25-14 RFP Risk Management Consultant EUS.pdf

CITY OF CAPE MAY COUNTY OF CAPE MAY STATE

OF NEW JERSEY

PROFESSIONAL SERVICES SOLICITATION

EXTRAORDINARY UNSPECIFIABLE SERVICES

N.J.S.A. 40A:11-5(1)(a)(ii)

RFP#25-14 RISK MANAGEMENT CONSULTANT

FAIR & OPEN PUBLIC SOLICITATION PROCESS PURSUANT

TO N.J.S.A. 19:44A-20.5 ET SEQ.

PUBLIC OPENING OF SUBMISSIONS: September 25, 2025, at 10:00am

MAYOR & COUNCIL

Mayor Zachary Mullock

Deputy Mayor Maureen K. McDade Councilmember Lorraine M. Baldwin

Councilmember Steve Bodnar Councilmember Shaine P. Meier

City Clerk Erin C. Burke City Manager Paul E. Dietrich

CITY OF CAPE MAY, COUNTY OF CAPE MAY, STATE OF NEW JERSEY

SOLICITATION OF

PROFESSIONAL SERVICES CONTRACTS -EXTRAORDINARY UNSPECIFIABLE SERVICE

RISK MANAGEMENT CONSULTANT

NOTICE IS HEREBY GIVEN that electronically sealed submissions will be received by the Cape May on September 25, 2025, at 10:00A.M. prevailing time conducted on electronic platform, in accord with N.J.A.C. 5:34-1 et. Seq., on BIDNET at www.bidnetdirect.com//capemaycity

RFP#25-14 RISK MANAGEMENT CONSULTANT

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., For zoom contact and opening invitation please contact the Qualified Purchasing Agent at scanning@thecanninggroup.org

Upon receipt of proposals, the City Clerk shall transmit copies of each proposal to a review committee consisting of various City Officials and employees.

Proposals will be evaluated on the basis of the most advantageous; price and other factors considered. The evaluation will consider:

a. Experience and reputation of the prospective contractor in the field that is the subject matter of the contract;

b. Knowledge of the City, issues that are unique to the City and the subject matter to be addressed under the contract;

c. Availability to accommodate any required meetings of the City or its various departments;

d. Compensation proposal; and

e. Other factors as demonstrated to be in the best interest of the City.

Upon completion of the review process, the review committee shall transmit its findings and recommendations to the City Council who may award the subject contract on or about January 1, 2025, or at reorganization meeting.

This RFP has been provided in accordance with the “Fair and Open Basis” (N.J.S.A. 19:44A-20.5).

http://www.bidnetdirect.com/capemaycity

Dated: August 27, 2025, Erin C. Burke, RMC, CMR

City Clerk/Registrar

Applicable to

Bid if marked “X”

DOCUMENTATION REQUIRED OR

REVIEWED

Read, Signed & Submitted

Bidder’s Initial

Bid Guarantee (Bid Bond or Certified/Cashier’s Check) (with POA for full amount of Bid Bond)

Consent of Surety (Certificate from Surety company)

Performance Bond and Labor and Material Payment Bond (Required from the Awarded Contractor)

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

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

X Statement of Ownership Disclosure Form

Declaration of Sub Contractors (Due with bid if indicated)

Public Works Contractor Registration Certificate(s) for the Bidder and all Sub Contractors (Prior to Award, but effective at time of bid)

X Required Evidence EEO/Affirmative Action Regulations

X Business Registration Certificate – Bidder and all Sub Contractors (Prior to Contract Award)

Non-Collusion Affidavit

X Experience and Qualifications

X Insurance and Indemnification Certificate

X Disclosure of Investment Activities in Iran Form

X Disclosure of Activities in Russia/ Belarus

Federal debarment Form

Prevailing Wage Certification (PL 2021, C301)

Equipment Certification

X Non Disclosure Agreement Risk Management Consultants

X Document Ownership Notice

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:

SEALED SUBMISSION LABEL FOR

PROPOSAL

PLEASE CUT OUT THE LABEL BELOW AND TAPE TO FRONT OF

SEALED SUBMISSION

**********DO NOT

OPEN************* IMPORTANT-

SEALED SUBMISSION ENCLOSED

IF ELECTRONIC SUBMITTAL, UPLOAD THIS WITH RESPONSE

NAME, COMPANY & ADDRESS:

TO: Municipal Clerk Erin C. Burke

RFP#25-14 RISK MANAGEMENT CONSULTANT

I. General Background & Purpose The CITY OF CAPE MAY (hereafter referred to as CITY OF CAPE MAY) is currently a member of the Atlantic County Municipal Joint Insurance Fund (ACM JIF).

