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SUBURBAN ADULT SERVICES, INC.

Company Details

Name: SUBURBAN ADULT SERVICES, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 22 Jan 1979 (46 years ago) (Companies founded in January 1979)
Entity Number: 534315
ZIP code: 14059 (Companies in Erie, 14059)
County: Erie
Place of Formation: New York
Address: 960 WEST MAPLE COURT, ELMA, NY, United States, 14059

Contact Details

Phone +1 716-805-1555

Phone +1 716-496-5551

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
ECE4KQ6NY297 2024-06-12 960 WEST MAPLE COURT, ELMA, NY, 14059, 9397, USA 960 WEST MAPLE COURT, ELMA, NY, 14059, USA

Business Information
Congressional District 23
State/Country of Incorporation NY, USA
Activation Date 2023-06-15
Initial Registration Date 2022-07-07
Entity Start Date 1979-01-22
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 623210, 624310

Points of Contacts
Electronic Business
Title PRIMARY POC
Name ELAINE MENDRYSA
Role ASSOCIATE VP OF FINANCE
Address 960 WEST MAPLE COURT, ELMA, NY, 14059, USA
Government Business
Title PRIMARY POC
Name COREY JARZYNIECKI
Role CONTRACT PROCUREMENT
Address 960 WEST MAPLE COURT, ELMA, NY, 14059, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
3Y857 Active U.S./Canada Manufacturer 1984-05-17 2024-06-14 2029-06-14 2025-06-12

Contact Information
POC JOSEPH PLACE
Phone +1 716-805-1555
Fax +1 716-805-1444
Address 960 WEST MAPLE COURT, ELMA, NY, 14059 9397, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUBURBAN ADULT SERVICES WELFARE PLAN 2023 161115992 2024-10-15 SUBURBAN ADULT SERVICES, INC, 2972
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2005-01-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 WEST MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 WEST MAPLE COURT, ELMA, NY, 14059

Number of participants as of the end of the plan year
Active participants 2273

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing AMANDA KILMARTIN
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES, INC. SECTION 105 PLAN 2023 161115992 2024-10-15 SUBURBAN ADULT SERVICES, INC. 395
File View Page
Three-digit plan number (PN) 525
Effective date of plan 2007-03-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 W. MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 W. MAPLE COURT, ELMA, NY, 14059

Plan administrator’s name and address
Administrator’s EIN 161115992
Plan administrator’s name SUBURBAN ADULT SERVICES, INC.
Plan administrator’s address 960 W. MAPLE COURT, ELMA, NY, 14059
Administrator’s telephone number 7168051555

Number of participants as of the end of the plan year
Active participants 288

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing AMANDA KILMARTIN
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES WELFARE PLAN 2022 161115992 2023-07-31 SUBURBAN ADULT SERVICES, INC, 3120
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2005-01-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 WEST MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 WEST MAPLE COURT, ELMA, NY, 14059

Number of participants as of the end of the plan year
Active participants 2972

Signature of
Role Plan administrator
Date 2023-06-13
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES, INC. SECTION 105 PLAN 2022 161115992 2023-07-31 SUBURBAN ADULT SERVICES, INC. 407
File View Page
Three-digit plan number (PN) 525
Effective date of plan 2007-03-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 W. MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 W. MAPLE COURT, ELMA, NY, 14059

Plan administrator’s name and address
Administrator’s EIN 161115992
Plan administrator’s name SUBURBAN ADULT SERVICES, INC.
Plan administrator’s address 960 W. MAPLE COURT, ELMA, NY, 14059
Administrator’s telephone number 7168051555

Number of participants as of the end of the plan year
Active participants 395

Signature of
Role Plan administrator
Date 2023-06-13
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES WELFARE PLAN 2021 161115992 2022-06-22 SUBURBAN ADULT SERVICES, INC, 1546
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2005-01-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 WEST MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 WEST MAPLE COURT, ELMA, NY, 14059

Number of participants as of the end of the plan year
Active participants 3120

Signature of
Role Plan administrator
Date 2022-05-25
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES, INC. SECTION 105 PLAN 2021 161115992 2022-06-22 SUBURBAN ADULT SERVICES, INC. 430
File View Page
Three-digit plan number (PN) 525
Effective date of plan 2007-03-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 W. MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 W. MAPLE COURT, ELMA, NY, 14059

Plan administrator’s name and address
Administrator’s EIN 161115992
Plan administrator’s name SUBURBAN ADULT SERVICES, INC.
Plan administrator’s address 960 W. MAPLE COURT, ELMA, NY, 14059
Administrator’s telephone number 7168051555

Number of participants as of the end of the plan year
Active participants 407

Signature of
Role Plan administrator
Date 2022-05-25
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES, INC. SECTION 105 PLAN 2020 161115992 2021-07-29 SUBURBAN ADULT SERVICES, INC. 499
File View Page
Three-digit plan number (PN) 525
Effective date of plan 2007-03-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 W. MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 W. MAPLE COURT, ELMA, NY, 14059

