state of new york department of transportation contract service firm annual … · 2008. 8. 23. ·...

STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION CONTRACT SERVICE FIRM ANNUAL FINANCIAL, OWNERSHIP AND ACCOUNTING PRACTICES REPORT FIRM NAME: __________________________________________

YEAR ENDED: _____ _____ _____ Month Day Year

ADDRESS: _____________________________________________

_____________________________________________ ______________________________________________

CONTACT: ___________________________________________________________

Name Title

Phone: (____) _______________________

FAX: (____) _______________________

Internet E-Mail Address:____________________

For DOT Use Date Reviewed Received Date By

Contracts ________ ________ ________ Audits ________ ________ ________

CONR 385 (6/15/05)

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STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION CONTRACT SERVICE FIRM ANNUAL FINANCIAL, OWNERSHIP AND ACCOUNTING PRACTICES REPORT PURPOSE: 1. To provide current identification and overhead rate information for contract billing and pre-contract pricing.

2. To provide basic information on the accounting system and organization of contract service firms for pre-award and post audit purposes.

FILING REQUIREMENTS: For contract service firms and associated subconsultants:

PART I - Required for each filing and when any changes in previously reported Part I information occur. PART II - Required for each filing of a CONR 385 report.

PART III - Required at the time of designation. Should be submitted for the most recently completed fiscal year. PART IV - Required for initial filing and each subsequent fiscal year. PART V - Required Certification for all submissions.

SUBMITTAL: The completed report should be sent to: Director Contract Management Bureau New York State Department of Transportation 50 Wolf Road

1st Floor South Albany, NY 12232

Contact Person : Mark Moody (518) 457-2601 EXEMPTION FROM FREEDOM OF INFORMATION: Information furnished will be held in strict confidence by NYSDOT and may be protected from public disclosure under the Freedom of Information Law pursuant to ART. 6 Sec. 87(2)(d) as adopted on January 25, 1994.

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STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION CONTRACT SERVICE FIRM ANNUAL IDENTIFICATION, FINANCIAL, OWNERSHIP AND ACCOUNTING PRACTICES REPORT GENERAL INSTRUCTIONS 1. If under normal business practice, the contract service firm requests overhead reimbursements for more than one reporting unit, a separate

report is required for each unit involved in NYSDOT services. Separate worksheets and supporting schedules should be attached for firms required to submit field and office overhead rates pursuant to Department instructions.

2. Attach continuation sheets for Part III, Sections A & B, as necessary. 3. Fringe benefit amounts are to include the employer's cost only. 4. Certification by a Principal Officer or Partner of the firm is required in Part V for all submissions. 5. Certification by an independent Certified Public Accountant covering Part III is optional (see Part V-Certification). Inclusion of a CPA

Certification will reduce the degree of testing of accounting records by NYSDOT. 6. The firm must attach a copy of its general purpose financial statements for the same fiscal year as Part III of this statement. 7. The firm must disclose all audits by other governmental entities and independent CPA firms when submitting this form. When available a

copy of all such overhead reports by should be submitted with this form. 8. If the firm's financial statements are not reviewed, compiled or audited by an independent CPA, a detailed chart of accounts and trial

balance must be submitted together with adjusting journal entries for the period covered by this report. 9. If you wish to submit Facilities Capital Cost of Money (FCCM), please refer to the "To All Consultants" letter dated October 5, 1990. IMPORTANT NOTES THIS DOCUMENT (OR ATTACHMENTS IN THE SAME FORMAT) MUST BE COMPLETE AND MUST BE SIGNED AND NOTARIZED ON PAGE 23 OR IT WILL BE RETURNED. PARTIAL YEAR INFORMATION WILL NOT BE ACCEPTED FOR FORWARD PRICING OR BILLING RATE CHANGES.

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STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION CONTRACT SERVICE FIRM ANNUAL FINANCIAL, OWNERSHIP AND ACCOUNTING PRACTICES REPORT DETAILED INSTRUCTIONS FOR PART III - FINANCIAL SCHEDULES INSTRUCTIONS 1. Complete Section A based on the DOT guidelines for maximum salary for the report year. If two or more salary maximums are identified

for a particular year, use the lowest maximum in effect per Department contract terms for all of your active agreements. If the excess of total compensation over the NYSDOT maximum for each individual is allocable to more than one reporting unit, describe the basis for allocation - otherwise the total excess amount is to be shown.

2. For Section C, Columns b-f should reference amounts allocable to this reporting unit only. Amounts excluded as unallowable in Column e are to be based on Federal Acquisition Regulations. 3. Any direct cost amounts included in Section C, Columns a and b, are to be identified and eliminated in Column c. If allocable amounts

(Column b) are different from total amounts (Column a), Column c should represent only the allocable portion of direct costs. If no direct costs are included in an account, Column c should be reported as zero.

4. For Section C, the firm should use its own account classifications within the major groupings of "fringe benefits and payroll burden",

"indirect payroll", "occupancy and other fixed overhead" and "unallowable expenses". * Use this only if the firm has arrangements predating December 1, 1989.

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DEFINITIONS 1. Allocable Cost - Cost which is properly assigned in accordance with Federal Acquisition Regulations, on a

consistent and relevant basis. Allocable costs may include direct costs, indirect costs and pooled direct cost.

2. Allowable Cost - Costs which are 1) allowable according to Federal Acquisition Regulations and contract

provisions; 2) allocable to the proposed or awarded contract; and 3) reasonable. 3. Contract Service Firm (firm) - Any firm seeking to provide services or actively providing services under approved contracts

with NYSDOT. The "firm" as referred to in this document generally means the highest level parent entity.

4. Direct Cost - Any cost which can be attributed specifically to a final cost objective, such as products or

projects. 5. Direct Payroll Base - That portion of allocable payroll cost related to projects. Allocable payroll cost excludes bonus

and the premium portion of overtime, but may include properly accrued deferred compensation plan amounts. Direct payroll cost will be allocated based on the proportion of work hours associated with projects over total work hours, including paid absence hours (normal weekends excepted).

6. General Purpose Financial - Balance sheet, statement of operations, statement of cash flow and financial statement notes

Statements as audited, reviewed or compiled by the firm's Independent Public Accountant or Certified Public Accountant.

7. Reporting Unit - The lowest level cost center, responsibility center or profit center for which the firm requests

indirect cost reimbursement. Generally, the reporting unit will be the firm.

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PART I - IDENTIFYING INFORMATION The Department of Transportation may require additional information deemed necessary for its review. Whenever more space is needed to answer any question, or you wish to give further explanation , attach extra pages if necessary. All questions must be answered. GENERAL INFORMATION 1.NAME OF FIRM_________________________________________________________________________________________ DBA NAME, IF ANY____________________________________________________________________________________ MAILING ADDRESS________________________________________FAX NO.(___)__________________________________ ACTUAL LOCATION_______________________________________PHONE NO.(___)_______________________________ CITY____________________________COUNTY_________________STATE___________ZIP___________________________ Date, City, County and State of Incorporation or Registration: DATE ___________________________ CITY____________________________COUNTY_________________STATE___________ZIP___________________________ 2. TYPE OF FIRM (check(T) only one) __CORPORATION __PARTNERSHIP __PROPRIETORSHIP __JOINT VENTURE

__LLP __LLC __Subchapter [S] __501(c)(3) 3. HOW MANY YEARS HAS THE FIRM BEEN IN BUSINESS?_____ UNDER THE SAME NAME?________________ FORMER NAME ______________________________________________________ 4. ARE YOU CERTIFIED AS A DBE__ MBE__ WBE__ IF SO, WITH WHAT AGENCY? ____________________________ 5. FEDERAL EMPLOYER ID NO. _________________ 6. STATE EMPLOYER ID NO. ___________________

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OWNERSHIP, MANAGEMENT, AFFILIATION Firm Name:________________________

6. Identify each person who is, or has been within the past five years, an owner of 5.0% or more of the firm's shares, a director, an officer, a partner or the proprietor. Joint ventures: provide information for all firms involved. Fill in name, % owned, office held; indicate by Y or N whether director, office or partner.

FIRST NAME MI

LAST NAME

DOB

mm/dd/yy

% OWNED

DIRECTOR

(Y OR N)

OFFICER (Y OR N)

TITLE

PARTNER (Y OR N)

7. Does the firm own, or has the firm or any of the firms's principal owners or officers identified in item number 6 above own or owned, 5.0% or more of any other firm or business? __Yes, list below __No

FEDERAL ID NO.

% OWNED

COMPANY NAME

ADDRESS

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Firm Name:________________________

8. Identify any affiliate not listed in your answers to questions 6 and 7. For purposes of this question your firm and another are affiliates when, either directly or indirectly, one controls or has a measure of control on the other or a third party or parties has a measure of control on both.

FEDERAL ID NO.

COMPANY NAME

ADDRESS

9. Identify any and all shareholders, directors, officers, partners, or proprietors in common between your firm and any firm listed in response to questions 6,7 or 8.

FEDERAL ID NO.

FIRST NAME, MI & LAST NAME

OTHER FIRM

10. Has the firm, or any firm listed in response to questions 6,7 or 8, defaulted or been terminated on any contract awarded within the past five years? If so, give date(s), agency(ies)/owner(s), project(s), contract numbers, and describe, including the result: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. 11. For all contracts list and describe all liens or claims over $25,000 filed against the firm and remaining undischarged or unsatisfied for more than 90 days.

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OTHER INFORMATION Firm Name:________________________ 12. Within the past five years has the firm, any affiliate, any predecessor company or entity, or any person identified in question number 6 above been the subject of any of the following: (respond to each question and describe in detail the circumstances of each affirmative answer: attach additional pages if necessary) (a) a judgment of conviction for any business-related conduct constituting a crime under state or federal law? no__ yes__ (b) a criminal investigation or indictment for any business-related conduct constituting a crime under state or federal law? no__ yes__ (c) a grant of immunity for any business-related conduct constituting a crime under state or federal law? no__ yes__ (d) a federal or state suspension or debarment? no__ yes__ (e) any administrative proceeding or civil action seeking specific performance or restitution in connection with any public works contract except any disputed work proceeding? no__ yes__ (f) an OSHA Citation and Notification of Penalty containing a violation classified as serious? no__ yes__ (g) an OSHA Citation and Notification of Penalty containing a violation classified as willful? no__ yes__ (h) a prevailing wage or supplement payment violation? no __ yes__ (I) a State Labor Law violation deemed willful? no__ yes__ (j) any other federal or state citations, Notices, violation orders, pending administrative hearings or proceedings, or determinations of a violation of any labor law or regulation? no__ yes__

(k) any criminal investigation, felony indictment or conviction concerning formation of, or any business association with, an allegedly false or fraudulent women's, minority or disadvantaged business enterprise? no__ yes__ (l) any denial, decertification, revocation or forfeiture of Women's Business Enterprise, Minority Business Enterprise or Disadvantaged Business Enterprise status? no__ yes__ (m) a consent order with the NYS Department of Environmental Conservation, or a federal, state or local government enforcement determination involving a violation of federal or state environmental laws? no__ yes__ (n) any bankruptcy proceeding? no__ yes__ (o) any suspension or revocation of any business or professional license? no__ yes__ (p) any citations, Notices, violation orders, pending administrative hearings or proceedings or determinations or violations of: no__ yes__ * federal, state or local health laws, rules or regulations * unemployment insurance or workers compensation coverage or claim requirements * ERISA (Employee Retirement Income Security Act) * federal, state or local human rights laws * federal or state security laws?

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PART II - GENERAL INFORMATION Firm Name: __________________________ 1. Location of accounting records: _______________________________________________________

2. CPA/Accounting Firm Name and Address: ______________________________________________

__________________________________________________________________________________

3. What is the firm's policy for capitalizing fixed assets? ______________________________________ __________________________________________________________________________________

4. Depreciation method used: ___________________________________________________________

5. Do your accounting system and overhead schedules submitted in Part II reflect the accrual

basis? [ ] Yes [ ] No If no, describe accounting basis used. _________________________

6. Type of system (check appropriate boxes): Outside/Inside Inside/

Service Manual Computer a. General Ledger [ ] [ ] [ ] b. Job Cost [ ] [ ] [ ] c. Payroll [ ] [ ] [ ] d. Labor Distribution [ ] [ ] [ ]

7. Does the firm's accounting system (check appropriate categories):

a. [ ] Allocate direct costs to projects/contracts? b. [ ] Identify unallowable costs according to Federal Acquisition Regulations? c. [ ] Allocate indirect costs to projects? d. [ ] Use standard costs to predetermined rates for any type of cost?

