98-24 Exhibits to the Agreement for the Operation of the Recycling Center - 2024.pdf

Part III DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS OR LLC MEMBERS LISTED IN PART II If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of the last annual federal Security and Exchange Commission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links to the website(s) containing the last annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent) that contain the name and address of each person holding a 10% or greater beneficial interest in the publicly traded parent entity, along with the relevant page numbers of the filing(s) that contain the information on each such person. Attach additional sheets if more space is needed. Website (URL) containing the last annual SEC (or foreign equivalent) filing Page #’s Please list the names and addresses of each stockholder, partner or member owning a 10 percent or greater interest in any corresponding corporation, partnership and/or limited liability company (LLC) listed in Part II other than for any publicly traded parent entities referenced above. The disclosure shall be continued until names and addresses of every non-corporate stockholder, and individual partner, and member exceeding the 10 percent ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach additional sheets if more space is needed. Stockholder/Partner/Member and Address Corresponding Entity Listed in Part II Part IV Certification 37

I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this certification on behalf of the bidder/proposer; that the Township of West Orange is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the completion of any contracts with Township of West Orange to notify the Township of West Orange in writing of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the, permitting the Township of West Orange to declare any contract(s) resulting from this certification void and unenforceable. Full Name (Print): Title: Signature: Date: 38

Article 3.02 State of New Jersey Township of West Orange Affidavit of Authorization for Contract State of _________________________ SS. County of _______________________ ________________________________ being duly sworn, deposes and says that he resides at ____________________________________________ that he is the ____________________(Title) who signed the Proposal for this Contract; that he was duly authorized to sign; that the seal attached is the seal of the Respondent; and that all declarations and statements contained in the Proposal are true, to the best of his knowledge and belief. ______________________________________ (Type and print name of affiant under signature Subscribed and sworn to before me this ____________ day of ____________________2024. ________________________________ (Notary Public) My commission expires ______________________________ 39

Article 3.03 MARKET CAPACITY AFFIDAVIT STATE OF NEW JERSEY COUNTY OF I, , am the (Name of Affiant) (Identify Relationship to Proposer) of the and being duly (Name of Proposer) sworn, I depose and say: All statements contained in this affidavit are true and correct and made with full knowledge that the State of New Jersey and West Orange will rely upon the truth of the statements contained in this affidavit and in this Proposal in signing the contract for the Contract term. At all times during the term of this Contract, _______________________agrees to commit, that ___________________________ has secured and will maintain sufficient market capacity for the Marketing of all Recyclable Materials as outlined within the RFP at a Market as defined under N.J.S.A. 13:1E-99.12 and received during the term of this Contract. I also understand and agree that failure to comply with the representations contained herein shall be cause for breach of contract and will entitle West Orange to damages arising there-from in accordance with the Liquidated Damages Provision within this Request for Proposal and Contract. Name of Firm or Individual Title Signature Date Subscribed and sworn to before me this day of 2024 ____________________________ Notary Public of My Commission expires , 2024 40

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). _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________ 41

5. That the Respondent does not appear on the State of New Jersey’s Treasurer’s Department List. 6. That the State in which the Respondent is incorporated is: ______________________ 7. That if the answer to question #6 is a State other than New Jersey, the Respondent has received from the Secretary of the State of New Jersey a certificate authorizing the corporation to conduct business in New Jersey. 8. That the names and address of the principals, officers, and shareholders of the Respondent are as follows: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ (Use additional sheets if required) 9. That he is personally acquainted with the operation of the Respondent; has full knowledge of the factual basis comprising the contents of this Affidavit; and that the contents are true. 10. That this Affidavit is made to the Township of West Orange to accept the Proposal for this Contract, knowing that the Township of West Orange relies upon the truth of the statements contained herein. _________________________________________ (Respondent) _________________________________________ (Type or print name of affiant under signature) Subscribed and sworn to before me this _________ day of _______________ 2024. ___________________________ (Notary Public) My commission expires ____________________________. 42

Article 3.05 Non-Collusion Affidavit State of_____________________ SS. County of___________________ I, __________________ of the Township of ________________________, in the County of __________________ and the State of __________________________, of full age being duly sworn according to law, on my oath depose and say that: I am _____________________ of the firm of _____________________, the Proposer making the proposal for the above named project, and that I executed the said proposal for the above named project, and that I executed the said proposal with full authority to do so; that said Proposer has not, directly or indirectly, entered into any agreement, participation in any collusion or otherwise taken any action in restraint of free, competitive Proposal in connection with the above named project; and that all statements contained in said proposal and in this Affidavit are true and correct, and made with full knowledge that the Township of West Orange, New Jersey relies upon the truth of the statements contained in said proposal and in the statements contained in the affidavit in awarding the contract for the said project. I further warrant that no person or selling agency has been employed or retained to solicit or secure such a contract upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, except bona fide employees or bona fide established commercial or selling agencies maintained by _________________________ (N.J.S.A. 52:34-15). Name of Contractor __________________________ __________________________ (Sign Name Here) Subscribed and sworn before me on this ______________ day of _________________________ 2024. _________________________ (Notary Public) My commission expires: ___________________________ Note to Notary: When completing this form, all notaries must: 1- Indicate date. 2. Indicate State. 3. Sign Name. 4. Affix name by Printing it, typing it, using a rubber stamp, using an impression seal or using a mechanical stamp. NOTE: The person who signed the proposal form from the respondent should sign this form also.

using an impression seal or using a mechanical stamp. NOTE: The person who signed the proposal form from the respondent should sign this form also. 43

Article 3.06 State of New Jersey Township of New Jersey Sub-Contractor Use Form Furnish below the company name, address, telephone number, and name of contact person for each sub-subcontractor, if any, to be used in the performance of the Work for the Contract. Experience statements shall be attached hereto for each sub-contractor. NOTE: If no work will be sub-contracted, indicate NONE. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ The contractor is advised that any change of sub-contractor(s) from the ones listed herein is subjected to the Township of West Orange’s approval. Change of sub-contractor(s) will be approved only if made for good cause and not as a result of an arbitrary purpose. Witness: ________________________________ (Name of Company) ________________________________ (Address) ___________________________ BY: ________________________________ (Date) (Sign Name (Original Signature Only) ________________________________ (Print Name & Title) 44

Article 3.07 Experience Statement Township of West Orange, West Orange, New Jersey Gentlemen: I hereby certify that my company has performed the following private or public work which is relevant to this proposal. I further certify that my company has never defaulted under any contract. (Give name of project, owner’s name and address, contact person, and phone number, type of work, when started and completed, and dollar amount of work.) ___________________________________ ________________________________ (Witness) (Name of Company) ________________________________ (Address) ___________________________________ BY: _____________________________ (Date) Sign Name (Original Signature Only) ________________________________ (Print Name and Title) (You may attach your own forms to this sheet if you prefer, but sign and witness this sheet) 45