25-02 Telephone Bid.pdf

Bid # 25-02

TELECOMMUNICATIONS SYSTEM, SERVICE, SOFTWARE, AND

HARDWARE PROVIDER

September 4, 2025, at 11:30A.M.

Mayor Brian Mullay

Council Members:

Bill Glaser, Council President

Andy Hardiman

Tom Kochanowski

Amy Switlyk

LEGAL NOTICE

Notice is hereby given by the Township of Clinton that a Invitation for Bid in accord with N.J.S.A. 40A:11-

1 et. seq., will be received by the Township on September 4, 2025 at 11:30AM prevailing time conducted on electronic platform, in accord with N.J.A.C. 5:34-1 et. Seq., on BIDNET at www.bidnetdirect.com//townshipofclinton

Bid 25-02 TELECOMMUNICATIONS SYSTEM, SERVICE, SOFTWARE AND HARDWARE

PROVIDER

NOTE:

It is the bidder’s responsibility to ensure that the bid package is uploaded onto the e-procurement site by the bid opening date and time. Any bid document received after the deadline established by the Department of Purchasing will not be accepted, regardless of the method of delivery.

Bidders must comply with the requirements of N.J.S.A. 10:5-31 et seq., and N.J.A.C. 17:27 et. Seq., The Township of Clinton will award this Invitation for Bid in accord with N.J.S.A 40A:11-1 et. Seq., Date: August 18, 2025

Sean P. Canning

Qualified Purchasing Agent http://www.bidnetdirect.com/townshipofclinton

Applicable to Bid if marked “X”

DOCUMENTATION REQUIRED OR REVIEWED

Initials When Due

Bid Guarantee (Bid Bond or Certified/Cashier’s Check) (with

POA for full amount of Bid Bond)

With Bid

Submission

Consent of Surety (Certificate from Surety company)

Performance Bond and Labor and Material Payment Bond

(Required from the Awarded Contractor)

At signing of contract

Maintenance Bond in the Amount of 100 % for a period indicated in “General Conditions” Required from the Awarded

Contractor Upon Acceptance of Project

Upon

Acceptance of

Project

Acknowledgement of Receipt of Addenda (To be Completed if Addenda are Issued)

X Ownership Disclosure Form With Bid

Submission

Named Subcontractors in Bid for Listed Specialty Trades

Public Works Contractor Registration Certificate(s) for the

Bidder and all Sub Contractors

Prior to Award, but effective at time of bid

X Business Registration Certificate – Bidder and all Sub

Contractors

Prior to

Contract

Award

Non-Collusion Affidavit

Prior to

Contract

Award

X Experience and Qualifications

Prior to

Contract

Award

X Insurance and Indemnification Certificate

Prior to

Contract

Award

X Disclosure of Investment in Russia/ Belarus

Prior to

Contract

Award

X Disclosure of Investment Activities in Iran Form

Prior to

Contract

Award

Federal debarment Form

Prior to

Contract

Award

Prevailing Wage Certification (PL 2021, C301)

Prior to

Contract

Award

Equipment Certification

Prior to

Award

EEO/AA Form AA-201

After Notice of

Award, Prior to

Signing

Contract

X EEO/AA Form AA-302 or Letter of Federal Approval or

Certificate of Employee Information Report

After Notice of

Award, Prior to

Signing

X Bidder’s Checklist

This checklist is provided for bidder’s use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications.

Bidder

Name:

Date:

Authorized

Representative:

Signature:

Print Name &

Title:

Prior to Contract Award

TOWN OF CLINTON

COUNTY OF HUNTERDON STATE OF NEW JERSEY

INVITATION FOR BID #25-02

Bid 25-02

Proposers shall provide response in Exhibit B and upload separately as part of the procurement response.

Company Name Federal ID # or Social Security #

Address

Signature of Authorized Agent Type or Print Name

Telephone Number Date

Fax Number E-mail address

Bid 25-02

INTRODUCTION

The Township of Clinton (“Township”) is soliciting Bid proposals through a fair and open process in accordance with N.J.S.A. 19:44A-20.5 et seq. for from persons or agencies to provide telephone cabling, computer cabling, installation of a Telephone Service, maintenance and programming of telephone system.

