16 - OSC Form B.doc

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Attached to
Project G06079 - Backdrop Term Agreements for Consultant Services (2027 – 2029)
Solicitation number
2139351
Issued by
Montgomery County, New York

About this file

This is New York State Consultant Services Contractor's Annual Employment Report (Form AC 3272-S) related to SUNY Geneseo's Project G06079 Backdrop Term Agreements for Consultant Services. The form serves as a reporting mechanism for contractors working under the Backdrop Term Agreements, which will run from 2027 through 2029. SUNY Geneseo is establishing up to six pre-awarded consultant/design firm agreements to provide services across diverse project scopes without requiring separate RFQ and award processes for each engagement. Anticipated consultant services include building envelope upgrades, mechanical/electrical/plumbing system replacements, structural assessments, interior building upgrades, campus safety and security improvements, hazardous material removal with engineering and asbestos monitoring, underground utility upgrades, hardscape improvements, construction administration services, and CADD mapping services. The selection of Backdrop Term consultants will be based on qualifications relative to these anticipated future projects.

The maximum consultant fee for each individual project under the Backdrop Term Agreement is $200,000, with a total cumulative value across all consultant term agreements limited to $700,000 over the three-year period. The Employment Report form requires contractors to document employment categories, number of employees, hours worked, and amounts payable under the contract during the reporting period of April 1 to March 31. The form includes checkboxes for various service scopes such as analysis, evaluation, research, engineering, architectural services, environmental services, accounting, auditing, legal services, and other consulting categories. Participation from Minority Business Enterprises (MBE), Women Business Enterprises (WBE), and Service Disabled Veteran-owned businesses is encouraged in the selection process.

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Text version

AC 3272-S (Effective 4/12)

FORM B

New York State Consultant Services Contractor’s Annual Employment Report

Report Period: April 1, to March 31, Contracting State Agency Name:

Contract Number:
Agency Business Unit:
Contract Term: / / to / /
Agency Department ID:

Contractor Name:

Contractor Address:

Description of Services Being Provided:

Scope of Contract (Choose one that best fits):

FORMCHECKBOX

Analysis FORMCHECKBOX Evaluation FORMCHECKBOX Research FORMCHECKBOX Training

FORMCHECKBOX

Data Processing FORMCHECKBOX Computer Programming FORMCHECKBOX Other IT consulting

FORMCHECKBOX

Engineering FORMCHECKBOX Architect Services FORMCHECKBOX Surveying FORMCHECKBOX Environmental Services

FORMCHECKBOX

Health Services FORMCHECKBOX Mental Health Services

FORMCHECKBOX

Accounting FORMCHECKBOX Auditing FORMCHECKBOX Paralegal FORMCHECKBOX Legal FORMCHECKBOX Other Consulting

Employment Category
Number of Employees
Number of

Hours Worked Amount Payable Under the Contract

0.00
0.00
$0.00
0.00
0.00
$0.00
0.00
0.00
$0.00
0.00
0.00
$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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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
0.00
0.00
$ 0.00
Grand Total

Name of person who prepared this report:

Title:
Phone #:

Preparer’s Signature: ________________________________

Date Prepared: / /

(Use additional pages, if necessary)

Page of

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