Township Council Meeting — Packet

STATE OF NEW JERSEY BUSINESS REGISTRATION CERTIFICATE TID RECS at BL Ts TAXPAYER NAME: TRADE NAME: S BROS., INC. ADDRESS: SEQUENCE NUMBER: t 18 SOBECHKO ROAD osogaes i MANALAPAN Nd 07726 EFFECTIVE DATE: ISSUANCE DATE: i § 93/04/10 10/07/93 Thts Certyticate is NOT asgaraei

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> j BROTHERS 5. Brothers Inc. °Q Box 317 South River, NJ 08882 732-446-3390 Fax: 732-446-0076 List of References Township of Clark 430 Westfield Avenue Clark, NJ 07066 Engineer: Grotto Engineering - 340 North Avenue East, Cranford, NJ 07016 — David Testa 908-272-8901 Class of work: Excavation, curbs, sidewalks, aprons, storm sewer, bicycle safe grates, ADA, milling and paving Project: 2021, Capital Roads & School Parking iot Improvements was work complete on time? — Yes Work was completed — 09/2021 Contract Amount - $1,239,274.79 Township of Colts Neck 124 Cedar Drive Calts Neck, NJ, 07722 Engineer: 1&IMi Associates — 1144 Hooper Avenue, Toms River, NJ 08753 - Glenn Gerken 732-473-3400 Project: FY 2019 Capital Road improvement Program Class of work: Excavation, RCP Pipe, Belgium blo ock curb, Storm Sewer, wil ling and Paving Was work completed on time? — Yes Work was completed — 09/2020 Contract Amount: 318,855.05

Tewnship of Hazlet 1766 Union Avenue Hazlet, NJ 07730 Engineer: T&M Associates — 11 Tindall Road, Middletown, NJ 07748 — Andrew Denbigh 732-865-9532 Project: Lynn Boulevard Area improvements Class of work: Excavation, RCP Pipe, Bicycle safe grates, Castings, Storm sewer, concrete curbs and sidewalks/aprons, Milling and Paving Was work complete on time? —Yes Work was complete — 10/2022 Contract Amount: $2,301,717.65 Township of Livingston 357 S. Livingston Ave Livingston, NJ 07039 Engineer: Livingston Engineering Department — Jeannette Harduby ~ 973-990-5000 of work: Excavation, RCP Pipe, Bicycle safe grates, Castings, Storm sewers, Belgium block curbs, Driveway aprons, Sidewalks, Milling, and Paving Was work complete on time? — Yes Work was complete —- 09/2021 Contract Amount: $1,987,364.05 City of New Brunswick 75 Bayard Street New Brunswick, NJ 08901 Engineer: RVE~ Remington & Vernick Engineers — 3 Jocama Boulevard, Old Bridge, NJ 088857 — Willian Dempsey 732-955-8000 ext: 1713 e - Project: Middlesex County — Borough of Sayreville ~ Main Street Improvements (Brookside Ave to Burnet Ave) Class of work: Concrete curbs, Sidewalks, Aprons, Bicycle safe grates, Castings, Storm sewer, Milling and Paving, ADAS Was work completed on time? ~ Yes Work was completed - 07/2021 Contract Amount: $1,014,054.50

Municipality of Princeton 400 Witherspoon Street Princeton, NJ 08540 eton, NJ 08540 ~lan Engineer: Municipatity of Princeton Engineering — 40¢ Baker 609-921-7077 Class of work: Curbs, Sidew Excavation, Aprons, Storm Sewer, Milling and Paving Project: Hearthstone Improvements Was work completed on time? ~ Yes Work was completed — 03/2021 Contract amount: $767,288.34 Township of Springfield 100 Mountain Avenue Springfield, NJ,07081 Gibraltar Dr Suite 24, ? Keller & Kirckoatrick (GP! Class of work: Excavation, curbs, sidewalis, aprons, storm sewer, Bicycle safe grates, ADA, Milling and aving Project: Improvements to Benjamin Drive and New Brook Lane Contract # sp-2020-04 Was work completed on time? —Yes Work was completed ~ 01/2021 Contract Amount: $365,868.70

FEDERAL NON-DEBARMENT CERTIFICATION CERTIFICATION OF NON-DEBARMENT FOR FEDERAL GOVERNMENT CONTRACTS N.J.S.A. 52:32-44.1 (P.L. 2019, c.406) This certification shall be completed, certified to, and submitted to the contracting unit prior to contract award, except for emergency contracts where submission is required prior to payment. PART I: VENDOR INFORMATION Individual or Organization Name larwa Oy he AZ Physical Address of Individual . - A ‘ omniaion | OC federal RA. mange) Unique Entity ID (if ° ¥ | applicable) CAGE/NCAGE Code . . ) f Ca waptens | HY F229 / CDR AD Check the box that represents the tyge of business organization: Dole Proprietorship (skip Parts III and 1V) CINon-Profit Corporation (skip Parts Il and IV) OFor-Profit Corporation (any type) OLimited Liability Company (LLC) ElPartnership OLimited Partnership Limited Liability Partnership (LLP) Oother (be specific): PART Il — CERTIFICATION OF NON-DEBARMENT: Individual or Organization | hereby certify that the individual or organization listed above in Part | is not debarred by the federal government from contracting with a federal agency. | further acknowledge: that | am authorized to execute this certification on behalf of the above-named organization; that the Township of West Orange is relying on the information contained herein and that | am under a continuing obligation from the date of this certification through the date of contract award by the Township of West Orange to notify the Township of West Orange in writing of any changes to the information contained herein; that | am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if | do so, | am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Township of West Orange permitting the Township of West Orange to declare any contract(s) resulting from this certification void and unenforceable. Sores ret” | TOG PD Mage | Signature: ad fp Dates CEPAABS P-49

