcare MTS USA Corp Contractor Address; 500 West Monroe Street, Chicago, IL 60661-3671 Description of Services Being Provided: On-site Field Engineering Support
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ - - Computer Programming □ Other IT consulting 0 Service/Support Engineering □ Architect Services □ Surveying □ Environmental Services □ Health Services □ Mental'Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractEmployment Category Number of Employees Number of Hours Worked
15-1121-00 40 hour/week for 17 weeks $73,4571
1 40 hour/week for 17 weeksTotal this page $73,4571Grand Total 40 hour/week for 17 weeks $73,457
Name of person who prepared this report: Preparer's Signature: 'Title: ' Customer Success ManagerDate Prepared:. 5/12-/2020 ' ^
Phone#: si7-247-1570
Use additional pages if necessary) Page ibfi
AC 3272-S (Effective 4/12)
FpRWlB
New York State Consultant Services Contractor’s Annual Ernployment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: C011153 Contract Term: 8/1/2016 to 7/31/2021 Contractor Name: Jzanus Consulting Inc.Contractor Address: 515 Hempstead Turnpike West Hempstead , NY-11552 Description of Services Being Provided: DRG Vaiidation
Agency Business Unit:Agency Department ID: 3320215
Scope of Contract (Choose.one that best fits);□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consulting□ Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Sen/lc'es □ Mental Health Services□ Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
Amount Payable Under the Contract
Number of Employees
Number of Hours Worked•Employment Category
Medical Record and Health Info Technicians 11.00 5,180.00 $410,085.00
$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00
0.00 $0.000.00$0.000.000.00$0.000.000.00$0.000.00 0.00$0.000.000.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00
11.00 5,180.00 $410,085.00Total this Page$410,085.0011.00 5,180.00Grand Total
Name of person who prepared this report: Monika Montante
Title: Manager of Financial Operations
Preparer’s Signature:Date Prepared: .5//13/2020
hone #: 516-240-8147
Page of(Use additional pages, if necessary)
DocuSIgn Envelope ID: 17283820-DC23^F9B.87FF-1E309968BZ07APPENDIX I
Consultant Disclosure Form B
FORM B OSC Use Only: Reporting Code; Ceteaofv Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1.2019 to March 31.2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: C011310 Contract Term: OB/OI/2018 Contractor Name: rcm Health Care Services Contractor Address: 575 sth Ave New York NY 10018 Description of Services Being Provided:Temporary RN Services
Agency Code: 3320215
to 05/31/2021
Scope of Contract (Choose one that best fits):AnalysisQ Evaluation! I Research! j TrainingO __Data Processing I I Computer Programming f ! Other IT consulting I I Engineering! | Architect Services[^ SurveYinaI ! Environmental Services! 1 Health Services [3 Mental Health ServicesLJAccounting Q Auditing Q Paralegal! ! Legal! lOBier Consulting! !
Amount Payable Under theContractNumber of Hours Worked•Employment Category Number of Employees
0 $0.000
0 $0.000Total this pageGrandTotal
Name of person who prep_arecjl^tN^^report: Michael Saks
Preparer's Signature:. /ktcluui, SaIlS''‘^6E5E22l&C0BDS472l7
Phone#: 917-286-5220Title: President5/14/2020
Date Prepared:
(Use additional pages if necessary)Page of
*, (Note; /tccGss me 0*net database, wnieh is available mrough the US Department of Labor's Employment and Training Administration, on4ine atnnUnejametceotnusig to rind a list of occupotlonc.)
OMH ATL August 2014
FORM Bi OSC Use Only; Reporting Code: Category Code:
1«
State Consultant Services Contractor's Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University HospitalContract Number: C011313Contract Term: 06/01/2018 to 01/31/2020Contractor Narne: White Glove PlacementContractor Address: 89 Bartlett StreetDescription of Services Being Provided: nursing
Agency Code: 3320215
IiI
s
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering □ Architect'Services Q Surveying □ Environmental Services □ Health Services ^ .Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractEmployment Category Number of Employees Number of Hours Worked
$30,008Registered Nurse/Emergency Room 2 440$3618.62Registered Nurse/Peds ■ 1 58
Total this page 3 $ 33,626.62498Grand Total 3 $ 33,626.62498
j Name of person who prepared this report: Miri RosenbergJliti Sta^mBe/ia.I Preparer's Signature:
Title: AR Manager Date Prepared: 05/13/2020
Phone#: 718-387-8181 123
Use additional pages if necessary) Page 1 of 1
iiiSS
12127660899 From: Tact Corporation of NYC2020-05-15 20:03:42 (GMT)To: Page 3 of 3 .. •••
APPENDIX!. QpnsMitant Dtsctosure
• Fprm B
. •.•*.•*.
FORM B . .DSC Use only:.. ■Report.ing Code; Catsgoiy Code:
• •. '.Stai^e Cons.ultant iServices... . Contractor's AnnMai.Ernpiqyment Report .Report Period: April 1, 2019 !to March 31,2020
.
