Administration Building - Second Floor Interior Alterations.pdf

Project Manual

Borough of Waldwick Administration Building - Second Floor Interior Alterations

Northwest Bergen Regional Health Commission 63 Franklin Turnpike Waldwick, Bergen County, New Jersey 07463

January 26, 2024

DRG Project No. TVC23-33900

Design Resources Group Architects 270 Davidson Avenue, Suite 303 Somerset, New Jersey 08873

Phone: (732) 560-7900

(Architect’s signature and seal are on inside cover)

Project Manual

Borough of Waldwick Administration Building - Second Floor Interior Alterations

Northwest Bergen Regional Health Commission

Waldwick, Bergen County, New Jersey 07463

January 26, 2024

DRG Project No. TVC23-33900

Design Resources Group Architects 270 Davidson Avenue, Suite 303 Somerset, New Jersey 08873

Phone: (732) 560-7900

Signature/seal:

Waldwick Borough Administration Building - Second Floor Interior Alterations Northwest Bergen Regional Health Commission

SUMMARY

DRG Project No. TVC23-33900 01 1000 - 1/3

SECTION 00 0001 - TABLE OF CONTENTS

A. Specifications for this Project are arranged in accordance with the Construction Specifications

Institute numbering system and format. Division and Section numbering is discontinuous and all numbers not appearing in the Table of Contents are not used for the Project.

B. DOCUMENTS BOUND HEREWITH

00 0001 Table of Contents 1 - 3

DIVISION 00 - BOROUGH OF WALDWICK, BIDDING REQUIREMENTS AND FORMS

00 0002 Uniform Bid Specifications 1-33

DIVISION 01 - GENERAL REQUIREMENTS

01 1000 Summary 1 – 5 01 2100 Allowances 1 - 3 01 2500 Substitution Procedures 1 - 3 01 2600 Contract Modification Procedures 1 - 2 01 2900 Payment Procedures 1 - 4 01 3100 Project Management and Coordination 1 - 5 01 3200 Construction Progress Documentation 1 – 4 01 3233 Photographic Documentation 1 - 2 01 3300 Submittal Procedures 1 - 5 01 3516 Alteration Project Procedures 1 - 8 01 4000 Quality Requirements 1 - 3 01 4200 References 1 - 3 01 5000 Temporary Facilities and Controls 1 - 3 01 6000 Product Requirements 1 - 5 01 7300 Execution, Cutting, and Patching 1 - 7 01 7410 Construction Waste Management and Disposal 1 - 5 01 7700 Closeout Procedures 1 - 4 01 7823 Operation and Maintenance Data 1 - 3 01 7839 Project Record Documents 1 - 3

DIVISION 02 – EXISTING CONDITIONS

02 4119 Selective Demolition 1 - 5

DIVISION 05 - METALS

NOT USED

DIVISION 06 – WOOD, PLASTICS AND COMPOSITES

06 1053 Miscellaneous Rough Carpentry 1 – 6 06 4116 Plastic-Laminate-Clad Architectural Cabinets 1 - 7

DIVISION 07 – THERMAL AND MOISTURE PROTECTION

07 9200 Joint Sealants 1 – 6

DRG Project No. TVC23-33900 01 1000 - 2/3

DIVISION 08 – OPENINGS

08 1213 Hollow Metal Frames 1 – 5 08 1416 Flush Wood Doors 1 – 6 08 4113 Aluminum-Framed Storefronts 1 – 6 08 7100 Door Hardware 1 – 10 08 8000 Glazing 1 – 10

DIVISION 09 – FINISHES

09 2216 Non-Structural Metal Framing 1 – 4 09 2900 Gypsum Board 1 – 6 09 5113 Acoustical Panel Ceilings 1 – 6 09 6513 Resilient Base and Accessories 1 – 4 09 6519 Resilient Tile Flooring 1 – 4 09 6813 Tile Carpeting 1 – 5 09 9123 Interior Painting 1 – 6

DIVISION 10 – SPECIALTIES

10 1423 Room-Identification Panel Signage 1 – 4

DIVISION 12 – FURNISHINGS

12 3661.19 Quartz Agglomerate Countertops 1 – 5

DIVISIONS 21, 22, 23, & 26 – FIRE PROTECTION, PLUMBING, HVAC, & ELECTRICAL

SEE SPECIFICATION NOTES ON DRAWINGS

C. DOCUMENTS BOUND SEPARATELY

The Drawings listed below and accompanying these documents constitute the Drawing portion of the Contract Documents.

