Township Council Meeting — Packet

INITIAL PROJECT WORKFORCE REPORT - CONSTRUCTION P-50

w 10. INSTRUCTIONS FOR COMPLETING THE INITIAL PROJECT WORKFORCE REPORT - CONSTRUCTION (AA201) DO NOT COMPLETE THIS FORM FOR GOODS AND/OR SERVICE CONTRACTS Enter the Federal Identification Number assigned to the contractor by the Internal Revenue Service, or if a Federal Employer Identification Number has been applied for but not yet issued, or if your business is such that you have not or will not receive a Federal Identification Number, enter the social security number assigned to the single owner or one partner, in the case of a partnership. Note: The Division of CC/EEO will assign a contractor ID number to your company. This number will be your permanently assigned contractor ID number that must be on all correspondence and reports submitted to this office. Enter the prime contractor’s name, address and zip code number. Check box if Company is Minority Owned or Woman Owned Enter the complete name and address of the Public Agency awarding the contract. Include the contract number, date of award and dollar amount of the contract. Enter the name and address of the project, including the county in which the project is located. . Note: A project contract ID number will be assigned to your firm upon receipt of the completed Initial Project Workforce Report (AA201) for this contract. This number must be indicated on all correspondence and reports submitted to this office relating to this contract. Check “Yes” or “No” to indicate whether a Project Labor Agreement (PLA) was established with the labor organization(s) for this project. Under the Projected Total Number of Employees in each trade or craft and at each level of classification, enter the total composite workforce of the prime contractor and all subcontractors projected to work on the project. Under Projected Employees enter total minority and female employees of the prime contractor and all subcontractors projected to work on the project. Minority employees include Black, Hispanic, American Indian and Asian, (J=Journeyworker, AP=Apprentice). Include projected phase-in and completion dates. Print or type the name of the company official or authorized Equal Employment Opportunity (EEO) official include signature and title, phone number and date the report is submitted. This report must be submitted to the Public Agency that awards the contract and the Division of Contract Compliance and

ial include signature and title, phone number and date the report is submitted. This report must be submitted to the Public Agency that awards the contract and the Division of Contract Compliance and Equal Employment Opportunity in Public Contracts no later than three (3) days after the contractor signs the contract. THE CONTRACTOR IS TO RETAIN THE FOURTH AND FINAL COPY MARKED “CONTRACTOR”, SUBMIT THE THIRD COPY MARKED “PUBLIC AGENCY” TO THE PUBLIC AGENCY AWARDING THE CONTRACT AND FORWARD THE REMAINING TWO (2) COPIES TO: NEW JERSEY DEPARTMENT OF THE TREASURY DIVISION OF CONTRACT COMPLIANCE & EQUAL EMPLOYMENT OPPORTUNITY IN PUBLIC CONTRACTS P.O. BOX 209 TRENTON, NJ 08625-0209 (609) 292-9550 P-51

FORM W-9 Request for Taxpayer Identification Number and Certification Deperan of te Teasry Intemal Revenue > Go to www.irs.gov/FormW9 for Instructions and the latest Information. 7 Name (as shawn on your income tax retum), Names required on this ine; do not leave this ine blank. om W-9 (Rev. October 2018) Give Form to the requester. Do not send to the IRS. @ Business name/disregarded ently name, i diferent Irom above 3. Check appropriate box for federal tax classification of the person whose name is emtered on ling 1. Check only one of the following sevan boxes. 4 Exemptions (codes apply only to Corizin entities, not individuals; see instructions on page 3) D scomoration 11 Parnerstin C1 Trsvestete 1 indivicuaeole prootietor or C1 6 Comoration ssingla-mamber LLC Exempt payse code ff any) 1 Limited tabiity company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) Note: Check the appropriate box in the lina above forthe tax classification of tha single-membar awner. Do nat check LLG tthe LLC i classed as a single-member LLC that is, trom the owner unless the owner ofthe LLC 18 another LLG that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that! is disregarded from the owner should check the appropriate box forthe tax ciasiication of ts owner. Cotter (00 instructions) Adress (number, street, and apt or cule no.) See intructions Exemption from FATCA reporting 0d (if any) Print or type. See Specific Instructions on page 3. (Appin accounts mantsnedeutde the LS) Requostere name and address (optional) @ Gily, stale, and ZIP code 7 Ust account numberisy here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box, The TIN provided must match the name given on line 1 to avoid backup withholding, For individuals, this is generally your social security number (SSN). , fora resident alien, sole proprietor, or disregarded entity, see the instructions for Part | later. For other - - entities, it is your employer identification number (EIN). If you do not have a number, see How fo get @ TWN, later. Note: It the account is in more than one name, $66 the instructions for ine 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. ‘Sociol eecurtty number jeation number Certification Under penatties of