Cantracting State Agency Name: Stony Brook gnlYersity Medica! Cetiter. Agency Co,cle;^Contract Numher: 0011316 'Contract.Term:.." 6/.i/2pt9.' ■• •. •.Contractor Narnej. Tact Corporation of NYC . ... ... ... -Contractor Address: so Broad Street Ste. 113.7 New York. NV. 100.04 OesGription of Services.Being Provided:" ■. .. .,' • . ' ; .. '••••Temporary Registered Nurses. ...' :■
•*.
- ...to ..1/31/2020 ......• ■.
Scope of Contract (Choose one that best fits);..Analysis I 1 Evaluation! I Researchn^ TrainingC] ...- Data Processing Computer Programming [33 Other IT consulting I I Engineering! | Architect Services! 1 SurveYino! ' I Environmental Services] Health Services f71 Mental Health ServicesCj Accounting [3] Auditing Q P.aralegal{~~| Legairnother Consultingpl .
• Amoiin! Payable. Under .the. Contract 'Number of Hours.WprKed •. %'f.riiployment Category . Number of Employees
• 129-1141,00 $29,828.1029-1141.00 7 3,617 273,463.342.9-1141.00 •■■ ■ 2- 144.' • 11.664.00
*.• ■.
•*. .
Total this page 10' • 4179- - ■ S 314;35544 '•Grand Total
Name of .person, who. prepared this report: Oded Kochayi... ; .
Preparer's Signature: * r "
.. . .
■. ••••
-Phone#: 212-.766-q2Qp, •Title: Operations Manager •.
Date Prepared: 5/14/2020
(Use additional pages, if necessary) • .!• • Page ■ ' ' of '
• •, .(Note: Access the 0*NET database, which, i.s avertable through the US’Department of tabor's Employment and Training Admintstratior^ on-line at '. . ^ 1? a tist of occupations.) '.....
■ QMHATL.August 20.14’ •
FORMB OSC Use Only: Reporting Code: Category Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Hospital Agency Code: 3320215Contract Number: C011363Contract Term: 2/1/2020 to 1/31/2023Contractor Name: Remede Consulting Group, IncContractor Address: 99 Tulip Avenue, Suite 105, Floral Park, New York 11001 Description of Sen/ices Being Provided: Temporary Nursing Staff
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering □ Architect Services □ Sun/eying □ Environmental Services □ Health Services X Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractEmployment Category Number of Employees Number of Hours Worked
Orientation non bill31.5Nursing 1
0 $ 0.00Total this page 031.5 0.00Grand Total 1
Name of person who prepared this report: Preparer's Signature: N^AArlb'
Marie Basile
Phone#: 516-616-6800Title: Office Manager Date Prepared: 5/13/2020Use additional pages if necessary) Page 1 of 1
To; Page 2 of 2 2020-05-14 20:28:42 (GMT) 12127660899 From: Tact Corporation of NYC■* • ••
.. •••. • •.. ' *..
appenoixiConsultant Oisclosure
Form Ef.•• •
FORMS . . ysiSJJs,eOnfy:. Repprtirig Code;
■ Category Code:. • . .
State Consultant Serylces , ... Contractor's Annual Employment Report
Report Period: April 1, 2019 to March 31.2020
. •.. • .• •• *
Cootractinp State. Agency Name: Stony Brook University. Me.diea! Center .' Contract:N.umber; C01l3$7.eoi.1.3i5 •ContractTerm:.. .6/1/20.19 ..... V.Contractor Name: Tact.C.orppration pf .Nyc ■Contractor Address; so Broad Street:Ste. 11.37 New York, NY .10004 Description of Services Being Prpvi.de.d:... .. • ' • •' -;Terr)Pprafy'..Re9istered. Nurses
. ' Agency Code.:*••• • ‘
.to ■;6/1/2p20 -.• •. •
• • •. • •... ^•• • •.
*.
w.*'
Scope of Contract (Choose one that best fits): .__AnalysisCIl .EvaluatipiiQH .Besearchpl TrainingCjData Processing .□ Computer. Programming I I Other IT consuiting__ ••Engineering □ Architect Services□ ■■Surveying FH Environmental.Servicesn • •HealthSenrices[Z3Mental Health SetvicesLJ ' .. '• ;■ 'V ..'Accounting Fli Auditing Pj Pa.ratega![F] LegalFj Other Consulting ll
*.
•••. .. •■■ AmpuRf Payable Under the.
.Coniraet••Number of Employees . . ; ■ -Numberof Hours.Worked.■Employmenl Category
•S 29..828.i029-1141.00 ■ 1 4187- 3,832 ■ .. 289,676.5229-1141.00
81,121.505 1,00229-1141.00
*.
'$406,626.12Total this page.Grand Total
13 5250,96... • •
Na.me of person who prepa red this .report: OdediKochavi •.
Preparer’.s Signature•••
*•%
:... .Phone #;>1^-766-0200^. ..Title: .pperatipn.s .Manager .'
