M E M O R A N D U M - New York State Department of ...



TO: Matt Bromirski, Acting Director, Office of Contract Management, 50 Wolf Road, 6th Floor,

Albany, NY 12232

CC: Accounting, Federal Aid Unit, 50 Wolf Rd., 5th Fl., Albany, NY 12232 (if Federally funded)

FROM: CJM Name

SUBJECT: REQUEST FOR EXTENSION OF CONSULTANT CONTRACT COMPLETION DATE

DATE: MM/DD/YYYY

DXXXXXX PIN XXXX-XX-XXX

PROJECT_________________________________________________________

_________________________________________________________________

In the County of ____________________________________________________

Consultant Name ___________________________________________________

Office Address _____________________________________________________

____________________________________________________

Original Contract Period From: MM/DD/YYYY To: MM/DD/YYYY

Current Completion Date: MM/DD/YYYY

Requested Extended Contract Completion Date: MM/DD/YYYY

Reason (s) for extension:

Attach additional sheet if necessary______________________________________

___________________________________________________________________

___________________________________________________________________

I certify that all information provided to the State with respect to the “Vendor Responsibility Questionnaire” submitted by (CONSULTANT FIRM NAME) __________________________on the _____ day of _______________________, 20______ pursuant to the requirements set forth on Office of the State Comptroller Bulletin G-221 is complete, true and accurate. I additionally certify that nothing has occurred since the date of that submission which would result in requiring a change or alteration to any of the answers provided on the “Vendor Responsibility Questionnaire” submitted on that date.

Agreed to by: Consultant (Print Name) ________________________________________________________

Consultant’s Signature_______________________________________ Date ______________

Recommended by: Project Manager (Print Name) ____________________________________________________

Project Manager ‘s Signature__________________________________ Date ______________

Recommended by: Regional/Division Director (Print Name) ____________________________________________

Regional/Division Director’s Signature___________________________ Date ______________

Approved by: Office of Contract Management (Print Name) ________________________________________

Office of Contract Management’s Signature ______________________ Date_______________

CONR 392 (06/2015)

Governmental Entity Report of Contact

Pursuant to State Finance Law §139-k(4)

If a firm contacts the Department, or you as its representative, regarding the extension of an existing consultant contract, that contact is required to be reported pursuant to the State Finance Law, section 139-k.

Contacts Are to Be Reported at the Web Site Below



Contacts reported at this web site will be recorded in a central data base and appropriately reported on an automatic basis pursuant to administrative requirements of the State Finance Law.

However,

If you contact a consultant firm regarding extension of an existing contract between a firm and the Department you are not required to record that contact.

If during any of your discussions with a consultant firm regarding extension of an existing contract between that firm and the Department the firm responds in a manner that a reasonable person would infer is an attempt to influence the terms of that contract, you must record that contact at the above web site. For example: if the firm attempts to convince you to extend the duration of the contract for a longer period of time than you initially thought appropriate, then you must record that contact.

New York State Finance Law §139-k(4) obligates Department staff to make a written record of any Contacts made. The term “Contact” is defined by statute and refers to those oral, written or electronic communications that a reasonable person would infer are attempts to influence the Governmental Procurement. A request to extend the duration of a contract is considered an attempt to influence a contract. In addition to obtaining the required identifying information, the Department must inquire and record whether the person or organization that made the contact was the consultant firm or was retained, employed or designated on behalf of the consultant firm to appear before or Contact the Department.

It is recommended that the Department inform consultant firms and those designated, employed or retained by consultant firms of the intention to record the contact.

If you determine a contact with a consultant has resulted in an attempt to influence the terms of a contract as described above, you must report that contact by using the above web site!

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