Township Council Meeting — Packet

NJ Department of Labor & Workforce Development Payroll Certification for Public Works Projects for Contractor and Subcontractor’s Weekly and Final Certification Other (specify) Name of  Contractor or  Subcontractor Business Address Project Name SUBMIT form by 298 Forest Road W. Orange Emrgency wall repair Balitano Contracting CO. Fort Lee, NJ 07024 email: equalpayact@dol.nj.gov F.E.I.N. 680599535 Contract I.D. or Project I.D. Project Location IMPORTANT: For purposes of law, Payroll No. Date Wages Due Week Ending Date you must also submit this form to

you must also submit this form to 1057 Pleasant Valley Way Contractor Registration # & Paid (mm/dd/yyyy) 06/21/2026 West Orange, NJ 07650 the appropriate public body or lessor. 3 06/26/2026 or  Final Certification Straight Time or 1. 2. Work 3. Demographics 4. Day and Date 5. 6. 7. 8. 9. 10. Total Job Title Work Classification/ Sex Race SU MO TU WE TH FR SA Hourly Gross Amt. Earned Deductions Net Wages Fringe Overtime Occupational Category

Overtime Occupational Category M=Male mm/dd mm/dd mm/dd mm/dd mm/dd mm/dd mm/dd State Other (specify) Employee Name e.g., apprentice, F=Female Total Rate This This Federal Total Paid for Benefit and Address journeyman, foreman e.g., carpenter, mason, plumber X=Non-Binary See Key Hours worked each day Hours of Pay Project Week FICA Tax Tax Deductions Week Cost/Hour Foreman S 8 8 8 8 32.00 60.00 M 1,920.00 $2,400.00 183.60 $ 204.15 87.75 10.08 $ 485.57 $ 1,914.42 O Journeyman S 8 8 8 8 32.00 50.00 M 1,600.00 $ 2,000.00 153.00 $ 311.91 61.00 8.40 $ 534.31 $ 1,465.69

0.00 153.00 $ 311.91 61.00 8.40 $ 534.31 $ 1,465.69 O Journeyman S 8 8 8 8 32.00 50.00 M 1,600.00 $ 1,600.00 122.40 $ 108.15 36.60 13.52 $ 280.67 $ 1,319.33 O S O S O S O S O S O

O S O W= White; B= Black or African American;  Check if additional sheets used A= Asian; N= American Indian or Native Alaskan; I = Native Hawaiian or Pacific Islander; M= 2 or More MW-562 (9/19)