INTENT

It is the goal of the Township to upgrade and reduce expenses of its current telecommunication system. The

Township seeks to evaluate new opportunities within telecommunications in order to; improve the delivery and quality of municipal services, streamline antiquated and redundant operations, increase employee productivity and maximize limited municipal resources. The initial term of this agreement for a period of two (2) years with an option to extend as per N.J.S.A.40A:11-15.

The selected Respondent will be a primary provider of to facilitate the telecommunications moves, adds, changes, rearrangements and repair service that normally occur within Township, The Township of Clinton presently has approximately 20 telephone lines and extensions, in the Municipal

Building, 40 lines and extensions at the Public Safety Building, and 5 lines and extensions at the Public

Works Garage. The contractor will be reporting to the Township Administrator for all assignments.

All moves, adds, changes, rearrangements and repairs will occur using new telecommunications equipment provided by the Respondent. The successful Respondent shall provide cable and wiring services. This agreement shall authorize service at all Township of Clinton building locations.

The Respondent shall report directly to the Township Administrator or their designee.

Current Services Qty Description

12 Hosted Seats

1 Hosted Fax

1 Usage

1 Taxes, Surcharges, Fees

1225 Route 31 S/Municipal Building

1 Comcast Internet 80mbps+;80mbps-

1 Static IP -1

1 TV Adapter; TV Basic

117 Annandale High Bridge Road/Public

Works Garage

1 Comcast Internet 200m/Business Class

1 Static IP-1

1 TV Adapter ; TV Basic

1370 Route 31 N/Public Safety Building

1 Comcast Internet 80mbps+;80mbps-

1 Equipment Fee Voice

1 TV Basic

1 TV Adapter

1 Static IP -1

1 Mobility Number

COMMUNICATIONS CONTRACTOR REQUIREMENTS

The Communication Contractor list years of experience in the installation of wiring and repair of telecommunication equipment. Minimum years of experience shall be five (5) years. Special training and licenses held shall be listed and a copy submitted with the proposal.

The Communications Contractor shall agree to:

A) Complete the telephone wiring starting at the MDF and IDF wiring closets and terminating at each handset location.

B) Provide, install and connect all necessary telephone instruments and devices, to permit full and proper operation of all telephone systems, features and equipment, including all handsets, wiring, and POE switches, and UPS units.

C) Utilize conduit or floor duct, following existing wire route. Existing cable shall be reused when possible. Install CAT6 cabling where needed.

D) Complete all work in full compliance with the local standards as well as the most current edition of the National Electrical Code (MEC) requirements and Part 68-215 FCC Code, including the use of fire- resistance or plenum-rated wire when required.

E) Secure and comply with all permits and certificates required by local and state laws and ordinances.

F) Perform all appropriate functional testing of telephone instruments, lines and associated equipment. This includes, but is not limited to: ringing, dialing, voice reception, voice transmission, data transmission and Central feature operation.

G) Promptly restore or reconnect any and all equipment which may be removed or temporarily disconnected due to the requirements or demands of a work order.

H) All removed and/or replaced telephone instruments and equipment will be returned to

Township of Clinton, Township Administrator’s office, designated representative.

I) The Contractor shall provide a written record to the Township of Clinton of any changes to the inside wiring plan upon completion of all work orders.

J) Contractor shall maintain an inventory and database of all telecommunication equipment and supplies as well as current up to date records of DID numbers and extension locations.

K) The successful contractor shall be expected to sign a contract with the Township of Clinton that complies with all other ordinances and rules governing independent contracts.

L) Provide necessary training and in-service to staff when applicable to effectively use equipment.

M) Response time for support shall be within (1) hour during business hours and within two hours outside of business hours. Response time for all other related services shall be within one business day. Business hours and days shall mirror Clinton Township operating hours and days.