Date Prepared: .5/14/2020.
(U.sje .additipnal pages if necessary) . ,Page ’ ’ ’. of
• ■ . 'X (No}(»v access. ihe.Q'NET .database..;which i.s ayenable through. Ihe US .Department bfUaboi^is-Emptoynient and Training AdmiriisUatipci, on-line a.l.. . aaJiagrPriOtM.OWr.PCOI.'^ tofind-alisii pfsccuRaHons.). •................ • ■• ..........
■ •OMHATL August 2014
.....
:*
■;
I!•FORMS OSC Use Only;
Reporting Code; Category Code:
!
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
iS
;
i•; Contracting State Agency Name: SUNY-Downstate Medical Center Agency Code: 3320218
Contract Number: C319472Contract Term: 1/1/2019 to 12/31/2023Contractor Name: Remede Consulting Group, IncContractor Address: 99 Tulip Avenue, Suite 105, Floral Park, New York 11001 Description of Sen/ices Being Provided: Temporary Nursing Staff .
I-i
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering □ Architect Services □ Surveying □ Environmental Sen/ices.□ Health Sen/ices X Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractNumber of Hours WorkedEmployment Category Number of Employees
15,732.952 585.5EKG-Phleb Tech 29-2031.0080,379.60Hemo Tech 29-2099.00 3 2556
1,090,384.8019567.5RN-MS 29-1141.00 49938,811.84RN - CC 29-1141.03 41 14972.75
RN-OR 29-1141 901.75 57,772.591542.5 22,977.50LPN 29-2061.00 1
39,126.0 $2,206,059.28Total this page . 97$2,206,059.28Grand Total 97 39,126.0
arie BasileName of person who prepared this report: Mj Preparer's Signature: N\Mri^
Phone#: 516-616-6800Title: Office Manager Date Prepared: 5/13/2020
Page 1 of 1Use additional pages if necessary)
05/19/2020 12:03 FAX .5184525579 HRFMLAW ®001/001
AC 3272-S (Effective 4/12)
FORMS
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name; Stony Brook University Contract Number; CM032Q3 Contract Term: 07/01/2018 to 06/30/2023 Contractor Name: Heslin Rothenberg Farley & Mesiti P C.Contractor Address: 5 Columbia Circle, Albany, NY 12203 Description of Services Being Provided; Advising on trademark registration, licensing, and related matters
Agency Business Unit;Agency Department ID; 3320215
Scope of Contract (Choose one that beat fits):□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consultingQ Engineering □ /M-chitect Services □ Surveying □ Environmental Sen/ices□ Health Services □ Mental Health Sen/ices□ Accounting □ Auditing □ Paralegal |3 Legal (□ Other Consulting
Number of Hours Worked
Amount Payable Under the Contract
Number of Employees■Employment Category
$14,532.902.00 48.8023-1011.00 lawyers$960.006.0023-2011.00 legal assistants 1.00
$5,401.14disbuisements paid on client's behalf 0.000.00$0.000.00 0.00$0.000.00 0.00$0.000.000.00$0.000.000.00$0.000.00 0.00$0.000.000.00$0.000.000.00
0.00 $0.000.000.00 $0.000.00
$0.00. 0.000.00$20,694.043.00 54.80Total this Page$20,894.043.00 54Grand Total
Name of person who prepared this report: Samuel J. Duro Title: Business Manager ^ ^Preparer’s Sionature^g^^^^^'*’**-*-^
Date Prepared; 05/19/2020
Phone #: 518-452-5600'
Page 1 of 1(Use additional pages, if necessary)
AC 3272-S (Effective 4/12)
FORMS
New York State Consultant Sen/ices
Contractor’s Annual Employment ReportReport Period: April 1,2019 to March 31,2020
Contracting State Agency Name: Stony Brook University Contract Number: CM002157 Contract Term: 9//13/2019 to 9/13/2020 Contractor Name: Hogan Lovells US LLP Contractor Address: 555 13*'’ Street NW, Washington, DC 20004 Description of Services Being Provided: Legal Services
Agency Business Unit: SNY01 Agency Department ID: 3320215
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consulting□ Engineering □ Architect Services □ Surveying □ Environmental Sen/ices□ Health Services □ Mental Health Services□ Accounting □ Auditing □ Paralegal 13 Legal □ Other Consulting
Number of Hours Worked
Amount Payable Under the Contract
Number of EmployeesEmployment Category
$33,693.0023-1011.00 Partner 1.00 45.00$0.0023-1011.00 Counsel 1.00 0.00
$7,957.000.00 20.0023-1011.00 Associate$0.0023-1011.00 Paralegal 0.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00
0.00 $0.000.00$41,650.002.00 65.00Total this Page
Grand Total
Name of person who prepared this report: Jeffrey G. Schneider Title: Partner Phone #: 212-918-3503
. ArPreparer’s Signature:Date Prepared: 05/21/2020
Page 1 of 1(Use additional pages, if necessary)
2020-05-15 09:48 DESMAN 1 212 779 1654 » NYSOSC P 2/5
AC 3272-S (Eflectiva 4/12)
FORM B'
New York State Consultant Services Contractor’s Annual Emiployment Report
Report Period: April 1, 2019 to March 31,2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number; T001792 Contract Term: 09/01/2013 to 08/31/2018 Contractor Name: DESMAN, INC.Contractor Address: 3 WEST STREET, 3’'° FL . NY . NY 10001 Description of Services Being Provided: ENGINEERING
f SftY*/SIAgency Business Unit:Agency Department ID: 3320215
