Township Council Meeting — Packet

Accompanying this Proposal isa Certified Check or Bid Bond payable to the Township of West Orange, New Jersey in the sum of $. Op Z & é 7)_— 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. as Yes If yes, state full details including the dates of all occurrences. ean The undersigned Bidder is a ¢orporation tinder the laws. individual individual poll of the State of a having its principal office at bbe C5edeyve/ Poed, Dime .NJ 0853) with a telephone number of QQ F2Q—B5uposes of receiving telephone communications in connection with the performance of the Contract. P-15