N) The Contractor shall provide/obtain quotes, lead time and plans to the Township Administrator or their designee in a timely manner for any upgrades or break/fix that may arise. This also includes updates and milestone progress communication.

O) The contractor shall provide a mobile application for remote use of the phone system on Apple IOS and Google Android devices.

P) The Contractor shall ensure compliance at all times with Ray Baum’s Act and Kari’s Law and all E911 calls will identify the precise location of the extension.

• BIDDERS MUST PROVIDE A DIAGRAM (Mapping) INDICATING THE COMPLIANCE WITH

THIS LAW, INDICATING THE IDENTIFICATION OF ROOMS AND TELEPHONE LOCATIONS

AS PART OF THE BID SUBMITTAL

Q) The Contractor shall ensure a selected group of DID’s and/or extensions to be recorded using the police department’s call recording system without any additional equipment of fees.

R) The contractor shall provide unlimited inbound and outbound calling and all necessary trunks for such purposes.

S) The Contractor shall provide basic and advanced telephone handsets having the ability to display caller-ID name and number and provide at minimum two (2) line appearances on the basic phones and at minimum three (3) line appearances and three (3) park locations on the advanced telephone handsets.

T) Voicemail shall be recorded and optionally at user’s option, transcribed with audio file and emailed to user’s email address.

U) All equipment provided shall be covered under full warranty for the duration of the initial term of this agreement.

V) All existing lines and numbers shall be included in Contractor’s service agreement. Numbers may be ported to a different carrier provided Contractor is responsible for all costs as part of and included in agreement.

W) All costs shall be included for a fixed monthly fee that shall not change for the duration of the agreement. Adding additional extensions or lines up to 10 % additional shall be included

Respondents may, at the sole discretion of the Township of Clinton, be asked to provide a presentation detailing their proposal and responding to clarification questions. Such a presentation, if it occurs, may include any or all of the respondents and will be considered as part of the evaluation process.

MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE

N.J.S.A. 10:5‐31 et seq. (P.L.1975, c.127)

N.J.A.C. 17:27 et seq.

GOODS, GENERAL SERVICES, AND PROFESSIONAL SERVICES CONTRACTS

During the performance of this contract, the contractor agrees as follows:

The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for employment because of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex. Except with respect to affectional or sexual orientation and gender identity or expression, the contractor will ensure that equal employment opportunity is afforded to such applicants in recruitment and employment, and that employees are treated during employment, without regard to their age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.

Such equal employment opportunity shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship.

The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency Compliance Officer setting forth provisions of this nondiscrimination clause.

The contractor or subcontractor, where applicable will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.

The contractor or subcontractor will send to each labor union, with which it has a collective bargaining agreement, a notice, to be provided by the agency contracting officer, advising the labor union of the contractor's commitments under this chapter and shall post copies of the notice in conspicuous places available to employees and applicants for employment.

The contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer pursuant to N.J.S.A. 10:5‐31 et seq., as amended and supplemented from time to time and the Americans with Disabilities Act.

The contractor or subcontractor agrees to make good faith efforts to meet targeted county employment goals established in accordance with N.J.A.C. l7:27‐5.2.

The contractor or subcontractor agrees to inform in writing its appropriate recruitment agencies including, but not limited to, employment agencies, placement bureaus, colleges, universities, and labor unions, that it does not discriminate on the basis of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex, and that it will discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices.

The contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to assure that all personnel testing conforms with the principles of job related testing, as established by the statutes and court decisions of the State of New Jersey and as established by applicable Federal law and applicable Federal court decisions.

In conforming with the targeted employment goals, the contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and layoff to ensure that all such actions are taken without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex, consistent with the statutes and court decisions of the

State of New Jersey, and applicable Federal law and applicable Federal court decisions. The contractor shall submit to the public agency, after notification of award but prior to execution of a goods and services contract, one of the following three documents:

Letter of Federal Affirmative Action Plan Approval; Certificate of Employee Information

Report; or

Employee Information Report Form AA‐302 (electronically provided by the Division and distributed to the public agency through the Division’s website at: http:// www.state.nj.us/treasury/contract_compliance.

