Township Council Meeting — Packet

Chapter 271 - Contribution Disclosure CONTRIBUTOR ‘DJ Samuel ‘DJ Samuel DJ Samuel DJ Samuel GR Valesi GR Valesi © Cornell McClelland ‘Triton ‘Trilon Trilon Trilon Trilon Trilon Trilon Trilon Trilon Trilon Trilon Trilon Trilon Trilon Trilon Triton - Waggoner Waggoner Waggoner Waggoner Page 1 of 2 CONTRIBUTION TO ‘Tammy Murphy for Senate “Middlesex County Republican Women's Club ;CTE Mundell for Mayor New Jersey Young Democrats Tammy Murphy for Senate Continued Progress Steve Sweeney for Governor Gopal for Senate for NJ Cryan for Senate CTE Mundell for Mayor Ocean County Republican Chairman's PAC Friends of Michael Testa for Senate [Belleville Victory 2026 oe | Middlesex County ‘Young, Democrats | DATE AMOUNT | 62/06/24, 500.00 oxfia/2 05/21/24! 500.00) a7/i0/za) 500.00 13/21/23, 5,000.00 01/2/28 500.00 o7/a5/2a 08/09/2. } 08/15/24; 98/33/34! |Friends of Michael Testa forsenate (Cre Mundell for Mayor i Community Action Guild |Luciano for Commissioner !Cryan for Senate | Cornerstone PAC Ciattarelli for Governor {EFO Bob Smith for Senate - Ocean County Conservative PAC : Ocean County Republican Chairman's PAC {SOC-R PAC Burzichelli for Senate Denise King for Senate Luciano for Commissioner Melham For Belleville 2026 tT 09/09/24" ™0s/09/24" ‘09/i3/2a' ‘09/i3/2a! "10/03/24" ; 10/07/24, 5,000.00 10/10/24, 300.00" 10/20/24" 1,000.00. 1,200.00 1,000.00 2,600.00 3,000.00 Ld 3,000.00 10/24/24 3,000.00 11/14/23 1,000.00 11/14/23. 400.00. 11/30/23. 300.00" 11/30/23. $00.00: Essex_1101 24

Chapter 271 - Contribution Disclosure CONTRIBUTOR Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner Waggoner |Waggoner ‘Waggoner Waggoner Waggoner Waggoner “Waggoner Waggoner Waggoner ‘Waggoner ‘Waggoner Waggoner Page 2 of 2 CONTRIBUTION TO DATE Burlington County Democratic Organization 01/11/24 Essex County Democratic Committee 02/06/24 Burlington County Federation Of Democratic Women 02/13/24 es r Ocean County Conservative Republican Orgsnization | 02/13/24 Ocean County Republican Chairman's PAC _ "02/13/24" PRG PAC 02/13/24 Cryan for Senate 02/13/24" Good Government PAC 02/20/24 SOC-R PAC 02/20/24 EFO Douglas Adams 03/26/24 CTE Mundell for Mayor 03/26/24 Cmte to Re-Elect Annbal Ramos Jr. 03/26/24 “Sweeney for Governor 03/26/24 Amato for Senate 04/16/24 Middlesex County Young Democrats 05/01/24 Melham For Belleville 2026 05/13/24 Ocean County Conservative PAC 05/13/24 Ocean County Republican Chairman's PAC 05/13/24 SOC-R PAC 05/13/24 Ciatterelli for Governor 05/13/24 Scutari for Senate 05/13/24 fal E Patrick Diegnan for Senate 05/21/24 , Tammy Williams 4 West Orange 05/30/24! “Ocean County Strong 05/30/24 Greenstein for Senate 05/30/24 Lagana for Senate 05/30/24 EFO Troy Singleton for Senate 05/30/24 Bob Smith for Senate 05/30/24 Owen Henry for Senate 06/05/24 Prosperity Rising NJ inc 06/16/24 Brick Progress ~ 07/08/24 Citizens for Good Government 07/08/24 Gopal for Senate 07/08/24 Polistina for Senate 07/08/24 AMOUNT 5,000.00 2,500.00. 2,500.00 1,000.00 2,500.00 2,500.00 1,000.00 2,500.00 2,000.00 4,900.00 1,000.00 500.00 300.00 4,000.00 4,000.00 4,000.00 1,000.00 5,200.00 750.00, 500.00, 2,500.00 1,250.00 1,250.00 750.00 2,500.00 500.00 5,000.00 5,000.00 1,200.00 5,200.00 4,000.00 Essex_1101.24

