Nys Office of General Services Procurement Services Group

NYS OFFICE OF GENERAL SERVICES PROCUREMENT SERVICES GROUP

SEMI-ANNUAL ACTIVITY REPORT

INSTRUCTIONS ONLY(fill out next page)

The attached form will be used by the Contractors to report awarded work under the back-drop contracts for IT Services (Computer Consulting, Systems Integration, Training, On-Going Services, Maintenance & Support) during the time period specified in the report heading. These reports will be submitted to the NYS Office of General Services Procurement Services Group (PSG) electronically no later than C.O.B no later than the 15th of January and the 15th of July unless otherwise specified by the PSG IT Services Team.

CONTRACT #……………………………………BACK-DROP CONTRACT NUMBER = CM__ (S or T) + 3 DIGIT # FOLLOWED BY AN “A”)

CONTRACTOR NAME………………………….NAME OF COMPANY

REPORT PERIOD ENDING……………………..PERIOD FOR WHICH REPORT IS BEING FURNISHED

PROJECT CODE AND/OR PROJECT NAME…..PROJECT CODE AND/OR PROJECT NAME ASSIGNED - i.e. OGS99001/NYS OGS Y2K PROJECT

NAME OF STATE, NON-STATE AGENCY……ENTITY FOR WHOM SERVICES WERE PROVIDED

STATE OR LOCALITY………………………….SERVICES PROVIDED TO STATE (S) AGENCY OR LOCALITY (L). A LOCALITY IS ANY OTHER AUTHORIZED USER WHO IS NOT A STATE AGENCY.

C, SI, T, EM, OnGS………………………………TYPE OF SERVICE: CONSULTING (C), SYSTEMS INTEGRATION (SI), ), TRAINING (T), EQUIPMENT

MAINTENANCE (EM), OR ON-GOING SERVICES, MAINTENANCE & SUPPORT (OnGS).

YOU CAN ONLY SELECT ONE (1) TYPE OF SERVICE PER PROJECT. IF A PROJECT IS MADE OF

SEVERAL COMPONENTS (i.e. Consulting + OnGS), LIST THIS AS 2 SEPARATE PROJECTS AND

APPROXIMATE THE DOLLAR VALUE OF EACH COMPONENT .

PROJECT TOTAL VALUE/SCOPE CHANGE…TOTAL DOLLAR AMOUNT OF THE PROJECT OR SCOPE CHANGE VALUE

SCOPE CHANGE YES OR NO………………..YES = SCOPE CHANGE TO A PROJECT PREVIOUSLY AWARDED/NO = ORIGINAL PROJECT

NYS OFFICE OF GENERAL SERVICES (OGS)

PROCUREMENT SERVICES GROUP (PSG)

SEMI-ANNUAL ACTIVITY REPORT

Contract Title: IT Services

Contract Number: ¨ CMS or ¨ CMT ("X" one)______A / Report Period Ending: __/__/__
Contractor Name: / Date Submitted: ____/____/____
PROJECT CODE
AND/OR PROJECT
NAME / NAME OF STATE,
NON-STATE AGENCY OR
OTHER AUTHORIZED USER / S = STATE
AGENCY or
L = LOCALITY
Non-State entity) / C, SI, T
EM, OnGS
(Select
only 1) / PROJECT TOTAL $
VALUE OR
SCOPE CHANGE
$ VALUE / SCOPE
CHANGE
YES OR NO