224-22 RFQ-CME.pdf

XX enue ASSOCIATES ATTACHMENT Stockholder Disclosure Form Partners of CME Associates owning 10% or more of the company: David J. Samuel 99 Winkler Road 37.36% Sayreville, NJ 08872 Jay B. Cornell 31 Tyska Avenue 20.88% Sayreville, NJ 08872 Michael J. McClelland 82 Ida Lane 20.88% Brick, NJ 08724 Gregory R. Valesi 6 Ella Drive 20.88% Millstone Township, NJ 08510 SCME COVER & RESUMES\TOWNSHIP REQUIRED FORMSIStockholder Disclosure Addresses & Percentages.doc

ASSOCIATES ATTACHMENT GENERAL SERVICE ENTITY INFORMATION FORM Name of Partner: David J. Samuel, P.E. Firm Name: CME Associates Office Address: 3141 Bordentown Avenue, Parlin, NJ 08859 Telephone No.: 732-727-8000 Federal ID#: 223484435 Fax No.: 732-727-3989 E-Mail: Dsamuel@cmeusa1.com Name of Partner: Gregory R. Valesi, P.E. Firm Name: CME Associates Office Address: 1460 Route 9 South, Howell, NJ 07731 Telephone No.: 732-462-7400 Federal ID#: 223484435 Fax No.: 732-409-0756 E-Mail: Gvalesi@cmeusat.com Name of Partner: Jay B. Cornell, P.E. Firm Name: CME Associates Office Address: 3141 Bordentown Avenue, Parlin, NJ 08859 Telephone No.: 732-727-8000 Federal ID#: 223484435 Fax No.: 732-727-3989 E-Mail: JCornell@cmeusat.com Name of Partner: Michael J. McClelland, P.E. Firm Name: CME Associates Office Address: 3141 Bordentown Avenue, Parlin, NJ 08859 Telephone No.: 732-727-8000 Federal ID#: 223484435 Fax No.: 732-727-3989 E-Mail: Mmcclelland@cmeusat.com

TOWNSHIP OF WEST ORANGE NON-CONFLICT OF INTEREST CERTIFICATION REQUEST FOR QUALIFICATIONS FOR Township Urban Tree Inventory (Title of RFQ) The undersigned certifies to the Township of West Orange, County of Essex, State of New Jersey that in performing services to the Township he/she is aware of no circumstance that would constitute a conflict of interest, financial or otherwise, between him/her (or his/her firm) and the interests of the Township. The undersigned certifies that he/she has made a search of his/her firm’s client base and has executed this certification subsequent to such search. The undersigned acknowledges this a continuing certification, and shall remain in effect for the term of the services contained in the solicited request for qualifications. I certify that the foregoing statements made by me are true and accurate to my personal knowledge; I am making this certification in good faith. I am aware that if any of the foregoing statements made by me are false, the Board is free to terminate any professional service agreement entered into with the undersigned and/or his or her firm. Certifying Official: PRINT NAME: egory R. Valesi f /) SIGNED BY: / PorX/ | WA j UV T ST TITLE: ___Partner 0) O = 4 DATE: August 15, 2022 Page | 19

l iT ORAI NEW EY Professional Service Contract Qualification and Costs Submission Form Note: A separate resume can be attached. 1. Please provide the name and address of Names and roles of the individuals who will perform the services and description of their education, municipal experience and experience with projects similar to the services contained herein including their education, degrees and certifications. Shari m. Spero, LTE, Licensed Tree Expert Dominick Pensabene, LLA, LTE, Licensed Landscape Architect, Licensed Tree Expert Please refer to their resumes in Section 4 "Resumes of Key Personnel" of our brochure. 2. References and record of success of same or similar service. Please refer to Section 5 "Specific Experience of the Firm" of our brochure. Page | 20