Plan administrator’s name and address
Administrator’s EIN 161115992
Plan administrator’s name SUBURBAN ADULT SERVICES, INC.
Plan administrator’s address 960 W. MAPLE COURT, ELMA, NY, 14059
Administrator’s telephone number 7168051555

Number of participants as of the end of the plan year
Active participants 430

Signature of
Role Plan administrator
Date 2021-05-25
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES WELFARE PLAN 2020 161115992 2021-07-29 SUBURBAN ADULT SERVICES, INC, 1740
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2005-01-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 WEST MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 WEST MAPLE COURT, ELMA, NY, 14059

Number of participants as of the end of the plan year
Active participants 1546

Signature of
Role Plan administrator
Date 2021-05-25
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES WELFARE PLAN 2019 161115992 2020-06-02 SUBURBAN ADULT SERVICES, INC, 659
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2005-01-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 WEST MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 WEST MAPLE COURT, ELMA, NY, 14059

Number of participants as of the end of the plan year
Active participants 1740

Signature of
Role Plan administrator
Date 2020-05-27
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature
SUBURBAN ADULT SERVICES, INC. SECTION 105 PLAN 2019 161115992 2020-06-02 SUBURBAN ADULT SERVICES, INC. 473
File View Page
Three-digit plan number (PN) 525
Effective date of plan 2007-03-01
Business code 624310
Sponsor’s telephone number 7168051555
Plan sponsor’s mailing address 960 W. MAPLE COURT, ELMA, NY, 14059
Plan sponsor’s address 960 W. MAPLE COURT, ELMA, NY, 14059

Plan administrator’s name and address
Administrator’s EIN 161115992
Plan administrator’s name SUBURBAN ADULT SERVICES, INC.
Plan administrator’s address 960 W. MAPLE COURT, ELMA, NY, 14059
Administrator’s telephone number 7168051555

Number of participants as of the end of the plan year
Active participants 499

Signature of
Role Plan administrator
Date 2020-05-27
Name of individual signing SHAWN CUNNINGHAM
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 960 WEST MAPLE COURT, ELMA, NY, United States, 14059

History

Start date End date Type Value
2007-03-20 2023-01-09 Address 960 WEST MAPLE COURT, ELMA, NY, 14059, USA (Type of address: Service of Process)
2004-02-27 2007-03-20 Address 960 WEST MAPLE COURT, ELMA, NY, 14059, USA (Type of address: Service of Process)
1996-07-23 2004-02-27 Address ROUTE 39, P.O. BOX 526, SARDINIA, NY, 14134, USA (Type of address: Service of Process)
1979-01-22 1996-07-23 Address P.O. BOX 152, BOSTON, NY, 14025, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230109002014 2023-01-09 CERTIFICATE OF AMENDMENT 2023-01-09
20180103053 2018-01-03 ASSUMED NAME LLC INITIAL FILING 2018-01-03
151229000450 2015-12-29 CERTIFICATE OF MERGER 2016-01-01
070320001006 2007-03-20 CERTIFICATE OF AMENDMENT 2007-03-20
040227000533 2004-02-27 CERTIFICATE OF CHANGE 2004-02-27
960723000682 1996-07-23 CERTIFICATE OF AMENDMENT 1996-07-23
A760802-10 1981-04-29 CERTIFICATE OF AMENDMENT 1981-04-29
A546384-8 1979-01-22 CERTIFICATE OF INCORPORATION 1979-01-22

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DO AWARD V657R89806 2008-09-24 2008-10-01 2008-10-01
Unique Award Key CONT_AWD_V657R89806_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V760P81430 2008-09-22 2008-09-30 2008-09-30
Unique Award Key CONT_AWD_V760P81430_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V636D8E021 2008-09-18 2008-09-25 2008-09-25
Unique Award Key CONT_AWD_V636D8E021_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V5738P9627 2008-09-18 2008-09-28 2008-09-28
Unique Award Key CONT_AWD_V5738P9627_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V548P86353 2008-09-12 2008-09-22 2008-09-22
Unique Award Key CONT_AWD_V548P86353_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V598Q88115 2008-09-09 2008-09-19 2008-09-19
Unique Award Key CONT_AWD_V598Q88115_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6640: LABORATORY EQUIPMENT AND SUPPLIES

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V598Q88024 2008-09-05 2008-09-15 2008-09-15
Unique Award Key CONT_AWD_V598Q88024_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V621P87455 2008-08-29 2008-09-08 2008-09-08
Unique Award Key CONT_AWD_V621P87455_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V548P86086 2008-08-29 2008-09-08 2008-09-08
Unique Award Key CONT_AWD_V548P86086_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530
DO AWARD V663P88079 2008-08-28 2008-09-07 2008-09-07
Unique Award Key CONT_AWD_V663P88079_3600_V797P2005_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP

Recipient Details
Recipient SUBURBAN ADULT SERVICES, INC.
UEI ECE4KQ6NY297
Legacy DUNS 118335090
Recipient Address UNITED STATES, 960 WEST MAPLE ROAD, ELMA, 140599530

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Date of last update: 16 Nov 2024

Sources: New York Secretary of State

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