The contractor and its subcontractors shall furnish such reports or other documents to the Division of

Purchase & Property, CCAU, EEO Monitoring Program as may be requested by the office from time to time in order to carry out the purposes of these regulations, and public agencies shall furnish such information as may be requested by the Division of

Purchase & Property, CCAU, EEO Monitoring Program for conducting a compliance investigation pursuant to N.J.A.C. 17:27‐1.1 et seq http://www.state.nj.us/treasury/contract_compliance

NEW JERSEY ANTI-DISCRIMINATION PROVISIONS

N.J.S.A. 10:2-1 ET SEQ.

Pursuant to N.J.S.A. 10:2-1, if awarded a contract, the contractor agrees that:

a. In the hiring of persons for the performance of work under this contract or any subcontract hereunder, or for the procurement, manufacture, assembling or furnishing of any such materials, equipment, supplies or services to be acquired under this contract, no contractor, nor any person acting on behalf of such contractor or subcontractor, shall, by reason of race, creed, color, national origin, ancestry, marital status, gender identity or expression, affectional or sexual orientation or sex, discriminate against any person who is qualified and available to perform the work to which the employment relates;

b. No contractor, subcontractor, nor any person on his behalf shall, in any manner, discriminate against or intimidate any employee engaged in the performance of work under this contract or any subcontract hereunder, or engaged in the procurement, manufacture, assembling or furnishing of any such materials, equipment, supplies or services to be acquired under such contract, on account of race, creed, color, national origin, ancestry, marital status, gender identity or expression, affectional or sexual orientation or sex;

c. There may be deducted from the amount payable to the contractor by the contracting public agency, under this contract, a penalty of $50.00 for each person for each calendar day during which such person is discriminated against or intimidated in violation of the provisions of the contract; and

d. This contract may be canceled or terminated by the contracting public agency, and all money due or to become due hereunder may be forfeited, for any violation of this section of the contract occurring after notice to the contractor from the contracting public agency of any prior violation of this section of the contract.

FormAA302

Rev. 11/11

STATE OF NEW JERSEY

Division of Purchase & Property

Contract Compliance Audit Unit

EEO Monitoring Program

EMPLOYEE INFORMATION REPORT

IMPORTANT-READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORM. FAILURE TO PROPERLY COMPLETE THE ENTIRE FORM AND TO SUBMIT THE REQUIRED

$150.00 FEE MAY DELAY ISSUANCEOF YOUR CERTIFICATE. DO NOT SUBMIT EEO-1 REPORT FOR SECTION B, ITEM 11. For Instructions on completing the form, go to:

http://www.state.nj.us/treasury/contract compliance/pdf/aa302ins.pdf

SECTION A- COMPANY IDENTIFICATION

I. FID. NO. OR SOCIAL SECURITY

2. TYPE OF BUSINESS

0 I. MFG O 2. SERVICE O 3. WHOLESALE

0 4.RETAIL O 5.OTHER

3. TOTAL NO. EMPLOYEES IN THE ENTIRE

COMPANY

4. COMPANY NAME

5. STREET TOWNSHIP COUNTY STATE ZIP CODE

6. NAME OF PARENT OR AFFlLIATED COMPANY (IF NONE, SO INDICATE) TOWNSHIP STATE ZIP CODE

7. CHECK ONE: IS THE COMPANY: 0 SINGLE-ESTABLISHMENT EMPLOYER 0 MULTI-ESTABLISHMENT EMPLOYER

I I

9. TOTAL NUMBER OF EMPLOYEES AT ESTABLISHMENT WHICH HAS BEEN AWARDED THE CONTRACT

10. PUBLIC AGENCY AWARDING CONTRACT

TOWNSHIP COUNTY STATE ZIP CODE

Official Use Onl DATE RECEIVED NAUG.DATE ASSIGNED CERTIFICATION NUMBER

SECTION B - EMPI OYMENJ DATA

11. Report all petmanent, temporary and part.time employees ON YOUR OWN PAYROLL. Enter the appropriate figures on all lines and in all columns. Where there are no employees in a particular category, enter a zero.Include ALL employees, not justthose in minority/non-minority categories, incolumns 1, 2, & 3. DONOTSUBMIT

AN EE0-1REPORT.