The ACM JIF commenced operations on January 1, 1987 with a membership of seven (7) municipalities. The ACM JIF was formed as a self-insurance pool and operates under the authority of N.J.S.A. 40A: 10-6 et seq. and related regulatory authority of the New Jersey Department of Banking and Insurance, N.J.A.C. 11:15-2.1 et seq. The ACM JIF has grown to forty-one (41) members today. The ACM JIF is subject to and must operate in compliance with the provisions of the “Local Fiscal Affairs Law” (N.J.S.A. 40A: 5-1 et seq.), the “Local Public Contracts Law (N.J.S.A. 40A:11-1 et seq.), and regulations including but not limited to (N.J.S.A. 5:34) and the Open Public Meetings Act (N.J.S.A. 10:4-12).

The ACM JIF was formed as a long-term vehicle through which member municipalities seek to stabilize their insurance related expenditures through "pooling" and the application of various risk management techniques. These techniques include pooled retention of the working layer of claims, enhanced safety and loss prevention, and group purchase of necessary administrative services including claims administration and legal defense counsel.

Coverage afforded through the ACM JIF includes Property, General Liability (including Police Liability), Automobile Liability, Employment Practices/Public Officials Liability, Cyber Liability, and Workers’ Compensation. The ACM JIF retains the first $500,000 per General, Automobile and Workers’ Compensation claim and $100,000 per Property claim.

The ACM JIF pools its resources with other New Jersey Joint Insurance Funds through an excess pool known as the Municipal Excess Liability Joint Insurance Fund (MEL) that provides coverage beyond the ACM JIF retention.

The ACM JIF is a member of the NJ Cyber Risk Management Joint Insurance Fund, which provides Cyber Liability coverage and various risk management services to its members. The ACM JIF also provides it members with Public Official’s and Employment Practices Liability coverage purchased in the commercial market. Finally, the ACM JIF is a member of the Environmental Risk Management Joint Insurance Fund, which provides Environmental Impairment Liability and various risk management services to its members.

Of primary importance to the City is a firm that is familiar with the local operations of CITY OF CAPE MAY with a thorough understanding and mastery of municipal risk as well as the programs and services provided through the ACM JIF or a similarly designed Insurance Fund.

II. RISK MANAGEMENT CONSULTANT - Applicant Requirements

The RISK MANAGEMENT CONSULTANT:

A. Shall be a New Jersey licensed Property and Casualty insurance producer who has demonstrated prior experience in the management of public insurance risks.

B. Shall demonstrate knowledge of Risk Management Programs and Services.

C. Shall demonstrate knowledge of CITY OF CAPE MAY’s operations and exposures.

D. Provide that its officials, officers, employees and appointees shall cooperate with the Fund, the Fund Attorney, Claims Administrator and any designated Defense Attorney in the defense of all claims, including any procedures established by the Executive Committee for the handling of claims, Notices of Claims and litigation.

E. Advise the CITY OF CAPE MAY on risk management matters and the appropriateness of coverage or optional coverage offered by the ACM JIF OR like funds;

III. Minimum Services

The Role of the RISK MANAGEMENT CONSULTANT is to provide Professional Risk Management services to the CITY OF CAPE MAY as follows:

A) The Consultant shall assist the CITY OF CAPE MAY in identifying its insurable exposures and shall recommend professional methods to reduce, assume or transfer the risk of loss.

B) The Consultant shall assist the CITY OF CAPE MAY in understanding and selecting the various types of coverage and limits available from the Atlantic County Municipal Joint Insurance Fund or like Funds.

C) The Consultant shall review with the CITY OF CAPE MAY any additional types of coverage that the Consultant believes the CITY OF CAPE MAY should purchase that are not available from the Fund. The Consultant shall purchase and bind any additional types of coverage authorized by the CITY OF CAPE MAY.

D) The Consultant shall assist the CITY OF CAPE MAY in the preparation of applications, statements of values and other documents requested by the Fund. However, this Agreement does not include any appraisal work by the Consultant.

E) The Consultant shall review the CITY OF CAPE MAY’s annual assessment as prepared by the Fund, and shall assist the CITY OF CAPE MAY in the preparation of its annual insurance budget.

