| Name: | FORM GUY SUPPLY LLC |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC LIMITED LIABILITY COMPANY |
| Status: | Active |
| Date of registration: | 28 Jul 2015 (10 years ago) |
| Entity Number: | 4795798 |
| ZIP code: | 14546 |
| County: | Monroe |
| Place of Formation: | New York |
| Address: | 3721 SCOTTSVILLE RD, SUITE 3, SCOTTSVILLE, NY, United States, 14546 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FORM GUY SUPPLY LLC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 474663754 | 2024-05-07 | FORM GUY SUPPLY LLC | 9 | |||||||||||||||||||||
|
||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-05-07 |
| Name of individual signing | EDWARD ROJAS |
| Name | Role | Address |
|---|---|---|
| FORM GUY SUPPLY LLC | DOS Process Agent | 3721 SCOTTSVILLE RD, SUITE 3, SCOTTSVILLE, NY, United States, 14546 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2015-07-28 | 2023-08-15 | Address | 6 HANFORD WAY, FAIRPORT, NY, 14450, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 230815000330 | 2023-08-15 | BIENNIAL STATEMENT | 2023-07-01 |
| 210715002472 | 2021-07-15 | BIENNIAL STATEMENT | 2021-07-15 |
| 150917000441 | 2015-09-17 | CERTIFICATE OF PUBLICATION | 2015-09-17 |
| 150728000233 | 2015-07-28 | ARTICLES OF ORGANIZATION | 2015-07-28 |
| USDOT Number | Carrier Operation | MCS-150 Form Date | MCS-150 Mileage | MCS-150 Year | Power Units | Drivers | Operation Classification | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2873601 | Intrastate Non-Hazmat | 2025-01-07 | 19000 | 2022 | 2 | 2 | Private(Property) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Total Number of Inspections for the measurement period (24 months) | 1 |
| 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 | 1 |
| Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value | 0 |
| Total Number of Driver Inspections for the measurment period | 1 |
| Vehicle Maintenance BASIC Roadside Performance measure value | 24 |
| Total Number of Vehicle Inspections for the measurement period | 1 |
| 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 | 1 |
| 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 | 1 |
| Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation | 1 |
| 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 |
Inspections
| Unique report number of the inspection | D507704862 |
| State abbreviation that indicates the state the inspector is from | NY |
| The date of the inspection | 2024-04-30 |
| ID that indicates the level of inspection | Full |
| State abbreviation that indicates where the inspection occurred | NY |
| Time weight of the inspection | 2 |
| Number of Out-Of-Service violations related to Driver | 0 |
| Number of Out-Of-Service violations related to vehicle | 2 |
| Number of violations related to Hazardous Materials | 0 |
| Total number of Out-Of-Service violations | 2 |
| Total number of Out-Of-Service violations related to Hazardous Materials | 0 |
| Description of the type of the main unit | STRAIGHT TRUCK |
| Description of the make of the main unit | CHEVROLET |
| License plate of the main unit | 71204ML |
| License state of the main unit | NY |
| Vehicle Identification Number of the main unit | 1GCVKPEC6JZ205931 |
| Description of the type of the secondary unit | SEMI-TRAILER |
| Description of the make of the secondary unit | UNPUBLISHE |
| License plate of the secondary unit | CD32549 |
| License state of the secondary unit | NY |
| Vehicle Identification Number of the secondary unit | 1M9DC18298G568008 |
| Unsafe Driving BASIC inspection | Y |
| Hours-of-Service Compliance BASIC inspection | Y |
| Driver Fitness BASIC inspection | Y |
| Controlled Substances/Alcohol BASIC inspection | Y |
| Vehicle Maintenance BASIC inspection | Y |
| Total number of BASIC violations | 6 |
| Number of Unsafe Driving BASIC violations | 0 |
| Number of Hours-of-Service Compliance BASIC violations | 0 |
| Number of Driver Fitness BASIC violations | 1 |
| Number of Controlled Substances/Alcohol BASIC violations | 0 |
| Number of Vehicle Maintenance BASIC violations | 5 |
