Township Council Meeting - Wednesday — Packet

Page 1 of 1 DATE (MMDDIYYYY) — ACORDY CERTIFICATE OF LIABILITY INSURANCE 07/10/2024 | THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: ff the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). | PRODUCER §RUIACT wrw Certificate Center HiLLis Towers Watean Dnwsrunoe Services West, se, Prone Ser AE 3-288-467-2578 P.O. Box 305191 AbuRESS: Certificates@wtwco.com : Nashville, TN 372305191 USA NSURERIS) AFFORDING COVERAGE mace | Liberty Mutual Fire Insurance Company 23035 INSURED isurerg, Liberty Insurance Corporation 42404 Consulting and Monieipal Engineers LLC (CME Associates) a er rl aenisconn lavas insureRc; ABerican Guarantee and Liability Insurance 26247 Parlin, NZ 08859, INguneRD; Allied Horld Surplus Lines Insurance Compa 24319 INSURERE: COVERAGES CERTIFICATE NUMBER; ¥34270360 REVISION NUMBER: THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NR__tee or msurawce JTSp Sem. pouevaumper (MDG, ARISE) Py mrs "SC COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE Ts 2,000,000 j ciams.maoe [>] occur PRES Nec, 8g 1,000, 000 a! MED EXP (Anyone pereon) | 25,000] yoy 12/31/2023 i" roc GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000 X pouey| | §B% [| 106 PRODUCTS-COMPIOPAGG $ 4,000,000 OTHER: . 7 i = - — | Cowen swote Leu os3;abal | | BODILY INJURY (Per person) § B SGHEQULED =

REGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000 X pouey| | §B% [| 106 PRODUCTS-COMPIOPAGG $ 4,000,000 OTHER: . 7 i = - — | Cowen swote Leu os3;abal | | BODILY INJURY (Per person) § B SGHEQULED = AST~641~446161-043 12/31/2023 12/31/2024! son! | NON-OWNED PROPERTY DAMAGE is AUTOS ONLY iPeraccidenti 1 i- Is c XX] umBREUALAR |X occur { EACHOCCURRENCE 10,000,000 |_| EXCESS LAB LOLS. Mae AUC 8344746-00 12/31/2023 '12/31/2024| aggreGarE 4 10,000,000 | CLAIMS: MADE; s | bED RETENTIONS 0} = a i ; re | — ‘WORKERS COMPENSATION ; BER aH wioeanovens i ace 8 ARTINE! DENT 7000, OSRMENSEREXCLUDEDS x woT-641-aae161-063 | 12/31/2023/12/31/2024, * EACHACCI fo (Mandatory in NH) | {E.. DISEASE -EA EMPLOYEE! $. DeSEAIPTION SF OPERATIONS below ELL. DISEASE -POLICY LIMIT | $ 1,000, 000 D Professional Liab incl Pollution 0313-8987 07/01/2023|12/31/2024 iach Claim Limit $5,000,000 [Pettey Aggregate $5,000,000 \ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Adaitional ‘Schedule, may be attached H more space Is required) The Certificate Holder included as an Additional Insured as respects to General Liability and Auto Liability. The General Liability and Auto Idability shall be Primary and Non-Contributory with any other insurance in force for or which may be purchased by The Certificate Holder. Waiver of Subrogation applies in favor of The Certificate Holder with respects to General Liability, Auto Liability, and Workers Comp, as permitted by law CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. "AUTHORIZED REPRESENTATIVE CX Evidence of Insurance ~— © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR 1D: 26154433 BATCH: 3533632

NON-CONFLICT OF INTEREST CERTIFICATION REQUEST FOR QUALIFICATIONS FOR Municipal Engineering Services (Title of RFQ) The undersigned certifies to the Township of West Orange, County of Essex, State of New Jersey that in performing services to the Township he/she is aware of no circumstance that would constitute a conflict of interest, financial or otherwise, between him/her (or his/her firm) and the interests of the Township. The undersigned certifies that he/she has made a search of his/her firm’s client base and has executed this certification subsequent to such search. The undersigned acknowledges this a continuing certification, and shall remain in effect for the term of the services contained in the solicited request for qualifications. I certify that the foregoing statements made by me are true and accurate to my personal knowledge; I am making this certification in good faith. I am aware that if any of the foregoing statements made by me are false, the Board is free to terminate any professional service agreement entered into with the undersigned and/or his or her firm. Certifying Official: PRINT NAME; Trevor J. Taylor, PE, PP, CME, CFM SIGNED BY: (WJ =. - ( TITLE: Senior Vite Président DATE: December 3, 2024 Page | 34

TOWNSHIP OF WEST JERSEY Professional Servi ract Qualification and Costs Submission Form Note: A separate resume can be attached. Please provide the name and address of Names and roles of the individuals who will perform the services and description of their education, municipal experience and experience with projects similar to the services contained herein including their education, degrees and certifications. Trevor J. Taylor, PE, PP, CME, CFM, Senior Vice President Please refer to his resumes in Section 3" Resumes of Key Staff" in our qualification package. References and record of success of same or similar service. Please refer to Section 4 "Government Clients/References" in our Qualification Package. 35

3. Description of ability to provide the services in a timely fashion (including staffing, familiarity and location of key staff. CME Associates has the staff and possesses the resources, experience and expertise to, including seven (7) offices in New Jersey, necessary to successfully represent the ———LTownship ina professional, efficient and timely manner 4. Cost details, including the hourly rates of each of the individuals who will perform services, and all expenses: Please refer to Section 7 "Cost Proposal” of our Qualification Package for our hourly rates. Authorized Representative. Trevor J. Taylor, PE, PP, Senior VP (print name) Authorized Representative. ae (signature) Telephone #_ 732-462-7400 pax __ 732-409-0756 36

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 | - Vendor Information Vendor Name: | _ CME Associates Address: | 1460 Route 9 South City: | Howell | State: NJ | Zip: 07731 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. yy Lo C NA eh 2 Michael Motyka CFO Signature Printed Name Title Part Il - Contribution Disclosure Disclosure requirement: Pursuant to N.J.S.A. 19:44A-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. (1 Check here if disclosure is provided in electronic form. Contributor Name Recipient Name Date Dollar Amount $ Please see attached. LO Check here if the information is continued on subsequent page(s)

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