Supporting Documentation · Nov 22, 2022
293-22 Exhibit A.pdf
c2847bad2f18f74ad97b7b6a3518ad5e59b57c96356056f9099764d4c8711163Indexed text
CERT-1 08/25104 Taxpayer Identification# 900-123-4391000 Dear Business Representative: Congratulations! You are now registered with the New Jersey Division of Revenue. Use the Taxpayer identification Number listed above on all correspondence with 1he Divisions of Revenue and Taxation, as well as with the Department of Labor (If the business is subject to unemployment withholdings). Your tax returns and payments will be filed under this number, and you will be able to access information about your account by referencing it. Additionally, please note that State law requires all contractors and subcontractors with Public agencies to provide proof of their registration with the Division of Revenue. The law also amended Section 92 or the Casino Control Act, which deals with the casino service Industry. We have attached a Proof of Registration Certificate for your use. To comply with the law, if you are currently under contract or entering in.to a contract with a State agency, you must provide a copy or the certificate to the contracting agency. STATE OF NEW JERSEY BUSINESS REGISTRATION CERTIFICATE TA: .. ~ ISStJANCE DATE: 08/25/04 ~ f ..0''· Actl FORM-BRC 08-0 This C11rt1flca!e Is NOT assignable or lransferabl be cons.p1ci.1011s!
Registration Date: 03119/2018 Cenificate Number Expiration Date: 03118/2020 665953 State of New Jersey Department of Labor and Workforce Development Division of Wage and Hour Compliance Public Works Contractor Registration Act Pursuant to N,J.S.A. 34:11~56.48, et seq. of the Pub!ic Works Contractor Registration Act, !his certificate of registration is issued for purposes of bidding on any contract for public work or for engaging in the performance of any public work to: Responsible Representatlve(s}: Responsible Representative(s): Nicholas Vene, President Joseph Ko!!ock Ill, Owner This certificate may not be transferred or assigned Robert Asaro-Angelo, Acting Commissioner and may be revoked for cause by the Commissioner Oepa·rtment of Labor and Workforce Development NON TRANSFERABLE of Labor and Workrorce Development.
Section 7: Bid bond Consent of Surety Insurance Certificate
FIRST INDEMNITY OF AMERICA INSURANCE COMPANY Z740Rt.10We.rt, Snite205 ~roi:ris Pla.Uts, Nr 079SO (973) 40Z-1200 BID BOND KNOW ALL MEN BY THESE PRESENTS: BOND NO. 00022933 That we, RELIABLE WOOD PRODUCTS, LLC 398 Lincoln Boulevard Middlesex, NJ 08846 as Principal and FIRST INDEMNITY OF AMERICA INSURANCE COMPANY, a corporation duly organized under the laws of the State ofNew Jersey, as Surety, are hereby held and firmly bound unto_r_o_w_N_SH_l_P_O_F_WE_S_r_o_R_A_N_G_E_ _ _ _ _ _ _ _ _ _ __ 66 MAIN STREET West Orange, NJ 07052 as Obligee, in penal sum of 10 % of AMOUNT BID NOT TO EXCEED $20,000.00 Dollars, lawful money of the United States, for which payment, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly, by these presents. WHEREAS the Principal has submitted a bid for OPERATION OF THE WEST ORANGE RECYCLING CENTER NOW THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety of the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee 10 % of the Bid amount not to exceed $20,000.00, the penalty hereof between the amount specified in said bid and such larger amount for which the Ob!igee may in good faith cdntract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. CONSENT OF SURETY It is hereby understood and agreed that the FIRST INDEMNITY OF Ai\1ERJCA INSURANCE COMPAi'lY will provide Surety on the Bond of the
CONSENT OF SURETY It is hereby understood and agreed that the FIRST INDEMNITY OF Ai\1ERJCA INSURANCE COMPAi'lY will provide Surety on the Bond of the Principal for the \Vork described above provided the Principal is the successful bidder and is awarded the Contract. ,, , The Consent of Surety contained herein is limited to a Contract award not to exceed s~1.o_o_o~.oo_o_.o_o_ _ _ _ _ _ _ _ _ __ I AL R~BLE wooO PRoDUcrs. LLC Witness/Attest As To Principal Eugene J. Clarkowsld ' fVI. ++1:-h~ "-' "A-s. ·\-~ :~~STINDE~~~ O_F AMB CC INSURANCE COMP~~: H:\/Jmull'ra\For111s18/D Bond FIA :!f)k Limi1101./ fJ6 0./ re1· 11