8. List the types of direct cost allocated to projects/contracts:

a. [ ] Travel meals and lodging b. [ ] Reproduction - internal c. [ ] Reproduction - external d. [ ] Computer/CADD (if Yes, completed CONR 388 must also be submitted) e. [ ] Supplies and equipment f. [ ] Subconsultants g. [ ] Other (specify) _____________________________________________

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Firm Name: __________________________ 9. Overhead (indirect cost) is computed and applied based on (check appropriate category):

a. [ ] Actual direct payroll cost b. [ ] Cost of services (associated fringes and payroll taxes are allocated to the direct labor base) c. [ ] Modified cost of services (some associated fringes and payroll taxes are allocated to the direct labor base) d. [ ] Other (specify) ____________________________________________________

If b or c are checked, indicate items that are included in the direct labor base: [ ] Holidays [ ] Life Insurance [ ] Vacation [ ] Disability/Workers Comp. [ ] Sick Leave/Personal Time [ ] Retirement Plans [ ] Health Insurance [ ] Other (specify) _________________

10. Are standard hours used (check appropriate box(es)):

a. [ ] To compute labor rates? b. [ ] To distribute labor costs? If either of these items are checked, describe the disposition of variance resulting from the difference between standard and the actual timesheet hours worked. ____________________________________________________________________________________

11. Non-reimbursed direct costs are (check appropriate box(es) and explain):

a. [ ] Charged to direct cost accounts ______________________________________ b. [ ] Charged to overhead (indirect cost) accounts _________________________ c. [ ] Other (specify) ______________________________________________________

12. Are leases capitalized as required by Financial Accounting Standards? [ ]Yes [ ]No

13. Does the firm have deferred compensation plans? [ ] Yes [ ] No

If yes, is the plan qualified by IRS? [ ] Yes, IRC Section _____ [ ] No

14. Does the firm have a retirement plan? [ ] Yes [ ] No If yes, is the plan (check appropriate box(es): [ ] Defined benefit pension? [ ] Defined contribution pension? [ ] Profit sharing? [ ] Qualified by IRS-IRC Section _____? Attach a copy of the summary plan description and IRS Letter of Determination.

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PART III - FINANCIAL SCHEDULES Firm Name: __________________________

A. Schedule of Compensation in excess of the DOT guidelines for maximum salary of $__________. (Enter applicable NYSDOT annual maximum and

complete the following for the fiscal year of this report. NYSDOT annual maximums may be obtained from the accompanying Audit Expectation letter or from the Contract Management Bureau. Use the lowest maximum in effect per the terms of any existing Department contracts.

a. b. c. d. e. f. g. h.*

Excess Total Balance Direct Indirect

Total Base Bonus Allocable to Excess Bonus Column d Excess Excess Name/Title Compensation Salary Amount This Unit ___________ Less e Compensation Compensation

w/bonus w/o exclusion ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ ____________________ ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ Total Section A ____________ ____________ ____________ __________ ____________ __________ _____________ _____________ Total compensation per IRS W-2 Salaries and Wages

* Note: Column f is to be distributed to Column g and h based on actual hours charged as direct/indirect. Carry Total Column e, h to Section E. Carry Total Column g to Section B.