List of Agencies with Elected Officials Required for Political Contribution Disclosure N.J.S.A, 19:44A-20.26 County Name: Essex State: Governor Legislative District #s: 26, 27, 28, 29, 34, & 40 State Senator and two members of the General Assembly per district. County: County CommissionersCounty Clerk Sheriff County Executive Surrogate Registrar of Deeds Municipalities (Mayor and members of governing body, regardless of title): Belleville Township Irvington Township Orange City Bloomfield Township Livingston Township Roseland Borough Caldwell Borough Maplewood Township South Orange Village Cedar Grove Township Millburn Township Verona Township East Orange City Montclair Township West Caldwell Township Essex Fells Township Newark City West Orange Township Fairfield Township North Caldwell Borough Glen Ridge Borough Nutley Township. Boards of Education (Members of the Board): Belleville Town Bloomfield Township Caldwell-West Caldwell Cedar Grove Township Essex Fells Borough Fairfield Township Glen Ridge Borough Irvington Township Livingston Township Millburn Township Newark City North Caldwell Borough Nutley Town Roseland Borough South Orange-Maplewood Verona Borough West Essex Regional West Orange Township Fire Districts (Board of Fire Commissioners): NONE 40

STATEMENT OF OWNERSHIP DISCLOSURE N.JS.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43) This statement shall be completed, certified to, and included with all bid and proposal submissions. Failure to submit the required information is cause for automatic rejection of the bid or proposal. Name of Organization:__ CME Associates 1460 Route 9 South, Howell, NJ 07731 Organization Address: Part | Check the box that represents the type of business organization: Dsote Proprietorship (skip Parts Il and III, execute certification in Part IV) oO Non-Profit Corporation (skip Parts II and III, execute certification in Part IV) Oo For-Profit Corporation (any type) Limited Liability Company (LLC) Oo Partnership Dhiimites Partnership Lal Limited Liability Partnership (LLP) Oo Other (be specific): Part Il Oo The list below contains the names and addresses of all stockholders in the corporation who own 10 percent or more of its stock, of any class, or of all individual partners in the partnership who own a 10 percent or greater interest therein, or of all members in the limited liability company who own a 10 percent or greater interest therein, as the case may be. (COMPLETE THE LIST BELOW IN THIS SECTION) 4 No one stockholder in the corporation owns 10 percent or more of its stock, of any class, or no individual partner in the partnership owns a 10 percent or greater interest therein, or no member in the limited liability company owns a 10 percent or greater interest therein, as the case may be. (SKIP TO PART IV) (Please attach additional sheets if more space is needed): Name of Individual or Business Entity Address N/A a

Part II] DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS OR LLC MEMBERS LISTED IN PART II If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of the last annual federal Security and Exchange Commission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links to the website(s) containing the last annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent) that contain the name and address of each person holding a 10% or greater beneficial interest in the publicly traded parent entity, along with the relevant page numbers of the filing(s) that contain the information on each such person. Attach additional sheets if more space is needed. Website (URL) containing the last annual SEC (or foreign equivalent) filing Page #’s Please list the names and addresses of each stockholder, partner or member owning a 10 percent or greater interest in any corresponding corporation, partnership and/or limited liability company (LLC) listed in Part I! other than for any publicly traded parent entities referenced above. The disclosure shall be continued until names and addresses of every non-corporate stockholder, and individual partner, and member exceeding the 10 percent ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach additional sheets if more space is needed. Stockholder/Partner/Member and Address Corresponding Entity Listed in Part Il Part IV Certification |, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. | acknowledge: that | am authorized to execute this certification ‘on behalf of the bidder/proposer; that the Township of West Orange is relying on the information contained herein and that | am under a continuing obligation from the date of this certification through the completion of any contracts with Township of West Orange to notify the Township of West Orange in writing of any changes to the information contained herein; that | am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if | do so, | am subject to criminal prosecution under the law and

ained herein; that | am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if | do so, | am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the, permitting the Township of West Orange to declare any contract(s) resulting from this certification void and unenforceable. Full Name (Print): Trevor J/taylon PE, PP, CME, CFM Title: | Senior VP Signature: 4 \) Date: | December 3, 2024 SSA 8

ACKNOWLEDGEMENT OF CORRECTIONS, ADDITIONS AND DELETIONS FORM l, Trevor J. Taylor, PE, PP, CME, CFM, Senior VP of the firm CME Associates hereby acknowledge that any corrections, additions and/or, deletions have been initialed and dated in this Submission Package. AY. \ (Signature). \ ( ( a Decel A ou (Date) Page | 43

