Bond_Counsel_RFQ.pdf

REQUEST FOR QUALIFICATIONS FOR

BOND COUNSEL SERVICES

SUBMISSIONS EXPECTED BY

April 29th, 2025 at 4:00 P.M.

ADDRESS ALL QUALIFICATION STATEMENTS & DELIVER TO THE

DEDICATED LOCKBOX LOCATED AT:

Raquel Tosado, Director, QPA

Department of Finance | Division of Purchasing

280 Grove Street, 1st Floor Room 116

Jersey City, New Jersey 07302 https://cityofjerseycity.com/

GENERAL INFORMATION & SUMMARY

ORGANIZATION REQUESTING STATEMENT OF QUALIFICATION

City of Jersey City (City Hall)

280 Grove Street

Jersey City, NJ 07302

CONTACT PERSON

John McKinney

Assistant Corporation Counsel City Hall

280 Grove Street

201-547-5179

PURPOSE OF REQUEST

The City of Jersey City (City) is requesting qualification statements from qualified individuals to provide Bond Counsel Services. Qualification Statements will be evaluated in accordance with the criteria set forth in this Request for Qualifications (RFQ). Using this RFQ, the City of Jersey City intends to establish a pool of attorneys who will be available to provide legal services as needed during the contract term. One or more individuals/firms may be selected to provide services. If selected, the governing body will approve a resolution awarding a contract to the attorney.

Bond Counsel shall be a licensed attorney at law of New Jersey. Bond Counsel performs and provides legal advice with regard to the following activities: the preparation of Bond Ordinances and the review of the adoption proceedings; the preparation and review of public finance resolutions, the preparation and issuance of Bond Anticipation, Special Emergency, and Tax Anticipation Notes and the preparation and issuance of General Obligation Bonds. In addition, Bond Counsel is responsible for the preparation and/or review of any Preliminary Official Statement and Official Statement of the

City. Bond Counsel is also responsible for the preparation and/or review of any application to the

Local Finance Board, and attendance at any related meetings of the Board.

As to the compensation for these services: For services rendered in connection with issuance of temporary and/or permanent obligations, Bond Counsel will receive a transactional fee. Please include in the response the proposed base fee for each type of transaction, as well as any additional increment which may apply in relationship to the par amount of the obligations.

Services rendered that do not result in the issuance of temporary and/or permanent obligations shall be compensated on an hourly basis. Please set forth the cost details in the response, including the hourly rates of each of the individuals who will perform services and time estimates for each individual, all expenses and the total cost of a “not to exceed” amount.

PERIOD OF QUALIFICATION

Contract Term: January 1st 2025 – December 31st 2025

CONTRACT FORM

If selected to provide services, the successful Respondent shall be required to execute a form contract, which includes indemnification, insurance, termination and licensing provisions. A complete copy of a draft City contract is available upon request.

It is also agreed and understood that the acceptance of the final payment shall be considered a release in full of all claims against the City arising out of, or by reason of, the work done and materials furnished under this Contract.

GLOSSARY

The following definitions shall apply to and are used in this Request for Qualifications (RFQ):

"City" - refers to the City of Jersey City.

"Qualification Statement"- refers to the complete responses to this RFQ submitted by the

Respondents.

"Qualified Respondent” refers to those Respondents who (in the sole judgment of the City) have satisfied the qualification criteria set forth in this RFQ.

"RFQ" - refers to this Request for Qualifications, including any amendments thereof or supplements thereto.

"Respondent" or "Respondents" - refers to the interested persons and/or firm(s) that submit a

Qualification Statement.

“Period of Qualification” – refers to the period (January 1st, 2025 – December 31st, 2025) during which a successful Respondent will remain eligible for services under the terms of this RFQ.

SECTION 1

INTRODUCTION AND GENERAL INFORMATION

1.1. Introduction and Purpose

The City is soliciting Qualification Statements from interested persons and/or firms for the provision of services, as more particularly described herein. Through the RFQ process described herein, persons and/or firms interested in assisting the City with the provision of such services must prepare and submit a Qualification Statement in accordance with the procedure and schedule in this RFQ. The City will review Qualification Statements only from those persons and/or firms that submit a Qualification Statement which includes all information required to be included as described herein (in the sole judgment of the City).

The City intends to qualify person(s) and/or firm(s) that:

A. possess the professional, financial and administrative capabilities to provide the proposed services; and

B. will agree to work under the compensation terms and conditions determined by the City to provide the greatest benefit to the taxpayers of the City.

