Preview
FILED:
FILED: ALBANY
ALBANY COUNTY
COUNTY CLERK
CLERK 01/20/2022
01/20/2022 12:37
12:37 PM
PM|
INDEX
INDEX NO.
NO. 900421-22
900421-22
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 11 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 01/20/2022
01/20/2022
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF ALBANY
X
WORKERS' :
COMPENSATION BOARD OF THE STATE OF NEW YORK,
Plaintiff,
-against- :
:
HEJ CONSTRUCTION CORP :
AFFIRMATION
Defendant(s) :
OF
NON-PAYMENT
:
:
:
X
Workers'
The undersigned, an attorney in theoffice of the Compensation Board of the Stateof New
York, Plaintiffherein, hereby affirms that the followingis trueunder the penalty of perjury,upon
information and belief:
Workers'
This affirmation isbased upon a review of the file
which ismaintained by the Compensation
Board initsregular course of business.
I am familiarwith the status of payment in thismatter. The award/penalty/assessment/demand for
deposit of security made against the defendant(s) in theamount of $2,500.00 isin default,as more than
thirtydays have elapsed since the demand upon the defendant(s) hereinfor payment. No payment has
been received nor has the aforesaid security been deposited incomp||anue with said demand to date,
except the sum of $0.00, leaving due and payble the sum of $2,500.00.
Dated: 20th day of __December , 2021 .
S/
James R. McGinn, Esq.
Judgment Unit
C-45.45E 1/2009
11 of
of 7
4
FILED:
FILED: ALBANY
ALBANY COUNTY
COUNTY CLERK
CLERK 01/20/2022
01/20/2022 12:37
12:37 PM
PM|
INDEX
INDEX NO.
NO. 900421-22
900421-22
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 11 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 01/20/2022
01/20/2022
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF ALBANY
X
WORKERS' :
COMPENSATION BOARD OF THE STATE OF NEWYORK,
Plaintiff,
-against- :
:
HEJ CONSTRUCTION CORP
AFFIRMATION
Defendant(s) :
OF
REGULARITY
:
:
:
X
Workers'
The undersiyried, an attorney in theoffice of the Compensation Board of the Stateof New
York, Plaintiffherein, hereby affirms that the followingis trueunder the penalty of perjury,upon
information and belief:
Workers'
This affirmation isbased upon a review of the file
which ismaintaiñêd by the Compensation
Board initsregular course of business.
Workers'
The Compensation Board of the State of New York, inaccGrdance with the provisions of the
Workers'
Compensation Law, has made an assmsment/award in thesum of $2,500.00, against the
defendant(s). Attached hereto and made a part hereof are certifiedcopies of the Notice of Drision and
Award, and/or a certifiedcopy ofthe demand for deposit of security,and/or a ceitiiit:d
copy ofthe chair's
order imposing, and the demand for payment of, assesments imposed by the chairpursuant to
Workers'
subdivision fiveof section fifty-twoand/or one hundred thirtyone of the Compensation Law, as
required for of
filing judgment per Workers Compensation Law, Section 26 and/or 219. Appeals before
the Board have been exhausted.
No payment of award has been made except $0.00, leaving $2,500.00 due and payable.
W||ERE ORE, it is
respectfullyrequated that judgment be entered against the Defendant(s) herein in
the sum stated as remaining due and pefab!e.
Dated: 20th day of December , 2021 .
S/
James R. McGinn, Esq.
Judgment Unit
C-45.1E 6/2007
2
3 of
of 7
4
FILED:
FILED: ALBANY
ALBANY COUNTY
COUNTY CLERK
CLERK 01/20/2022
01/20/2022 12:37
12:37 PM
PM|
INDEX
INDEX NO.
NO. 900421-22
900421-22
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 11 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 01/20/2022
01/20/2022
STATE OF NEW YORK
WORKERS'
NEW Workers' COMPENSATION BOARD THISAGENCYEMPLOYSAND SERVES
compenn,u. JUDGMENT UNIT PEOPLEW TH DISABILITIES W THOUT
RZE ...._.....
