24
SUNY at Stony Brook 3320215
SUNY at Stony Brook 3320215
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period April 1, 2020 to March 31, 2021
Contracting State Aaencv Name:
Contract Number C002157
Agency Buines UnitContract Term: 09 /13/2020 to 09/13/2021
Agency Department ID:
Contractor Name: Hogan Loveils US LLP
Contractor Address: Columbia Square, 555 Thirteenth St. NW, Washington, DC 20004
Description of Services Being Provided: Legal Services
Scope of Contract (Choose one that best fits):Analysis Evaluation D Research El TrainingData Processing 1J Computer Programming D Other IT consulting
O Engineering D Architect Services Surveying a Environmental Services
D Health Services fl Mental Health ServicesE] Accounting a Auditing 0 Paralegal Q Legal a Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
23-2011.0 Partners 2 75 $45,549
23-2011.0 Associates 3 233 $85,611
23-2011.0 Paralegals 0 0 0
Total this PageGrand Total 308 $131,160
Name of person who prepared this report: JEFFREY G. SCHNEIDER
Title: PARTNER Phone # 212-918-3503
Preparer s Signature:
Date Prepared: 04/2212021
(Use additional pages, if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University HospitalContract Number: COl 1377 Agency Business Unit: SNY01Contract Term: 02/01/2020 to 01/31/2023 Agency Department ID: 3320215Contractor Name: Fastaff, LLCContractor Address: 5700 S. Quebec Street, Suite 300, Greenwood Village, CO 80111Description of Services Being Provided: Temporary Healthcare Personnel
Scope of Contract (Choose one that best fits):El Analysis El Evaluation El Research El Training -El Data Processing El Computer Programming El Other IT consultingEl Engineering El Architect Services El Surveying El Environmental Services
Health Services El Mental Health ServicesEl Accounting El Auditing El Paralegal El Legal El Other Consulting
Number of Number of Amount Payable
Employment Category Employees Hours Worked Under the Contract29-1141.00 7.00 3,519.53 490674.23
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
Total this Page 7.00 3,519.53 $490,674.23
Grand Total 7.00 3,519 490674.23
Name of person who prepared this report: Michelle GaronTitle: Sr. Sales Director Phone #: 720-921-3853
Preparer's Signature: I ;Date Prepared: 04/16/2021
(Use additional pages, if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University HospitalContract Number: COl 1378 /PO 16I 141 3/-J Agency Business Unit: 28050Contract Term: 4/1/2020 to 3/31/2021 Agency Department ID: 3320215Contractor Name: Worldwide Travel Stafing, LimitedContractor Address: 2829 Sheridan Drive, Tonawanda, New York 14150Description of Services Being Provided: Temporary nurse staffing
Scope of Contract (Choose one that best fits):
El Analysis El Evaluation [1 Research El Training
El Data Processing 0 Computer Programming El Other IT consulting
El Engineering El Architect Services El Surveying El Environmental Services
Health Services El Mental Health Services
El Accounting El Auditing El Paralegal El Legal El Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
29-1141.00 7.00 3,986.67 $561,026.70
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
Total this Page 7.00 3,986.67 $561,026.70
Grand Total 7.00 3,986 $561,026.70
Name of person who prepared this report: Leo R. Blatz
Title: C.E.O. Phone #: 716-821-9001
Preparer's Signature:
Date Prepared: 4/30/2021
(Use additional pages, if necessary) Pagel of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University Hospital
Contract Number: COl 1422 Agency Business Unit: SNY01Contract Term: 02/01/2021 to 01/31/2024 Agency Department ID: 3320215Contractor Name: Birdsall Voss & Associates Inc
Contractor Address: 250 W Coventry Court, Suite 300, Milwaukee, WI 53217
Description of Services Being Provided: Advertising - Marketing and Advertising CampaignServices
Scope of Contract (Choose one that best fits):Analysis LI Evaluation Research 1J Training
fl Data Processing LI Computer Programming fl Other IT consulting
LI Engineering E1 Architect Services LI Surveying [J Environmental Services
LI Health Services LI Mental Health Services
LI Accounting LI Auditing LI Paralegal LI Legal 0 Other Consulting
Number of Number of Amount Payable
Employment Category Employees Hours Worked Under the Contract13-1161.00 3.00 66.00 $8,580.0011-2011.00 10.00 435.84 $56,659.2041-3011.00 3.00 132.75 $17,257.5013-1161.01 4.00 47.25 $6,142.50