FIRST INDEMNITY OF AMERICA INSURANCE COMPANY 2740 Rt. 10 West, Suite 205 Morris Plains, New Jersey 07950 Telephone: (973) 402-1200 POWER OF ATTORNEY FOR BONDS AND UNDERTAKINGS Know All Men By These Presents: That First Indemnity of America Insurance Company, a Corporation of the State of New Jersey does hereby appoint: ·Michele Chare!le • its true and ]awful Attorneys-in-Fact: to make, execute, sign, ackno\vledge, affix the Company Seal to, deliver any and all surety bonds, undertakings, recognizances, and other contracts of indemnity and writings obligatory in the nature of a bond, for and on behalf of said Company and as an act and deed of said Company. IN WITNESS WHEREOF, First Indemnity of America Insurance Company of the State of New Jersey has executed these presents this 20th day of March, 2012. Patrick J. Lynch, President STATEOFNEWJERSEY ) COUNTY OF MORRIS ) ss: On this 20th day of March, 2012, before me came the above named officer ofFirst Indemnity of America Insurance Company KATHLEEN FOCHESTO of New Jersey, to me personally known to be the individual and officer described herein, and acknowledge that be executed the NOTARY PUBLIC OF NEW JERSEY foregoing instrument and affixed the seal of said corporation My Commission Expires 3116/2020 thereto by authority of this office. CERTIFICATE Excerpts ofResolutioos (Article V, Paragraph 5, of the By-Laws of said Company) adopted by the Board of Directors of the First Indemnity of America Insurance Company of the State ofNew Jersey, March 20, 2012. RESOLVED, that the President, or any one of the Vice Presidentsspecially authorized to do so by the Board of Directors, or by the Executive Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Attorneys-in-Fact as the business of the company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertakings, recognizances, stipulations, policies, contracts,
in-Fact as the business of the company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertakings, recognizances, stipulations, policies, contracts, agreements, deeds, and release and assignment ofjudgments, decrees, mortgages and instruments in the nature of mortgages, and also all other instruments and documents which the business of the Company may require and to affix the Seal of the Company thereto. RESOLVED, that the signatures and attestations of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating to the Power of Attorney by facsimile and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond, undertaking, recogaizances or other contract of indemnity of writing obligatory in the nature thereof. I, Jane E. Lynch, Secretary ofFirsl Indemnity of America Insurance Company of New Jersey, do hereby certify that the foregoing excerpts of the Resolution adopted by the Board of Directors of the Corporation and the Powers of Attorney issued pursuant thereto, are true and correct and that both the Resolution and the Powers of Attorney are in full force and effect. IN WITNESS WHEREOF, I have herewith set my hand and affixed the seal of said Corporation this~ day of_J~uly'------' 2018 , (7 J) !FIA POWER 2014 06 03]
FIRST INDEMNITY OF AMERICA INSURANCE COMPANY 2740 Route 10 West, Suite 205, Morris Plains, N.J. 07950 STATEMENT OF FINANCIAL CONDITION AS OF DECEMBER 31, 2017 Assets: Bonds $ 1,175,645 Preferred & Common Stocks 7,445,188 Mortgage Loans 120,000 Real Estate 1,066,243 Cash and Short Tenn Investments 1,314,787 Investment Income Due and Accrued 20,576 Premiums in the Course of Collection (Under 90 Days) 258,211 Reinsurance Recoverable on loss and ~E Payments 82,415 Deferred Tax Asset 381,188 Other Assets 79,848 Total Admitted Assets 11,944,101 liabilities and surplus: Reserve for Loss amd Loss Adjustment E>:penses 2,171.169 Other Expenses 250,441 Taxes licenses and Fees 77,118 Federal Income Tax Payable 31,000 Unearned Premium 2,113,536 Amounts Withheld or Retained for Others 21,664 Ceded Reinsurance Balances Payable
2,113,536 Amounts Withheld or Retained for Others 21,664 Ceded Reinsurance Balances Payable 155,322 Uabi!itiy for Unauthorized Reinsurers Total Liabititfes 4,820,250 Capital & Surplus: Common Stock, Paid Up 2,500,000 Paid in and Contributed Surplus 1,480,945 Unaslgned Surplus 3,142,906 Surplus as Regards to Pollcyholders 7,123,851 Total Liabilities and Surplus $ 11,944,101 I, Glenn A. Runne, Chief Financial Officer of First Indemnity of America Insurance Company, do hereby certify that the foregoing statement is a correct exhibit of the assets and surplus of the said company, on the 31st day of December, 2017, according to the best information, knowledge, and belief, .4a&n o R~ Glenn A Runne Chleffim:mcial Officer State of New Jersey) County of Morris) SS» Subscribed and sworn to, before me, a Notary Public of the State of New Jersey in the Township of Morris Plains, this 31st day of December, 2017. ~~hr£ I &/;ekJ) My Commission Expires March 16, 2020
Vl"!A I DOA (T~ 1 ~ RELIW00-01 ACORD" I..--- CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS I OATE (MMJDDNYYY) 07/1212018 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the c&rtfflcato holder rs an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cenaln polfcles may require an endorsement A statement on this c.ertlficata does not confer riahts to the certificate holder In lieu of such endorsementts}, PRODUCeR f,Q!fJ:ACT Acrlsure, LLC 0/BfA Chadlir Solutfons 100 Passarc Aveb Suite 120 tA}g;wo, ExtJ: {973) 227·0025 Ir~ "•'' 973) 221-102s l;;.M_ajf:. __ ' Falrfleld, NJ 070 4-3508 AFF v••••• ... ~.
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- Sep 29, 2026
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