328 STATE STREET DISCRIMINATION.
SCHENECTADY, NY 12305-2318
866-298-7830
HEJ CONSTRUCTION CORP WCB EMPLOYER #: 2923329
97 SOUTHERN BLVD UlER #: 54-43622
ALEANY NY 12209-18D5
FEIN/SS #: *****6771
It Is hereby that
certified thlsIs a true
and correct copy ofthe originalas filed
Workers'
with the Compensation Board
S/
James R. McGinn, Esq.
DATE: 12/20/2021 J"ds-sin Unit
Non-Compliance
Item Description Dates Acddent Date Ba!anceDue
I
2021W0006951 Failure to Workers' Ins 11/11/2020-12/31/2020 $2,500.00
Carry Comp
Total Balance Due $2,500.00
*
If payment isnot received immediately, jüc|gmêñt willbe filedand the employeris subject to seizure
of assets, both business and personal, without furthernotice from the Board.
In orderto insureprompt creditof yourpaymet, complete thefollowingwiththe
Date, Number and Amount of yourcheck and return with
It, along your payment to:
WORKERS'
COMPENSATION BOARD
FINANCE OFFICE
328 STATE STREET, SCHENECTADY, NY 12305-2318
Please detach and return bottom portion with your payment.
__________________________________________________ _______________________________
MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND".
PLEASE INCLUDE YOUR WCB EMPLOYERNUMBER ON YOUR CHECK.
Employer HEJ CONSTRUCTION CORP WCB Empicycc# 2923329
Customer ID #
Check
Check Date Check #
Amount
C-45.37 5/2004 Page 1 of 2
3
5 of
of 7
4
FILED:
FILED: ALBANY
ALBANY COUNTY
COUNTY CLERK
CLERK 01/20/2022
01/20/2022 12:37
12:37 PM
PM|
INDEX
INDEX NO.
NO. 900421-22
900421-22
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 11 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 01/20/2022
01/20/2022
Non-Compliance
Da-criptici-
Item Dates Accident Date Balance Due
MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND".
Mail payment along with this form to:
WORKERS'
COMPENSATION BOARD
FINANCE OFFICE
328 STATE STREET
SCHENECTADY, NY 12305-2318
C-45.37 5/2004 Page 2 of 2
46 of
of 7
4
Preview
FILED: FILED: ALBANY ALBANY COUNTY COUNTY CLERK CLERK 01/20/2022 01/20/2022 12:37 12:37 PM PM| INDEX INDEX NO. NO. 900421-22 900421-22 NYSCEF NYSCEF DOC. DOC. NO. NO. 11 RECEIVED RECEIVED NYSCEF: NYSCEF: 01/20/2022 01/20/2022 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF ALBANY X WORKERS' : COMPENSATION BOARD OF THE STATE OF NEW YORK, Plaintiff, -against- : : HEJ CONSTRUCTION CORP : AFFIRMATION Defendant(s) : OF NON-PAYMENT : : : X Workers' The undersigned, an attorney in theoffice of the Compensation Board of the Stateof New York, Plaintiffherein, hereby affirms that the followingis trueunder the penalty of perjury,upon information and belief: Workers' This affirmation isbased upon a review of the file which ismaintained by the Compensation Board initsregular course of business. I am familiarwith the status of payment in thismatter. The award/penalty/assessment/demand for deposit of security made against the defendant(s) in theamount of $2,500.00 isin default,as more than thirtydays have elapsed since the demand upon the defendant(s) hereinfor payment. No payment has been received nor has the aforesaid security been deposited incomp||anue with said demand to date, except the sum of $0.00, leaving due and payble the sum of $2,500.00. Dated: 20th day of __December , 2021 . S/ James R. McGinn, Esq. Judgment Unit C-45.45E 1/2009 11 of of 7 4 FILED: FILED: ALBANY ALBANY COUNTY COUNTY CLERK CLERK 01/20/2022 01/20/2022 12:37 12:37 PM PM| INDEX INDEX NO. NO. 900421-22 900421-22 NYSCEF NYSCEF DOC. DOC. NO. NO. 11 RECEIVED RECEIVED NYSCEF: NYSCEF: 01/20/2022 01/20/2022 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF ALBANY X WORKERS' : COMPENSATION BOARD OF THE STATE OF NEWYORK, Plaintiff, -against- : : HEJ CONSTRUCTION CORP AFFIRMATION