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
Total this Page 20.00 681.84 $88,639.20
Grand Total 20.00 681 $88,639.20
Name of person who prepared this report: MaryKay Lee
Title: Accounting Manager Phone #: 414-247-3893
Preparer's Signature:
Date Prepared: 4/29/2021
(Use additional pages, if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook UniversityContract Number: CM03203 Agency Business Unit: 28050Contract Term: 07/01/2018 to 06/30/2023 Agency Department ID: 3320215Contractor 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, andrelated matters
Scope of Contract (Choose one that best fits):
El Analysis El Evaluation El Research El TrainingF1 Data Processing El Computer Programming El Other IT consulting
U Engineering El Architect Services U] Surveying El Environmental Services
El Health Services El Mental Health ServicesEl Accounting El Auditing El Paralegal Legal U] Other Consulting
Number of Number of Amount Payable
Employment Category Employees Hours Worked Under the Contract
23-1011.00 lawyers 2.00 20.80 $9,348.30disbursements paid on client's behalf 0.00 0.00 $5,612.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
Total this Page 2.00 20.80 $14,960.30
Grand Total 2.00 20 $14,960.30
Name of person who prepared this report: Samuel J. Duro
Title: Business Manager Phone #: 518-452-5600
Preparer's Signature:Date Prepared: 04/23/2021
(Use additional pages, if necessary) Page 1 of I
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: SUNY at Stony Brook Dental SchoolContract Number: T01908A Agency Business Unit:Contract Term: 9/1/2015 to 8/31/2020 Agency Department ID:Contractor Name: EFPR Group, CPAs, PLLCContractor Address: 6390 Main Street, Suite 200, Williamsville, NY 14221Description of Services Being Provided: Audit Services
Scope of Contract (Choose one that best fits):Analysis Evaluation LI Research TrainingData Processing LI Computer Programming E Other IT consultingEngineering Architect Services 0 Surveying Environmental ServicesHealth Services LII Mental Health Services
LI Accounting X Auditing LI Paralegal LI Legal LI Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
13-2011.02 Auditors 4.00 31.75 $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 $0.000.00 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
Total this Page 4.00 31.75 $36,000.00Grand Total 4.00 31 $36,000.00
Name of person who prepared this report: Douglas E. Zimmerman, CPATitle: Partner
Preparer's Signature:Phone #: (716) 634-0700
Date Prepared: 5/1 1/2O
(Use additional pages, if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University
Contract Number: T002103 Agency Business Unit: 28050
Contract Term: 04/09/2018 to 12/31/2020 Agency Department ID: 3320215
Contractor Name: Bums Engineering, Inc.
Contractor Address: 1261 Broadway, Suite 708 New York, NY 10001
Description of Services Being Provided: Engineering consulting
Scope of Contract (Choose one that best fits):
LI Analysis LI Evaluation LI Research LI Training
LI Data Processing LI Computer Programming LI Other IT consulting
Engineering LI Architect Services LI Surveying LI Environmental Services
LI Health Services LI Mental Health Services
LI Accounting LI Auditing LI Paralegal LI Legal LI Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
Principal 1.00 24.00 $6,750.04
Project Manager 1.00 30.00 $5,203.50
Sr. Project Engineer 1.00 8.00 $1,625.16
Sr. Engineer 1.00 93.00 $16,260.30
Engineer 4.00 231.00 $22,931.17
Drafter 0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
Total this Page 8.00 386.00 $52,770.17
Grand Total
Name of person who prepared this report: Maria Pena Torres
Title: Project Administrator Phone #: (c) 215-870-7173
Preparer1s Signature:
Date Prepared: 4/19/20
(Use additional pages, if necessary)
Page 1 of I
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: SUNY at Stony BrookContract Number: T002187 Agency Business Unit: SNY01Contract Term: 05/03/2019 to 12/31/2020 Agency Department ID: 3320215Contractor Name: Popli, Architecture + Engineering & LS, DPCContractor Address: 555 Penbrooke Drive Penfield, NY 14526Description of Services Being Provided: Professional engineering services for ChapinApartments structural analysis
