293-22 Exhibit A.pdf

Article 3.04 State of New Jersey Township of West Orange Moral Integrity Affidavit for Contract State of _________________________ SS. County of _______________________ I, ______________________________, the __________________________________of ________________________________ hereinafter called the Respondent, being duly sworn, deposes and says: 1. That the Respondent herewith submits a proposal regarding this Contract to the Township of West Orange. 2. That the Respondent wishes to demonstrate moral integrity to the satisfaction of the Township of West Orange. 3. That, as of the date of signing this Affidavit, neither the Respondent, nor any of his owners, officers, or directors are involved in any Federal, State or other Governmental investigations concerning criminal or quasi-criminal violations, except as follows: (if none, so state). ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ 4. That neither the Respondent not any of his owners, officers or directors have ever committed any violations of a Federal or State of quasi-criminal statute, except as follows (if none, no state). _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________ 38