Scope of Contract (Choose one that best fits): n Analysis □ Evaluation P Research P Training□ Data Processing □ Computer Programming O Other IT consulting□ Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Services □ Mental Health Services□ /Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
Number of Hours Worked
Number of Employees
Amount Payable Under the ContractEmployment Category
$0.000.00CIVIL DRAFTER 0.00$0.000.00CIVIL ENGINEERING 0.00$0.000.000.00
• $0.000.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.00 0.00$0.000.000.00
$ 0.000.00Total this Page 0.00Grand Total
Name of person who prepared this report: Anup Chhabra Title: C.F.OPreparer’s Signature: _Date Prepared: 05/01/20
Phone #: 212-686-5360
Page 1 of(Use addidonal pages, if necessary)
05/13/2020 12:58:16 PM -0400 FAXCOM PAGE 2 OF 2
FORMB OSC Us0 Only: Reporting Cpde: Cateopty Code:
State Consultant Services Contractor's Annual Employment Report
Report Period: April 1,2019 to March 31. 2020
Contracting State Agency Name: Stony Brook University Hospital Agency Code: 3320215Contract Number: T100357Contract Term: 03/01/2019 to 02/28/2021Contractor Name: Cardinal Health Pharmacy Services, LLCContractor Address: 13651 Dublin CT. Stafford, TX. 77477Description of Services Being Provided: Pharmacy consulting services to help build anoutpatient retail pharmacy on the Stony Brook University Hospital campus.
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ computer Programming □ other 11 consulting □ Engineering □ Architect Services □ Surveying □ Environmental Senrices □ Health Services □ Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting IS
Amount Payable Underthe ContractNumber of Hours WorkedNumber of EmployeesEmployment Category
21,300.001423Pharmacist
Total this page $21:300,003 142Grand Total 3 142 21,300.00
Name of person who prepared this report: John McMillen Preparer's Signature: —~ ~Title: National Operations^irector Date Prepared: 5/12/2020 i
Phone #: 832.567.9712
Use additional pages if necessary) Page l.of 1
s.
2020-05-15 09:49 . DESMAN 1 212 779 1654 » NYSOSC P 3/5
AC32/2-S(E/fec«vo4/12)
,FORM B
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1,2019 to March 31.2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: T001801 Contract Term: 10/01/2013 to 12/31/2018 Contractor Name: DESMAN. INC.Contractor Address: 3 WEST 35™ STREET, FL . NY , NY 10001 Description of Servfces Being Provided: ENGINEERING
IAgency Business UniU Agency Department ID: 3320215
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research P Training□ Data Processing P Computer Programming P Other IT consulting□ Engineering □ Architect Services □ Surveying P Environmental Services□ Health Services □ Mental Health Services□ Accounting P Auditing □ Paralegal □ Legal □ Other Consulting
Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployment Category
$0.000.00CIVIL DRAFTER 0.00$0.00CIVIL ENGINEERING 0.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00
, $0.000.000.00$ 0.000.00 0.00Total this Page
$0.000.000.00Grand Total
Name of person who prepared this report: Anup Chhabra Title; C.F.0Preparer's Signature; _Date Prepared; 05/01/2020
Phone#: 212-686-5360
Page 1 of 1(Use additional pages, if necessary)
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant Services
Contractor’s Annual Employment ReportReport Period: April 1,2019 to March 31,2020
Contracting State Agency Name: SUNY at Stony Brook Dental SchoolAgency Business Unit: Agency Department ID:
Contract Number: T01908A Contract Term: 9/1/2015 to 8/31/2020 Contractor Name: EFPR Group. CPAs. PLLC Contractor Address: 6390 Main Street. Suite 200. Williamsville. NY 14221 Description of Services Being Provided: Audit Services
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consulting□ Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Services □ Mental Health Services□ Accounting Kl Auditing □Paralegal □Legal □ Other Consulting
Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployment Category
13-2011.02 Auditors 7.00 176.70 $36,000.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.00
$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00
0.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 $0.000.007.00 176.70 $36,000.00Total this Page7.00 176 $36,000.00Grand Total
Name of person who prepared this report;-^ouglas E. Zimmerman, CPA
Title: Partner Preparer’s Signature:Date Prepared: SllSIim
Phone #: (716) 634-0700
(Use additional pages, if necessary) Page 1 of 1
2020-05-15 09:49 DESMAN 1 212 779 1654-» NYSOSC P 4/5
AC3272-S(Erreetiv«4/12)
FORMS
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31,2020
Contracting State Agency Name; Stony Brook University Hospital Contract Number T002097 ' Agency Business Unit;i|||||||p {Contract Term: 03/01/2018 to 02/28/2023 Agency Department iD: 3320215Contractor Name: DESMAN, INC.Contractor Address; 3 WEST 35™ STREET, 3"° FL , NY, NY 10001 Description of Services Being Provided; ENGINEERING
