Township Council Meeting — Packet

Part III 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 II 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 Corresponding Entity Listed in Part II Address Part IV Certification I, 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. I acknowledge: that I 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 I 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 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 am subject to criminal prosecution under the law and

ained herein; 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 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): Title: Signature: Date: 32

BUSINESS REGISTRATION CERTIFICATION AND PUBLIC WORKS CONTRACTOR REGISTRATION CERTIFICATION Effective September 1, 2004, the State has expanded its Contractor Registration Program to local Government contracts, P.L. 2004, c57. All business organizations that do business with a local government agency are required to be registered with the State. The business must provide proof of that registration to the local government agency before that local government agency can enter into a contract with the business. A copy of the Business Registration Certificate must also be on file before any purchase order/voucher or other contracting document can be issued. Contractors are responsible for notifying subcontractors. Further information and registration can be obtained online from the NJ Treasury, Division of Revenue or by calling (609) 292-1730. ************************ P.L. 1999 Chapter 238. The Public Works Contractor Registration Act specifies that no contractor or subcontractor shall bid on or engage in any contract (or part thereof) for public work which is subject to the provisions of the "New Jersey Prevailing Wage Act", P.L. 1963 C. 150 (c. 34:11-56.25 et seq.) for the construction, reconstruction, demolition, alteration, repair, or maintenance of a public building regularly open to and used by the general public or public institution, and includes any subcontractor or lower tier subcontractor of a contractor unless they are registered with the Commissioner of Labor. 33

ay CERTIFICATION OF NON-INVOLVEMENT IN Ss PROHIBITED ACTIVITIES IN RUSSIA OR BELARUS. Pursuant to N.J.S.A. 52:32-60.1, et seq. (L_ 2022, c. 3) any person or entity (hereinafter “Vendor") that seeks to enter into or renew a contract with a State agency for the provision of goods or 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 https://sanctionssearch.ofac.treas.gow/. 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. |, 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) account of activity related to Russia and/or Belarus. O A That the Vendor is not identified on the OFAC Specially Designated Nationals and Blocked Persons list on OR B That | am unable to certify as to “A” above, because the Vendor is 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 identified on the OFAC Specially O c. Designated Nationals and Blocked Persons list. 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.) Signature of Vendor's Authorized Representative Date Print Name and Title of Vendor's Authorized Representative Vendor's FEIN Vendor's Name Vendor's Phone Number Vendor's Address (Street Address) Vendor's Fax Number Vendor's Address (City/State/Zip Code) Vendors Email Address ‘ Vendor means: (1) A natural person, corporation, company,

me Vendor's Phone Number Vendor's Address (Street Address) Vendor's Fax Number Vendor's Address (City/State/Zip Code) Vendors Email Address ‘ Vendor means: (1) A natural person, corporation, company, limited partnership, limited liability partnership, limited liability company, business association, sole proprietorship, joint venture, partnership, society, trust, or any other nongovernmental entity, organization, or group; (2) Any governmental entity or instrumentality of a government, including a muitilateral development institution, as defined in Section 1701(c)(3) of the International Financial Institutions Act, 22 U.S.C. 262r(c)(3); or (3) Any parent, successor, subunit, direct or indirect subsidiary, or any entity under common ownership or control with, any entity described in paragraph (1) or (2) NJ Rev. 1.22.2024 34

SITE INSPECTION AFFIDAVIT I, ____________________________, on behalf of the bidder, __________________________, do hereby declare that, I or my duly authorized representative, did satisfactorily inspect the project limits for the purpose of being fully informed as to the locations and conditions of the various Sidewalks, Paths, Crosswalk and Bus Shelters and Stops within the Township of West Orange for snow removal to be cleared under this contract. I inspected the various sites on the ______ day of_______________, ________, and I hereby acknowledge that I have satisfied myself regarding the conditions of the various sites and the nature and extent of the work to be performed under this contract. By________________________________ (Print or type name) ________________________________ (Bidding Firm/Contractor) Subscribed and sworn to Sworn before me this ____ day of __________ 20_____. ______________________________ (Notary Public) My commission expires on ______________, __________. 35

STANDARD BID DOCUMENT REFERENCE Name of Form Statutory Reference Disclosure of Investment Activities in Iran DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN N.J.S.A. 52:32-55 et seq. N.J.S.A. 40A:11-2.1 N.J.S.A. 18A:18A-49.4 Y/N Applicability Mandatory LPCL Y Goods and Services PSCL Y Construction Optional N/A X X Instructions Reference Description P.L. 2012, c.25 prohibits the awarding of State and local public contracts for goods and services with persons or entities engaging in certain investment activities in energy or finance sectors of Iran. Prior to contract award, vendors and contractors must certify that neither they nor any parent entity, subsidiary, or affiliate is listed on the New Jersey Department of the Treasury’s list of entities determined to be engaged in prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). The Certification form requires the insertion of contracting unit identification information which should be filled in (in italics on the form) prior to its use. 36

Person or Entity Part 1: Certification COMPLETE PART 1 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/Chapter25List.pdf. 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 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  I am 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 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. Part 2: Additional Information 37

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) Title Signature Date 38

REQUEST FOR BIDS The Township of West Orange requests bids, for Snow Removal Services from Sidewalks, Paths, Crosswalk and Bus Shelters and Stops within the Township for the period November 1, 2025 through April 30, 2026 winter season. The Township prepared this bid with the following options: Please note is bid is for services “as needed”. This bid is only for services when called upon. Option 1: NORTHEAST AND NORTHWEST QUADRANT Provide snow plowing equipment with operators and other personnel to clear snow from sidewalks, paths, crosswalks, and bus stops under Municipal jurisdiction. Option 2: SOUTHEAST AND SOUTHWEST QUADRANT Provide snow plowing equipment with operators and other personnel to clear snow from sidewalks, paths, crosswalks, and bus stops under Municipal jurisdiction. Option 3: 10 ROONEY CIRCLE AND WEST ORANGE DOG PARK (EXECUTIVE DRIVE) Provide snow plowing equipment with operators and other personnel and calcium chloride pellet form to clear snow from sidewalks, paths, crosswalks, and bus stops under Municipal jurisdiction. SCOPE OF WORK AND SERVICES TO BE PERFORMED BY CONTRACTOR The contractor shall provide the necessary equipment, operators and personnel as specified and listed in the Proposal for the snow removal from sidewalks, paths, crosswalks and bus stops and shelters under Municipal jurisdiction. These services shall be at the times, places and routes designated by the Township in accordance with the terms and conditions set forth hereafter and in accordance with the “Rules and Regulations for Snow Plowing, Salting, Removal and Hauling” which are attached hereto and made a part hereof. Contractors will be notified to report to work at the direction of the Superintendent of Public Works or his designee. Equipment to be Furnished by Contractors Each and every snow blower and tractor, to be furnished by the Contractor or Contractors in the performance of this bid shall be in good operating condition, and they shall be Model Year 2006 or newer. All vehicles and equipment shall have skid chains. All operators shall have the appropriate licenses, including Commercial Drivers Licenses, to operate the vehicles and equipment. Each operator shall supply sufficient tools to operate each piece of equipment as specified. The equipment to be provided is as follows: Snowblower, minimum 5HP, with a minimum width of 20 inches and maximum width of