I

SECTION C-SIGNATUREAND IDENTIFICATION

17. ADDRESS NO. & STREET TOWNSHIP COUNTY STATE ZIP CODE PHONE (AREA CODE, NO.,EXTENSION)

JOB

CATEGORIES

ALL EMPLOYEES -MINORITY caaD1nvcc .- • •1 ~-••n•

COL. I

TOTAL

(Cols.2 &3)

COL. 2

MALE

COL.3

FEMALE

********* MALE********************** *************FEMAL!=**********************

'3LACK

HISPANIC

AMER.

NDIA}

ASIAN

NON

MIN.

BLACK

HISPANIC

AMER.

INDIAN

ASIAN

NON

MIN.

Officials/ Managers

Professionals

Technicians

Sales Workers

Office & Clerical

Craftworkers

(Skilled)

Operatives

(Semi-skilled)

Laborers

(Unskilled)

Service Workers

TOTAL

Total employment

From previous Reoort (If anv)

Temporary & Part-

Time Employees The data below shall NOT be included in the figmes for the appropriate categories above.

1 2□. HOW WASINFOR M□AT ION ASTORACEORETHNICGROUPINSECTIONB OBTAINED

1. Visual Survey 2. Employment Record D3- Other (Specify)

14. ISTHISTHEFIRST

Employee lnfonnation

15. IF NO, DATE LAST

REPORT SUBMITTED

Report Submitted?

MO IDAYIYEAR

13. DATES OF PAYROLL PERIOD USED

From: To: I.YES! 2.NOI http://www.state.nj.us/treasury/contractcompliance/pdf/aa302ins.pdf

SAMPLE CERTIFICATE OF EMPLOYEE INFORMATION REPORT

New Jersey Business Registration Certification

Pursuant to N.J.S.A. 52:32-44, The Township of Clinton (“Contracting Agency”) is prohibited from entering into a contract with an entity unless the bidder/proposer/contractor, and each subcontractor that is required by law to be named in a bid/proposal/contract has a valid Business Registration Certificate on file with the Division of Revenue and Enterprise

Services within the Department of the Treasury.

Prior to contract award or authorization, the contractor shall provide the Contracting Agency with its proof of business registration and that of any named subcontractor(s).

Subcontractors named in a bid or other proposal shall provide proof of business registration to the bidder, who in turn, shall provide it to the Contracting Agency prior to the time a contract, purchase order, or other contracting document is awarded or authorized.

During the course of contract performance:

(1) the contractor shall not enter into a contract with a subcontractor unless the subcontractor first provides the contractor with a valid proof of business registration.

(2) the contractor shall maintain and submit to the Contracting Agency a list of subcontractors and their addresses that may be updated from time to time.

(3) the contractor and any subcontractor providing goods or performing services under the contract, and each of their affiliates, shall collect and remit to the Director of the Division of Taxation in the Department of the Treasury, the use tax due pursuant to the Sales and Use Tax Act, (N.J.S.A. 54:32B-1 et seq.) on all sales of tangible personal property delivered into the State. Any questions in this regard can be directed to the Division of Taxation at (609)292- 6400. Form NJ-REG can be filed online at http://www.state.nj.us/treasury/revenue/busregcert.shtml.

Before final payment is made under the contract, the contractor shall submit to the Contracting Agency a complete and accurate list of all subcontractors used and their addresses.

Pursuant to N.J.S.A. 54:49-4.1, a business organization that fails to provide a copy of a business registration as required, or that provides false business registration information, shall be liable for a penalty of $25 for each day of violation, not to exceed $50,000, for each proof of business registration not properly provided under a contract with a contracting agency.

Emergency Purchases or Contracts

For purchases of an emergent nature, the contractor shall provide its Business Registration Certificate within two weeks from the date of purchase or execution of the contract or prior to payment for goods or services, whichever is earlier.

http://www.state.nj.us/treasury/revenue/busregcert.shtml.