3. Description of ability to provide the services in a timely fashion (including staffing, familiarity and location of key staff. CME Associates has the staff and possess the resources, experience and expertise, including (8) offices in New Jersey, necessary to successfully represent the Township in a professional, efficient, and responsive manner. 4. Cost details, per tree: Please refer to Section 7 "Rate Schedule" of our brochure for our hourly rates. (print name) 7 Authorized Representative, EK YX | / WY (signature) Ty Telephone #__ 732-462-7400 { FAX # 732-409-0756 Authorized Representative. Page | 21

vii i hii range Pursuant to Section 2-68.1 of the Revised General Ordinances of the Township of West Orange, please set forth below all political contributions in cash or in kind of two hundred ($200.00) dollars or more made within five (5) years of the date of acceptance of a proposal for a negotiated contract with the Township of West Orange, or within five (5) years of the notice of award for a bid contract with the Township of West Orange, either directly or indirectly, by the individuals or any of the principals of the business entity completing this form or by the business entity itself, to any elected official of the Township of West Orange currently in office or any political organization affiliated with an elected official of the Township currently in office. The current elected officials of the Township include the following: Mayor Robert D. Parisi; Councilwoman Susan McCartney; Councilwoman Cindy Matute Brown; Councilman Bill Rutherford; Councilwoman Tammy Williams; and Councilwoman Michelle Casalino. Name of Contributor Amount Recipient of Contribution Contribution Sx Ariel Date If you have NOT made any contributions within the scope of Section 2-68.1, as set forth above, please indicate here : | hereby certify under penalty of perjury that the information provided herein is true and accurate to the best of my knowledge, information and belief. / vp Signature eo wy Ht iJ — Print Name: Sitines_ Se Dhol Company: CVE Psse COATES Page | 22

Wset Orange Political Disclosure Chapter 2. Sec 68 CONTRIBUTOR CONTRIBUTION TO DATE AMOUNT DJ Samuel Casalino for Council "09/18/20 250.00 DJ Samuel CTE Jerry Guarino | 09/18/20 , 250.00 _ DJ Samuel EFO Susan McCartney _| 09/18/20 250.00 GR Valesi Casalino for Council 09/20/20 250.00 GR Valesi _ CTE Jerry Guarino _ 09/20/20 250.00 GR Valesi EFO Susan McCartney 09/20/20 | 250.00 MJ McClelland EFO Susan McCartney 09/18/20 250.00 Page 1of1 West Orange 07 29 22

TOWNSHIP OF WEST ORANGE ACKNOWLEDGMENT OF RECEIPT OF ADDENDA The undersigned Bidder hereby acknowledges receipt of the following addenda: Please assign the number, date and initial. Addendum Number Dated Acknowledge Receipt _ (Initial) [x ]Ne addenda was received. edged for: eMouka / Ack (Cotrfany Name) By: (Signature an ed Representative) Name: _ Gregory R¢ Valesi (Print) Title: Partner Date: August 15, 2022 Page | 23

TOWNSHIP OF WEST ORANGE DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN Proposer: __CME Associates Pursuant to Public Law 2012, c. 25, any person or entity that submits a bid or proposal or otherwise proposes to enter into or renew a contract must complete the certification below to attest, under penalty of perjury, that the person or entity, or one of the person or entity's parents, subsidiaries, or affiliates, is not identified on a list created and maintained by the New Jersey Department of the Treasury as a person or entity engaging in investment activities in Iran. If the Director finds a person or entity to be in violation of the principles which are the subject of this law, s/he shall take action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring, declaring the party in default and seeking debarment or suspension of the person or entity. I certify, pursuant to Public Law 2012, c. 25, that the person or entity listed above for which | am authorized to submit a proposal: Must check appropriate boxes Is not providing goods or services of $20,000,000 or more in the energy sector of Iran, including a person or entity that provides oil or liquefied natural gas tankers, or products used to construct or maintain pipelines used to transport oil or liquefied natural gas, for the energy sector of Iran, and {s not a financial institution that extends $20,000,000 or more in credit to another person or entity, for 45 days, or more, if that person or entity will use the credit to provide goods or services in the energy sector in fran. In the event that a person or entity is unable to make the above certification because it or one of its parents, subsidiaries, or affiliates has engaged in the above referenced activities, a detailed, accurate and precise description of the activities must be provided in part 2 below to the New Jersey Turnpike Authority under penalty of perjury. Failure to provide such will result in the proposal being rendered as non- responsive and appropriate penalties, fines and/or sanctions will be assessed as provided by law. Part 2: PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN You must provide a detailed, accurate and precise description of the activities of the proposer, or one of its parents,

2: PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN You must provide a detailed, accurate and precise description of the activities of the proposer, or one of its parents, subsidiaries or affiliates, engaging in the investment activities in Iran outlined above by completing the boxes below. Name: Relationship to Proposer: Description of Activities: Duration of Engagement: Anticipated Cessation Date: Proposer Contact Name: Contact Phone Number: Page | 24