Town CrierWest Orange, New Jersey
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Supporting Documentation · May 20, 2025

141-25 Exhibit.pdf

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i | I certify, pursuant to law, that neither the person or entity listed above, nor any parent entily, subsidiary, or affiliate is listed on the N.J. Department of the Treasury's lists of entities determined to be engaged in prohibited activities in Russia or Belarus pursuant to PL. 2022, c. 3. I further certify that I am the person listed above, or I am an officer or representative of the entily listed above and am authorized te make this certification on its.behalf(Skip Part 2_and_sign and complete-the Certification-|__ below.) Jam unable to certify ay above because ihe person or entity and/or a parent entity, subsidiary, or affiliate is listed on the Department's Russia-Belarus list and/or Chapter 25 Ivan list. I will provide a detailed, accurate, and precise description of the activities as directed in Part 2 below, and sign and complete the Certification below. Failure to provide such will prevent the award of the contract to the person |, or entity, and appropriate ‘penalties. fines, and/or sanctions will be assessed as provided by law.

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