Part 2: Additional Information Disclosure of Investment Activities in Iran Person or Entity CME Associates Part 1: Certification COMPLETE PART | BY CHECKING EITHER BOX. Pursuant to Public Law 2012, c. 25, any person or entity that is a successful bidder or proposer, or otherwise proposes to enter into or renew a contract, must complete the certification below to attest, under penalty of perjury, that neither the person or entity, nor any parent entity, subsidiary, or affiliate is identified on the State Department of Treasury's Chapter 25 list as a person or entity engaging in investment activities in Iran. The list is found on Treasury’s website at www.state.nj.us/treasury/purchase/pdf/ List. The Chapter 25 list must be reviewed prior to completing the below certification. If a vendor or contractor is found to be in violation of law, action may be taken as appropriate and as may provided by law, rule or contract, including but not limited to imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party. I certify, pursuant to Public Law 2012, c. 25, that neither the person or entity listed above, nor any parent entity, subsidiary, or affiliate thereof is listed on the N.J. Department of the Treasury’s list of entities determined to be engaged in prohibited mM activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). I further certify that I am the person listed above, or I am an officer or representative of the entity listed above and am authorized to make this certification on its behalf. I will skip Part 2 and sign and complete the Certification below. OR Iam unable to certify as above because the person or entity and/or a parent entity, subsidiary, or affiliate thereof is listed on the N.J. Department of the Treasury’s oO Chapter 25 list. I will provide a detailed, accurate and precise description of the activities in Part 2 below sign and complete the Certification below. Page | 44

PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN. You must provide a detailed, accurate and precise description of the activities of the person or entity, or a parent entity, subsidiary, or affiliate thereof engaging in investment activates in Iran below and, if more space is needed, on additional sheets provided by you. Part 3: Certification of True and Complete Information I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments there to the best of my knowledge are true and complete. I attest that I am authorized to execute this certification on behalf of the above-referenced person or entity. I acknowledge that the Township of West Orange is relying on the information contained herein and thereby acknowledge that I am under a continuing obligation from the date of this certification through the completion of any contracts with the Reference to Township of West Orange to notify the Reference to Township of West Orange in writing of any changes to the answers of information contained herein. I acknowledge that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, I recognize that I am subject to criminal prosecution under the law and that it will also constitute a material breach of my agreement(s) with the Township of West Orange and that the Reference to Township of West Orange at its option may declare any contract(s) resulting from this certification void and unenforceable. Full Name (Print) | + vor J. Taylor PE,PP, CME, CFM Title | Senior Vice President Signature V \We- Date | December 3, 2024 NI Page | 45

CERTIFICATION OF NON-INVOLVEMENT IN PROHIBITED ACTIVITIES IN RUSSIA OR BELARUS Pursuant to NJ.S.A. 52:32-60.1, et seq. (L. 2022, c. 3) any person or entity (hereinafter “Vendor") that seeks to enter info or renew a contract with a State agency for the provision of goods ar services, or the purchase of bonds or other obligations, must complete the certification below indicating whether or not the Vendor is identified on the Office of Foreign Assets Control (OFAC) Specially Designated Nationals and Blocked Persons list, available _ here: z . If the Department of the Treasury finds that a Vendor has made a certification in violation of the law, it shall take any action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party. I, the undersigned, certify that | have read the definition of “Vendor” below, and have reviewed the Office of Foreign Assets Control (OFAC) Specially Designated Nationals and Blocked Persons list, and having done so certify: (Check the Appropriate Box) Gg ‘4, That the Vendor is not identified on the OFAC Specially Designated Nationals and Blocked Persons list on "account of activity related to Russia and/or Belarus. OR That | am unable to certify as to "A" above, because the Vendor is ones on the QEAG Specialy OR That | am unable to certify as to “A" above, because the Vendor is identified on the OFAC Specially oO ©. However, the Vendor is engaged in activity related to Russia "and/or Belarus consistent with federal law, regulation, license or exemption. A detailed description of how the Vendor's activity related to Russia and/or Belarus is consistent with federal law is set forth below. = (- } (Attach Additional Sheets if Necessary.) December 3, 2024 ‘Signature of Vendors AuiNprized Representative Date Trevor {Taylor E, PP, Senior VP 22-3484435 Print Name and Title of Vendor's Authorized Representative Vendor's FEIN + CME Associates 732-462-7400 Vendor's Name Vendor's Phone Number 1460 Route 9 South 732-409-0756 Vendor's Address (Street Address) Vendor's Fax Number Howell, NJ 07731 ttaylor@cmeusa1.com Vendor's Address (City/State/Zip Code) Vendor's Email Address: | Vendor means: (1) A natural person, corporation, company, limited partnership, ted fabilty