Scope of Contract (Choose one that best fits):LI Analysis LI Evaluation LI Research LI TrainingEl Data Processing El Computer Programming LI Other IT consulting
Engineering Z Architect Services LI Surveying LI Environmental ServicesEl Health Services LI Mental Health ServicesLI Accounting LI Auditing LI Paralegal LI Legal El Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
11-9041.00 1.00 109.00 $14,377.1017-2051.00 2.00 720.00 $71,944.0317-1011.00 4.00 390.00 $40,480.08
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 $0.000.00 0.00 $0.00
Total this Page 7.00 1,219.00 $126,801.21Grand Total 7.00 1,219 $126,801.21
Name of person who prepared this report: Krystal LearnTitle: Accountant IP
Phone #: 585-364-1648
reparer's Signature: Date Prepared: 05/12/2021
(Use additional pages, if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook UniversityContract Number: T002201 Agency Business Unit: 28050
Contract Term: 09/01/2019 to 08/31/2021 Agency Department ID:
Contractor Name: Bums Engineering, PCContractor Address: 1261 Broadway, Suite 708 New York, NY 10001Description of Services Being Provided: Engineering Consulting
Scope of Contract (Choose one that best fits):
El Analysis El Evaluation El Research El Training
El Data Processing El Computer Programming El Other IT consulting
Engineering El Architect Services El Surveying El Environmental Services
El Health Services El Mental Health Services
El Accounting El Auditing El Paralegal El Legal El Other Consulting
Employment Category
PrincipalProject ManagerSr. EngineerEngineerCADD
Total this Page
Grand Total
Number ofEmployeesJ
1.00
3.003.003.000.000.000.000.000.000.000.000.00
11.00
Number ofHours Worked
30.0041.0024.00
893.00298.00
0.000.000.000.000.000.000.000.00
1,286.00
Amount Payable IUnder the Contractj
$8,534.00]
$7,150.65$5,077.20
- $109,756.33$30,849.30
$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
$161,367.48
Name of person who prepared this report: Mariana Pena Tones
Title: Project Administrator
Preparer's Signature:Date Prepared: 4/19/2021
(Use additional pages, if necessary)AC 3272-S (Effective 4112)
Phone #:(o) 215-979-7700 x 7779cell 215-870-7173
Page 1 of I
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University HospitalContract Number: T100369 Agency Business Unit: SNYOIContract Term: 4/1/2020 to 03/31/2021 Agency Department ID: 3320215Contractor Name: InfraWareContractor Address: 1414 Main St., Springfield, MA 01144Description of Services Being Provided: Transcription
Scope of Contract (Choose one that best fits):El Analysis El Evaluation El Research El TrainingEl Data Processing El Computer Programming El Other IT consulting• Engineering El Architect Services El Surveying El Environmental Services• Health Services El Mental Health Services• Accounting El Auditing El Paralegal El Legal • Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
0.00 0.00 $0.00Quality Assurance Editors 1.00 120.00 $2220.00Account Manager 2.00 108.00 $2106.00Independent Contractors/ 0.00 1380.00 $13805.72Transcription & Editing (3 ICs)
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
Total this Page 3.00 1528.00 $ 18131.72
Grand Total 3.00 1528.00 $ 18131.72
Name of person who prepared this report: Robert McClellandTitle: coo Phone #: 812-235-7239Preparer's Signature: /f04L2t / .Af'tlla,zdDate Prepared: 05/06/2021
(Use additional pages, if necessary) Page 1 of 1Doc ID: ea2a09578a301 000038cf23Of8eeB23bb8bedf6c
AC 3272-S (Effective 4/12)
FORM B
INew York State Consultant Services
I Contractor's Annual Employment Report
[ Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University HospitalContract Number: TI 00391 Agency Business Unit: SNY01Contract Term: 4/9/2021 to 4/8/2024 Agency Department ID: 3320215Contractor Name: PriceWaterhouse Coopers Advisory (PwC)Contractor Address: 2001 Market St. #1800, Philadelphia, PA, 19103Description of Services Being Provided: PwC will provide annual consulting hours that can beutilized at Client's discretion for health information management ("HIM") / coding services.These professional Services may include medical record coding and documentationassessments, professional instruction on the use of the SMART® technology tool and / orProfessional Coders and Physician education and training, and use of SMART® data analyticsto identify coding and educational opportunities.
