Township Council Meeting — Packet

DEPARTMENT OF ECONOMIC DEVELOPMENT, TRAINING AND EMPLOYMENT DIVISION OF HOUSING & COMMUNITY DEVELOPMENT 20 Crestrmont Road Verona, New Jersey 07044 Tel. (973) 655-0200 Joseph N. DiVincenzo, Jr. Anibal Ramos, Jr. Essex County Executive Department Director CONTRACTOR CERTIFICATION OF ELIGIBILITY LF of (Name of Contractor) (Name of Firm) by entering into this contract certify that neither I, nor my firm, nor any person or firm who has an interest in my firm, is a person or firm ineligible to be awarded government contracts by virtue of section 3 (a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1). No part of this contract shall be contracted to any person or firm ineligible for award of a government contract by virtue of section 3(a) of the Davis Bacon Act or 29 CFR 5.12 (a)(1). The penalty for making false statement is prescribed in the US Criminal Code, 18USC 1001. DATE: PROJECT AND YEAR: TOWN: SIGNATURE: