Township Council Meeting — Packet

t 2: PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN [RAN You must provide a detailed, accurate and precise description of the activities of the proposer, or one of its parents, subsidiaries or affiliates, engaging in the investment activities in Iran outlined above by completing the boxes below, Meas & Name: Relationship to Proposer: Description of Activities: Duration of Engagement: Anticipated Cessation Date: Proposer Contact Name: Contact Phone Number: Certification: I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. | attest that | am authorized to execute this certification on behalf of the above referenced person or entity. | acknowledge that the Township of West Orange, State of New Jersey Is relying on the Information contained herein and thereby acknowledge that | am under a continuing obligation from the date of this certification through the completion of any contracts with the Township to notify the Township in writing of any changes to the answers of information contained herein. | acknowledge that | am aware that it is a criminal offense to make a false statement or misrepresentation in this 25|Page

‘ i | | | sex, and that it will discontinue the use of any recruitment agency which engages in direct or indirect discriminatary practices. The contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to assure that all personnel testing conforms with the principles of job-related testing, as established by the statutes and court decisions of the State of New Jersey and as established by applicable Federal law and applicable Federal court decisions. In conforming with the targeted employment goals, the contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and layoff to ensure that all such actions are taken without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex, consistent with the statutes and court decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions. The contractor shall submit to the public agency, after notification of award but prior to execution of a goods and services contract, one of the following three documents: Letter of Federal Affirmative Action Plan Approval Certificate of Employee Information Report Employee Information Report Form AA302 (electronically provided by the Division and distributed to the public agency through the Division’s website at www.state.nj.us/treasury/contract_compliance) The contractor and its subcontractors shall furnish such reports or other documents to the Division of Public Contracts Equa! Employment Opportunity Compliance as may be requested by the office from time to time in order to carry out the purposes of these regulations, and public agencies Shall furnish such information as may be requested by the Division of Public Contracts Equal Employment Opportunity Compliance for conducting a compliance investigation pursuant to Subchapter 10 of the Administrative Code at N.J.A.C. 17:27.

| i | | | I certification, and if | do so, | recognize that | am subject to criminal prosecution under the law and that it will also constitute 2 material breach of my agreement(s) with the Township of West Orange, State of New Jersey and that the Township at its option may declare any contract(s) resulting from this certification void and unenforceable. ef Full Name (Print); GA47 BOeTES — sipnature:_< Title: LE-B0N B Date: off 2 [zsb

t 1 | i i 1 i t AFFIDAVIT OF NON-COLLUSION The undersigned bidder of full age, being duly sworn according to law depose and hereby specifically certifies that: A. To the best of the bidder's knowledge and belief, the annexed bid proposal for this project has not been prepared in collusion with any other bidder of like item or services and the prices, discounts, terms and conditions thereof have not been directly or indirectly communicated by or on behalf of the bidder to any person other than the recipient of the bid and will not be communicated to any person prior to the official opening of the bid. B. The bidder fully understands that no premiums, rebates, or gratuities are permitted either with, prior to, or after signing of contract. Any violation will result in cancellation and removal from the bid list. C, The bidder further certifies that the undersigned has the necessary authority, to sign this stipulation stating that the bidder has not entered into any agreement, or otherwise taken any action in restraint of free competitive bidding in connection with this bid. All references to the bidder are understood to include the undersigned and all principals, partners and officers of the bidder.. Date: f= =e (Signature) GARY Boerées ZG ~ Oto SR (Name and Tile) e opettintG SECURMTIGS ‘Company Name) a Ce Domerens AE UEROLA KT OPOYY (Address) (Corporate Seal) Subscribed and sworn to before me 2A F this__ /Y day of Loe 20 274 F Notary Seal_ ra a Us vi ude AS pean) (ee RO oes Bu din, C ee c 3 %,

