21-6v - Disclosure of Regulatory Agency Violations.pdf

This is a Disclosure of Regulatory Agency Violations form issued by the Township of Stafford, New Jersey for Bid No. 2026-045-TWP, which pertains to a dredging and Popular Point restoration project. All prospective bidders are required to complete and submit this disclosure form as part of their bid proposal package. The form requires bidders to answer two mandatory questions: whether they currently have any open violations from regulatory agencies, and whether they have been issued any violations from regulatory agencies for projects completed within the past 24 months. Should a bidder respond affirmatively to either question, they must submit an additional page with their proposal that details the specific project, the nature of the violation, the date the violation was received, and the resolution.

The disclosure form must be executed by an authorized representative of the bidding company or firm, including a printed or typed name, signature, title, and date. The form requires notarization, with the notary public providing their signature, commission expiration date, and printed name and title. A corporate seal should be affixed to the document. This form serves as a compliance and transparency mechanism to ensure that bidders have not been subject to regulatory violations that could affect their ability to perform the contracted dredging work in Stafford Township.