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming ' □ Other IT consulting□ Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Services . □ Mental Health Services□ Accounting. □ Auditing □ Paralegal □ Legal □ Other Consulting
Amount Payable Under the Contract
Number of ■ Employees
Number of Hours WorkedEmployment Category
$0.00CIVIL DRAFTER 4.001.00$0.00CIVIL ENGINEERING 3.00 64.00$0.000.000.00$0.000.00 0.00$0.00. 0.000.00$0.000.000.00$0.000.000.00
. $0.00o.oo.0.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.000.00$0.000.00 0.00
$ 0.0068.004.00Total this Page$16,597.98Grand Total 4.00 68.00
Name of person who prepared this report; Anup Chhabra Title; C.F.0Preparer’s Signature: __Date Prepared: 05/01/2020
Phone #: 212-686-5360
Page of'^(Use additional pages, if necessary)
FORMB OSC Use Only: Reporting Code; Category Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1. 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Contract Number: T002104 Contract Term: 5/24/2018 to 3/31/2021 Contractor Name: GEI Consultants, Inc., P.C.Contractor Address: 110 Walt Whitman Road, Ste. 204, Huntington Station, NY 11746 Description of Services Being Provided: Engineering Services
Agency Code:
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering X Architect Services □ Surveying □ Environmental Services □ Health Services □ Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractEmployment Category Number of Employees Number of Hours Worked
184.75 04Civil Engineer (17-2051.00)2 682.50 0Architect (17-1011.00)1 4.00 0Construction & Building Inspector (47-4011.00)2 39.25 0Civil Engineering Technician (17-3022.00)
229.001 0Civil Drafter (17-3011.02)1 20.00 0Compliance Manager (11-9199.02)
000000
1159.50 0 $ 183,685.67Total this page 0Grand Total
report: ElizabelName of person who preparedPreparer's Signature:______ cTitle: Contract Professional Date Prepared: 05/19/2020
irnenA
, Phone#: (212)804-7636
Page 1 of 1Use additional pages if necessary)
05/15/2020 07:45 FAX 2032396340 HOFFMANN ARCH @002
FORM B OSC Use Only: Reporting Code: Cateqon; Code:
State ConsuKant Services Contractor’s Annual Employment Report
Report Period: April 1.2019 to March 31.2020
Contracting State Agency Name; Stony Brook University Hospital Agency Code: 3320215Contract Number T200008Contract Term: 05/09/2012 to 12/31/2021Contractor Name: Hofftnann Architects, Inc.Contractor Address: 1040 Av«iue of the Americas, Suite 14C, New Yoi1<, NY 10018 Description of Services Being Provided: Architectural and Engineering Services
Scope of Contract (Choose, one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming Q Other IT consulting □Engineering IS! Architect Senrtces IS Surveying □ Emrironmental Services □ Health Services □ Mental Health Services □.Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractNumber of Hours WorkedEmployment Category Number of Employees
3 $35.097.5011-1011.00 104.5017-2199.00 2 530.00 $154,610.00
$68,117.502 351.5017-1011.006 544.00 $77,220.0017-3011.01
17-3029.00 1 5.50 $865.00
Totai this page Grand Totai
0 1,536 $335,910.001.536 $335,910.00
me of person who prepare^this report: Cathy A. OeiiaValiePreparer's Signature:_____ (JftArtvu OL ^iiLa.0Title: Marketing Coordinator Date Prepared: 05/13/2020
Na
Phone#: 203-239-6660
VUse additional pages if necessary) Page 1 of 1
AC 3271-S (Effective 4/12)
FORMB
New York State Consultant ServicesContractor’s Annual Employment Report
Report Period: April 1,2019 to March 31,2020
Contracting State Agency Name: SUNY at Stony BrookAgency Business Unit: SNY01 Agency Department ID: 3320215
Contract Number: T200073 Contract Term: to Contractor Name: CannonDesign Contractor Address: 50 Fountain Plaza, Suite 200
Buffalo, NY 14202 Description of Services Being Provided: Professional Design Services
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training
□other IT consulting□ Data Processing □ Computer Programming
□ Engineering lEI Architect Services □ Surveying □ Environmental Services
□ Health Services □ Mental Health Services
□ Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployment Category
$178,484.051362.417-1011.00 11$6,282.701 3617-2071.00$3,211.161 2017-2141.00$3,438.052 1817-2199.00
$55,931.8576317-3011.00 2$215,557.351150.327-1025.00 3
$3,653.232 50.127-3042.00$5,859.692 60.843-9199.00
$472,418.08Total this page 24 3460.6$472,418.0824 3460.6Grand Total
Name of person who prepared this report: Shari Safee Title: Project Biller
Preparer's Signature:
Date Prepared: 5/15/2019
Phone#: (716)774-3400ShlBn 3Bf^^O»^jnQnDe5^n,CN^liaii
FORMB OSC Use Only: Reporting Code: Category Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Hospital Agency Code: 3320215Contract Number: T200082Contract Term: 10/08/2018 to 09/30/2021Contractor Name: LiRo Engineers, IncContractor Address: 3 Aerial Way, Syosset, NY 11791Description of Services Being Provided: Engineering Anaiysis and Design Services: Cost Estimating; Hazardous Materials Testing.
