215-26 REHS Inspection Services Agreement with the Essex Regional Health Commission.pdf

5 If to ERHC: Carrie Nawrocki, Health Officer Essex Regional Health Commission 204 Hillside Avenue Livingston, New Jersey 07039 If to WEST ORANGE: Michael A. Fonzino Director of Health and Welfare Township of West Orange 66 Main Street West Orange, NJ 07052 17. Copy. a. A copy of this signed Agreement shall be submitted to the New Jersey Department of Health, Office of Local Public Health, P.O. Box 360, Trenton, New Jersey 08625-0360. b. Pursuant to the provisions set forth in N.J.S.A. 40A:65-4(b), a copy of this fully executed Agreement shall be filed by the local authorities with the New Jersey Department of Community Affairs, Division of Local Government Services, 101 South Broad Street, P.O. Box 803, Trenton, New Jersey 08625-0803. IN WITNESS WHEREOF, this Addendum to the Professional Services Agreement has been duly executed by the authorized representatives of the parties hereto as of the date first set forth above. Dated: _____________, 2026 ESSEX REGIONAL HEALTH COMMISSION By: ___________________________________ Name: _________________________________ Title: __________________________________ Dated: ______________, 2026 TOWNSHIP OF WEST ORANGE DEPARTMENT OF HEALTH By: ____________________________________ Name: MICHAEL FONZINO Title: DIRECTOR OF HEALTH & WELFARE