SCHEDULE OF DRAWINGS

CVR Cover Sheet

ARCHITECTURAL

G-001 General Information, Partition Types, Door Schedule, Door Types, Door Frame

Types, Sill Types, Signage, Window Types, Fire Extinguisher D-102 Second Floor Demolition Plan A-102 Second Floor Plan A-610 Second Floor Finish Plan A-611 Enlarged Floor Finish Plans & Elevations A-702 Second Floor RCP

PLUMBING

P-001.00 Plumbing Cover Sheet P-002.00 Plumbing Specifications P-102.00 Plumbing 2nd Floor Construction Plan P-501.00 Plumbing Details, Riser Diagrams, and Schedules

DRG Project No. TVC23-33900 01 1000 - 3/3

FIRE SUPPRESSION

SP-001.00 Sprinkler Cover Sheet SP-102.00 Sprinkler 2nd Floor Construction Plan SP-501.00 Sprinkler Details, Riser Diagrams, and Schedules SP-902.00 Sprinkler 2nd Floor Removal Plan

MECHANICAL

M-001.00 Mechanical Notes, Abbreviations, and Symbols M-002.00 Mechanical Specifications M-003.00 Mechanical Specifications M-004.00 Mechanical Specifications M-101.00 Mechanical 2nd Floor Construction Plan M-601.00 Mechanical Schedules M-701.00 Mechanical Details

ELECTRICAL

E-001.00 Electrical Cover Sheet E-002.00 Electrical General Notes E-003.00 Electrical Specifications, 01 of 02 E-004.00 Electrical Specifications, 02 of 02 E-101.00 Electrical 2nd Floor Power Plan E-201.00 Electrical 2nd Floor Lighting Plan E-501.00 Electrical One-Line Diagram E-601.00 Electrical Schedules E-701.00 Electrical Details

FIRE ALARM

FA-001.00 Fire Alarm Cover Sheet FA-002.00 Fire Alarm Rise Diagram FA-101.00 Fire Alarm 2nd Floor Construction Plan

END OF SECTION 00 0001

UNIFORM BID SPECIFICATIONS

BOROUGH OF WALDWICK

ADMINISTRATION BUILDING – SECOND FLOOR ALTERATIONS

NORTHWEST BERGEN REGIONAL HEALTH COMMISSION

BID OPENING DATE: Friday, March 1, 2024

LOCATION: Administration Building Conference Room

Waldwick, NJ 07463

TIME: 11:00 AM (EST)

Borough of Waldwick – Administration Building Second Floor Alterations

Bidding Requirements and Forms

NOTICE TO BIDDERS

Notice is hereby given that sealed bids will be received by the Mayor and Council of the Borough of Waldwick, Bergen County, New Jersey on Friday, March 1, 2024 at 11:00 AM prevailing time, in the conference room of the Administration Building of the Borough of Waldwick, 63 Franklin Turnpike, Waldwick, New Jersey.

Administration Building – Second Floor Interior Alterations

Specifications and bid forms may be obtained beginning Friday, January 26, 2024, at the Administration Building of the Borough of Waldwick, 63 Franklin Turnpike, Waldwick, New Jersey 07463. Specifications and bid forms may be found at https://www.bidnetdirect.com/new-jersey/boroughofwaldwick.

Each bid must be accompanied by a certified check, bid bond, or cashier’s check in an amount equal to ten percent (10%) of the total amount bid, but not in excess of $20,000.

Certified checks to be made payable to the Borough of Waldwick. All bids must be enclosed in a properly sealed envelope bearing on the outside the name of the bidder and the nature of the bid contained therein.

The Contractor will be required to comply with requirements of N.J.S.A. 10:2-1 (Anti- Discrimination in Employment), N.J.S.A. 10:5-31 et seq. and N.J.A.C.17:27 et seq. (Equal Employment Opportunity), 42 U.S.C. § 12101 et seq. (Americans with Disabilities Act), and N.J.S.A.34:11-56.48. (Public Works Contractor Registration). N.J.S.A.52:32-44 et seq.

(New Jersey Business Registration) and N.J.S.A. 34:11-56.25 et seq. (State Prevailing Wage Act).

A pre-bid meeting will be conducted at the Borough Hall on Tuesday, February 20, 2024, at 10:00 AM. Attendance is not mandatory but is recommended.

The Borough of Waldwick reserves the right to waive any informalities or to reject any and all bids.

By order of the Mayor and Council of the Borough of Waldwick.

Steven Neale Borough Administrator

Matthew Guilder Qualified Purchasing Agent

1. GENERAL CONDITIONS

1. The attached Request For Bid (RFB) must be used and fully completed.

2. Bids must be enclosed in a sealed envelope bearing the name and address of the bidder. THE NAME OF THE BID MUST BE DESIGNATED ON THE OUTSIDE

OF THE ENVELOPE.