Percent of Organization Section A (Check the Box that applies) PART Ill — CERTIFICATION OF NON-DEBARMENT: Individual or Entity Owning Greater than 50 ra Below is the name and address of the stockholder in the corporation who owns more than 50 percent of its voting stock, or of the partner in the partnership who owns more than 50 percent interest therein, or of the member of the limited liability company owning more than 50 percent interest therein, as the case may be. Name of Individual or Organization AIST (anita. Physical Address lot fr3clovael BP, Nuame , ul No one stockholder in the corporation owns more than 50 percent of its voting stock, or no partner in the partnership owns more than 50 percent interest therein, or no member in the limited liability company owns more than 50 percent interest therein, as the case may be. Section B (Skip if no Business entity is listed in Section A above) Oo Below is the name and address of the stockholder in the corporation who owns more than 50 percent of the voting stock of the organization’s parent entity, or of the partner in the partnership who owns more than 50 percent interest in the organization’s parent entity, or of the member of the limited liability company owning more than 50 percent interest in organization’s parent entity, as the case may be. Stockholder/Partner/Member Owning Greater Than 50 Percent of Parent Entity Physical Address OR No one stockholder in the parent entity corporation owns more than 50 percent of its voting stock, no partner in the parent entity partnership owns more than 50 percent interest therein, or no member in the parent entity limited liability company owns more than 50 percent interest therein, as the case may be, P-50

Section C — Part Ill Certification | hereby certify that no individual or organization that is debarred by the federal government from contracting with a federal agency owns greater than 50 percent of the Organization listed above in Part | or, if applicable, owns greater than 50 percent of a parent entity of . | further acknowledge: that | am authorized to execute this certification on behalf of the abovenamed organization; that the Township of West Orange is relying on the information contained herein and that | am under a continuing obligation from the date of this certification through the date of contract award by the Township to notify the Township in writing of any changes to the information contained herein; that | am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if | do so, lam subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Township permitting the Township to declare any contract(s) resulting from this certification void and unenforceable. Full Name (Print): Toe (p ANA Title: WYER. | 4 Part IV— CERTIFICATION OF NON-DEBARMENT: Contractor — Controlled Entities Section A Below is the name and address of the corporation(s) in which the Organization listed in Part ! owns more than 50 percent of voting stock, or of ps the partnership(s) in which the Organization listed in Part | owns more than 50 percent interest therein, or of the limited liability company or companies in which the Organization listed above in Part | owns more than 50 percent interest therein, as the case may be. Name of Business Entity Physical Address ASF Lata.| loc feceyal bel Mnnrae, aT 1k Tt wane ta Af dom | “Pb a8 ad **Add additional sheets if necessary** OR The Organization listed above in Part | does not own greater than 50 percent Oo of the voting stock in any corporation and does not own greater than 50 percent interest in any partnership or any limited liability company. P-51

Section B (skip if no business entities are listed in Section A of Part Iv) Below are the names and addresses of any entities in which an entity listed in oO Part Ill A owns greater than 50 percent of the voting stock (corporation) or owns greater than 50 percent interest (partnership or limited liability company). Name of Business Entity Controlled by Entity Physical Address Listed in Section A of Part IV **Add additional Sheets if necessary** OR No entity listed in Part Ill A owns greater than 50 percent of the voting stock Oo in any corporation or owns greater than 5O percent interest in any partnership or limited liability company. Section C — Part IV Certification ' hereby certify that the Organization listed above in Part | does not own greater than 50 percent of any entity that that is debarred by the federal government from contracting with a federal agency and, if applicable, does not own greater than 50 percent of any entity that in turns owns greater than 50 percent of any entity debarred by the federal government from contracting with a federal agency. | further acknowledge: that | am authorized to execute this certification on behalf of the above-named organization; that the Township of West Orange is relying on the information contained herein and that | am under a continuing obligation from the date of this certification through the date of contract award by Township to notify the Township in writing of any changes to the information contained herein; that | am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if | do so, lam subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Township permitting the Township to declare any contract(s) resulting from this certification void and unenforceable. Full Name (Print): WAN D SPA. Title: WZ Ca ee viii owe |” NEB DZ KU P-52

DUNS / FEDERAL ID NUMBER The undersigned Bidder hereby affirms the following to be their DUNS / Federal ID number as issued by the United States Federal Government. DUNS No. GUY KBAR 2 Federal ID No. _EPRAPO se bhp. bh fe f_oahatporr e TN. (Authorifett SieHathre)L Tae. Dp - Mase [yes (Namdand Title) 7 aa P-53