Township Council Meeting — Packet

Person or Entity = | COMPLETE PARI t BY CHECKING EITHER BOX, Pursuant to: Public Law 2022, .¢. 23, afly: piorson.or entity that'is. a suecessfill bidder or proposer, or identified -o investinent . The lst is found . on: » ‘Treasury's. website. at soww.slate.n}.us/treasury/pirchase/pdl/Chapter25Listpdf, 7 The Chapter 25 tist must be teviewed prior to completing tHe below certification, Ha vendor or contractor is found to be in violation of law, action may be taken as appropriate and as may provided. by law, role or contract, Inchuding but not limited to dinposing sanctions, seeking compliance, redoveting damages, declaring the: partyin default and seeking debarment or'suspension of the party, . E certify, pursuant to Public Law 2012, ¢. 25, that neither the person or entity listed above, nor any parent entity, subsidiary, or affiliate thereof is listed on the oa Nl. Department of the Treasury's list of entities determined to be engaged in | prohibited activities in Tran pursuant to PL, 2012, ¢. a5 ("Chapter 25 List"), £ further certify that I am the person listed above, or I am an officer or represenialive of the entity listed above _and_om authorized to_make_this certification on tis behalf, Iwill skip Part 2 and sign and complete the Certification below, Jam 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, Iwill provide a detailed, accurate and precise description of the O activities in Part 2 below sign and complete the Certification below. a7