SAMPLE BUSINESS REGISTRATION CERTIFICATE

Pay to Play

Disclosure Requirement

P.L. 2005, Chapter 271, Section 3 Reporting

(N.J.S.A. 19:44A – 20.27)

Any business entity that has received $50,000 or more in contracts from government entities in a calendar year will be required to file an annual disclosure report with ELEC.

The report will include certain contributions and contract information for the current calendar year.

At a minimum, a list of all business entities that file an annual disclosure report will be listed on ELEC’s website at www.elec.state.nj.us.

If you have any questions please contact ELEC at: 1-888-

313-ELEC (toll free in NJ) or

609-292-8700

An analyst from ELEC’s Special Programs Section will assist you.

http://www.elec.state.nj.us/

STATEMENT OF OWNERSHIP DISCLOSURE

N.J.S.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43)

This statement shall be completed, certified to, and included with all bid and proposal submissions. Failure to submit the required information is cause for automatic rejection of the bid or proposal.

Name of Organization:

Organization Address:

Part I Check the box that represents the type of business organization:

Sole Proprietorship (skip Parts II and III, execute certification in Part IV)

Non-Profit Corporation (skip Parts II and III, execute certification in Part IV)

For-Profit Corporation (any type) Limited Liability Company (LLC)

Partnership Limited Partnership Limited Liability Partnership (LLP)

Other (be specific):

Part II

The list below contains the names and addresses of all stockholders in the corporation who own 10 percent or more of its stock, of any class, or of all individual partners in the partnership who own a 10 percent or greater interest therein, or of all members in the limited liability company who own a 10 percent or greater interest therein, as the case may be. (COMPLETE

THE LIST BELOW IN THIS SECTION)

OR

No one stockholder in the corporation owns 10 percent or more of its stock, of any class, or no individual partner in the partnership owns a 10 percent or greater interest therein, or no member in the limited liability company owns a 10 percent or greater interest therein, as the case may be. (SKIP TO PART IV)

(Please attach additional sheets if more space is needed):

Name of Individual or Business Entity Address

Part III DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS

OR LLC MEMBERS LISTED IN PART II

If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of the last annual federal Security and Exchange Commission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links to the website(s) containing the last annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent) that contain the name and address of each person holding a 10% or greater beneficial interest in the publicly traded parent entity, along with the relevant page numbers of the filing(s) that contain the information on each such person. Attach additional sheets if more space is needed.

Website (URL) containing the last annual SEC (or foreign equivalent) filing Page #’s

Please list the names and addresses of each stockholder, partner or member owning a 10 percent or greater interest in any corresponding corporation, partnership and/or limited liability company (LLC) listed in Part II other than for any publicly traded parent entities referenced above. The disclosure shall be continued until names and addresses of every noncorporate stockholder, and individual partner, and member exceeding the 10 percent ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach additional sheets if more space is needed.

Stockholder/Partner/Member and Corresponding Entity Listed in Part II

Address

Part IV Certification

I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this certification on behalf of the bidder/proposer; that the Township is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the completion of any contracts with Township to notify the Township in writing of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the, permitting the Township to declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print):

Signature:

Date:

Experience & Qualifications Questionnaire

This questionnaire must be filled out and submitted as a part of the Proposal. Failure to complete this form or to provide any of the requested information will be grounds for the rejection of the bid proposal. If additional space is required, the respondent shall add additional sheets, which identify the question being answered.

Number of years in business under present name & address:

If less than 5 years, list previous names and address:

Within the last 5 years has the business or any officer/partner failed to complete a contract awarded to them: . If yes, provide the details in on a separate page.