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering ^ Architect Services □ Surveying □ Environmental Services □ Heaith Services □ Mental Health Services QAccounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractNumber of Hours WorkedEmployment Category Number of Employees
$42,670.00Mechanical Engineers 8 284$19,000.00112Electrical Engineers 4$4,085.00Structural Engineers 3 27$7,300.00Cost Estimators 3 55
$17,556.002 116Project Managers$2,688.0018Environmental Engineers 4
$93,299.00Total this page 24 612$93,299.0024 612Grand Total
Name of person who prepared this report: Eugene Grigortsevich, PEPreparer's Signature:_____Title: Project Manager Date Prepared: 05/14/2020
Phone #: 516-214-8470
Page 1 of 1Use additional pages if necessary)
FORM B OSC Use Only: Reporting Code: Category Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University HospitaiContract Number: T200095Contract Term: 4/24/2018 to 8/20/2020Contractor Name: LiRo EngineersContractor Address: 3 Aerial Way, Syosset NYDescription of Services Being Provided: AE Design Services
Agency Code: 3320215
Scope of Contract (Choose one that best fits):Analysis Q Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering X Architect Sen/ices □ Surveying □ Environmental Services □ Health Services □ Mental Health Sen/ices □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractEmployment Category Number of Hours WorkedNumber of Employees
27,679.91Mechanical Engineers 3 3337,457.60Electrical Engineers 2 60
172 20,370.48Architects 23,000.00Cost Estimators 2 24
$ 58,507.99589Total this page 9589 58,507.99Grand Total 9
ce KorrowName of person who prepared tte report: ^ Preparer's Signature:______
Phone #: 516-880-8504Titie: AssociateDate Prepared: 5/13/2020Use additional pages if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORWIB
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1,2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: T200103 Contract Term: 06/18/2018 to 06/18/2019 Contractor Name: Cameron Engineering & Associates, LLP Contractor Address: 177 Crossways Park Drive, Woodbury, NY 11797 Description of Services Being Provided: Engineering Consulting Services
Agency Business Unit: 28050 Agency Department ID: 3320215
Scope of Contract (Choose one that best fits);□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consultingIS Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Services □ Mental Health Services□ Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployment Category
0.00 $0.0017-2051,00 Civil Engineers 0.000.00 0.00 $0.00
0.00 $0.00.0.000.00 $0.000.000.00 $0.000.00
0.00 0.00 $0.000.00 $0.000.000.00 $0.000.000.00 $0.000.00
0.00 0.00 $0.00$0.000.00 0.00
0.000.00 $0.000.000.00 $0.000.000.00 $ 0.00Total this Page0.000.00 $0.00Grand Total'
Name of person who prepared this report: Carol Fusco
Title: Controller
Preparer’s. Signature:Date Prepared: 05/05/2020
Phone #: 516-224-5257
(Use additional pages, if necessary) Page 1 of 1
^S73
FORMS
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name:
WStContract Number: T200111 Contract Term: 03/12/2019 to 03/11/2020 Contractor Name: Cameron Engineering Associates LLP Contractor Address: 177 Crossways Park Dr.Description of Services Being Provided: Structural Design R&F Room
Agency Business Unit: Agency Department ID
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training
□other IT consulting□ Data Processing □ Computer Programming□ Architect Services □ Surveying □ Environmental ServicesK Engineering
□ Health Services □ Mental Health Services□ Auditing □ Paralegal □ Legal □ Other Consulting□ Accounting
Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployment Category
2,636.8017-2051 Civil Engineers 2 2417-3022 Civil Engineering Technologists and Technicians
58.5 6,427.203
82.5 $ 9,064Total this page 582.5 9,064Grand Total 5
Name of person who prepared this report: Carol Fusco Title: Controller Preparer's Signature:Date Prepared: 05/18/2020 (Use additional pages, if necessary)
Phone #: 516-224-5257
Page 1 of 1
FORMB OSC Use Only: Reporting Code: Category Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
•Contracting State Agency Name: Stony Brook University Hospital Agency Code: 3320215Contract Number: T200028Contract Term: 11/22/2013 to 08/31/2019Contractor Name: AECOM USA Inc.Contractor Address: 71 West 23"* Street, 12“’ Floor, New York, New York 20010 Description of Services Being Provided: Design Services: University Hospital Surgery, Dining, Wayfinding/Signage Renovation
