9-21 Exhibit - Authorizing Execution of Grant Agreement for the HDSRF Grant Funds for Removal of UST at the Selecto-Flash Property a_.pdf

nd effect as if the same were a fully executed and delivered original. P45524 Township of West Orange (Selecto Flash Inc.)

Page 2 of 2 SCHEDULE B PROJECT COMPLETION CERTIFICATE (CONT’D.) CALCULATION OF UNEXPENDED PROCEEDS FORM DATE PROJECT COMPLETED: ____________________________ The following actual approved project costs have been paid: NJ DEP Oversight (actual dollars invoiced): $_______________________ Preliminary Assessment $_______________________ Site Investigation $_______________________ Remedial Investigation $________________________ Remedial Action $________________________ Contingency $________________________ Other costs (Itemize) $ ________________________ (A) Total Project Costs Paid: $_________________________ (B) Project Grant Amount (from Schedule A) $________________________ Amount to be Remitted to NJEDA (B) – (A) $__________________________ Kindly make checks payable to the “New Jersey Economic Development Authority” or “NJEDA” and returned with the Project Completion Certificate. Should you prefer to wire the unexpended funds instead you may do so by using the following instructions: Wells Fargo Bank, N.A. 1 West State Street Trenton, NJ 08608 ABA #121 000 248 ACCT # 2100009100456 New Jersey Economic Development Authority 36 West State Street P.O. Box 990 Trenton, NJ 08625 Re: ____________ Fee (type of fee) ________________________________________ (P__________) (Project Name) (Project #) This Project Completion Certificate may be executed and delivered to the above Finance Officer by email with attached PDF all with the same force and effect as if the same were a fully executed and delivered original. P45524 Township of West Orange (Selecto Flash Inc.)

P45524 Township of West Orange Project Site: Selecto Flash Inc. Grant Award: Up to $41,934.00 SCHEDULE C CERTIFICATION OF AWARDED CONTRACTS The undersigned hereby certifies as follows: 1. I am an Authorized Representative of the Grantee. 2. As of the date noted below, Grantee has awarded contract(s) to the contractors listed below for preliminary assessment (PA), site investigation (SI), remedial investigation (RI), or remedial action (RA) of the "Project" defined in Schedule A of the Agreement. 3. Listed below are the contracts awarded. Copies of said contracts are attached hereto and made a part of this certification. 4. Attached hereto are certified copies of each resolution(s) awarding such contract(s). 5. All terms not defined herein shall have the means ascribed to them in the defined in the Agreement, to which this Schedule C is attached, and which was entered into by and between Grantor and Grantee. Name of Contractor Nature of Contract Date of Contract Amount of Contract (PA, SI, RI, RA) Award 1. 2. 3. 4. 5. ---------------------- ----------------- TOTAL $ Authorized Representative (Signature):_________________________ Name(Print):_________________________ Dated:________________ Title:_________________________ P45524 Township of West Orange (Selecto Flash Inc.)

SCHEDULE D SAMPLE RESOLUTION A RESOLUTION ACCEPTING A GRANT FROM THE HAZARDOUS DISCHARGE SITE REMEDIATION FUND PUBLIC ENTITY PROGRAM THROUGH THE NEW JERSEY ECONOMIC DEVELOPMENT AUTHORITY AND THE NEW JERSEY DEPARTMENT OF ENVIRONMENTAL PROTECTION WHEREAS, Township of West Orange has applied for and has been awarded a grant in the amount of up to $41,934.00 from the Hazardous Discharge Site Remediation Fund Municipal Grant Program through the New Jersey Department of Environmental Protection and the New Jersey Economic Development Authority for Remedial Action of the Selecto Flash Inc. property; NOW, THEREFORE, BE IT RESOLVED by the governing body of the Township of West Orange that the above referenced grant is hereby accepted and the (Mayor, Administrator, etc.) is hereby authorized to execute grant documents as an authorized representative thereunder, as the representative for the Township of West Orange. BE IT FURTHER RESOLVED that a comprehensive plan exists specifically for the development or redevelopment of contaminated or potentially contaminated real property in the host municipality or that a realistic opportunity exists that the Project Site will be developed or redeveloped within a three-year period from the completion of the remediation. BE IT FURTHER RESOLVED that a certified copy of this Resolution be forwarded to the New Jersey Economic Development Authority. [SEAL] Date Adopted by (Council/Committee):_______________ Attest: ________________________________ ________________________________ Clerk (Council President/Mayor) P45524 Township of West Orange (Selecto Flash Inc.)

SCHEDULE E Hazardous Discharge Site Remediation Fund (HDSRF) Public Entity Project Status Summary Public Entity:____________________________ Latest Project #:___________________________ Site Name:______________________________ Site Location: _____________________________ Size of Site: _____________________________ Current Zoning of Site: _____________________ Who owns the site: Public Entity Redeveloper Private Other Contact: ________________________________ County: _________________________________ Address:__________________________________________________________________________ Phone: _________________________________ Fax: ___________________________________ Latest Application Closing Date: ____________ Total grant funding to date:__________________ Has the Preliminary Assessment (PA), Site Investigation (SI) and Remedial Investigation (RI) studies been completed? If not, what is the status of the work? Yes No PA __ __ _________________________________________________ SI __ __ _________________________________________________ RI __ __ _________________________________________________ Does the site have contamination? Yes / No If yes, describe__________________________________ _________________________________________________________________________________ Has the site been remediated? Yes / No If no, when will it be done __________________________ What are the projected cleanup costs? (Please circle estimated costs) 0-$100,000 $100,000 -$ 500,000 $500,000 -$1,000,000 $1,000,000 & over How was the site used previous to contamination? _________________________________________ Has the site been redeveloped? Yes / No If yes, what is the current use? _______________________ __________________________________________________________________________________ P45524 Township of West Orange (Selecto Flash Inc.)

If the site has not been redeveloped, what are the plans for redeveloping the site? ________________ _______________________________________________________________. TOWNSHIP OF WEST ORANGE By:____________________________________________ Title: Date:__________________________________________ New Jersey Economic Development Authority Underwriting Attn: Kathy Junghans, Finance Officer kjunghans@njeda.com This Public Entity Project Status Summary may be executed and delivered to the above Finance Officer by email with attached PDF all with the same force and effect as if the same were a fully executed and delivered original. P45524 Township of West Orange (Selecto Flash Inc.)