MM / DD / YY __ / __ / __ Current Report Year End

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B. Computation of Direct Payroll Base Firm Name: ________________________________

Amount Allocable To

Total This Unit

Direct Payroll (including Premium OT) ____________ ____________ Principal/Partners Direct Time (Total) ____________ ____________

Total Direct Labor (Note) ____________ ____________

Deductions Direct Portion of Salaries in Excess of DOT Maximums (Section A, Column g) (__________) (__________) Premium Portion of Overtime (__________) (__________) Prevailing Wages or Benefits in excess of (__________) (__________)

normal rates Other (specify)___________________________ (__________) (__________)

Total Deductions (__________) (__________)

Total Section B ____________ ____________ ____________ ____________

Note: Exclusive of Bonus


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Firm Name:________________________________________

C. Computation of Allowable Indirect Cost. Show total cost by category. (pages 15-19) a. b. c. d. e. f.

Allowable Amount Indirect Unallowable Indirect Allocable Direct Costs Per Federal Cost

Total To Costs This Unit Acquisition This Unit Amount This Unit This Unit b Less c Regulations d Less e

Account Classification Fringe Benefits & Payroll Burden Employers FICA $________ $________ $________ $________ $__________ $________ Federal & State Employment ________ ________ ________ ________ __________ ________ Disability Insurance ________ ________ ________ ________ __________ ________ Workers Compensation ________ ________ ________ ________ __________ ________ Health Insurance ________ ________ ________ ________ __________ ________ Retirement/Profit Sharing ________ ________ ________ ________ __________ ________ Group Life Insurance ________ ________ ________ ________ __________ ________ Union Welfare Fund ________ ________ ________ ________ __________ ________ Other (Specify): ________ ________ ________ ________ __________ ________ _____________________________ ________ ________ ________ ________ __________ ________ _____________________________ ________ ________ ________ ________ __________ ________ _____________________________ ________ ________ ________ ________ __________ ________ TOTAL $________ $________ $________ $________ $__________ $________ NOTE: Incremental Benefits and Payroll Burden Applied to Prevailing Wages and Benefits in excess of normal In Part III-C if Claimed Directly Net on Prevailing Wages on Contracts should be Deducted as a Direct Cost above.

MM / DD / YY __/ __ / __ Current Report Year End

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Firm Name:_______________________

a. b. c. d. e. f. Allowable

Amount Indirect Unallowable Indirect Allocable Direct Costs Per Federal Cost


Account Classification (cont=d) Indirect Payroll Indirect Technical Time $________ $________ $________ $________ $__________ $________ Indirect Partner/Principal Time ________ ________ ________ ________ __________ ________ Administrative Payroll (10000) ________ ________ ________ ________ __________ ________ Training (11000) ________ ________ ________ ________ __________ ________ Proposal (12000) ________ ________ ________ ________ __________ ________ Pre-Proposal (13000) ________ ________ ________ ________ __________ ________ Research (14000) ________ ________ ________ ________ __________ ________ Downtime (15000) ________ ________ ________ ________ __________ ________ Vacation (16000) ________ ________ ________ ________ __________ ________ Sick Leave (17000) ________ ________ ________ ________ __________ ________ Holidays (18000) ________ ________ ________ ________ __________ ________ Jury Duty (19000) ________ ________ ________ ________ __________ ________ Bonus & other pay ________ ________ ________ ________ __________ ________ TOTAL $________ $________ $________ $________ $__________ $________

MM/DD/YY __/__/__ Current Report Year End

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Firm Name:_____________________________

a. b. c. d. e. f.



Account Classification (cont=d) Occupancy & Other Fixed Overhead Rent $________ $________ $________ $________ $__________ $________ Utilities ________ ________ ________ ________ __________ ________ Depreciation ________ ________ ________ ________ __________ ________ Property Insurance ________ ________ ________ ________ __________ ________ Prof. Liability ________ ________ ________ ________ __________ ________ Maintenance & Repairs ________ ________ ________ ________ __________ ________ Business Taxes (Other than FIT) ________ ________ ________ ________ __________ ________ Other (Specify): ________ ________ ________ ________ __________ ________ _____________________________ ________ ________ ________ ________ __________ ________ _____________________________ ________ ________ ________ ________ __________ ________ _____________________________ ________ ________ ________ ________ __________ ________ _____________________________ ________ ________ ________ ________ __________ ________ TOTAL $________ $________ $________ $________ $__________ $________


16

Firm Name:____________________________

a. b. c. d. e. f. Allowable

Amount Indirect Unallowable Indirect Allocable Direct Costs Per Federal Cost Total To Costs This Unit Acquisition This Unit Amount This Unit This Unit b Less c Regulations d Less e