Have any liens and lawsuits been filed against the company in the past 5 years:

If yes, please provide details:

List similar services you are now providing for which you have signed contract, but not yet started work:

List all major subcontractors to be used to complete the service and the area of their responsibility:

Please provide at least 3 references below:

Name: Phone:

Address:

Equipment/Service Provided:

Contract Amount:

Americans with Disabilities Act of 1990

The CONTRACTOR and the OWNER do hereby agree that the provisions of Title 11 of the Americans With

Disabilities Act of 1990 (the "ACT") (42 U.S.C~ S12101 et seq.), which prohibits discrimination on the basis of disability by public entities in all services, programs, and activities provided or made available by public entities, and the rules and regulations promulgated pursuant thereunto, are made a part of this contract. In providing any act benefit, or service on behalf of the OWNER pursuant to this contract, the CONTRACTOR agrees that the performance shall be in strict compliance with the Act. In the event that the Contractor, its agents, servants, employees, or subcontractors violate or are alleged to have violated the Act during the performance of this contract, the CONTRACTOR shall defend the OWNER in any action or administrative proceeding commenced pursuant to this Act. The Contractor shall indemnify, protect, and save harmless the OWNER, its agents, servants, and employees from and against any and all suits, claims, losses, demands, or damages, of whatever kind or nature arising out of or claimed to arise out of the alleged violation. The CONTRACTOR shall, at its own expense, appear, defend, and pay any and all charges for legal services and any and all costs and other expenses arising from such action or administrative proceeding or incurred in connection therewith. In any and all complaints brought pursuant to the OWNER grievance procedure, the CONTRACTOR agrees to abide by any decision of the OWNER which is rendered pursuant to said grievance procedure. If any action or administrative proceeding results in an award of damages against the OWNER or if the OWNER must any expense to cure a violation of the ADA which has been brought pursuant to its grievance procedure, the CONTRACTOR shall satisfy and discharge the same at its OWN expense.

The OWNER shall, as soon as practicable after a claim has been made against it, give written notice thereof to the

CONTRACTOR along with frill and complete particulars of the claim. if any action or administrative proceedings is brought against the OWNER or any of its agents, servants, and employees, the OWNER shall expeditiously forward or have forwarded to the CONTRACTOR every demand, complaint, notice, summons, pleading, or other process received by the OWNER or its representatives.

It is expressly agreed and understood that any approval by the OWNER of the services provided by the

CONTRACTOR pursuant to this contract will not relieve the CONTRACTOR of the obligation to comply with the

Act and to defend, indemnify, protect, and save harmless the OWNER pursuant to this paragraph.

It is further agreed and understood that the OWNER assumes no obligation to indemnify or save harmless the

CONTRACTOR, its agents, servants, employees and subcontractors for any claim which may arise out of their performance of this Agreement. Furthermore, the CONTRACTOR expressly understands and agrees that the provisions of this indemnification clause shall in no way limit the CONTRACTOR'S obligations assumed in this

Agreement, nor shall they be construed to relieve the CONTRACTOR from any liability, nor preclude the OWNER from taking any other actions available to it under any other provisions of the Agreement or otherwise at law.

Furthermore, the contractor expressly understands and agrees that the provisions of this indemnification clause shall in no way limit the contractor’s obligations assumed in this Agreement, nor shall they be construed to relieve the contractor from any liability, nor preclude the owner from taking any other actions available to it under any other provisions of the Agreement or otherwise at law.

Part 2: Additional Information

Disclosure of Investment Activities in Iran

Person or Entity

Part 1: Certification

COMPLETE PART 1 BY CHECKING EITHER BOX.

Pursuant to Public Law 2012, c. 25, any person or entity that is a successful bidder or proposer, or otherwise proposes to enter into or renew a contract, must complete the certification below to attest, under penalty of perjury, that neither the person or entity, nor any parent entity, subsidiary, or affiliate is identified on the State Department of Treasury's

Chapter 25 list as a person or entity engaging in investment activities in Iran. The list is found on Treasury’s website at www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf.

The Chapter 25 list must be reviewed prior to completing the below certification. If a vendor or contractor is found to be in violation of law, action may be taken as appropriate and as may provided by law, rule or contract, including but not limited to imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.