$66 the instructions for ine 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. ‘Sociol eecurtty number jeation number Certification Under penatties of perjury, | certify that: 1, The number shown on this form is my correct taxpayer identification number (or | am waiting for a number to be issued to me}; and 2. am not subject to backup withholding because: (2} | am exempt from backup withholding, or (o) | have not been notified by the Intemal Revenue Service (IRS) that | am subject to backup withholding as a result of a fallure to report all interest or dividends, or (c) the IRS has notified me that | am no longer subject to backup withholding; and 3. lam aUS. citizen or other U.S. person (defined below); and 4, The FATCA code(s) entered on this form (if any) indicating that | am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above i you have been natified by the IRS thet you are currently subject to backup withhiokding because you have failed to report all interest andi dividends on your tax retum. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of sacured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part Il, later. ‘Signature of U.S. person Dato = Form 1088-DIV (dividends, including those from stocks or mutual funds) + Form 1099-MISC (various types of income, prizes, awards, or gross, General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments. related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.rs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required te file an information retum with the IRS must obtain your correct t. identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adaption taxpayer identification number (ATIN). or employer identification number {EIN), to report on an information retum the amount paid

mber (SSN), individual taxpayer identification number (ITIN), adaption taxpayer identification number (ATIN). or employer identification number {EIN), to report on an information retum the amount paid to you, or other amount reportable on an information retum. Examples of information returns include, but are not limited to, the following_ » Form 1099-INT (interest eared or paid) ‘+ Form 1099-6 {stock or mutual {und sales and certain other transactions by brokers) » Form 1089-S (proceeds from real estate transactions} ‘+ Form 1099-K (merchant card and third party network transactlons) + Form 1098 (home mortgage interest), 1088-E (student loan interest), 1088-T (tuition) ‘+ Form 1098-C (canceled debt) * Form 1099-A {acquisition or abandonment of secured property) Use Form W-9 only if you are 2 U.S. person (Including a resklent alien}, to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withbolding, tater. Cat. No. 10231% Form We (Rev. 10-2018) P-52

STATE OF NEW JERSEY BUSINESS REGISTRATION CERTIFICATE Business Registration Certification and Public Works Contractor Registration Certification Effective September 1, 2004, the State has expanded its Contractor Registration Program to local Government contracts, P.L. 2004, c57. All business organizations that do business with a local government agency are required to be registered with the State. The business must provide proof of that registration to the local government agency before that local government agency can enter into a contract with the business. A copy of the Business Registration Certificate must also be on file before any purchase order/voucher or other contracting document can be issued. Contractors are responsible for notifying subcontractors. Further information and registration can be obtained online from the NJ Treasury, Division of Revenue or by calling (609) 292-1730. ************************ P.L. 1999 Chapter 238. The Public Works Contractor Registration Act specifies that no contractor or subcontractor shall bid on or engage in any contract (or part thereof) for public work which is subject to the provisions of the “New Jersey Prevailing Wage Act”, P.L. 1963 C. 150 (c. 34:11-56.25 et seq.) for the construction, reconstruction, demolition, alteration, repair, or maintenance of a public building regularly open to and used by the general public or public institution, and includes any subcontractor or lower tier subcontractor of a contractor unless they are registered with the Commissioner of Labor. P-53

SAMPLE CERTIFICATE NE SAM) SES NNN STATE OF NEW JERSEY BUSINESS REGISTRATION CERTIFICATE FOR STATE AGENCY AND CASINO SERVICE CONTRACTOR® POT Pe ey: = WAME 4 1 REGISTRATION 4 NCE NUMBER: i TAXPAYER NAME; TAX REGISTRATION TEST ACCOUNT TAXPAYER IDENTIFICATION#: 970-097-382/500 0 ADDRESS: ISSUANCE DATE: | 242 2 OE BLING AVE o7y14io4 i ¢ i TREW FON NJ 086” Ae 2 FORN-BRC ORL Foie Cemueatere NOT sesipranie 6 warcteratY 11 must be corubvevoushf cisplayes at stove ™ Reason cermnruananspepecraaiacs STATE OF NEW JERSEY BUSINESS REGISTRATION CERTIFICATE Taxpayer Name: TAX REG TEST ACCOUNT Trade Name: Address: 847 ROEBLING AVE TRENTON, NJ 08611 Certificate Number: 1093907 Date of Issuance: October 14, 2004 For Office Use Only: 200-41014112823533 P-54

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TOWNSHIP OF WEST ORANGE ESSEX COUNTY, NEW JERSEY ________________________________________ NJDOT MA 2025 HELEN AVENUE, LAWRENCE AVENUE, FLORENCE PLACE AND LOWELL AVENUE IMPROVEMENTS PROJECT ________________________________________ CONTRACT AND AGREEMENT THIS AGREEMENT made this __________ day of ____________, the year of 2026 by and between, THE TOWNSHIP OF WEST ORANGE, in the County of Essex, a municipal corporation of the State of New Jersey, hereinafter called the Owner, party of the first part, and _______________________________________________________ hereinafter called the Contractor, party of the second part: COVENANT WITNESSETH: That the parties to these presents each in consideration of the undertakings, promises and agreements of the other herein contained, have undertaken, promised and agreed, and do hereby undertake, promise and agree, the party of the first part for itself, its successors and assigns, and the party of the second part and for their heirs, executors, administrators, successors and assigns as follows: Note 1. The subheadings are for convenience of reference only and do not form a part of the Contract Documents. ARTICLE I - CONTRACT INCLUDES The Contractor, at their own sole cost and expense, shall furnish all labor, materials, and services necessary for constructing the improvements and completing the grading as shown on the Plans and as specified herein. The Contractor will construct, complete and finish the same in the most thorough, workmanlike and substantial manner, in every respect to the satisfaction and approval of the Engineer, in the manner and within the time hereinafter limited, and in strict accordance with the Notice to Bidders, Instructions to Bidders, Proposal, General Conditions of Contract, General Requirements, Specifications and the Plans for the work, which Contract Documents are hereby made a part of this Contract as fully as if the same were repeated at length herein. ARTICLE II - RATE OF PROGRESS AND TIME OF COMPLETION The Contractor shall within ten (10) calendar days after the date of the