3. Bids may be hand delivered or mailed to the Borough of Waldwick, Borough Administrator. All bid proposals will be date and time stamped upon receipt. The Borough assumes no responsibility for bids received after the designated date and time and will return late bids to the bidder unopened.

4. The award of contract shall be by resolution of the governing body of the Borough of Waldwick within sixty (60) days after receipt of bids, unless otherwise extended at the request of the Borough of Waldwick with the consent of the bidder or bidders.

5. The bidder must indicate any variance to the specifications, terms and/or conditions. If variances are not shown in the RFB, the bid will be evaluated based on full compliance with the specifications.

6. The Borough of Waldwick (“Borough”) reserves the right to waive any informalities in the bids.

7. The Borough is exempt from most Federal, State and Municipal excise, sales and other taxes.

8. The Contractor shall bill the Borough by submitting detailed invoices and certified vouchers to the Borough Administrator. The Borough will make payment of amounts justly due and owing to the Contractor within sixty (60) days thereafter, unless a sooner payment is required under the New Jersey Prompt Payment Law (N.J.S.A. 2A:30A-1, et seq.).

9. In case of default by the bidder or contractor, the Borough may procure the articles or services from other sources and hold the bidder or contractor responsible for any excess cost occasioned thereby in addition to any other damages to the Borough.

10. The contract will contain the following provisions:

A. The Contractor will indemnify and hold the Borough and its Agents harmless for and from any and all losses, costs, damages, claims, suits and/or liabilities arising from any and all State or Federal actions of whatever kind, including counsel fees and costs of suit (collectively the “losses’), to which the Borough may be put by reason of any claim for damages of any kind to persons, business entities, or property due, in whole or in part, to the negligence or intentional acts of the Contractor.

B. The Contractor will also indemnify and hold the Borough harmless for and from any and all losses to which the Borough may incur by reason of the Contractor’s failure to pay its workers, suppliers, or subcontractors for labor or materials provided to the Borough.

C. The Contractor further agrees that the Borough reserves its right to monitor and actively participate in the defense of any and all claims against the Borough, at its own expense, if, in its sole discretion, it chooses to do so.

D. For the purpose of subparagraphs a. through c. above, “Borough” shall include the Borough of Waldwick, its Mayor, its Borough Council, and its respective employees, volunteers, and agents.

11. The contractor shall maintain the following insurance coverage, and provide proof of same upon award of a contract, in a form and with a company satisfactory to the Borough:

A. Worker’s Compensation Unlimited coverage and in accordance with New Jersey Status for employers liability.

B. Commercial General Liability and Contractual Liability Insurance Coverage Policy to include personal liability, property, contractual liability and completed operations coverage. Bodily Injury limits of $1,000,000.each person $2,000,000 per occurrence and Property Damage limits of $1,000,000.

C. Comprehensive Automobile Liability Insurance Coverage

Bodily Injury Liability limits of $1,000,000. Each person and $2,000,000. Each occurrence.

D. Umbrella Liability coverage of $5,000,000.

To follow form in excess of the underlying coverages and limits.

NOTE: The Borough reserves the right to waive or modify the above insurance requirements, if appropriate.

12. List each unit price and extension on the bid proposal form. Prices shall be net, including any charges for packing, crating, containers, etc. and all transportation charges fully prepaid, by the contractor F. O. B. destination and placement at locations specified by the Borough.

No additional charges will be allowed for any transportation costs resulting from partial http://www.state.nj.us/labor/lsse/lspubcon.html shipments made at the vendor’s convenience when a single shipment is ordered. ALL

PRICES MUST INCLUDE ALL SHIPPING CHARGES AND DELIVERY.

13. Pursuant to N.J.S.A. 34:11-56.25 et seq., contractors on projects for public work shall adhere to all requirements of the New Jersey Prevailing Wage Act. The contractor shall be required to submit a certified payroll record to the owner within ten (10) days of the payment of the wages. The contractor is also responsible for obtaining and submitting all subcontractors' certified payroll records within the aforementioned time period. The contractor shall submit said certified payrolls in the form set forth in N.J.A.C. 12:60-6.1(c). It is the contractor's responsibility to obtain any additional copies of the certified payroll form to be submitted by contacting the New Jersey Department of Labor and Workforce Development, Division of Workplace Standards. Additional information is available at www.state.nj.us/labor/lsse/lspubcon.html.

14. The bidder, by submitting a bid, attests to the fact that neither the bidder nor any of its sub-contractors are prohibited from receiving the award under N.J.S.A. 34:11-56.38 (regarding State of New Jersey list of debarred Contractors and Sub-Contractors).

15. The Borough reserves the right to accept any one of equal or tie bids or proposals in accordance with N. J. S. A. 40A:11-6.1(d).

