SUNY PP Home Page   Print Page   Close Page   Convert current file into a PDF document   Convert current file into a DOC document

Form D

          State University of New York        

Procurement Lobbying Law

Record of Contact

 

Procurement Information


AGENCY:  _______________________                               (SUNY System Administration)

                                                                                               

TO:  _____________________                                              (Gail Barcher, Contract Manager)

 

FROM:  ______________________                                      (employee, officer, Trustee)

 

SUBJECT:  Record of Contract under State Finance Law §139-k(4)

 

Procurement Description: ________________________________________________________

 

            RFP/IFB Contract # (if applicable):  _____________________

 

******************************************************************************

Contact Information                                                   Date(s) of Contact:

 

SUNY Contact Name: ____________________________________________________

 

            Designated Contact:  ___                      Non-designated Contact:  ___

 

Name of Offerer Firm or Organization: ______________________________________________

           

        Address:   __________________________________________________________

                         __________________________________________________________

 

Name of Person Contacting State University on behalf of Offerer:         ________________________________________________________

 

        Telephone Number: ______________________________________________________

 

        Place of Principal Employment: _____________________________________________

 

        Occupation: _____________________________________________________________

 

Person/Organization Making the Contact was:

 

            The Offerer: _____

                        OR

            Retained/Employed/Designated by or on behalf of the Offerer: _____

 

General description/content of the contact (multiple contacts), including form (e-mail, letter, conversation):