F) The Consultant shall review the loss and engineering reports for the CITY OF CAPE MAY, and shall assist the Safety Committee in its loss containment objectives within the CITY OF CAPE MAY.

G) The Consultant shall attend and actively participate in the CITY OF CAPE MAY’s Safety Committee activities and meetings, and shall present information to the Safety Committee on Safety related topics.

H) The Consultant shall attend the CITY OF CAPE MAY’s Member Accident Review Panel meetings and assist the CITY OF CAPE MAY in determining the cause of accidents. The Consultant shall suggest any remedial actions necessary to avoid future accidents.

I) The Consultant shall assist the CITY OF CAPE MAY in determining the necessary training for each employee in each Municipal Department based upon the employee’s job description and in accordance with OSHA and other governmental regulations.

J) The Consultant shall assist the CITY OF CAPE MAY in scheduling employee training, both internal and external, including the tracking of course attendance and completion of course requirements.

K) The Consultant shall review the CITY OF CAPE MAY’s loss data on a regular basis and prepare reports to the CITY OF CAPE MAY on recent losses, open claims, and loss trends.

L) The Consultant shall assist the CITY OF CAPE MAY by reporting to the Fund changes in exposures including the deletion and addition of vehicles, equipment, and properties and the contracting of Municipal services to third parties.

M) The Consultant shall assist the CITY OF CAPE MAY and Fund professionals in the annual renewal process including the gathering and verification of exposure data.

N) The Consultant shall order Certificates of Insurance from the Fund.

O) The Consultant shall review Certificates of Insurance received by the CITY OF CAPE MAY.

P) The Consultant shall review proposed contracts between the CITY OF CAPE MAY and organizations and contractors to verify that the appropriate indemnification and hold harmless language is contained in the Contract and that the Certificate of Insurance Guidelines are being followed.

Q) The Consultant shall evaluate and advise the CITY OF CAPE MAY on the risk management aspects of public events being staged or sponsored by the CITY OF CAPE MAY.

R) The Consultant shall review the annual coverage documents to verify the accuracy of the policies.

S) The Consultant shall respond to questions regarding coverage from the CITY OF CAPE MAY’s officials.

T) The Consultant shall actively attend and participate on the Fund Subcommittees as authorized by the Fund Bylaws.

U) The Consultant shall regularly attend the Monthly Executive Committee meetings of the Fund.

V) The Consultant shall execute and file with the CITY OF CAPE MAY, as part of this agreement, and the Executive Director’s office a copy of the Atlantic County Municipal Joint Insurance Fund Confidentiality Agreement.

W) The Consultant shall at least twice annually, prepare and present a written report to the Governing Body of the CITY OF CAPE MAY outlining the CITY OF CAPE MAY’s Insurance and Safety Program.

X) The Consultant shall perform any other services required by the Fund’s Bylaws.

IV. Fees:

The fee for this contract has been established by the CITY OF CAPE MAY as outlined in herein. The CITY OF CAPE MAY is not seeking competitive pricing proposals. Instead the CITY OF CAPE MAY is seeking proposals from qualified firms/individuals that can provide the services established in Section VII below.

For 2025, the CITY OF CAPE MAY compensates the existing RISK MANAGEMENT CONSULTANT an annual fee of $_________________ for all services. It is anticipated that the CITY OF CAPE MAY will pay the RISK MANAGEMENT CONSULTANT a fee equal to or greater than $_________________in 2025.

The proposer agrees to holding the prices as submitted, through January 31, 2026, or until such time that City Council holds their annual Reorganization, whichever occurs first.

V. Proposals Written proposals are being requested from applicants (firms) qualified to perform all required services. Proposals should outline what the firm will do for the CITY OF CAPE MAY in all areas of service requested. All proposals should include, at a minimum, the following:

A. Narrative Provide a narrative setting forth your ability to provide the services outlined in Sections IV and V of this

RFQ.

B. Knowledge of Risk:

Describe your knowledge and experience with applicable coverage particularly:

• Property • Liability (Including Police and Elected Officials)

• Automobile • Workers’ Compensation

C. Experience:

1) Demonstrate a minimum of five (5) years of experience as a Risk Management Consultant within the ACM JIF or a minimum of five (5) years’ experience as a Risk Management Consultant.

