238-25 Exhibit B.pdf

eee SITE_INSPECTION AFFIDAVIT I, DANIEL CHRISTOFFERSON__, on behalf of the bidder, DWC ENTERPRISES INC,__, do hereby declare that, I or my duly authorized representative, did satisfactorily inspect the project limits for the purpose of being fully informed as to the locations and conditions of the vatious Sidewalks, Paths, Crosswalk and Bus Shelters and Stops within the Township of West Orange for snow removal to be cleared under this contract. Jinspected the various sites on the 28TH__day of SEPTEMBER__, 2025____, and Thereby acknowledge that I have satisfied myself regarding the conditions of the various sites and the nature and extent of the By DANIEL CHRISTOFFERSON DWC ENTERPRISES INC. (Print or type name Bidding Hirm/Contractor) Subsertbed-and sworn to Sworn before me this £ a day of Okey 20, 25" MARX. Li Mel briSho (han Sy 261 \ CLR?) (Notary Public) waistosy, ry lf ‘ / 20 25 se EXP. 15tte Oe, Tee aa S we My commission expires on

AMERICANS WITH DISABILITIES ACT OF 1990 Lqual Opportunity for Individuals with Disability ‘The contractor and the Township of West Orange, (hereafter "TOWNSEIP") do hereby agree thet the provisions of Title 11 of the Americans With Disabilities Act of 1990 (the "Act") (42 U.8.C. $121 01 et seq.), which pronibits ' discrimination on the basis of disability by public entities in all services, programs, activities provided or made available by public entities, and the rules and regulations promulgated pursuant there unto, are made a part of this contract, In providing any aid, benefit, or service on behalf of the TOWNSHIP pursuant to this contract, the contractor agrees that the performaiice shall be in strict compliance with the Act. Jn the event that the contractor, its agents, servants, employees, or subcontractors violate or are alleged to have violated the Act during the performance of this contract, the contractor shall defend the TOWNSHIP in any action or administrative proceeding commenced pursuant to this Act, ‘Thecontractor shell indemmify, protect, and save hamless the TOWNSHIP, its agents, servants, and employees from and against ; any and all suits, claims, losses, demands, or damages, of whatever kind of nature arising out of or claimed to arise ont of the alleged violation. The contractor shall, at its own expense, appeer, defend, and Pay any and alt charges for legal services and any and all costs and other expenses arising from such action or administrative proceeding or incurred in connection therewith Ia any and all complaints brought pursuant to the TOWNSHIP's grievance procedure, the contractor agrees to abide by any decision of the TOWNSHIP which is rendered pursuant to said grievance procedure, If eny action or adininisivative proceeding results in an award of damages against the TOWNSHIP, or if the TOWNSHIP incurs any expense to cure a violation of the ADA which bas been brought pursuant to its grievance procedure, the contractor shall salisfy and discharge the same at its own expense, on ~The TOWNSHIP shall, a8-soon-as-practicable after.a claim -has-besn-nade against it, give-written notiee-theteofto-the —-_____.___ | contractor slong witirfithand completes partioulars of tie claim, ifmiy actor or administrative procesding ts browght—————————-— E against the TOWNSEEP ny of ite agents, servants, and etaployecs, te TOWNSHIP shalt

ong witirfithand completes partioulars of tie claim, ifmiy actor or administrative procesding ts browght—————————-— E against the TOWNSEEP ny of ite agents, servants, and etaployecs, te TOWNSHIP shalt expeditiously forward or have u aint, notice, summons, pleading, or other process reoaived by the demaud, TOWNSHIP or iis representatives. } Itis expressly agreed and understood that any approval by the TOWNSHIP of the services provided by the contractor pursuant to this contract will not relieve the cotractor of the obligation to comply with the Act and to defend, indeannify, protect, und save harmless the TOWNSHIP pursuant to this paragraph, Itis further agreed and understood that the TOWNSHIP assumes no obligation to indemnify or save harmless the contractor, its agents, servants, cmployces and subcontractors for any claim which may atise out of their performance of this Agreement. Futhermore, the contractor expressly understands and agrees that the provisions of this indenmification clause shail inno way limit the contractor's obligations assumed in this Agreement, nor shall they be —_____couisitued toietieve the conitactor front any- liability, no1-proclude-the TOWNS freirtaking-any-o tie actions avanmne TIE under any otver provisions of the Agreement or otherwise at law, Tacknowledge:

i TOWNSHIP OF WEST ORANGE ACKNOWLEDGMENT OF RECEIPT OF ADDENDA i ‘The undersigned Bidder hereby acknowledges receipt of the following addenda: : Please assign the number, date and initial, Addendum Number Dated Acknowledge Receipt | | _ (Initial) a No addenda was received, (please check off if no addenda received) ;_ Acker mledged for, DWC ENTERPRISES INC (Company Name) (Sighature dfAuthorized Representative) t ' 1 | 1 | i i | | | | | 1 i Name: DANIEL CHRISTOFFERSON | (Crint) i Title: PRESIDENT, Date: 10/1/25,

oS ne a wt ri ec - fee eene REQUIRED EVIDENCE AFFIRMATIVE ACTION REGULATIONS NJ, 8.A, 10:5-31, et seq. (NLA. C, 17:27) Ifawarded a coniract, the Bidder will be required to comply with the requirements of NLLS.A, 10:531, ef seq, and N.LA.C, 17:27, Within five (5) days after receipt of the notification of intent to award the contract, the Bidder shall present one of the following: 1, Appropriate evidence that the Contractor is operating under an existing federally approved or , sanctioned affirmative action program; or 2, A Certificate of Employee Information Report Approval issued in accordance with N.LA.C, 17:27-4; or 3. Aninitial Employee Information Report consisting of forms provided by the Affirmative Action Office and completed by Contractor in accordance with N.LA.C, 17:27-4. ‘The Bidder must submit no later than three (3) days after the signing of the Contract an Initial Project Manning Table consisting of forms provided by the Affirmative Action Office and completed by Contractor in accordance with N.LA.C, 17:27-7, Bidders are referred to thé Bidder's Intormahion Section of the Bid Packer tora furtier desciiption of the.abave_requirements NO BIDDER MAY BE ISSUED 4 CONTRACT UNLESS THEY COMPLY WITH THE AFFIRMATIVE ACTION REGULATIONS OF N.J.S.A. 10:5-31, et seq. The following questions must be answered-by all Bidders: 1 Do you have a federally-approved or sanctioned Affirmative Action Program? Yes__—___(If yes, submit a copy of suck approval.) ‘No 2, Do you have a State Certificate of Employee Information Report approval? , Yes 4 $ {if yes, submit a copy of such approval.) No The undersigned Bidder certifies that he is aware of the commitment to comply with the requirements of NLLS.A, 10:5-31, ef seq., and agroes to furnish the requited documentation, pursuant to the law. TITLE; PRESIDENT. NOTE; A bid must be rejected ag non-responsive if a Bidder fails to comply with requirements of N.J.S.A, 10:5-31, et seq,, within stipulated time, 12

C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM Required Pursuant To N.LS.A. 19:44A-20.26 This form or its permitted facsimile must be submitted to the local unit no later than 10 days prior to the award of the contract. Parti — Vendor Information : Vendor Name: [WC ENTERPRISES INC, | Address: PO BOX 1293 City: [MAPLEWOOD | State:NT | Zip:07040 | The undersigned being authorized to certify, hereby certifies that the submission provided herein represents ! compliance with the provisions of N.J.S.A, 19:44A-20,26 and as represented by the Instructions accompanying this form. CoN ee Signature Printed NameDANIEL CHRISTOFFERSON TitlePRESIDENT Part H - Contribution Disclosure Disclosure requirement: Pursuant to NLLS.A, 19:44A-20,26 this disclosure must include all reportable political contributions (more than $200 per election cycle) over the 12 months prior to submission to the committees of the government entities listed on the form provided by the local Unit, a Check here if disclosure is provided in electronic form. Contributor Name Recipient Name Date Dollar Amount $ 15