Account Classification (cont=d) All Other Allowable Indirect Expenses Travel & Auto $________ $________ $________ $________ $__________ $________ Dues & Subscriptions ________ ________ ________ ________ __________ ________ Accounting & Auditing ________ ________ ________ ________ __________ ________ Legal & Professional Consulting ________ ________ ________ ________ __________ ________ Office Supplies ________ ________ ________ ________ __________ ________ Technical Supplies ________ ________ ________ ________ _________ ________ Office Equipment Rental ________ ________ ________ ________ __________ ________ Technical Equipment Rental ________ ________ ________ ________ __________ ________ Printing & Reproduction ________ ________ ________ ________ __________ ________ Computer Expense ________ ________ ________ ________ __________ ________ Business Development ________ ________ ________ ________ __________ ________ Research & Development ________ ________ ________ ________ __________ ________ Recruiting ________ ________ ________ ________ __________ ________ Professional Activities ________ ________ ________ ________ __________ ________ Meals ________ ________ ________ ________ __________ ________ Postage ________ ________ ________ ________ __________ ________ Seminars ________ ________ ________ ________ __________ ________ Subconsultants ________ ________ ________ ________ __________ ________ Misc. Bank Charges ________ ________ ________ ________ __________ ________ Other Project Expenses ________ ________ ________ ________ __________ ________ TOTAL $________ $________ $________ $________ $__________ $________


17

Firm Name: _______________________________________

a. b. c. d. e. f.



Account Classification (cont=d) Unallowable Expenses Interest $________ $________ $________ $________ $__________ $________ Contributions ________ ________ ________ ________ __________ ________ Entertainment ________ ________ ________ ________ __________ ________ Bad Debts ________ ________ ________ ________ __________ ________ Other Losses ________ ________ ________ ________ __________ ________ Federal Income Taxes ________ ________ ________ ________ __________ ________ Other (Specify): ________ ________ ________ ________ __________ ________ Officer’s Life Insurance (Keyman) ________ ________ ________ ________ __________ ________ Amortization Expense ________ ________ ________ ________ __________ ________ Advertising _______________________ ________ ________ ________ ________ __________ ________ TOTAL $________ $________ $________ $________ $__________ $________

TOTAL SECTION C $________ $________ $________ $________ $__________ $________ ________ ________ ________ ________ __________ ________

MM / DD / YY _ _/_ _/_ _ Current Report Year End

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Firm Name: _______________________________ D. Reconciliation of Total Expenses With Financial Statements

Total Section C Expenses (Col. A) ___________________

Less: Non-Financial Statement Items (Specify): ______________________________________________ (___________________) ______________________________________________ (___________________) ______________________________________________ (___________________)

Plus: Total Direct Labor Base (Section B before deductions) ___________________

Other Adjustments (Specify): ______________________________________________ ___________________ ______________________________________________ ___________________

Total Financial Statement Expenses ___________________

* * * * * * * * * * E. Indirect Cost Computation

1. Total Section C Allowable (Column F):

Fringe Benefits ___________________ Indirect Payroll ___________________ Occupancy & Other Fixed Overhead ___________________ Other Allowable Expenses ___________________

Total Less: Excess Bonus (Section A, Column e) (___________________) Excess Compensation (Section A, Column h) (___________________)

Net Allowable Indirect Cost ____________________ ____________________

2. Total Section B Allowable Direct Payroll Base ____________________

3. Indirect Cost Rate #1/#2 X 100 ____________________

MM /DD / YR _ _/_ _/_ _ Current Report Year End

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Firm Name:______________________________________ F.1. Distribution of Field and Office Expenses

1. Direct Labor Amount Percent

Office Engineering _______________ _______________ Field Engineering _______________ _______________

Total _______________

2. Indirect Cost Total Field Office Non-Attributable

Indirect Technical Payroll _________ _________ _________ ___________ Administrative & Executive Payroll _________ _________ _________ ___________ Other Indirect Payroll _________ _________ _________ ___________ Payroll Taxes, Insurance & Fringes _________ _________ _________ ___________ Occupancy & Other Fixed Assets _________ _________ _________ ___________ Computer/CADD _________ _________ _________ ___________ Blueprinting/Reproduction _________ _________ _________ ___________ Other Allowable Expenses _________ _________ _________ ___________ Less: Excess Bonus _________ _________ _________ ___________ Excess Compensation _________ _________ _________ ___________