i i BID PROPOSAL FORM ARMED [enaaned BSELUUTY OFFICERS FoR. TNE _ - (Description of item/service being bid) TOWN SHI? OF .W- ORAKMIGO We the undersigned propose to furnish and deliver the above item/service pursuant to the bid specification and made part hereof: oo 4 s 25 TPurty Five Cost per hour per Armed security officer ° Written Figure oe a, —_+ 5 AS / very Five Cost per hour per Unarmed security officer x Written Figure Below to come to the cost please use 1960 hours per year OQ . ‘ & 3 6¢ 600 S ache Eth ITH pesto Six Mb eembract Annual Cost 1 Armed security officers Written Figure 3 1G, 009 Foal Nine Th eusand Annual cost 1 Unarmed security officer Written Figure The undersigned is a (Corporation), (Partnership), or (Individual) under the laws of the State of NAT having its principal office at. 1SE POrAPTO RYE UBIO A cao ap o4Y STERLING SECURITIES 22-39 (3275 Company Name Fed I.D. # or S.S. Number C—Sof2 Gary A60oTeS Signature of Authorized Agent Type or Print Nami 973-477-GEY¥) ‘ fe 3s l[ey Telephone Number Date PLEASE SUBMIT ONE ORIGINAL AND 1 COPY. COPY MUST BE SUPPLIED ON AN EXTERNAL FLASH DRIVE. THE AMOUNT SHALL BE SHOWN IN BOTH WORDS AND FIGURES. IN CASE OF A DISCREPANCY, THE AMOUNT SHOWN IN WORDS WILL GOVERN.

TOWNSHIP OF WEST ORANGE ACKNOWLEDGMENT OF RECEIPT OF ADDENDA The undersigned Bidder hereby acknowledges receipt of the following addenda: Please assign the number, date and initial. Addendum Number Dated Acknowledge Receipt (Initial) [2° No addenda was/were received. Acknowledged for: ESTERUNG SecenrstT/ES (Company Name) mn Co p~o? (Signature of Authorized Representative) Name: O4794 BO60T#S (Print) Cy -OUN BTR Title: Date: EAE 4 27|Page

ni 1 C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM Contractor Instructions Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant toa “fair and open” process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of N.J.S.A. 19:44A4-20.26. This law provides that 10 days prior to the award of such a contract, the contractor shall disclose contributions to: ® any continuing political committee (a.k.a., political action committee) ® any candidate committee of a candidate for, or holder of, an elective office: oof the public entity awarding the contract © of that county in which that public entity is located © of another public entity within that county © or ofa legislative district in which that public entity is located or, when the public entity is a county, of any legislative district which includes all or part of the county The disclosure must list reportable contributions to any of the committees that exceed $200 per election cycle that were made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more details on reportable contributions. N.J.S.A. 19:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not a natural person. This includes the following: * individuals with an “interest” ownership or control of more than 10% of the profits or assets of a business entity or 10% of the stock in the case of a business entity that is a corporation for profit e all principals, partners, officers, or directors of the business entity or their spouses * any subsidiaries directly or indirectly controlled by the business entity e IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business entity and filing as continuing political committees, (PACs). When the business entity is a natural person, “a contribution by that person's spouse or child, residing therewith, shall be deemed to be a contribution by the business entity.” [N.J.S.A. 19:44A-20.26(b)] The contributor must be listed on the disclosure. Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in an amount to be determined by the Commission which may be based upon the amount that the business entity failed to report. The enclosed list of agencies is

all be subject to a fine imposed by ELEC in an amount to be determined by the Commission which may be based upon the amount that the business entity failed to report. The enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected official and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor's responsibility to identify the specific committees to which contributions may have been made and need to be disclosed. The disclosed information may exceed the minimum requirement. The enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along with a signed cover sheet) may be used as the contractor’s submission and is disclosable to the public under the Open Public Records Act. The contractor must also complete the attached Ownership Disclosure Certification. This will assist the agency in meeting its obligations under the law. NOTE: This section does not apply to Board of Education contracts.

| | C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM Required Pursuant To N.J.S.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. Part I - Vendor Information Vendor Name: | STERN G SECOMT/ BES Address: | Sf POraPTenT ALT City: | verewn [ State: AZT [zips OF04Y 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. > EPA fe 4 Gat4y Bvorss Ca Owen ek Signature Printed Name Title Part Il — Contribution Disclosure Disclosure requirement: Pursuant to N.J.S.A. 19:444-20.26 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. (J Check here if disclosure is provided in electronic form. Contributor Name Recipient Name Date Dollar Amount $ AJ OWS SKE 7 AST Zt bart

Continuation Page C.271 POLITICAL CONTRIBUTION DISCLOSURE FORM Page__ of. Vendor Name: Required Pursuant To N.J.S.A. 19:44A-20,26 Contributor Name Recipient Name Date Dollar Amount $