180-26 - Exhibit B. AJ Contractors_compressed.pdf

PROPOSAL AND SCHEDULE OF BIDS BID DOCUMENT SUBMISSION CHECKLIST - TOWNSHIP OF WEST ORANGE 2025 CDBG ROAD REHABILITATION STANDISH AVENUE & FREMONT STREET (Name of Construction/Public Works Project) A. Failure to submit the following documents is a mandatory cause for the bid to be rejected. (NJSA A0A:11-23.2) Required With Submission of Bid (Owner's checkmarks) Initial Each Item Submitted With Bid (Bidder's initials) X |+ Bid guarantee as required, by N.J.S.A. 40A: 11-21 fL X | + Certificate from a surety company, pursuant to N.J.S.A. 40A: 11-22 We X | + Statement of corporate ownership, pursuant to N.J.S.A. 52:25-24.2 yl X | + Listing of Subcontractors as required by N.J.S.A. 40A: 11- 16 ae X | + Ifapplicable, Bidder's acknowledgment of receipt of any notice(s) or re-vision(s) or addenda to an advertisement, specifications or bid document(s) Ww B. Failure to submit the following documents may be a cause for the bid to be rejected, (NJSA 40A: 11-23.1b,) Required with Initial Each Item Required with Initial Each Item Submission of Bid Submitted with Bid Submission of Bid Submitted with Bid (Owner's checkmarks) (Bidder's initials) (Owner's checkmark) (Bidder's initials) A Certified Financial Statement prepared within the X | last 12 months and certification showing ability to uy Consent of surety as to maintenance bond as required by NWJSA. 40: 11 - 16.3b perform contract Consent of Surety as to a Labor and material x Submission of a Non-Collusion Affidavit (this form must be Payment Bond Notarized) U Statement of compliance with NJ.S.A. 45: 14C- x Certification of Bidder showing that Bidder owns, leases or 2(h) (licensed master plumber) controls any necessary equipment A Ll Affirmative Action Program Information AU Qualification Questionnaire A_| Diedoauraioh powital Canidlctlons AL Decors of Investment Activities In Iran pursuant to PL A Business Registration Certificate (must be valid at time of Bid Opening) and all Subcontractors, Public Work Contractor Registration for General and Certificate of Registration required if this is a x “Public Work" project as defined in the Public Work Contractor Registration Act (PL Subcontractor Statement of Non-Debarment for Federal X | Government Contracts (shalll be provided to contract award) X | Lowest Bidder Prevailing Wage Certification 1999,C.238) Certification of Non-Involvement in Prohibited

Non-Debarment for Federal X | Government Contracts (shalll be provided to contract award) X | Lowest Bidder Prevailing Wage Certification 1999,C.238) Certification of Non-Involvement in Prohibited Activities in Russia or Belarus SAM Number, Cage Code Number and DUNS Numbers. Certificate of Insurance - All parties to the Contract X | must be named as additional insured/co-insured (this is provided after the award) Americans With Disabilities Act of 1990 x | Bid Documents Submission Checklist (Signed A & | eimai Below) X | Hold Harmless Agreement 4 C, SIGNATURE: Th Name of Bidder:, By Authorized Represeditivg: come: M Print Name and Tite: | Jp Ze, A (Made, Pyeg Date: TYnVTa~ 4 4 : "7 Fsedeaaacee THIS Fi BE EXECUTED BY THE BIDDER (ALL ITEMS MUST BE COMPLETED IN INK.) id y acknowledge: we, is submitted the above listed requirements. g ZN A vi) a a P-1