160-25 Exhibit.pdf

CONTRACT AMENDMENTS AND EXTENSIONS / certify, pursuant to law, that neither the person or entity listed above, nor any parent entity, 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 oO ursuant to P.L. 2022, c. 3. I further certify that I am the person listed above, or 1am jan officer or representative of the entity listed above and am authorized to make this certification on its behalf. (Skip Part 2 and sign and complete the Certification below.) IF UNABLE TO CERTIFY 7 am unable to certify as above because the person or entity and/or a parent entity, subsidiary, or affiliate is listed on the Department's Russia-Belarus list and/or Chapter 125 Iran list. Iwill provide a detailed, accurate, and precise description of the activities O las 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. Part 2: Additional Information PLEASE PROVIDE FURTHER INFORMATION RELATED TO PROHIBITED ACTIVITIES IN RUSSIA OR BELARUS AND/OR INVESTMENT ACTIVITIES IN IRAN. You must provide a detailed, accurate, and precise description of the activities of the person or entity, or of al parent entity, subsidiary, or affiliate, engaging in prohibited activities in Russia or Belarus and/or investment| activities in Iran in the space below and, if needed, on additional sheets provided by you.

Part 3: Certification of True and Complete Information , being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments there, to the best of my knowledge, are true and complete. I attest that I am authorized to execute this certification on behalf of the above-referenced person or entily. acknowledge that the Township of West Orange is relying on the information contained herein and hereby acknowledge that I am under a continuing obligation from the date of this certification through the completion of any contracts with the Township of West Orange to notify the Township of West Orange in writing of any changes to the answers of information contained herein. ! acknowledge that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification. If Ido so, I recognize that I am subject to criminal prosecution under the law and that it will also constitute a material breach of my agreement(s) with the Township of West Orange and that the Township of West Orange at its option may declare any contract(s) resulting from this certification void land unenforceable. Full Name Title (Print) ; Edward Farmer President and CEO Signature Ya ae Date 07/06/2023 17

TOWNSHIP OF WEST ORANGE ACKNOWLEDGMENT OF RECEIPT OF ADDENDA The undersigned Bidder hereby acknowledges receipt of the following addenda: Please assign the number, date and initial. Addendum Number Dated Acknowledge Receipt (Initial) (Kh addenda was/were received. Millennium Strategies LLC (Company Name) Acknowledged for: (Signature of Authorized Representative) Name: Edward Farmer (Print) tite, President and CEO pate;__07/06/2023

AFFIDAVIT OF NON-COLLUSION The undersigned bidder of full age, being duly sworn according to law depose and hereby specifically certifies that: A. To the best of the bidder's knowledge and belief, the annexed bid proposal for this project has not been prepared in collusion with any other bidder of like item or services and the prices, discounts, terms and conditions thereof have not been directly or indirectly communicated by or on behalf of the bidder to any person other than the recipient of the bid and will not be communicated to any person prior to the official opening of the bid. B. The bidder fully understands that no premiums, rebates, or gratuities are permitted either with, prior to, or after signing of contract. Any violation will result in cancellation and removal from the bid list. C. The bidder further certifies that the undersigned has the necessary authority, to sign this stipulation stating that the bidder has not entered into any agreement, or otherwise taken any action in restraint of free competitive bidding in connection with this bid. All references to the bidder are understood to include the undersigned and all principals, partners and officers of the bidder. Date: 07/06/2023 wh —— (Gignature) Edward Farmer, President and CEO (Name and Title) Millennium Strategies LLC (Company) 60 Columbia Road, Building B, Suite 230 (Address) Morristown, Nd, 07960 (Corporate Seal) ee Subscribed and sworn to before me Semnnuscions r} oh ee My Commission Expires 06/03/2026 this_6th day of __July , 20.23 Notary Seal fuse Ch pe Jessica Carvajal ig Human Resources Generalist

INSURANCE REQUIREMENTS AND ACKNOWLEDGEMENT FORM Certificate(s) of Insurance shall be filed with the Municipal Clerk's Office upon award of contract by the Mayor and Township Council, The minimum amount of insurance to be carried by the Professional Service Entity shall he as follows: PROFESSIONAL LIABILITY INSURANCE Limits shall be a minimum of $1,000,000.00 for each claim and $1,000,000.00 aggregate each policy period. Acknowledgement of Insurance Requirement: Millennium Strategies LLC wW pp 07/06/2023 (Signature) (Date) Edward Farmer, President and CEO (Printed Name and Title)

MILLSTR-O41 MLESZCZYNSKI —, ACCORD CERTIFICATE OF LIABILITY INSURANCE on eereoes THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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 certificate holder is an ADDITIONAL INSURED, the policy{ies) must have ADDITIONAL INSURED provisions or be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an ondorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER §QNTACT Dianne DeMott Levi 60 Pascale Ave, Suite 120 {H-No,cxp (973) 797-0841 1168 TER no: Fairfield, NJ 07004-3508 oles: DLevi@acrisure.com INSURER(S) AFFORDING COVERAGE NAIC # insurer A: Hartford Insurance Company of Midwest 37478 INSURED isurer Sentinel Insurance Company Ltd 11000 to Golunitis Rost Bite, B isuzer c: Twin City Fire Insurance Company 29459 Ste 230 insurero: RL Insurance Company 13056 Morristown, NJ 07960 INSURER E.:, INSURER F ! COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDLSI hal TYPE OF INSURANCE Neo wa POLICY NUMBER (GRIDDAY | daMoD YD LIMIT A |X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000) [| J cxams-tape [X] occur H3SBAILe856 2izei2023 | 2izerzoz4 | PAMGETOREMTES | | 500,000 |_| MED Exp (Any one person) | $s 10,000 poof PERSONAL & ADVINJURY |S 4,000,000) | GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE. 2,000,000 LX roucy| | 8% | Ytoc pnoouers -counerace |& 7,000,000 OIHeR: 8 A | auromopite LIABILITY GOMBINES SINGLE LIMIT 7,000,000) |__| ANY AUTO M3SBAIL6856 2/28/2023 | 2/28/2024 | soniy INJURY (Per