Defendant(s) : OF REGULARITY : : : X Workers' The undersiyried, an attorney in theoffice of the Compensation Board of the Stateof New York, Plaintiffherein, hereby affirms that the followingis trueunder the penalty of perjury,upon information and belief: Workers' This affirmation isbased upon a review of the file which ismaintaiñêd by the Compensation Board initsregular course of business. Workers' The Compensation Board of the State of New York, inaccGrdance with the provisions of the Workers' Compensation Law, has made an assmsment/award in thesum of $2,500.00, against the defendant(s). Attached hereto and made a part hereof are certifiedcopies of the Notice of Drision and Award, and/or a certifiedcopy ofthe demand for deposit of security,and/or a ceitiiit:d copy ofthe chair's order imposing, and the demand for payment of, assesments imposed by the chairpursuant to Workers' subdivision fiveof section fifty-twoand/or one hundred thirtyone of the Compensation Law, as required for of filing judgment per Workers Compensation Law, Section 26 and/or 219. Appeals before the Board have been exhausted. No payment of award has been made except $0.00, leaving $2,500.00 due and payable. W||ERE ORE, it is respectfullyrequated that judgment be entered against the Defendant(s) herein in the sum stated as remaining due and pefab!e. Dated: 20th day of December , 2021 . S/ James R. McGinn, Esq. Judgment Unit C-45.1E 6/2007 2 3 of of 7 4 FILED: FILED: ALBANY ALBANY COUNTY COUNTY CLERK CLERK 01/20/2022 01/20/2022 12:37 12:37 PM PM| INDEX INDEX NO. NO. 900421-22 900421-22 NYSCEF NYSCEF DOC. DOC. NO. NO. 11 RECEIVED RECEIVED NYSCEF: NYSCEF: 01/20/2022 01/20/2022 STATE OF NEW YORK WORKERS' NEW Workers' COMPENSATION BOARD THISAGENCYEMPLOYSAND SERVES compenn,u. JUDGMENT UNIT PEOPLEW TH DISABILITIES W THOUT RZE ...._..... 328 STATE STREET DISCRIMINATION. SCHENECTADY, NY 12305-2318 866-298-7830 HEJ CONSTRUCTION CORP WCB EMPLOYER #: 2923329 97 SOUTHERN BLVD UlER #: 54-43622 ALEANY NY 12209-18D5 FEIN/SS #: *****6771 It Is hereby that certified thlsIs a true and correct copy ofthe originalas filed Workers' with the Compensation Board S/ James R. McGinn, Esq. DATE: 12/20/2021 J"ds-sin Unit Non-Compliance Item Description Dates Acddent Date Ba!anceDue I 2021W0006951 Failure to Workers' Ins 11/11/2020-12/31/2020 $2,500.00 Carry Comp Total Balance Due $2,500.00 * If payment isnot received immediately, jüc|gmêñt willbe filedand the employeris subject to seizure of assets, both business and personal, without furthernotice from the Board. In orderto insureprompt creditof yourpaymet, complete thefollowingwiththe Date, Number and Amount of yourcheck and return with It, along your payment to: WORKERS' COMPENSATION BOARD FINANCE OFFICE 328 STATE STREET, SCHENECTADY, NY 12305-2318 Please detach and return bottom portion with your payment. __________________________________________________ _______________________________ MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND". PLEASE INCLUDE YOUR WCB EMPLOYERNUMBER ON YOUR CHECK. Employer HEJ CONSTRUCTION CORP WCB Empicycc# 2923329 Customer ID # Check Check Date Check # Amount C-45.37 5/2004 Page 1 of 2 3 5 of of 7 4 FILED: FILED: ALBANY ALBANY COUNTY COUNTY CLERK CLERK 01/20/2022 01/20/2022 12:37 12:37 PM PM| INDEX INDEX NO. NO. 900421-22 900421-22 NYSCEF NYSCEF DOC. DOC. NO. NO. 11 RECEIVED RECEIVED NYSCEF: NYSCEF: 01/20/2022 01/20/2022 Non-Compliance Da-criptici- Item Dates Accident Date Balance Due MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND". Mail payment along with this form to: WORKERS' COMPENSATION BOARD FINANCE OFFICE 328 STATE STREET SCHENECTADY, NY 12305-2318 C-45.37 5/2004 Page 2 of 2 46 of of 7 4