Additional_Mandatory_RFP_Documents.pdf

Certification of Compliance with Charitable Registration and Investigation Act (N.J.S.A. 45:17A-18 et seq.)

The New Jersey Charitable Registration and Investigation Act (N.J.S.A. 45:17A-18 et seq.) (the professional fund raisers, and solicitors conducting business within the State of New Jersey by requiring a charitable organization, unless exempted from registration requirements pursuant to Section 9 of the Act, to file an annual registration statement with the New Jersey Attorney General.

Under the Act "Charitable organization" means: (1) any person determined by the federal Internal

Revenue Service to be a tax exempt organization pursuant to section 501(c) (3) of the Internal

Revenue Code of 1986, 26 U.S.C. s.501(c) (3); or (2) any person who is, or holds himself out to be, established for any benevolent, philanthropic, humane, social welfare, public health, or other eleemosynary purpose, or for the benefit of law enforcement personnel, firefighters or other persons who protect the public safety, or any person who in any manner employs a charitable appeal as the basis of any solicitation, or an appeal which has a tendency to suggest there is a charitable purpose to any such solicitation.

I do hereby certify that I am a duly authorized officer of _________________________________, and that I am authorized to certify on its behalf. I further certify that I have read or caused to be read the Act, and that I am knowledgeable of the laws and regulations contained therein, and that

_____________________________ is in compliance with all of the provisions of the Act, as amended.

I understand that the City of Newark will rely on this certification to review and approve any contracts, agreements or other related documentation with this organization.

Signature

CERTIFICATE OF COMPLIANCE WITH CONTRACTOR PAY-TO-PLAY REFORM

CITY OF NEWARK REVISED ORDINANCE 2:4-22C

______________________________, the Business Entity, as that term is defined in the City of Newark Revised Ordinance 2:4-22C, nor any subcontractor, as that term is defined therein, has not made a prohibited contribution in violation thereof in the twelve (12) month period prior to the award of this contract (or the renewal, extension, or material modification of the contract).

Name of Business Entity: ________________________________________________

Signature Name Title Date orm P-2ved 3/2/15

CITY OF NEWARK

HOLD HARMLESS AGREEMENT

The Contractor, shall defend, indemnify and hold harmless the City of Newark, its employees, directors, elected officials, appointed officials, agents, servants, and administrators from and against any and all claims or actions at law, whether for personal injury, property damage or liability, including any cost of defense incurred by the City of Newark and any payments, recoveries and judgements against the City of Newark, which arise from actions or omissions of the Proposer, his agents or employees in the execution of the work and/or duties to be performed under the contract.

witness fees, reproductions costs, and long distance travel and phone expenses in connection with defense and shall bear the prevailing interest rate, where applicable.

The Proposer shall be responsible for all damage to persons or property caused or alleged to have been caused by or incident to the execution of this work, and shall defend claims or suite arising from or incident to the work under the aforementioned contract without expense to the City of Newark, its agents, servants and/or administrators.

By signing this Agreement, the Affiant is affirming that he/she is authorized to execute this Agreement on behalf of the proposer.

On behalf of: ___________________________________________________________

Name of Organization

Sworn to and subscribed before me this________ day of ____________, 2021.

Notary Public in and for

_____________________ County, this __________ day of ____________, 2021.

This is an official standardized form of the City of Newark.

This form may be photocopied, but reproducing, re-formatting, revising and similar alterations are prohibited and will not be accepted.

City Form PNP-2 Approved 5/1/13

DISCLOSURE STATEMENT FOR NONPROFITS

SECTION A

Name of Entity: _________________________________________________________

Which is a Non-profit Corporation organized under Title 15A of the Revised

Statutes of the State of New Jersey. (check if applicable)

Principal place of business:

Incorporated in the State of: ______________________________________________

Annexed hereto is a true copy of the Certificate of Incorporation and Articles of Incorporation together with all amendments thereto which are on file with the Secretary of the State of New Jersey.

SECTION B

The officers/directors of the entity are:

(Attach additional sheets if necessary)