99-24 Exhibit to Temporary Extension Agreement.pdf

5. That 5. That the the Respondent Respondent does does not not appear appear on on the the State State of of New New Jersey’s Jersey’s Treasurer’s Treasurer’s Department List. Department List. 6. That 6. That the the State State in in which the Respondent which the Respondent is is incorporated incorporated is: is: ______________________ 7. That 7. That if if the the answer answer to to question question #6#6 is is aa State State other other than than New New Jersey, Jersey, the the Respondent Respondent has has received from received from the the Secretary Secretary ofof the the State

received from the the Secretary Secretary ofof the the State State of of New New Jersey Jersey aa certificate certificate authorizing authorizing the the corporation to corporation to conduct conduct business business in in New New Jersey. Jersey. 8. That 8. That the the names names and and address address of of the the principals, principals, officers, officers, and and shareholders shareholders of of the the Respondent are Respondent are as as follows: follows: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ (Use additional (Use additional sheets sheets if

______ _____________________________________________________________________ (Use additional (Use additional sheets sheets if if required) required) 9. That 9. That he he is is personally personally acquainted acquainted with the operation with the operation of of the the Respondent; Respondent; has has full full knowledge of knowledge of the the factual factual basis basis comprising comprising the the contents contents of of this this Affidavit; Affidavit; and and that that the the contents are contents are true. true. 10. That 10. That this this Affidavit Affidavit is is made made toto the the Township Township of

made toto the the Township Township of of West West Orange Orange to to accept accept the the Proposal Proposal for this Contract, knowing that the Township of West Orange relies upon the truth for this Contract, knowing that the Township of West Orange relies upon the truth of of the statements the statements contained contained herein. herein. _________________________________________ (Respondent) (Respondent) _________________________________________ (Type or (Type or print print name name of of affiant affiant under under signature) signature) Subscribed and Subscribed and sworn sworn to to before before me me this this _________ day

to before before me me this this _________ day day of of _______________ 2018. 2018. ___________________________ (Notary Public) (Notary Public) My commission My commission expires expires ____________________________. 39 39