Scope of Contract (Choose one that best fits):O Analysis Evaluation J Research 0 TrainingE] Data Processing fl Computer Programming Other IT consultingO Engineering 0 Architect Services D Surveying 0 Environmental Services[J Health Services 0 Mental Health ServicesO Accounting [3 Auditing DParalegal OLegal Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
29-2072.00- Medical Record 3.00 64.00 $25,600.00Specialists0.00 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 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.00
Total this Page 3.00 64.00 $25,600.00Grand Total 3.00 64 25,600
Name of person who prepared this report: Jade MillerTitle: Manager Phone #: 215-863-1736Preparer's Signature: 'V 'flt4-lttDate Prepared: 5/12/2021
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University HospitalContract Number: T200028 Agency Business Unit: SNYOIContractTerm: 11/22/2013 to 08/31/2021 Agency Department ID: 3320215Contractor Name: AECOM USA Inc.Contractor Address: 71 West 23rd Street, 12th Floor, New York, New York 20010Description of Services Being Provided: Design Services - University Hospital Surgey, Dining,Wayfinding, Signage Renovation
Scope of Contract (Choose one that best fits):
El Analysis El Evaluation El Research El TrainingEl Data Processing El Computer Programming El Other IT consulting
Engineering Architect Services 0 Surveying El Environmental Services0 Health Services El Mental Health ServicesEl Accounting 0 Auditing El Paralegal 0 Legal El Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
Project Manager 1.00 95.25 $17,954.63Architect 1.00 148.00 $21,464.44Life Safety Engineer 2.00 24.00 $2,870.40Senior Electrical Engineer 2.00 77.00 $10,610.60Clerical Support 1.00 122.00 $5,709.60Interior Designer II 1.00 108.00 $14,489.28Mechanical Engineer 2.00 80.00 $8,320.00St. Plumbing Engineer 2.00 74.00 $8,721.64Interior Designer (CA) 1.00 18.00 $2,700.00Architectural Drafter (CA) 1.00 22.00 $2,200.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00Total this Page 14.00 768.25 $95,040.59
Grand Total
Name of person who prepared this report: Jeannie GasperTitle: Senior Associate, Project Manager Phone #: 703-682-6050
Preparer's Signature:Date Prepared: 04/09/2021
(Use additional pages, if necessary)
Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University Hospital
Contract Number: T200037 Agency Business Unit: SNY01
Contract Term: 06/2812017 to 11/28/2020 Agency Department ID: 3320215
Contractor Name: RMF Engineering, Inc., P.C.
Contractor Address: 5520 Research Park Dr, suite 3, Baltimore
Description of Services Being Provided: Design And CA
Scope of Contract (Choose one that best fits):
Li Analysis Li Evaluation Li Research Li TrainingLi Data Processing Li Computer Programming Li Other IT consulting
Engineering Li Architect Services Li Surveying [I Environmental ServicesLi Health Services []Mental Health ServicesLi Accounting Li Auditing Li Paralegal Li Legal Li Other Consulting
Number of Number Of Amount PayableEmployment Category Employees Hours Worked Under the Contract
Managers 4.00 116.50 $16,132.61Design 1 277.50 $30,845.19Design Engineer 1.00 33.00 $2,544.30Other 1.00 10.00 $488.30
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00Total this Page 7.00 437.00 $50,010.40Grand Total 7.00 437 50,01040
Name of person who prepared this report: Ayo Akinyemi
Title: Staff Accountant Phone #: 410-576-0505
Preparer's Signature:
Date Prepared: 4//26/2021
(Use additional pages, if necessary) Page of
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor’s Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: State University of New York at Stony Brook Contract Number: T200073 Agency Business Unit: SNY01Contract Term: 11/8/2017 to 7/15/2022 Agency Department ID: 3320215 Contractor Name: Cannon Design Architecture and Engineering, P.C.Contractor Address: 50 Fountain Plaza, Suite 200 Buffalo, NY 14202Description of Services Being Provided: Professional Design 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 Auditing Paralegal Legal Other Consulting
Employment Category Number of Employees
Number of Hours Worked
Amount Payable Under the Contract
17-1011 8.00 562.00 $94,379.7617-2071 2.00 26.00 $4,050.5527-1025 2.00 8.00 $1,446.9217-2141 1.00 1.00 $176.9027-3042 2.00 28.00 $3,630.4243-9199 1.00 8.00 $580.00 0.00 0.00 $0.00 0.00 0.00 $0.00 0.00 0.00 $0.00 0.00 0.00 $0.00 0.00 0.00 $0.00 0.00 0.00 $0.00 0.00 0.00 $0.00
Total this Page 16.00 633.00 $104,264.55
Grand Total 16.00 633 $104,264.55
Name of person who prepared this report: Shari SafeeTitle: Project Biller Phone #: 716-774-3400Preparer’s Signature: ________________________________Date Prepared: 5/10/2021
(Use additional pages, if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University Hospital
Contract Number: T200082 Agency Business Unit: SNYOI
Contract Term: 10/08/2018 to 09/30/2021 Agency Department ID: 3320215
Contractor Name: LiRo Engineers, Inc.
Contractor Address: 3 Aerial Way, Syosset, NY 11791
Description of Services Being Provided: Engineering Analysis and Design Services, CostEstimating, Hazardous Materials Testing, Construction Support Services.