16. Unless otherwise specified, brand names, if any, are mentioned for identification purposes only. An equivalent may be accepted if proved to be a true equivalent. The brand or model, etc. must be stated on the bid, otherwise the bid item(s) will be deemed to be exactly as specified.

17. In accordance with N.J.S.A. 40A:11-18 only manufactured and farm products of the

United States, wherever available may be used.

18. If there is a discrepancy between the extended price and the unit price, the unit price shall prevail, and the Borough retains the right to re-compute the extended price.

19. In order to comply with requirements of the Local Public Contracts Law, the Borough may cancel the contract whenever the dollar amount expended under the contract reaches or exceeds the initial total contract amount.

20. Any discrepancy between a numerical price and a price written in words shall be resolved in favor of the price as written in words. Any discrepancy between the unit price multiplied by the quantity and the corresponding total price figure set forth in the Proposal Forms shall be resolved in favor of a total price reached by multiplying the unit price by the quantity. The corrected total shall be used to determine the award of the contract. After all Bid Proposals have been read, the bids will be tabulated and adjusted, if necessary, in accordance with this paragraph. If any mathematical corrections must be made on any bid proposal, then the Borough may not award a contract until all tabulations are complete.

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

21. The successful contractor will not assign or subcontract the work specified and covered under the terms of the Agreement or any part thereof, without the consent of the Borough, except for any subcontractors named in the RFB.

22. LUMP SUM AWARD – This bid will be awarded on a lump sum basis. All items must be bid in order to be considered for award.

23. Unit price must not exceed four (4) decimal places.

24. ADVISORY TO ALL VENDORS

Notice of “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 cumulatively in contracts from New Jersey governmental entities in a calendar year is required to file an annual Business Entity (“BE”) disclosure report with ELEC. These reports are due by March 31 following the year being reported. 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 1- 609-292-8700.

25. The successful vendor may not impose fuel surcharges during the term of the contract.

26. Persons who receive advertisements, bid documents, revisions or addenda to advertisements or bid documents from a secondary source, such as a bidding service, do so at their own risk as to the timeliness, completeness and accuracy of the information they receive. The Borough is not responsible for sending notices of revisions or addenda to advertisements or bid documents to anyone who receives the advertisements or bid documents from a secondary source and of whom the Borough is not aware.

27. CANCELLATION WITHOUT CAUSE

At its option, the Borough may also cancel any or all called for orders for goods, provided that the Borough will compensate the contractor for the contractor’s reasonable overhead and profit related to such orders, but not for the overhead and profit associated with any other goods not called for by the Borough. Likewise, a service contractor shall be entitled to payment for services duly requested by the Borough and rendered by the contractor prior to the cancellation, also at the contract rate(s), but not for the overhead and profit associated with services not performed. If a contract is partially cancelled, the remainder of the contract shall continue in effect, subject to reasonable adjustment to cover the contractor’s actual increased costs, if any, in supplying the remaining goods or services.

28. The Borough reserves the right, in its discretion, to reject unbalanced bids.

29. The contract will contain the following provision: "The contractor shall maintain all documentation related to products, transactions or services under this contract for a period of five years from the date of final payment. Such records shall be made available to the New Jersey Office of the State Comptroller upon request. (N.J.A.C. 17:44-2.2)"

30. A Bid Guarantee in the form of a Bid Bond, Cashier's Check, or Certified Check, made payable to the Borough of Waldwick in the amount of 10% of the highest aggregate year bid submitted, not to exceed twenty thousand dollars ($20,000) must accompany each Bid Proposal. In the event that the bidder to whom the Contract is awarded fails to enter into the Contract in the manner and within the time required, the award to the bidder shall be rescinded and the bid guaranty shall become the property of the Borough of Waldwick.

31. This project is being bid as a single prime. The bidder shall set forth in the bid the name or names of all subcontractors to whom the bidder will subcontract.

32. The contract will be awarded to the bidder whose aggregate bid price for the selected option or .options is the lowest responsible bid.

33. All equipment proposed shall be of the manufacturer’s latest model and design.

34. Warranty – The warranty shall be set forth in the bid.

35. All terms noted as standard in the manufacturer’s specifications are considered to be included in the bidder’s proposal and, likewise, any items not included in the specification text, which are normally prerequisites to the machine’s operation, shall be provided as though specified therein.

36. These specifications represent minimum standards and all divergences shall be noted in the bidder’s exceptions.

37. Where brand names are used, they are intended to be descriptive in nature and approved equals will be considered.

38. Any exceptions to these specifications by the bidder must be noted within the spaces provided below or in a separate sheet if additional space is needed. Vendor’s literature alone will not suffice in explaining exceptions to these specifications.

