Township Council Meeting — Packet

Accompanying this Proposal is a Certified Check or Bid Bond payable to the Township of West Orange, New Jersey in the sum of $ which the undersigned agrees to be forfeited as liquidated damages, and not as a penalty, if the Contract is awarded to the undersigned and the undersigned shall fail to execute the Contract for the project, or furnish the Performance Bond required within the stipulated time. Otherwise, the check or bid bond will be returned to the undersigned. Has the undersigned bidder, or has any person, firm, corporation or partnership having an interest in the undersigned bidder, ever been listed or barred from the performance of public work by any department or agency of the State of New Jersey by reason of the violation of any law, rule or regulation of the State? No, Yes If yes, state full details including the dates of all occurrences. partnership The undersigned Bidder is a corporation under the laws. individual individual of the State of having its principal office at with a telephone number of ( _—) for purposes of receiving telephone communications in connection with the performance of the Contract.

RESOLUTION OF AUTHORIZATION IF BIDDER IS A CORPORATION RESOLVED that be authorized to sign and submit the bid or proposal of this corporation for this project, and to include in such bid or proposal the certificate as to non-collusion as the act and deed of such corporation, and for any inaccuracies or misstatements in such certificate this corporate bidder shall be liable under the penalties of perjury. If awarded the contract(s), said individual is also authorized to sign and execute the Contract Agreement as the act and deed of such corporation. The foregoing is a true and correct copy of the resolution adopted by at a meeting of its Board of Directors held on the day of , 20 SEAL OF CORPORATION Secretary P-16

STATEMENT OF OWNERSHIP DISCLOSURE N.JS.A. 52:25-24.2 (PL. 1977, ¢.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: Organization Address: Part I Check the box that represents the type of business organization: Osole Proprietorship (skip Parts II and III, execute certification in Part IV) Dnon-Profit Corporation (skip Parts II and III, execute certification in Part IV) Dror-Profit Corporation (any type) Oimitea Liability Company (LLC) Oartnership Ciimited Partnership CU Limited Liability Partnership (LLP) Dlotnher (be specific): Part I oOo 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) OR oOo No one stockholder in the corporation owns 10 percent or more of its stock, of any class, or no individual rp 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 P-17

Part I] DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS OR LLC MEMBERS LISTED IN PART II Ifa 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 Il 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 II Part IV Certification 1, 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 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, P-18

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: P-19

BIDDER'S AFFIDAVIT State of New Jersey ) )ss: County of ) being of full age and being duly sworn, upon his oath deposes and says: 41. I reside at 2: lam of the firm of (Name of Bidder) 3. | am the person who signed the foregoing Bid and | was duly authorized to execute such Bid. The Bid is a true offer of the Bidder. If the Bidder has a seal, then such seal is affixed to the Bid. All of the statements and declarations contained in the Bid are true to the best of my knowledge and belief. (Seal) (Signature) Subscribed and sworn to before me this day of , 2026. Notary Public of the State of New Jersey My Commission expires (Notary Seal) P-20

AFFIDAVIT OF NON-COLLUSION The undersigned bidder of full age, being duly sworn according to law depose and hereby specifically certifies that: A. To the best of the bidder's knowledge and belief, the annexed bid proposal for this project has not been prepared in collusion with any other bidder of like item or services and the prices, discounts, terms and conditions thereof have not been directly or indirectly communicated by or on behalf of the bidder to any person other than the recipient of the bid and will not be communicated to any person prior to the official opening of the bid. B. The bidder fully understands that no premiums, rebates, or gratuities are permitted either with, prior to, or after signing of contract. Any violation will result in cancellation and removal from the bid list. ion The bidder further certifies that the undersigned has the necessary authority, to sign this stipulation stating that the bidder has not entered into any agreement, or otherwise taken any action in restraint of free competitive bidding in connection with this bid. All references to the bidder are understood to include the undersigned and all principals, partners and Officers of the bidder. Date: (Signature) (Name and Title) (Company Name) (Address) (Corporate Seal) Subscribed and sworn to before me this day of , 20. Notary Seal P-21

BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned, as Principal, and as Surety, is hereby held and firmly bound unto the Township of West Orange, in the County of Essex as Owner, in the Penal Sum of $ (the penal sum shall be equal to ten percent (10%) of the Base Bid, but not more than $20,000) for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, successors and assigns. Signed this. day of. 2026 The condition of the above obligation is such that whereas the Principal has submitted to the Township of West Orange, in the County of Essex, New Jersey acertain bid, attached hereto and hereby made a part of hereof, to enter into a contract in writing for the 2025 CDBG ROAD REHABILITATION STANDISH AVENUE AND FREMONT STREET NOW THEREFORE, A) If said bid shall be rejected or in the alternative, B) If said bid shall be accepted and the Principal shall execute and deliver a contract properly completed in accordance with said bid and shall furnish a bond for his faithful performance of said contract, and for the payment of all persons performing labor or furnishing materials in the connection therewith, and shall in all other respects perform the agreement created by the acceptance of said bid, Then this obligation shall be void, otherwise the same shall remain in full force and effect; it being expressly understood and agreed that the liability of the surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall be in no way impaired or affected by any extension of the time within which the Owner may accept such bid; and Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of them as are corporations have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. Principal BY: Witness Surety BY: Witness Attomey-in-Fact P-22

CONSENT OF SURETY In consideration of the premises and of One Dollar ($1.00) lawful money of the United States, to it is hand paid by the Contractor, the receipt whereof is hereby acknowledged, the undersigned surety consents and agrees that if the contract, for which the preceding estimate and proposal is made, be awarded to the person or persons submitting the same as contracted, it will become bound as surety and guarantor for its faithful performance, in an amount equals to one hundred percent (100%) of the contract price, and will execute it as party of the third part thereto when required so to do by the Owner, and if the said Contractor shall omit or refuse to execute such Contract, remand to the Owner any increase between the sum to which the said Contract would have been entitled upon the completion of the said Contract and the sum which the said Owner may afterwards be awarded, the amount in such case to be determined by the bids plus the cost, if any, of readvertising the bids for this work, less the amount of any certified check or bid bond payable and received. In Witness whereof, said surety has caused these presents to be signed and attested by a duly authorized officer and its corporate seal to be hereto affixed this day of , 2026. Acorporate acknowledgment and statement of authority to be here attached by the surety company. A performance bond will be required from the successful contractor on this project, and consequently, all bidders shall submit, with their bid, a consent of surety in substantially the following form: To: (Owner) Re: (Contractor) (Project Description) This is to certify that the (Surety Company) will provide to a performance bond in the full amount (Owner) of awarded contract in the event that said contractor is awarded a contract for the above project. (CONTRACTOR) (Authorized Agent of Surety Company) Date: CONSENT OF SURETY MUST BE SIGNED BY AN AUTHORIZED AGENT OR REPRESENTATIVE OF A SURETY COMPANY AUTHORIZED TO DO BUSINESS IN NEW JERSEY AND NOT BY THE INDIVIDUAL OR COMPANY REPRESENTATIVE SUBMITTING THE BID. P-23

BID SECURITY This Proposal is accompanied by bid security in accordance with the conditions stated in the Invitation to Bid. The bid security in the form of: A. Surety Bid Bond B. Certified/Treasurer's check C. Cash the amount of G___ i=”) payable to Township of West Orange The Bidder hereby agrees that if this Proposal shall be accepted by the Owner and the Bidder shall fail to execute and deliver the Contract and the required Performance Bond or other required documents in accordance with the requirements of this Proposal and other sections of the Contract Documents within the time specified, then the Bidder shall be deemed to have abandoned the Contract and thereupon the Proposal and acceptance shall be null and void and the security accompanying the Proposal shall be forfeited to and retained by the Owner, as liquidated damages for such failure or neglect, and to indemnify the Owner for any loss which may be sustained by failure of the Bidder to execute the Contract and furnish documents as aforesaid. In compliance with the Laws of the State the Bidder is: An Individual A Partnership A Corporation of having principal offices at P-24