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  5. UPSTATE SPRAY FOAM INSULATION LLC

UPSTATE SPRAY FOAM INSULATION LLC

Company Details

Name: UPSTATE SPRAY FOAM INSULATION LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 16 Sep 2004 (21 years ago)
Entity Number: 3102941
ZIP code: 13491
County: Herkimer
Place of Formation: New York
Address: 122 SOUTH STREET, WEST WINFIELD, NY, United States, 13491

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
CEAAXJWENCE6 2021-12-01 122 SOUTH ST, WEST WINFIELD, NY, 13491, 2827, USA 122 SOUTH STREET, WEST WINFIELD, NY, 13491, 2827, USA

Business Information
Congressional District 22
State/Country of Incorporation NY, USA
Activation Date 2020-12-01
Initial Registration Date 2012-01-24
Entity Start Date 2005-01-01
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 238310

Points of Contacts
Electronic Business
Title PRIMARY POC
Name WILLIAM GIBSON
Address 122 SOUTH STREET, WEST WINFIELD, NY, 13491, USA
Government Business
Title PRIMARY POC
Name WILLIAM GIBSON
Address 122 SOUTH STREET, WEST WINFIELD, NY, 13491, USA
Past Performance
Title PRIMARY POC
Name CAROL SLOSEK
Address 122 SOUTH ST, WEST WINFIELD, NY, 13491, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
6MX99 Active Non-Manufacturer 2012-01-26 2024-03-09 2025-12-01 2021-12-01

Contact Information
POC WILLIAM GIBSON
Phone +1 315-822-5238
Address 122 SOUTH ST, WEST WINFIELD, NY, 13491 2827, 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
UPSTATE SPRAY FOAM INSULATION 401(K) PROFIT SHARING PLAN & TRUST 2020 201667171 2021-07-30 UPSTATE SPRAY FOAM INSULATION 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2021-07-30
Name of individual signing JAMIE CHRISTIAN
UPSTATE SPRAY FOAM INSULATION 401(K) PROFIT SHARING PLAN & TRUST 2019 201667171 2020-06-10 UPSTATE SPRAY FOAM INSULATION 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2020-06-10
Name of individual signing JAMIE CHRISTIAN
UPSTATE SPRAY FOAM INSULATION 401 K PROFIT SHARING PLAN TRUST 2018 201667171 2019-08-09 UPSTATE SPRAY FOAM INSULATION 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2019-08-09
Name of individual signing JAMIE CHRISTIAN
UPSTATE SPRAY FOAM INSULATION 401 K PROFIT SHARING PLAN TRUST 2018 201667171 2019-07-23 UPSTATE SPRAY FOAM INSULATION 27
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2019-07-23
Name of individual signing JAMIE CHRISTIAN
UPSTATE SPRAY FOAM INSULATION 401 K PROFIT SHARING PLAN TRUST 2017 201667171 2018-07-24 UPSTATE SPRAY FOAM INSULATION 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2018-07-24
Name of individual signing JAMIE CHRISTIAN
UPSTATE SPRAY FOAM INSULATION 401 K PROFIT SHARING PLAN TRUST 2016 201667171 2017-06-13 UPSTATE SPRAY FOAM INSULATION 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2017-06-13
Name of individual signing JAMIE CHRISTIAN
UPSTATE SPRAY FOAM INSULATION 401 K PROFIT SHARING PLAN TRUST 2015 201667171 2016-05-23 UPSTATE SPRAY FOAM INSULATION 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2016-05-23
Name of individual signing JAMIE CHRISTIAN
UPSTATE SPRAY FOAM INSULATION 401 K PROFIT SHARING PLAN TRUST 2014 201667171 2015-06-09 UPSTATE SPRAY FOAM INSULATION 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 812990
Sponsor’s telephone number 3158225238
Plan sponsor’s address 122 SOUTH ST, WEST WINFIELD, NY, 13491

Signature of
Role Plan administrator
Date 2015-06-09
Name of individual signing JAMIE CHRISTIAN

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 122 SOUTH STREET, WEST WINFIELD, NY, United States, 13491

History

Start date End date Type Value
2004-09-16 2006-08-28 Address 122 SOUTH STREET, WEST WINDFIELD, NY, 13491, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200903060940 2020-09-03 BIENNIAL STATEMENT 2020-09-01
180905006665 2018-09-05 BIENNIAL STATEMENT 2018-09-01
160906007658 2016-09-06 BIENNIAL STATEMENT 2016-09-01
140903006199 2014-09-03 BIENNIAL STATEMENT 2014-09-01
120911006080 2012-09-11 BIENNIAL STATEMENT 2012-09-01
100929002245 2010-09-29 BIENNIAL STATEMENT 2010-09-01
080912002331 2008-09-12 BIENNIAL STATEMENT 2008-09-01
060828002284 2006-08-28 BIENNIAL STATEMENT 2006-09-01
041220000582 2004-12-20 AFFIDAVIT OF PUBLICATION 2004-12-20
041220000580 2004-12-20 AFFIDAVIT OF PUBLICATION 2004-12-20

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
342642493 0215800 2017-09-13 1013 WEST ST., UTICA, NY, 13501
Inspection Type Prog Related
Scope Complete
Safety/Health Safety
Close Conference 2017-09-13
Emphasis L: LOCALTARG, P: LOCALTARG
Case Closed 2018-05-15

