180-26 - Exhibit A. CDBG 2025 SPECS_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 40A:11-23.2) Required With Initial Each Item Submission of Bid Submitted With Bid (Owner's checkmarks) (Bidder's initials) X | + Bid guarantee as required, by N.J.S.A. 40A: 11-21 * _ Certificate from a surety company, pursuant to N.J.S.A. 40A: 11-22 * _ Statement of corporate ownership, pursuant to N.J.S.A. 52:25-24.2 Listing of Subcontractors as required by N.J.S.A. 40A: 11- 16 + — If applicable, Bidder's acknowledgment of receipt of any notice(s) or re-vision(s) or addenda to an advertisement, specifications or bid document(s) >| ><] ><] >< 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) ACertified Financial Statement prepared within the X | last 12 months and certification showing ability to perform contract Consent of surety as to maintenance bond as required by NWJS.A. 40: 11 - 16.3b Consent of Surety as to a Labor and material Submission of a Non-Collusion Affidavit (this form must be Payment Bond x Notarized) Statement of compliance with N.J.S.A. 45: 14C- x Certification of Bidder showing that Bidder owns, leases or 2(h) (licensed master plumber) controls any necessary equipment X | Affirmative Action Program Information Qualification Questionnaire X | Disclosure of Political Contributions Disclosure of Investment Activities in Iran pursuant to PL 2012, ¢.25 Business Registration Certificate (must be valid at Certificate of Registration required if this is a x | time of Bid Opening) and all Subcontractors, Public x_ | "Public Work" project as defined in the Public Work Contractor Registration for General and Work Contractor Registration Act (PL Subcontractor 1999,C.238) Statement of Non-Debarment for Federal . ae x | Government Contracts (shall be provided to Ot | ere te ee nmernnne i cease cites i contract award) X | Lowest Bidder Prevailing Wage Certification X | SAM

atement of Non-Debarment for Federal . ae x | Government Contracts (shall be provided to Ot | ere te ee nmernnne i cease cites i contract award) X | Lowest Bidder Prevailing Wage Certification X | 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 x (this is provided after the award) Americans With Disabilities Act of 1990 Bid Documents Submission Checklist (Signed Below) Bid Proposal Form X | Hold Harmless Agreement C. SIGNATURE: The undersigned hereby acknowledges and has submitted the above listed requirements. Name of Bidder: By Authorized Representative: Signature: Print Name and Title: Date: THIS FORM MUST BE EXECUTED BY THE BIDDER (ALL ITEMS MUST BE COMPLETED IN INK.) Pt