2. BID SUBMISSION CHECKLIST

The following documents shall be submitted by every bidder at the time and date specified in the public notice to prospective bidders:

1. Bid Guarantee in the form of a bid bond, certified check or cashier's check in the amount of 10% of the total amount of the bid proposal, not to exceed $20,000;

payable to the Borough of Waldwick

2. Stockholder statement of ownership

3. Non-collusion affidavit

4. Consent of surety

5. Russia Belarus Iran Disclosure

6. Bid Proposal

7. Acknowledgement of Receipt of Revisions or Addenda

8. Equipment Certification

9. Naming of Subcontractors

10. Equal Employment Opportunity Form – Exhibit A

11. Americans With Disabilities Form – Exhibit B

12. New Jersey Anti-Discrimination Provisions Exhibit C

13 Public Works Contractor Registration – Exhibit D (With Bid or Prior to Execution of contract)

14 Business Registration - Exhibit E

15. Evidence of affirmative action compliance; see section 5.3

3. BID SUBMISSION REQUIREMENTS

1. Each bidder shall sign, where applicable, all bid submissions as follows:

A. For a corporation, by a principal executive officer;

B. For a partnership or sole proprietorship, by a general partner or the proprietor respectively;

or

C. A duly authorized representative if:

i. The authorization is made in writing by a person described in sections 1 and 2 above;

and

ii. The authorization specifies either an individual or a position having responsibility for the overall operation of the business.

2. CONFLICT OF INTEREST AND NON-COLLUSION

Each bidder must execute and submit as part of the Bid Proposal a "Non-Collusion affidavit" which at a minimum shall attest that:

i. The bidder has not entered into any agreement or participated in any collusion with any other person, corporate entity or government entity, or competitive bidding either alone or with any other person, corporate entity or government entity in connection with the above named project;

ii. All statements made in the bid proposal are true and correct and made with the full knowledge that the contracting unit relies upon the truth of those statements in awarding the contract; and

3. NO ASSIGNMENT OF BID

The bidder may not assign, sell, transfer or otherwise dispose of the Bid or any portion thereof or any right or interest therein. This section is not intended to limit the ability of the successful bidder to assign or otherwise dispose of its duties and obligations under the contract provided that the Borough of Waldwick agrees to the assignment or other disposition.

4. SPECIFICATIONS

Bidders Exceptions to Specifications

5. AWARD OF CONTRACT

1. NOTICE OF AWARD AND EXECUTION OF CONTRACT

Within fourteen calendar days of the award of the contract, the Borough of Waldwick shall notify the successful bidder in writing, at the address set forth in the Bid Proposal and such notice shall specify the place and time for delivery of the executed contract, the performance bond, and the appropriate affirmative action documentation. Failure to deliver the aforementioned documents as specified in the notice of award shall be cause for the Borough of Waldwick to declare the contractor non-responsive and to award the contract to the next lowest bidder.

2. RESPONSIBLE BIDDER

The Borough of Waldwick shall determine whether a bidder is "responsible" in accordance with N.J.S.A. 40A:11-6.1 and N.J.A.C. 7:26H-6.8. The Bid Proposal of any bidder that is deemed not to be "responsible" shall be rejected.

3. AFFIRMATIVE ACTION REQUIREMENTS

A. If awarded a contract, the successful bidder will be required to comply with the requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq.

B Within seven days after receipt of notification of the Borough's intent to award any contract, the contractor must submit one of the following to the contracting unit.

i. If the Contractor has a federal affirmative action plan approval, which consists of a valid letter from the Office of Federal Contract Compliance Programs, the Contractor should submit a photocopy of its letter of approval.

ii. If the Contractor has a certificate of employee information report, the Contractor shall submit a photocopy of the certificate.

iii. If the Contractor has none of the above, the contracting unit shall provide the Contractor with an (A.A.302) affirmative action employee information report.

C. If the Contractor does not submit the affirmative action document within the required time period the Borough may extend the deadline by a maximum of the fourteen calendar days. Failure to submit the affirmative action document by the fourteenth calendar day shall be cause for the Borough to declare the Contractor to be non-responsive and to award the contract to the next lowest bidder.

4. CERTIFICATES

Upon notification by the Borough, the lowest responsible bidder shall supply to the Borough Administrator, within five days of notification, a certificate of insurance as proof that the insurance policies required by these specifications are in full force and effect.

5. LABOR AND MATERIAL (PAYMENT) BOND

Bidder shall with the delivery of the performance bond submit an executed payment bond to guarantee payment to laborers and suppliers for the labor and material used in the work performed under the contract.