2) Demonstrate familiarity with and knowledge of:

i. Other Insurance/ Risk Management solutions outside of JIF/MEL

ii. ORIGAMI Exposure System

iii. ACM JIF Safety Programs including but not limited to:

Role of MUNICIPAL Safety Coordinator Functioning of the MUNICIPAL Safety Committee Optional Safety Program Safety Incentive Program MEL Safety Institute

iv. ACM JIF Claims Programs including but not limited to:

1. Role of MUNICIPAL Claims Coordinator

2. Transitional Duty Programs

3. Accident Investigation

v. ACM JIF Risk Management Programs including but not limited to:

1. TULIP Program

2. Model Contract Provisions

3. EPL Helpline

4. EPL Risk Management Program

5. ACM JIF Website

• ACM JIF Reports including but not limited to:

Loss Ratio Reports Loss Control Reports Monthly Agenda Packet tracking reports

D. Qualifications:

• You should clearly set forth your credentials and describe your experience that qualifies you for this position by describing experience with similar engagements by the individual who will actually be providing the Consulting services to the CITY OF CAPE MAY. Include a resume of the individual indicating active membership in any professional organizations. Include a listing of clients with their contact names, addresses, and telephone numbers.

• The City of Cape May solicits proposals to look at future strategies for risk management solutions for the City.

• The City of Cape May may request that vendors who have submitted proposals provide a presentation, at the recommendation of the City Manager, during a future meeting scheduled by the City Manager. The purpose of the presentation will be to outline risk management strategies for the City of Cape May.

VIII. Additional Mandatory Submittal Requirements In submitting its response to this RFP, the Applicant acknowledges that it has reviewed, understands, and will comply with all the CITY OF CAPE MAY’s mandatory contract requirements. In addition, the Applicant shall comply with the following additional provision(s):

A. NJ Business Registration Certificate:

All proposals are required to provide a copy of their NJ Business Registration Certificate.

B. Insurance License:

All proposals are required to provide a copy of NJ Property & Casualty Insurance License for principal(s) assigned to perform work under this contract.

C. Proof of Insurance All applicants are required to submit proof of existing insurance coverage and limits as follows:

1. Workers’ Compensation (Statutory) - in compliance with the Compensation Law of the State of New

Jersey, which shall include the Other States Endorsement specifically providing for benefits payable under New Jersey State Law.

2. General Liability - With a minimum combined single limit of liability per occurrence for bodily injury and property damage of one million ($1,000,000) dollars with a minimum annual aggregate of two million ($2,000,000) dollars.

3. Automobile Liability Insurance - With a minimum combined single limit of liability per accident of one million ($1,000,000) dollars for bodily injury and property damage. This insurance must include coverage for owned, hired, and non-owned automobiles.

4. Errors and Omissions - A minimum limit of liability of one million ($1,000,000) dollars per incident and in the annual aggregate.

All applicants responding to this RFP are hereby notified that should they be awarded a contract pursuant to this RFP they will be required to name the CITY OF CAPE MAY as an Additional Insured for coverage listed under Section VIII, subsection c. 2 and 3.

VI. Selection Criteria & Form of Contract

A. The CITY OF CAPE MAY will select the Applicant deemed most advantageous to the CITY OF CAPE MAY.

While many factors will be considered (references, perceived ability to perform, and proven ability to perform), the CITY OF CAPE MAY intends to select the Applicant that they determine is most capable of effectively and competently providing the professional services required under this Contract.

B. The successful applicant shall execute a contract with the CITY OF CAPE MAY in a prescribed format that is acceptable to the CITY OF CAPE MAY. It should also be noted that although the CITY OF CAPE MAY is undertaking a “Non-Fair and Open” Process, in seeking out qualified candidates for the position of RISK MANAGEMENT CONSULTANT, it is the CITY OF CAPE MAYS’ intention to award this contract as a “Non- Fair and Open” contract pursuant to NJSA 19:44A-20.4 et seq., thereby eliminating the RISK MANAGEMENT CONSULTANT and/or their firm from making reportable campaign contributions.

C. The RISK MANAGEMENT CONSULTANT shall be considered an appointed official and shall serve until January 1 of the following year, or until a successor is duly appointed; however, the CITY OF CAPE MAY and RISK MANAGEMENT CONSULTANT may mutually agree to two one year extensions. The CITY OF CAPE MAY and/or RISK MANAGEMENT CONSULTANT shall have the right to cancel the contract with 30 days written notice.

D. The CITY OF CAPE MAY reserves the right to award a Contract, at its sole discretion, for the completion of any or all of the professional services offered by an Applicant in response to this RFP.

E. The CITY OF CAPE MAY will select the Applicant, who in the opinion of the CITY OF CAPE MAY, will be able to execute a Contract with the CITY OF CAPE MAY within fourteen (14) days of the approval of the Contract by the CITY OF CAPE MAY, and provide all necessary documentation required by the Contract to the CITY OF CAPE MAY within fourteen (14) days.

F. The CITY OF CAPE MAY will select the Applicant, who in the opinion of the CITY OF CAPE MAY, will be able to immediately assign an officer responsible for all services required under the Contract and all necessary support staff upon approval by the CITY OF CAPE MAY so as to commence the services outlined under the contract.

G. Any Applicant that submits a Proposal acknowledges that they understand that this is not a bid process. The CITY OF CAPE MAY will determine the best qualified service provider based upon the Applicant’s proven ability to perform as evidenced by the Applicant’s performance under prior and/or current Contracts that are similar to the Contract being proposed in this RFP. The CITY OF CAPE MAY retains the right to reject any or all Proposals and to negotiate all terms and conditions, service fees, or any other items included in any proposal received.

H. The Applicant selected through this process is to understand that they shall be required to comply with any and all requirements imposed by United States and/or New Jersey Code, Statute or Regulation for providers of services to public entities in the State of New Jersey. Such compliance shall include, but not be limited to, the completion of any forms, documents or procedures related to compliance with equal employment opportunity and/or affirmative action.

I. The CITY OF CAPE MAY reserves the right to reject any or all proposals, to waive technicalities and to award a contract to the firm offering the most favorable terms in the opinion of the CITY OF CAPE MAY. All proposals will be evaluated on their total content and not on any one factor. Some of the items to be considered are:

• References

• Ability to perform

• Qualifications and experience

J. At its sole discretion, the CITY OF CAPE MAY may choose to interview some or all candidates. If selected for an interview, you should clearly set forth your credentials and describe your experience that qualifies you for this position.

K. The Applicant selected through this process is to understand that they shall be required to comply with the Non- Disclosure Agreement (attached hereto) as dictated by the ACM JIF. Specifically, the contract may be voided by the CITY OF CAPE MAY if the RISK MANAGEMENT CONSULTANT fails to disclose an actual or potential conflict of interest as defined in the ACM JIF's Bylaws, or in N.J.S.A. 40A:9-22.1 et. seq. (the "Local Government Ethics Laws") and including, but not limited to, any interest, direct or indirect, in any other servicing organization providing services to the CITY OF CAPE MAY. Any potential respondent to this RFQ who cannot comply with this policy is discouraged from submitting a proposal in response to this RFQ.

EXHIBIT A

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.

SAMPLE CERTIFICATE OF EMPLOYEE INFORMATION REPORT

New Jersey Business Registration Certification

Pursuant to N.J.S.A. 52:32-44, The City of Cape May (“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

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:

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.

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):

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 City 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 City to notify the City 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 City to declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print): Title:

Signature: Date:

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.

DOCUMENT OWNERSHIP NOTICE

This document was prepared by the City of Cape May (owner) and is provided solely to any vendor who has presented a written request for a copy of said document in order to participate in the qualification process. This document is not to be reproduced for distribution to other vendors regardless whether the vendor intends to charge, or not to charge, for said copy. Copies of this document are made available from the owner and there is no other agent authorized to distribute same. The owner shall retain all of its rights and interest in any and all documents and property both hard copy and digital furnished by the owner to the contractor for the purpose of assisting the contractor in the performance of this contract. All such items shall be returned immediately to the owner at the expiration or termination of Ae contract or completion of any related services, pursuant thereto, whichever comes first. None of the documents and/or property shall, without the written consent of the owner, be disclosed to others or used by the contractor or permitted by the contractor to be used by their parties at any time except in the performance of the resulting contract.

Ownership of all data, plans, materials and documentation originated and prepared for the owner pursuant to this contract shall belong exclusively to the owner. All data, plans, reports, computerized information, programs and materials related to any project for which contractor provides services shall be delivered to the owner upon request both in electronic and paper format. The contractor shall not have the right to use, sell, or disclose any part or total of the interim or final work products, or make available to third parties, without the prior written consent of the owner.

ACKNOWLEDGED BY:

S/ _____________________________________________________ President, Vice President or Signature of Authorized Representative

Print Name__________________________________

Title _______________________________________

Date _______________________________________

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

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 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/ 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