| Number of Hazardous Materials Compliance BASIC violations | 0 |
Violations
| The date of the inspection | 2024-04-30 |
| Code of the violation | 39617CPI |
| Name of the BASIC | Vehicle Maintenance |
| The violation is identified as Out-Of-Service violation | N |
| The weight that is assigned to a violation if it's identified as an Out-Of-Service violation | 0 |
| The severity weight that is assigned to a violation | 4 |
| The time weight that is assigned to a violation | 2 |
| The description of a violation | Operating a CMV without documentation of a periodic inspection |
| The description of the violation group | Inspection Reports |
| The unit a violation is cited against | Vehicle secondary unit |
| The date of the inspection | 2024-04-30 |
| Code of the violation | 3939ALLPL |
| Name of the BASIC | Vehicle Maintenance |
| The violation is identified as Out-Of-Service violation | N |
| The weight that is assigned to a violation if it's identified as an Out-Of-Service violation | 0 |
| The severity weight that is assigned to a violation | 2 |
| The time weight that is assigned to a violation | 2 |
| The description of a violation | Lighting - License plate lamp inoperative |
| The description of the violation group | Clearance Identification Lamps/Other |
| The unit a violation is cited against | Vehicle secondary unit |
| The date of the inspection | 2024-04-30 |
| Code of the violation | 39395A1 |
| Name of the BASIC | Vehicle Maintenance |
| The violation is identified as Out-Of-Service violation | N |
| The weight that is assigned to a violation if it's identified as an Out-Of-Service violation | 0 |
| The severity weight that is assigned to a violation | 2 |
| The time weight that is assigned to a violation | 2 |
| The description of a violation | Emergency Equipment - Fire Extinguishers - no fire extinguisher present or not properly rated. |
| The description of the violation group | Emergency Equipment |
| The unit a violation is cited against | Vehicle main unit |
| The date of the inspection | 2024-04-30 |
| Code of the violation | 39375A1TBTP |
| Name of the BASIC | Vehicle Maintenance |
| The violation is identified as Out-Of-Service violation | Y |
| The weight that is assigned to a violation if it's identified as an Out-Of-Service violation | 2 |
| The severity weight that is assigned to a violation | 8 |
| The time weight that is assigned to a violation | 2 |
| The description of a violation | Tires - Bias ply - Has more than one ply exposed in the tread area exceeding 2 square inches |
| The description of the violation group | Tires |
| The unit a violation is cited against | Vehicle secondary unit |
| The date of the inspection | 2024-04-30 |
| Code of the violation | 39343DB |
| Name of the BASIC | Vehicle Maintenance |
| The violation is identified as Out-Of-Service violation | Y |
| The weight that is assigned to a violation if it's identified as an Out-Of-Service violation | 2 |
| The severity weight that is assigned to a violation | 4 |
| The time weight that is assigned to a violation | 2 |
| The description of a violation | Brake - Missing or inoperable breakaway braking system on a trailer(s) or converter dolly |
| The description of the violation group | Brakes All Others |
| The unit a violation is cited against | Vehicle secondary unit |
| The date of the inspection | 2024-04-30 |
| Code of the violation | 39141AMCPC |
| Name of the BASIC | Driver Fitness |
| The violation is identified as Out-Of-Service violation | N |
| The weight that is assigned to a violation if it's identified as an Out-Of-Service violation | 0 |
| The severity weight that is assigned to a violation | 1 |
| The time weight that is assigned to a violation | 2 |
| The description of a violation | Medical (Certificate) - Operating a property-carrying vehicle without possessing a valid medical certificate |
| The description of the violation group | Medical Certificate |
| The unit a violation is cited against | Driver |
Date of last update: 25 Mar 2025
Sources: New York Secretary of State