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering (E Architect Services IS Surveying □ Environmental Sen/ices □ Health Services □ Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the Contract■ t'lumber of Hours WorkedEmployment Category Number of Employees
Principal$15,551.251 82.5Project Manager
$290.062Architect 1$50,388.00Design Advisor ■ 2281$7,848.36Project Interior Designer II 1 82.5$1,016.60Fire Protection Engineer 2 8.5
$317.223,Electrical Engineer 1$93.60Technical / Clerical Support 1 2
384.5 $75,505.09Total this page 8Grand Total
Name of person who prepared this report: Jeannie Gasper
Preparer's Signature:,Title: Senior Associate, Project Manager Date Prepared: 5/11/2020___________
' Phone #: 703-683-6050
Page 1 of 1Use additional pages if necessary)
FORMS OSC Use Only: . Reporting Code: Category Code:
State Consultant Services Contractor’s Annual Employment ReportReport Period: April 1,2019 to March 31,2020
Contracting State Agency Name: Stony Brook University Agency Code: 3320215Contract Number: T200037Contract Term: 6/28/2017 to 11/28/2013Contractor Name: rmf Engineering, Inc., P.c.Contractor Address: 5520 Research Park Dr, suite 3, Baltimore Description of Services Being Provided: phase 2 - Exhaust Air System
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering B Architect Services □ Surveying □ Environmental Services □ Health Services □ Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting □
Amount Payable Under the ContractNumber of Employees Number of Hours WorkedEmployment Category
17-9199.99 Managers 1529.252 1117-2199 Engineering Other 444.641 4
1973.893Total this page 151973.893 15Grand Total
Name of person who prepared this report:Preparer's Signature: ^7° Akinyemi_______Title: 5taff AccountantDate Prepared: 05/15/2020_____________
:SD1BiOS.3iessrOO-4«'OT.OU9
Phone#: (410)576-0505
Page ofUse additional pages if necessary)
AC 3272-S (Effective 4/12)
FORMB
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1,2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: T200079 Contract Term: 04/01/2017 to 03/31/2020 Contractor Name: Cameron Engineering & Associates, LLP Contractor Address: 177 Crossways Park Drive, Woodbury, NY 11797 Description of Services Being Provided: Engineering Consulting Services
Agency Business Unit:||P|PliF Agency Department ID: 3320215
Scope of Contract (Choose one that best fits): '□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consultingK Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Services □ Mental Health Services□ Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployment Category
$0.000.00 0.000.00 $0.000.000.00 $0.000.00
$0.000.00 0.000.00 $0.000.00
$0.000.00 0.000.00 $0.000.00
$0.00. 0.00 0.000.00 $0.000.00
0.00 0.00 $0.000.00 0.00 $0.00
0.00 $0.000.00■ 0.000.00 $0.00
0.00 0.00 $ 0.00Total this PageGrand Total
V-
Name of person who prepared this report: Carol Fusco
Title: Controller
Preparer's Signature:Date Prepared: 05/18/2020
Phone #: 5.16-224-5257
Page of 1(Use additional pages, if necessary)
AC 3272-S (Effective 4/12)
FORWIB
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: T200084 Contract Term: 09/01/2017 to 08/31/2020 Contractor Name: Cameron Engineering & Associates, LLP Contractor Address: 177 Crossways Park Drive, Woodbury, NY 11797 Description of Services Being Provided: Engineering Consulting Services
Agency Business Unit:Agency Department ID: 3320215
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consulting^ Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Services ' □ Mental Health Services□ Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
. Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployrhent Category
0.00 $0.000.00$0.000.00 0.00
0.00 $0.000.000.00 $0.000.000.00 $0.000.000.00 $0.000.000.00 $0.000.00
$0.000.00 0.000.000.00 $0.000.00 $0.000.00
0.00 0.00 $0.000.00 $0.000.00
0.00 0.00 $0.000.000.00 $ 0.00Total this Page
Grand Total
Name of person who prepared this report: Carol Fusco
Title: Controller
Preparer’s Signature:Date,Prepared: 05/18/2020
Phone #: 516-224-5257
(Use additional pages, if necessary) Page 1 of 1
P 5/5DESMAN 1 212 779 1654 » NYSOSC2020-05-15 09:49
AC3272-S(Effectfv«4/l2)
. FORMS
New York State Consultant Services Contractor’s Annual Employment Report
Report Period; April 1,2019 to March 31,2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: T200097 'Contract Term: 10/16/2018 to 10/15/2021 Contractor Name: DESMAN, INC.Contractor Address: 3 WEST 35™ STREET, 3"® FL . NY , NY 10001 Description of Services Being Provided: ENGINEERING
• Agency Business UnibMllir 1 Agency Department ID: 3320215 .
