Township Council Meeting — Packet

PUBLIC WORKS CONTRACTOR REGISTRATION Alt bidders, contractors and subcontractors must be registered by the New Jersey Department of Labor as a Public Works Contractor at the times bids are received pursuant fo the Public Works Contractor Registration Act (P.L. 2003, ¢.91, N.J.S.A. 34:11- 56.51). | | | | [ i 87

C.271 POLITICAL CONTRIBUTION DISCLOSURE FORM Contractor Instructions Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a “fair and open” process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of N.J.S.A. 19:44A-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: of the public entity awarding the contract of that county in which that public entity is located of another public entity within that county or of a 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 oo00 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. 19:44A4-8 and 19:444-16 for more details on reportable contributions. NwS.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 bsidiaries directly or indirectly controlled by the business entity « 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 éntity 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 provided to assist

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 contractors submission and is disclosable to the public under the Open Public Records Act. 88

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. 89

C.271 POLITICAL CONTRIBUTION DISCLOSURE FORM Required Pursuant To N.J.S.A. 19:444-20.26 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 Ve di ay * Name: Ces Phe SP ony Cece gHouses, Caw Address: | 4/79 Litt ton Rod, City: [Py x2! Paws LNW State: | Zip. o7ds7 The undersigned being authorized to certify, hereby certifies that the submission provided herein represents compliance with the provisions of N.J.S.A. 19:44A4-20.26 and as represented by the Instructions accompanying this form. 4p {/ 7 : Q Signature 2 tinted Name Cath ‘o (peg Title y : ¢- Part (4 Contributior’ 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 2 $ \ WA I\ “| yt 90

Continuation Page C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM Required Pursuant To N.J.S.A. 19:44A-20.26 Page ___ of Vendor Name: Contributor Name Recipient Name Date Dollar Amount $ : i] i : i | ptf} A r AT —} | | OL

List of Agencies with Elected Officials Required for Political Contribution Disclosure N.J.S.A. 19:444-20.26 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 Commissioners County Clerk County Executive Surrogate Sheriff Registrar of Deeds Municipalities (Mayor and members of governing body, regardless of title): Belleville Township Bloomfield Township Caldweli Borough Cedar Grove Township East Orange City Irvington Township Livingston Township Maplewood Township Millburn Township Montclair Township Orange City Roseland Borough South Orange Village Verona Township West Caldwell Township. Boards of Education (Members of the Board): Belleville Town Bloomfield Township Caldwell-West Caldwell Cedar Grove Township Essex Fells Township Newark City ‘West Orange Township —_____—_______—Fairfield-Township. North Caldwell Borough Glen Ridge Borough Nutley 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 Town Fire Districts (Board of Fire Commissioners): NONE 92

NON-COLLUSION AFFIDAVI TOWNSHIP OF WEST ORANGE COUNTY OF ESSEX Cyan Ca ous of the (Township, City, Town, Township) of Pagssppany in the County of gee ts ‘ re ‘ and the State of N ne of full age, being duly sworn according to law on my oath depose and say that: + “7 = lam V- Z of the firm of CER Ba! Facsygean/ OEE thew Oe . oENe. ‘ : The Bidder making the Proposal for the above named Project, and that | executed the said Proposal [ with full authority so to do; that said Bidder has not, directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named Project; and that all statements contained in said Proposal and relies upon the truth of the statements contained in this affidavit in awarding the Contract for the : said Project, | further warrant that no person or selling agency has been employed or retained to solicit of secure such Contract upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, except bonafide employees or bonafide established commercial or selling agencies maintained by Coeds Paasi Ci) Cocenbsuses. Ene - 4Name of Contractor) opt hea! bpusgae, (NISA. 52:34-15) (Also type or print née of Affiant under signature) Cy piri ~ Caabere Sworm and Subscribed to lObeh before me this Notary Public of Notary Public of New Jersey Commission Expires 1/ 2/2028 My commission expires 93

: CONTRACTOR'S EXPERIENCE STATEMENT The Bidder is requested to state below what work of a similar character to that included in the proposed Contract he has done, and give references that will enable the TOWNSHIP to judge his experience, skill, and business standing. BIDDERS and proposed Subcontractors may be required to submit additional information regarding their respective financial condition prior to the award of the Contract ' DATE PROJECT COMPLETED _LOCATION OWNER CONTRACT AMOUNT NOTE: USE ADDITIONAL SHEETS IF NECESSARY 94

This ‘This ne Ao Ga one Path : PARSTEPANY, Nay CEDKS GOrTGA Le OF AMENGETY {ort} MUSE BO Gree Tay Ssh _astitieae at det ‘xfer wahieg tak is heey alithorizad sRSeY SALES | & USE. TAX . plrhuent WNT. S 8. cee er ste: “Yor tinned paosin athe tot tnt in aay cae af eunerat d STATE OF NEW JERSEY STATE OF NEW JERSEY _ SINESS REGISTRATION CERTIFICATE y _ | Taxpayer Name: ‘| Brade Name: | Addtese: . . + ; - Certificate Number: | Effective Date: J Date of Issuance CERBO'S PARSIPPANY GREENHOUSES,INC. = 440 LITTLETON RD. . PARSIPPANY, NJ 97054-4802 0872310 January 23, 1991 October 01, 2015 i For Office Use Only: . 20151001143540138 -