STATE OF ERSUIP LOSURE NSA, 52:25-24.2 (P.L, 1977, 6.33, as amended by P.L, 2016, 6.43) This statement shall be completed, certified to, and included with all bid and proposal submissions, Failure to submit the required information is cause for automatic rejection of the bid or proposal. Name of Organization:DWC ENTERPRISES INC, Organization Address:PO BOX 1293 MAPLEWOOD NJ 07040 Part I Check the box that represents the type of business organization: sole Proprietorship (skip Parts I and IH, execute certification in Part IV) [Non-Profit Corporation (skip Parts II and II, execute certification in Part IV) Adfror-proti Corporation (any type) i Limited Liability Company (L1.C) [}Partnership [Limited Partnership [_luimited Liability Parmership (LLP) O Other (be specific): Parti — | The list below contains the names and addresses of all stockholders in the corporation who own 10 percent or more of its stock, of any class, or of all individual partners in the partnership who own a 10 percent or greater interest therein, or of all members in the limited liability company who own a 10 percent or greater interest therein, as the case may be. (COMPLETE THE LIST BELOW IN THIS SECTION) . OR Ol No one stockholder ta the corporation owns 10 percent or more of its stock, of any class, or no individual partner in the partnership owns a 10 percent or greater interest therein, or no member inthe limited liability company owns a 10 percent or greater interest therein, as the case may be, (SKIP TO PART IV) (Please attach additional sheets if more space is needed): Name of Individual or Business Entity Address Z [DANIEL CHRISTOFFERSON B35 HAZELWOOD PLACE PISCATAWAY NJ 08854 18

ee a cee rt ema Part I DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS OR LLC MEMBERS LISTED IN PART II Ifa 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 Secutities 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 SEG (or foreign equivalent) filing Page #s Ploase 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 I 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 ——pereent- ownership eriteria-established-pursuant-to NJ-S-A-52:35-24.3-has-beemlisted-Attach additionat sheets ———__ jeeded. ted, Stocknolder/Partner/Memberand Address Corresponding Entity Listed in Part Il Part JV Certitication I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the best ofmy knowledge are true and complete. Lacknowledge: that Iam authorized to execute this certification on behalf of the bidder/proposer, that the Lownship 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 itis a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, 1am subject to criminal prosecution under the

ation contained herein; that I am aware that itis a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, 1am subject to criminal prosecution under the law and that it will constitute a material breach of my agreemeni(s) with the, permitting the Township of West Orange to declare any contract(s) resulting from this certification void and unenforceable, Full Name Prin, PANIEL. CHRIST ORFERSON Tite: PRESIDENT Signature: qt Date: [t0/1/25 a

CERTIFICATION OF NON-INVOLVEMENT IN PROHIBITED ACTIVITIES IN RUSSIA OR BELARUS | ; Pursuant to N.JS.A, 62:92-60.1, of seq. (L..2022,.6.3) any person or ontlty (herotnafter "Vencorl") that seeks to enter Into or renew @ contract with a State agency for the provision of goods or services, or the purchase of bonds or other obligations, | must complete ths certification below Indicating whether or nat the Vendor Is identiied on the Office of Forelgn Agssts | Control (OFAC) Specially “Designated Natlonals and Blocked Persons list, available here: H 7 If the Department of the Treasury finda that @ Vendor has made a cartifleatlon In i violation ofthe law, it shell take any actlon as may be appropriate and provided by law, rule or contract, inciding but not i limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking t debarment or suspension of the party, i . |, the undarsigned, certify that | have read the definition of Vendor” below, and have reviewed the Office of Foreign Assets H Control (OFAC) Specially Designated Nationals and Blocked Persons list, and Having done so certify: (Cheok the Appropriate Box) QO ° BaahatRa annals Ghd Lis Mr SPa Ra AOR ene, ey Gened 95 the, QAR, Segal OR. That | am tunable to certify as to “A” above, because the Vendor Is Identified on the OFAG one i yo, —Bailahad Nelonale act : eet ia a iganse oF Oxornpt Pog ana ay ees iw the Vendor's activity related to Russla and/or Belarus Is conelstent with fecleral law |s set forlh below, {Aliaoh Additional Sheets 18 as 10/1/26 ie thorized Raprawonlalve Dale DANIEL. CHRISTOFFERSON 223750226 “Print Naito and Tile of Vendor's Authorized Representalve Vandre FEIN DWG ENTERPRISES INC. 973-449-4789 Vendors Navid Vendor’ Phone Number 335 HAZELWOGi) PLACE Vendors Alinies (Sirwal Adare) Vandars Fax Number PISCATAWAY Nu 08854 DWCSECURE1@GMAIL.COM Vendors Aidiess (ly/Stataizip Goa) Vendor's Emall Aildroes ' Vendor means: (1) A nalural. person, corporation, company, Himited partnershio, limited Mlabllly partnership, limited llahllly company, ‘ousiness assoclaton, solo prapristorship, jolat venture, partnership, eocialy, trusl, or any other nongovemmental entity, organization, of respi (2) Ary goversmental enlly or harumentaky of government, Inludhng auliaterel devoloprant inion, 35 dined in Seton 1704(c)(8) of the Intemational