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training ‘ .□ Data Processing □ Computer Programming □ Other IT consulting□ Engineering □ Architect Services □ Surveying □ Environmental Services□ Health Services □ Mental Health Services□ Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
Number of Hours Worked
Number of Employees
Amount Payable Under the ContractEmployment Category
3.00 ■CIVIL DRAFTER 561.00 $0.00$0.00CIVIL ENGINEERING 292.003.00$0.00ARCHITECT ' 0.000.00$0.000.000.00■$o:oo0.000.00$0.000.00 0.00$0.00■0.00 0.00$0.000.000.00$0.000.000.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.000.00
$ 0.00853.00Total this Page 6.00$34,471.54853Grand Total , 6.00
Name of person who prepared this report; Anup Chhabra Title: C.F.0Preparer's Signature: ___Date Prepared: 05/01/2020
.Phone #: 212-686-5360
Page 1 of 1(Use additional pages, if necessary)
FORM B OSC Use Only; Reporting Code: Category Code:
State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2019 to March 31, 2020
Contracting State Agency Name: Stony Brook University Hospital Agency Code: 3320215Contract Number: P.O. 001954HContract Term: 07/01/2014 to 06/30/2020Contractor Name: Lewis CommunicationsContractor Address: 2030 1®* Avenue North, Birmingham, AL 35203Description of Services Being Provided: Marketing and Advertising Campaign Services
Scope of Contract (Choose one that best fits):Analysis □ Evaluation □ Research □ Training □Data Processing □ Computer Programming □ Other IT consulting □ Engineering □ Architect Services □ Suh/eying □ Environmental Services □ Health Services □ Mental Health Services □Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting IEI
Amount Payable Under ' the ContractNumber of EmployeesEmployment Category Number of Hours Worked
13-1161.00- Market Research Analysts and Marketing Specialists 6 163 $15,568.75
$77,287.5027-1011.00-Art Directors 7 79027-1014.00 - Multimedia Artists and Animators $217.501 58.7511-2021.00 - Marketing Manager ~ $159,600767.50411-2011.00-Advertising and Promotions Managers 1362.25 $137,303.75615-1199.10 - Search Marketing Strategists $86,677.502 514
$62,268.7527-3043.04 - Copy Writers 4 513.2527-2012.01 - Producers 3 323.50 $833.75
$027-4021.00 - Photographers 1 227-4032.00 - Film and Video Editors 1 $72.50143-5061.00-Production, Planning, and Expediting Clerks 82.25 $2,5001
$542,330Grand Total 36 4577.50
Name of person who prepared this report: Chrystal Forshee
Preparer's Signature: Title: Account Supervisor Phone #: 205-747-1823Date Prepared: 5/13/2020Use additional pages if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORMB
New York State Consultant Services
Contractor’s Annual Employment ReportReport Period: April 1,2019 to March 31,2020
Contracting State Agency Name: Stony Brook University Hospital Contract Number: 011294 Contract Term: 4/1/2019 to 3/31/2020 Contractor Name: Worldwide Travel Stating, Limited Contractor Address: 2829 Sheridan Drive, Tonawanda, New York 14150 Description of Services Being Provided: Temporary nurse staffing
Agency Business Unit: 28050 Agency Department ID: 3320215
Scope of Contract (Choose one that best fits):□ Analysis □ Evaluation □ Research □ Training□ Data Processing □ Computer Programming □ Other IT consulting□ Engineering □ Architect Services □ Surveying □ Environmental Sen/ices 13 Health Services □ Mental Health Services□ Accounting □ Auditing □ Paralegal □ Legal □ Other Consulting
Number of Employees
Number of Hours Worked
Amount Payable Under the ContractEmployment Category
$152,432.5029-1141.00 3.00 1,361.50$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00
0.00 $0.000.000.00 0.00 $0.00
$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00$0.000.00 0.00
0.00 $0.000.00$152,432.50Totai this Page 3.00 1,361.50$152,432.50Grand Total 3.00 1,361
Name of person who prepared tNs report: Leo R. Blatz
Title: C.E.O.Preparer’s Signature: (Date Prepared: 4/17/2020
Phone #: 716-821-9001
(Use additional pages, if necessary) Page 1 of 1
OSC Use Only: Reporting Code: Category Code;Date Contract Approved:
FORMA
State Consultant Services - Contractor's Planned Employment
From Contract Start Date Through The End Of The Contract Term
State Agency Name: ^rock.Contractor Name;daJor'‘L^ior‘̂ Contract Start Date: ^ // 7 / VOZ O-
Agency Code; Contract Number:
Contract End Date: ^1 / Z^OZ >
Number of Employees
Number of hours to be worked
Amount Payable Under the ContractEmployment Category
l9'/0^>9. O'? I 30,0003013 - Q-^ 3
2^ . S>oOTotal this page
Phone #;Name of person who prepared this report: Title: ^> re^tJr9rTr
Preparer's Signature; ^Date Prepared: C, /'Z^Z^
(Use additional pages, if necessary) Page / of /