I certify, pursuant to Public Law 2012, c. 25, that neither the person or entity listed above, nor any parent entity, subsidiary, or affiliate thereof is listed on the N.J. Department of the

Treasury’s list of entities determined to be engaged in prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). I further certify that I am the person listed above, or I am an officer or representative of the entity listed above and am authorized to make this certification on its behalf. I will skip Part 2 and sign and complete the Certification below.

I am unable to certify as above because the person or entity and/or a parent entity, subsidiary, or affiliate thereof is listed on the N.J. Department of the Treasury’s Chapter

25 list. I will provide a detailed, accurate and precise description of the activities in Part 2 below sign and complete the Certification below.

http://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf

PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN.

You must provide a detailed, accurate and precise description of the activities of the person or entity, or a parent entity, subsidiary, or affiliate thereof engaging in investment activates in Iran below and, if more space is needed, on additional sheets provided by you.

Part 3: Certification of True and Complete Information

I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments there to the best of my knowledge are true and complete. I attest that I am authorized to execute this certification on behalf of the above-referenced person or entity.

I acknowledge that the City is relying on the information contained herein and thereby acknowledge that I am under a continuing obligation from the date of this certification through the completion of any contracts with the

City to notify the City in writing of any changes to the answers of information contained herein.

I acknowledge that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, I recognize that I am subject to criminal prosecution under the law and that it will also constitute a material breach of my agreement(s) with the City and that the City at its option may declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print)

Title

Signature

Date

CERTIFICATION OF NON‐INVOLVEMENT IN PROHIBITED

ACTIVITIES IN RUSSIA OR BELARUS

Pursuant to N.J.S.A. 52:32-60.1, et seq. (L. 2022, c. 3) any person or entity (hereinafter “Vendori”) that seeks to enter into or renew a contract with a State agency for the provision of goods or services, or the purchase of bonds or other obligations, must complete the certification below indicating whether or not the Vendor is identified on the Office of Foreign Assets Control

(OFAC) Specially Designated Nationals and Blocked Persons list, available here: https://sanctionssearch.ofac.treas.gov/. If the

Department of the Treasury finds that a Vendor has made a certification in violation of the law, it shall take any action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.

I, the undersigned, certify that I have read the definition of “Vendor” below, and have reviewed the Office of Foreign Assets

Control (OFAC) Specially Designated Nationals and Blocked Persons list, and having done so certify:

(Check the Appropriate Box)

A.

That the Vendor is not identified on the OFAC Specially Designated Nationals and Blocked Persons list on account of activity related to Russia and/or Belarus.

B. That I am unable to certify as to “A” above, because the Vendor is identified on the OFAC Specially Designated

Nationals and Blocked Persons list on account of activity related to Russia and/or Belarus.

C.

That I am unable to certify as to “A” above, because the Vendor is identified on the OFAC Specially Designated

Nationals and Blocked Persons list. However, the Vendor is engaged in activity related to Russia and/or Belarus consistent with federal law, regulation, license or exemption. A detailed description of how the Vendor’s activity related to Russia and/or Belarus is consistent with federal law is set forth below.

(Attach Additional Sheets If Necessary.)

Signature of Vendor’s Authorized Representative Date

Print Name and Title of Vendor’s Authorized Representative Vendor’s FEIN

Vendor’s Name Vendor’s Phone Number https://pub.njleg.state.nj.us/Bills/2022/PL22/3_.PDF https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/

Vendor’s Address (Street Address) Vendor’s Fax Number

Vendor’s Address (City/State/Zip Code) Vendor’s Email Address i Vendor means: (1) A natural person, corporation, company, limited partnership, limited liability partnership, limited liability company, business association, sole proprietorship, joint venture, partnership, society, trust, or any other nongovernmental entity, organization, or group; (2) Any governmental entity or instrumentality of a government, including a multilateral development institution, as defined in Section 1701(c)(3) of the

International Financial Institutions Act, 22 U.S.C. 262r(c)(3); or (3) Any parent, successor, subunit, direct or indirect subsidiary, or any entity under common ownership or control with, any entity described in paragraph (1) or (2).

NJ Rev. 1.22.2024