Scope of Contract (Choose one that best fits):U Analysis U Evaluation U Research U TrainingU Data Processing U Computer Programming U Other IT consulting
Engineering U Architect Services U Surveying U Environmental ServicesU Health Services U Mental Health ServicesU Accounting U Auditing U Paralegal U Legal U Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
Electrical Engineer 1.00 43.00 $7,000.00Project Manager 1.00 48.00 $8,293.58
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 $0.000.00 0.00 $0.000.00 0.00 $0.00
Total this Page 2.00 91.00 $15,293.58Grand Total 2.00 91 $15,293.58
Name of person who prepared this report: Eugene Grigortsevich, PE
Title: Project Manager Phone #: 516-214-8470
Preparer's Signature:
Date Prepared: 05/05/202 1
(Use additional pages, if necessary)
Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University Hospital
Contract Number: T200086 Agency Business Unit: SNY01
Contract Term: 09/07/2017 to 08/31/2020 Agency Department ID: 3320215
Contractor Name: Bladykas Engineering, PC
Contractor Address: 50 Jackson Avenue, Suite 300, Syosset, NY 11791Description of Services Being Provided: MEP Engineering Services
Scope of Contract (Choose one that best fits):O Analysis El Evaluation El Research 0 TrainingEl Data Processing El Computer Programming El Other IT consultingED Engineering El Architect Services El Surveying El Environmental Services
El Health Services El Mental Health ServicesEl Accounting El Auditing [:] ,Paralegal El Legal El Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
Electrical Engineering 2.00 322.50 $115,650.00Architectural 2.00 77.50 $9,010.00Scheduler 2.00 40.00 $8,000.00Cost Estimator 3.00 21.00 $7,500.00
0.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.000.00 0.00 $0.00
Total this Page 9.00 j 461.00 $140,160.00
Grand Total 9.00 1 461 $140,160.00
Name of person who prepared this report: Meredith Schnall
Title: Administrative Assis a Phone #: 516-364-8700
Preparer's Signature: L/e6tDate Prepared: 05/04/2021
(Use additional pages, if necessary) Page 1 of 1
AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University HospitalContract Number: T200095 Agency Business Unit: SNY01Contract Term: 4/24/2018 to 4/24/2021 Agency Department ID: 3320215Contractor Name: LiRo EngineersContractor Address: 3 Aerial Way, Syosset NYDescription of Services Being Provided: AE Design Services
Scope of Contract (Choose one that best fits):El Analysis U Evaluation U Research U TrainingU Data Processing U Computer Programming U Other IT consulting
Engineering U Architect Services U Surveying U Environmental Services
U Health Services U Mental Health ServicesU Accounting El Auditing U Paralegal U Legal U Other Consulting
Number of Number of Amount PayableEmployment Category Employees Hours Worked Under the Contract
Mechanical Engineers 5.00 200.25 $28,668.49Electrical Engineers 1.00 98.00 $15,821.00Fire Prevention and Protection 2.00 19.00 $3,573.21Engineers
Civil Engineers 1.00 9.00 $1,493.86Drafters 1.00 4.00 $441.08
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
0.00 0.00 $0.00
Total this Page 10.00 330.25 $49,997.64
Grand Total 10.00 330.25 $49,997.64
Name of person who prepared this report: Bruce KorrowTitle: Associate Phone #: 516-880-8504
Preparer's Signature: 1^^Date Prepared: 4/19/2021
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AC 3272-S (Effective 4/12)
FORM B
New York State Consultant ServicesContractor’s Annual Employment Report
Report Period: April 1, 2020 to March 31, 2021
Contracting State Agency Name: Stony Brook University HospitalContract Number: Agency Business Unit: 28050Contract Term: / / to / / Agency Department ID: 3320215 Contractor Name: Cannon Design Architecture and Engineering, P.C.Contractor Address: 50 Fountain Plaza, Suite 200 Buffalo, NY 14202Description of Services Being Provided: Professional Design 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 Auditing Paralegal Legal Other Consulting
Employment Category Number of Employees
Number of Hours Worked
Amount Payable Under the Contract
17-1011 6.00 210.50 $40,211.9927-3042 1.00 8.00 $1,276.0017-2199 1.00 29.00 $3,784.5017-2141 3.00 182.00 $28,457.8217-3013 1.00 65.00 $4,468.4517-2071 3.00 90.00 $11,772.9227-1025 1.00 3.40 $737.3513-1051 5.00 80.50 $8,264.0843-9199 2.00 5.30 $340.75 0.00 0.00 $0.00 0.00 0.00 $0.00 0.00 0.00 $0.00 0.00 0.00 $0.00
Total this Page 23.00 673.70 $99,313.86
Grand Total 23.00 673 $99,313.86
Name of person who prepared this report: Shari SafeeTitle: Project Biller Phone #: 716-774-3400Preparer’s Signature: ________________________________Date Prepared: 5/14/2021
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