Township Council Meeting — Packet

AFFIRMATIVE ACTION AFFIDAVIT (To be completed by firms with less than 50 employees) STATE OF NEW JERSEY ) ) SS. COUNTY OF ESSEX ) L, of the (City, Town, Borough, Township) of in the County of , State of of full age, being duly sworn according to law on my oath, depose and say that: 1. lam (President, Partner, Owner) of the Firm of a bidder making a proposal upon the above named project does not have 50 or more employees, inclusive of all officers and employees of every type 3. lam familiar with the Affirmative Action requirements of P.L. 1975, C. 127 and the rules and regulations issued by the Treasurer, State of New Jersey, pursuant thereto, 4. has complied with all Affirmative Action requirements of the State of New Jersey, including those required by P.L. 1975, C. 127, and the rules and regulations issued by the Treasurer, State of New Jersey, pursuant thereto. 5. lam aware that if does not comply with P.L. 1975, C. 127, and the tules and regulations pursuant thereto, that no monies will be paid by the State of New Jersey, County of Essex, (City, Town, Borough, Township} of » until an Affirmative Action Plan is approved. | am also aware that the contract may be terminated and the may be debarred form all public contracts for a period of up to five (5) years. 6. In the event my workforce increases to 50 employees, | must contact the State Affirmative Action Office and complete the Employee Information Report Signature of Authorized Representative Subscribed and Sworn to me before me the day of 2019 (SEAL) Notary Public of New Jersey Print Name and Title COMMUNITY DEVELOPMENT FUNDED PROJECT Essex County is an Equal Opportunity Employer