Failure to submit a labor and material bond with the performance bond shall be cause for declaring the contract null and void.

6. MAINTENANCE BOND

Upon acceptance of the work by the owner, the contractor shall submit a maintenance bond (N.J.S.A. 40A:11-16.3) in an amount not to exceed ten (10)% of the project costs guaranteeing against defective quality of work or materials for the period of:

_____ 1 year X 2 years

6. BIDDING DOCUMENTS

1. BID GUARANTY

BID BOND TO BE PROVIDED BY THE CONTRACTOR

2. 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 Home Address (for Individuals or Business 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

Home Address (for Individuals) or Business 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 <name of contracting unit>________________ 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 <type of contracting unit>__________________ to notify the <type of contracting unit>____________________ 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 <type of contracting unit> __________________ to declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print) Title:

Signature: Date:

3. NON-COLLUSION AFFIDAVIT

State of New Jersey County of _________________ ss:

I, ________________________________ residing in ______________________________ (name of affiant) (name of municipality) in the County of __________________________ and State of _____________________, of full age, being duly sworn according to law on my oath depose and say that:

I am _______________________________ of the firm of ___________________________ (title or position) (name of firm)) _____________________________________ the bidder making this Proposal for the bid entitled ________________________________, and that I executed the said proposal with (title of bid posting) full authority to do so; that said bidder has not, directly or indirectly entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named project; and that all statements contained in said proposal and in this affidavit are true and correct, and made with full knowledge that the _______________________________________ relies upon the truth of the statements (name of contracting unit) contained in said Proposal and in the statements contained in this affidavit in awarding the contract for the said project.

I further warrant that no person or selling agency has been employed or retained to solicit or secure such contract upon an agreement or understanding for a commission, percentage, brokerage, or contingent fee, except bona fide employees or bona fide established commercial or selling agencies maintained by _________________________________.

(name of firm) Subscribed and sworn to before me this day, ________________, 2____:

Signature of affiant

Type or print name of affiant

Notary public of

My Commission expires _______________ (Seal)

4. CONSENT OF SURETY

A performance bond will be required from the successful contractor on this project, and consequently, all bidders shall submit, with their bid, a consent of surety in substantially the following form

To: _________________________________________________ (Owner) Re: ___________________________________________________ (Contractor)

(Project Description)

This is to certify that the ____________________________________________________ (Surety Company) will provide to _________________________________________ a performance bond in (Owner) the full amount of awarded contract in the event that said contractor is awarded a contract for the above project.

(Contractor)

(Authorized Agent of Surety Company)

Date:__________________________

CONSENT OF SURETY MUST BE SIGNED BY AN AUTHORIZED AGENT OR

REPRESENTATIVE OF A SURETY COMPANY AUTHORIZED TO DO BUSINESS IN NEW

JERSEY AND NOT BY THE INDIVIDUAL OR COMPANY REPRESENTATIVE

SUBMITTING THE BID.

https://www.nj.gov/treasury/administration/pdf/RussiaBelarusEntityList.pdf http://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf

5. Prohibited Russia-Belarus Activities & Iran Investment Activities

Person or Entity

Part 1: Certification

COMPLETE PART 1 BY CHECKING ONE OF THE THREE BOXES BELOW

Pursuant to law, any person or entity that is a successful bidder or proposer, or otherwise proposes to enter into or renew a contract, for goods or services must complete the certification below prior to contract award to attest, under penalty of perjury, that neither the person or entity, nor any parent entity, subsidiary, or affiliate, is identified on the Department of Treasury's Russia-Belarus list or Chapter 25 list as a person or entity engaging in prohibited activities in Russia, Belarus or Iran. Before a contract for goods or services can be amended or extended, a person or entity must certify that neither the person or entity, nor any parent entity, subsidiary, or affiliate, is identified on the Department of Treasury's Russia-Belarus list. Both lists are found on Treasury’s website at the following web addresses:

https://www.nj.gov/treasury/administration/pdf/RussiaBelarusEntityList.pdf www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf.

As applicable to the type of contract, the above-referenced lists must be reviewed prior to completing the below certification.

A person or entity unable to make the certification must provide a detailed, accurate, and precise description of the activities of the person or entity, or of a parent entity, subsidiary, or affiliate, engaging in prohibited activities in Russia or Belarus and/or investment activities in Iran. The person or entity must cease engaging in any prohibited activities and provide an updated certification before the contract can be entered into.

If a vendor or contractor is found to be in violation of law, action may be taken as appropriate and as may be 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.

CONTRACT AWARDS AND RENEWALS

Part 2: Additional Information

PLEASE PROVIDE FURTHER INFORMATION RELATED TO PROHIBITED ACTIVITIES IN

RUSSIA OR BELARUS AND/OR INVESTMENT ACTIVITIES IN IRAN.