2,000,000 LX roucy| | 8% | Ytoc pnoouers -counerace |& 7,000,000 OIHeR: 8 A | auromopite LIABILITY GOMBINES SINGLE LIMIT 7,000,000) |__| ANY AUTO M3SBAIL6856 2/28/2023 | 2/28/2024 | soniy INJURY (Per person) | $ ‘OwiNED 7] geygguee |__| AUTOS ony AUTOS BODILY INJURY (Per accident} | § [LX] HER ower [XC] NOSE ca 8 A X/umpreuauas |X| occur ACH OCCURRENCE $ 2,000,000} EXCESS LIAB CLAIMS. MADE |13SBAILBB56 2128/2023 | 2/28/2024 |. coproatc $ 2,000,000) pep |X| aerenrions 10,000] : B |workens compensation [Pfoe |S AND EMPLOYERS’ LIABILITY STATUTE te ‘ANY PROPRIETORIPARTNEREXECUTIVE [—) {3WECTC8758 3112023 | SH112024 |e) exch ACCIDENT $ 1,000,000) OrFIGERUMEMBER EXCLUDED? Nin 7000-000 endorse EL. DISEASE -EA EMPLOYEE) § ,000, DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | § 1,000,000 ¢C |Directors & Officers. 13KB0381514-23 5/20/2023 | 5/20/2024 [Limit 1,000,000) D |Errors & Omissions IRTPO028688. 3/1/2023 | 34/2024 |Limit 1,000,000) DESCRIPTION OF OPERATIONS / LOCATIONS /VEHIGLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE GANGELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PROOF OF INSURANCE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD

REFERENCES

Municipal Government References Township Of Middletown Name: Stephanie Teoli Kuhls Title: Township Manager Phone: 215-750-3836 Email: steoli@middletownbucks.org Address: 3 Municipal Way, Langhorne, PA, 19047 Services: Grant Consulting Service Township Of Falls Name: Matthew Takita Title: Township Manager Phone: 215- 949-9000 Email: m.takita@fallstwp.com Address: 188 Lincoln Hwy, Fairless Hills, PA, 19030 Service: Grant Consulting Service Town of Monroe Name: Tony Cardone Title: Town Supervisor Phone: 845-742-0769 Email: tceardone@monroeny.org Address: 1465 Orange Tpke, Monroe, NY, 10950 Service: Grant Consulting Service City Of Paterson Name: Kathleen Long Title: Business Administrator Phone: 973-321-1556 Email: klong@patersonnj.gov Address: 155 Market St, Paterson, NJ, 07505 Services: Grant Consulting Services City of Hackensack Name: Vincent Caruso Title: City Manager 101-646-3980 citymanager@hakensack.org. Address: 65 Central Ave, Hackensack, NJ, 07601 Services: Grant Consulting Services City Of Hoboken Name: Caleb Stratton Title: Assistant Business Administrator Phone: 201-420-2000 Email: cstrattion@hobokennj.gov Address: 94 Washington St, Hoboken, NJ, 07030 Services: Grant Consulting Services Township Of Harrison Name: Mike Amodeo Title: Town Engineer Phone: 914-670-3102 Email: mamodeo@harrison-ny.gov Address: 1 Heinman Pl, Harrison, NY, 10528 Services; Grant Consulting Services Village Of Port Chester Name: Curt LaValla, AICP Title: Director of Planning Phone: 914-937-1556 Email: clavalla@portchesterny.gov Address: 222 Grace Church St, Port Chester, NY, 10573 Services Grant Consulting Services Borough of Franklin Lakes Name: Greg Hart Title: Borough Administrator Phone: 201-891-4000 Email: ghart@franklinlakes.org Address: 480 DeKorte Dr, Franklin Lakes, NJ, 07417 Servies: Grant Research Portal Service Township of Ocean Name: David G. Brown, Il Title: Township Manager Phone: 732-531-5000 Email: manager@oceantwp.org Address: 399 Monmouth Rd, Oakhurst, NJ, 07755 Services: Grant Research Portal Service Borough of North Caldwell Name: Kevin O’Sullivan Title: Borough Administrator Phone: 973-228-6410 Email: kosullivan@northcaldwell.org Address:141 Gould Ave, North Caldwell, NJ, 07006 Services: Grant Research Portal Service Township of Verona Name: Joseph D’Arco Title: Township Manager Phone:

Email: kosullivan@northcaldwell.org Address:141 Gould Ave, North Caldwell, NJ, 07006 Services: Grant Research Portal Service Township of Verona Name: Joseph D’Arco Title: Township Manager Phone: 973-857-4767 Email: jdarco@veronanj.org Address:600 Bloomfield Ave, Verona, NJ, 07044 Services: Grant Research Portal Service