Subtotal _________ _________ _________ ___________

Distribution of Non-Attributable _________ _________ _________ (___________)

Total Allowable Indirect Cost _________ _________ _________

3. Overhead Cost Rate (#2/#1 * 100) _________ _________ _________

MM /DD /YR __ /__ /__ Current Report Year End

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Firm Name: _______________________________ PART IV - SCHEDULE OF NEW YORK STATE DEPARTMENT OF TRANSPORTATION ACTIVITY

NYSDOT Labor - To assist in post audit planning, please indicate the amount of direct labor on all NYSDOT projects which were active during the period covered by the CONR 385. (Notes: Please exclude labor on Specific Hourly Rate and Lump Sum agreements. Amounts may be rounded/estimated within the nearest thousand or hundred thousand.)

NYSDOT DIRECT LABOR THIS PERIOD

PROJECT TYPE

CONTRACT #

C/I

DESIGN

OTHER SPECIFY

TOTAL

SCHEDULED COMPLETION

PRIME CONSULTANT

MM /DD / YY ___/___/___ Current Report Year End

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Firm Name: _____________________________________ PART V - CERTIFICATION Certification by authorized official of the firm I, ____________________________________ (Name) certify that: The representations in this Annual Financial, Ownership and Accounting Practices Report are accurate and complete; that financial information is based on official financial records of _________________________ (Name of Reporting Unit) for the year ended _____________________; and that the submitted indirect cost schedule (Part II, Section A-F) and related schedules were prepared in accordance with standard NYS Department of Transportation agreement provisions and Part 31 of the Federal Acquisition Regulations 48 CFR 31). All known material transactions or events which have occurred, or are expected to occur in the future, affecting the firm's ownership, organization and indirect cost rates have been disclosed in the body of this report or in supplementary information provided to the Director, Contract Audit Bureau, concurrent with this report submission. The undersigned recognizes that the information is submitted for the express purpose of assisting the Department of Transportation in the process of awarding and/or administering a contract or a subcontract; acknowledges that the Department of Transportation may in its discretion, by means which it may choose, determine the truth and accuracy of all statements made herein; acknowledges that intentional submission of false or misleading information may constitute a felony under Penal Law '210.40 or a misdemeanor under Penal Law '210.35 or '210.45, and may also be punishable by a fine of up to $10,000 or imprisonment of up to five years under 18 U.S.C. '1001; and states that the information submitted in this report and any attached pages is true, accurate and complete. The Documents requested by Items 5, 6 and 7 on Page 3 of this form are attached. ____________________________________ ________________________ _________

Signature of Officer Title Date Sworn to before me this _______day of ____________________,_______. _______________

Commission Expiration Date __________________________________________ Notary Public

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Firm Name: ______________________________ Name:________________________________ Certification by firm's Independent Certified Public Accountant (Optional) I/We, ________________________________ (Name) have reviewed the financial information presented in Part III, Sections A-F of this Annual FINANCIAL, OWNERSHIP AND ACCOUNTING PRACTICES REPORT for ______________________ (Name of Reporting Unit). This review was performed to determine if the financial information presented is based on the financial statements of _____________________________ (Name of Firm) for the year ended _____________ (Date) which were (audited)(compiled)(reviewed) [cross out non-applicable items] by us and to determine if the financial information is presented in accordance with standard NYS Department of Transportation agreement provisions and Part 31 of the Federal Acquisition Regulations (48 CFR, Chapter I, Part 31). In (my/our) opinion, except as otherwise noted, the financial information presented in Part II, Sections A-F, is consistent with representations made in the financial statements for the same period and is presented in accordance with the criteria identified in the preceding paragraph. _______________________________ (Signed) _____________________________ (Title) __________ (Date) Note: The Independent Certified Public Accountant should describe deviations from Generally Accepted Accounting Principles and provide an explanation

if cost schedules (Section E) are not reconcilable with financial statements.