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

I certify, pursuant to law, that neither the person or entity listed above, nor any parent entity, subsidiary, or affiliate appears on the N.J. Department of Treasury’s lists of entities engaged in prohibited activities in Russia or Belarus pursuant to P.L. 2022,

c. 3 or in investment 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. (Skip Part 2 and sign and complete the Certification below.)

CONTRACT AMENDMENTS AND EXTENSIONS

I certify, pursuant to law, that neither the person or entity listed above, nor any parent entity, subsidiary, or affiliate is listed on the N.J. Department of the Treasury’s lists of entities determined to be engaged in prohibited activities in Russia or Belarus pursuant to P.L. 2022, c. 3. 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. (Skip Part 2 and sign and complete the Certification below.)

IF UNABLE TO CERTIFY

I am unable to certify as above because the person or entity and/or a parent entity, subsidiary, or affiliate is listed on the Department's Russia-Belarus list and/or Chapter 25 Iran list. I will provide a detailed, accurate, and precise description of the activities as directed in Part 2 below, and sign and complete the Certification below. Failure to provide such will prevent the award of the contract to the person or entity, and appropriate penalties, fines, and/or sanctions will be assessed as provided by law.

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 Contracting Unit is relying on the information contained herein and hereby acknowledge that I am under a continuing obligation from the date of this certification through the completion of any contracts with the Contracting Unit to notify the Contracting Unit 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. 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 Contracting Unit and that the Contracting Unit at its option may declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print)

Title

Signature Date

6. BID PROPOSAL FORM

BOROUGH OF WALDWICK

ADMINISTRATION BUILDING - SECOND FLOOR INTERIOR

ALTERATIONS

NORTHWEST BERGEN REGIONAL HEALTH COMMISSION

The undersigned proposes to furnish and deliver the above goods/services pursuant to the bid specifications, drawings, Addenda (if issued) and made part hereof:

Amount in words

Amount in numbers Delivery Date

Bid includes a Contingency Allowance in the amount of

Amount in words

Amount in numbers

Company Name Federal I.D. #

Address

Signature of Authorized Agent Type or Print Name

Title:__________________________________

Telephone Number Date

Fax Number E-mail address

7. ACKNOWLEDGMENT OF RECEIPT OF ADDENDA

The undersigned Bidder hereby acknowledges receipt of the following Addenda:

Addendum Number Dated Acknowledge Receipt

(Initial)

No addenda were received:

Acknowledged for: __________________________________________ (Name of Bidder)

By: _________________________________________ (Signature of Authorized Representative)

Name: ______________________________________ (Print or Type)

Title: ________________________________________

Date: ________________________________________

8. EQUIPMENT CERTIFICATION

The undersigned Bidder hereby certifies as follows:

The Bidder owns or controls all the necessary equipment required to accomplish the work described in the specifications.

Name of Bidder: ___________________________________

By: ___________________________________ (Signature)

Name of above: _____________________________________ (Print)

Title: __________________________

Date:__________________________

9. NAMING OF SUBCONTRACTORS

The Bidder shall set forth below the name or names of all subcontractors to whom the Bidder will subcontract for the following categories, pursuant to N.J.S.A 40A:11-16:

• The plumbing and gas fitting and all kindred work;

• Steam power plants, steam and hot water heating and ventilating and refrigeration apparatus and all kindred work;

• Electrical work, including any electrical power plants, tele-data, fire alarm, or security system; and

• Structural steel and ornamental ironwork.

Name of Subcontractor Category of work

(Name of Bidder)

By: _________________________________________

(Signature of Authorized Representative)

Name: ______________________________________

(Print or Type)

Title: ________________________________________

Date: ________________________________________

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

CONSTRUCTION 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 take affirmative action to ensure that such applicants are recruited and employed, 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 action shall include, but not be limited to the following: employment, up-grading, 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, where applicable, will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency contracting officer advising the labor union or workers' representative of the contractor's commitments under this act 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.

