181-26 Exhibit A- Final Specifications_compressed.pdf

PROPOSAL AND SCHEDULE OF BIDS BID DOCUMENT SUBMISSION CHECKLIST - TOWNSHIP OF WEST ORANGE NJDOT MA 2025 HELEN AVE., LAWRENCE AVE., FLORENCE PL, AND LOWELL AVE. IMPROVEMENT PROJECT (Name of Construction/Public Works Project) (Project Or Bid Number) 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 NJSA 40A: 11-21 X • Certificate from a surety company, pursuant to NJSA 40A: 11-22 X • Statement of corporate ownership, pursuant to NJSA 52:25-24.2 X • Listing of Subcontractors as required by NJSA 40A: 11- 16 X • 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) A Certified Financial Statement Consent of surety as to maintenance bond prepared within the last 12 months as required by NJSA 40: 11 - 16.3b Consent of Surety as to a Labor and X Submission of a Non-Collusion Affidavit (this Material Payment Bond form must be notarized) Statement of compliance with NJSA X Certification of Bidder showing that Bidder 45: 14C-2(h) (licensed master owns, leases, or controls any necessary plumber) equipment X Affirmative Action Program Information X Qualification Questionnaire Disclosure of Political Contributions

plumber) equipment X Affirmative Action Program Information X Qualification Questionnaire Disclosure of Political Contributions X Disclosure of Investment Activities in Iran X Business Registration Certificate X Certificate of Registration required if this is a "Public Work" project as defined in the Public Work Contractor Registration Act (PL 1999,C.238) X Business Registration Certificate for all X Certificate of Registration required if this is a subcontractors "Public Work" project as defined in the Public Work Contractor Registration Act (PL 1999,C.238) for all subcontractors X Statement of Non-Debarment for X Certification of Non-Involvement in Prohibited Federal Government Contracts Activities in Russia or Belarus Lowest Bidder Prevailing Wage X SAM Number, Cage Code Number and Certification DUNS Numbers X Certificate of Insurance - All parties to X Americans with Disabilities Act of 1990 the Contract must be named as Acknowledgement additional insured/co-insured 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.) P-1