Related Activity
Type Inspection
Activity Nr 1264225
Safety Yes
Type Inspection
Activity Nr 1264256
Safety Yes
Type Inspection
Activity Nr 1264274
Safety Yes
Type Inspection
Activity Nr 1263788
Safety Yes
Type Inspection
Activity Nr 1292951
Safety Yes

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 19260050 G
Issuance Date 2017-10-31
Abatement Due Date 2017-11-13
Current Penalty 0.0
Initial Penalty 2897.0
Contest Date 2017-11-27
Final Order 2018-04-30
Nr Instances 1
Nr Exposed 2
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1926.50(g): Where employees were exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body were not provided within the work area for immediate emergency use: a) On or about 9/13/2017, Truck: Eye wash equipment was not provided for employees using/ exposed to products such as, but not limited to FL 2000 - Foamlok Polyol and LPA-ISO. Abatement certification is required for this item.
Citation ID 01002
Citaton Type Serious
Standard Cited 19260501 B04 I
Issuance Date 2017-10-31
Abatement Due Date 2017-11-13
Current Penalty 0.0
Initial Penalty 2173.0
Contest Date 2017-11-27
Final Order 2018-04-30
Nr Instances 1
Nr Exposed 1
Gravity 1
FTA Current Penalty 0.0
Citation text line 29 CFR 1926.501(b)(4)(i): Each employee on walking/working surfaces was not protected from falling through holes (including skylights) more than 6 feet (1.8 m) above lower levels, by personal fall arrest systems, covers, or guardrail systems: a) On or about 9/13/2017, Stairway opening: A floor opening and exposed 38 inch long by 24 inch wide hole were not provided with a guardrail or cover to prevent employees from falling 6.5 feet to the next lower surface. Abatement certification is required for this item.
337960611 0215800 2012-12-20 LIBERTY GARDEN APARTMENTS 200 NORTH LEVITT STREET, ROME, NY, 13440
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2013-01-31
Case Closed 2013-05-22

Related Activity
Type Complaint
Activity Nr 714771
Health Yes

Violation Items
Citation ID 01001
Citaton Type Other
Standard Cited 19100134 F02
Issuance Date 2013-02-04
Abatement Due Date 2013-04-19
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2013-02-28
Nr Instances 2
Nr Exposed 1
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.134(f)(2): Employee(s) using tight-fitting facepiece respirators were not fit tested prior to initial use of the respirator, whenever a different respirator facepiece was used, or at least annually thereafter: (Construction Reference 1926.103) a) At the jobsite, on or about 12/20/12: An employee spraying CertaSpray foam insulation, containing MDI, wore a full face PAPR respirator, and had not received an initial fit test. b) At the jobsite, on or about 12/20/12: An employee spraying CertaSpray foam insulation, containing MDI, wore a half face respirator, and had not received a fit test at least annually. Abatement certification must be submitted for these items.
Citation ID 01002
Citaton Type Other
Standard Cited 19101200 E01
Issuance Date 2013-02-04
Abatement Due Date 2013-04-19
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2013-02-28
Nr Instances 1
Nr Exposed 15
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1200(e)(1): The employer did not develop, implement, and/or maintain at the workplace a written hazard communication program which describes how the criteria specified in 29 CFR 1910.1200(f), (g), and (h) will be met: (Construction Reference: 1926.59) a) At the jobsite, on or about 12/20/12: A written hazard communication was not developed by the employer where products including CertaSpray foam insulation, containing MDI were used. Abatement certification must be submitted for this item.

Motor Carrier Census

USDOT Number Carrier Operation MCS-150 Form Date MCS-150 Mileage MCS-150 Year Power Units Drivers Operation Classification
1604415 Intrastate Non-Hazmat 2019-12-03 120000 2019 8 8 Private(Property)
Legal Name UPSTATE SPRAY FOAM INSULATION LLC
DBA Name -
Physical Address 122 SOUTH ST, WEST WINFIELD, NY, 13491, US
Mailing Address 122 SOUTH ST, WEST WINFIELD, NY, 13491, US
Phone (315) 822-5238
Fax (315) 822-0096
E-mail -

Safety Measurement System - All Transportation
Total Number of Inspections for the measurement period (24 months) 0
Driver Fitness BASIC Serious Violation Indicator No
Vehicle Maintenance BASIC Acute/Critical Indicator No
Unsafe Driving BASIC Acute/Critical Indicator No
Driver Fitness BASIC Roadside Performance measure value 0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value 0
Total Number of Driver Inspections for the measurment period 0
Vehicle Maintenance BASIC Roadside Performance measure value 0
Total Number of Vehicle Inspections for the measurement period 0
Controlled Substances and Alcohol BASIC Roadside Performance measure value 0
Unsafe Driving BASIC Roadside Performance Measure Value 0
Number of inspections with at least one Driver Fitness BASIC violation 0
Number of inspections with at least one Hours-of-Service BASIC violation 0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation 0
Number of inspections with at least one Vehicle Maintenance BASIC violation 0
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation 0
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation 0
Number of inspections with at least one Unsafe Driving BASIC violation 0

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Related by address

122 SOUTH STREET, WEST WINFIELD, NY, United States, 13491

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State

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