When hiring or scheduling workers in each construction trade, the contractor or subcontractor agrees to make good faith efforts to employ minority and women workers in each construction trade consistent with the applicable employment goal prescribed by N.J.A.C. l7:27-7.3; provided, however, that the Division may, in its discretion, exempt a contractor or subcontractor from compliance with the good faith procedures prescribed by the following provisions, A, B and C, as long as the Division is satisfied that the contractor or subcontractor is employing workers provided by a union which provides evidence, in accordance with standards prescribed by the Division, that its percentage of active "card carrying" members who are minority and women workers is equal to or greater than the applicable employment goal established in accordance with N.J.A.C. l7:27-7.3. The contractor or subcontractor agrees that a good faith effort shall include compliance with the following procedures:

(A)If the contractor or subcontractor has a referral agreement or arrangement with a union for a construction trade, the contractor or subcontractor shall, within three business days of the contract award, seek assurances from the union that it will cooperate with the contractor or subcontractor as it fulfills its affirmative action obligations under this contract and in accordance with the rules promulgated by the Treasurer pursuant to N.J.S.A. 10:5-31 et. seq., as supplemented and amended from time to time and the Americans with Disabilities Act. If the contractor or subcontractor is unable to obtain said assurances from the construction trade union at least five business days prior to the commencement of construction work, the contractor or subcontractor agrees to attempt to hire or schedule minority and women workers directly, consistent with the applicable employment goal. If the contractor's or subcontractor's prior experience with a construction trade union, regardless of whether the union has provided said assurances, indicates a significant possibility that the trade union will not refer sufficient minority and women workers consistent with the applicable employment goal, the contractor or subcontractor agrees to be prepared to hire or schedule minority and women workers directly, consistent with the applicable employment goal, by complying with the hiring or scheduling procedures prescribed under (B) below; and the contractor or subcontractor further agrees to take said action immediately if it determines or is so notified by the Division that the union is not referring minority and women workers consistent with the applicable employment goal.

(B) If the hiring or scheduling of a workforce consistent with the employment goal has not or cannot be achieved for each construction trade by adhering to the procedures of (A) above, or if the contractor does not have a referral agreement or arrangement with a union for a construction trade, the contractor or subcontractor agrees to take the following actions consistent with the applicable county employment goals:

(l) To notify the public agency compliance officer, the Division, and minority and women referral organizations listed by the Division pursuant to N.J.A.C. 17:27-5.3, of its workforce needs, and request referral of minority and women workers;

(2) To notify any minority and women workers who have been listed with it as awaiting available vacancies;

(3) Prior to commencement of work, to request that the local construction trade union refer minority and women workers to fill job openings, provided the contractor or subcontractor has a referral agreement or arrangement with a union for the construction trade;

(4) To leave standing requests for additional referral to minority and women workers with the local construction trade union, provided the contractor or subcontractor has a referral agreement or arrangement with a union for the construction trade, the State Training and Employment Service and other approved referral sources in the area until such time as the workforce is consistent with the employment goal;

(5) If it is necessary to lay off some of the workers in a given trade on the construction site, to assure, consistent with the applicable State and Federal statutes and court decisions, that sufficient minority and women employees remain on the site consistent with the employment goal; and to employ any minority and women workers laid off by the contractor on any other construction site on which its workforce composition is not consistent with an employment goal established pursuant to rules implementing N.J.S.A. 10:5-31 et. seq.;

(6) To adhere to the following procedure when minority and women workers apply or are referred to the contractor or subcontractor:

(i) If said individuals have never previously received any document or certification signifying a level of qualification lower than that required in order to perform the work of the construction trade, the contractor or subcontractor shall determine the qualifications of such individuals and if the contractor's or subcontractor's workforce in each construction trade is not consistent with the applicable employment goal, it shall hire or schedule those individuals who satisfy appropriate qualification standards. However, a contractor or subcontractor shall determine that the individual at least possesses the requisite skills, and experience recognized by a union, apprentice program or a referral agency, provided the referral agency is acceptable to the Division. If necessary, the contractor or subcontractor shall hire or schedule minority and women workers who qualify as trainees pursuant to these rules. All of the requirements, however, are limited by the provisions of (C) below.

(ii) If the contractor's or subcontractor's workforce is consistent with the applicable employment goal, the name of any interested women or minority individual shall be maintained on a waiting list for the first consideration, in the event the contractor's or subcontractor's workforce is no longer consistent with the applicable employment goal.

(iii) If, for any reason, said contractor or subcontractor determines that a minority individual or a woman is not qualified or if the individual qualifies as an advanced trainee or apprentice, the contractor or subcontractor shall inform the individual in writing of the reasons for the determination, maintain a copy of the determination in its files, and send a copy to the public agency compliance officer and to the Division.

(7) To keep a complete and accurate record of all requests made for the referral of workers in any trade covered by the contract, on forms made available by the Division and submitted promptly to the Division upon request.

(C) The contractor or subcontractor agrees that nothing contained in (B) above shall preclude the contractor or subcontractor from complying with the union hiring hall or apprenticeship policies in any applicable collective bargaining agreement or union hiring hall arrangement, and, where required by custom or agreement, it shall send journeymen and trainees to the union for referral, or to the apprenticeship program for admission, pursuant to such agreement or arrangement.