1.2. Procurement Process and Schedule.

The selection of Qualified Respondents is subject to the “New Jersey Local Unit Pay-to- Play”

Law, N.J.S.A. 19:44A-20.4 et seq. The City has structured a procurement process that seeks to obtain the desired results described above, while establishing a competitive process to assure that each person and/or firm is provided an equal opportunity to submit a Qualification Statement in response to the RFQ. Qualification Statements will be evaluated in accordance with the criteria set forth in Section 5 of this RFQ, which will be applied in the same manner to each Qualification

Statement received.

Qualification Statements will be reviewed and evaluated by the City’s Corporation Counsel. The

Qualification Statements will be reviewed to determine if the Respondent has met the minimum professional, administrative and financial requirements.

Based upon the totality of the information contained in the Qualification Statement, including information about the reputation and experience of each Respondent, Corporation Counsel will determine which Respondents are qualified (professionally, administratively and financially) to provide the services.

The RFQ process commences with the issuance of this RFQ. The steps involved in the process and the anticipated completion dates are set forth in Table 1, Procurement Schedule. The City reserves the right to, among other things, amend, modify or alter the Procurement Schedule upon notice to all potential Respondents.

All communications concerning this RFQ or the RFQ process shall be directed to the City’s

Designated Contact Person, in writing. Qualification Statements should be submitted to, and be received by the Purchasing Agent, via mail or hand delivery to the dedicated lockbox, by 4:00 p.m.

prevailing time on April 29th, 2025. Qualification Statements will not be accepted by facsimile transmission or e-mail.

Subsequent to issuance of this RFQ, the City (through the issuance of addenda to all persons and/or firms that have received a copy of the RFQ) may modify, supplement or amend the provisions of this RFQ in order to respond to inquiries received from prospective Respondents or as otherwise deemed necessary or appropriate by (and in the sole judgment of) the City.

TABLE 1: ANTICIPATED PROCUREMENT SCHEDULE

1 Issuance of Request for Qualifications 4/11/25

2 Receipt of Qualification Statements 4/29/25 at 4:00 p.m.

1.3 Conditions Applicable to RFQ.

Upon submission of a Qualification Statement in response to this RFQ, the Respondent acknowledges and consents to the following conditions relative to the submission and review and consideration of its Qualification Statement:

1. This document is an RFQ and does not constitute a Request for Proposals (RFP).

2. This RFQ does not commit the City to issue an RFP.

3. All costs incurred by the Respondent in connection with responding to this RFQ shall be borne solely by the Respondent.

4. The City reserves the right (in its sole judgment) to reject for any reason any and all responses and components thereof and to eliminate any and all Respondents responding to this RFQ from further consideration for this procurement.

5. The City reserves the right (in its sole judgment) to reject any Respondent that submits incomplete responses to this RFQ, or a Qualification Statement that is not responsive to the requirements of this RFQ.

6. The City reserves the right, without prior notice, to supplement, amend, or otherwise modify this RFQ, or otherwise request additional information.

7. All Qualification Statements shall become the property of the City and will not be returned.

8. All Qualification Statements will be made available to the public at the appropriate time, as determined by the City (in the exercise of its sole discretion) in accordance with law.

9. The City may request Respondents to send representatives to the City for interviews.

10. All Qualification Statements should be received by the City by 4:00 p.m. prevailing time on April 29th, 2025. However, interested Respondents may submit Qualification

Statements after April 29th, 2025 as well.

11. Neither the City nor its officers, officials or employees shall be liable for any claims or damages resulting from the solicitation or preparation of the Qualification Statement, nor there any reimbursement to Respondents for the cost of preparing and submitting a

Qualification Statement or for participating in this procurement process.

1.4. Rights of City.

The City reserves, holds and may exercise, at its sole discretion, the following rights and options with regard to this RFQ and the procurement process in accordance with the provisions of applicable law:

1. To determine that any Qualification Statement received complies or fails to comply with the terms of this RFQ.

2. To supplement, amend or otherwise modify the RFQ through issuance of addenda to all prospective Respondents who have received a copy of this RFQ.

3. To waive any technical non-conformance with the terms of this RFQ.

4. To change or alter the schedule for any events called for in this RFQ upon the issuance of notice to all prospective Respondents who have received a copy of this RFQ.

5. To conduct investigations of any or all of the Respondents, as the City deems necessary or convenient, to clarify the information provided as part of the Qualification Statement and to request additional information to support the information included in any

Qualification Statement.

6. To suspend or terminate the procurement process described in this RFQ at any time (in its sole discretion.) If terminated, the City may determine to commence a new procurement process or exercise any other rights provided under applicable law without any obligation to the Respondents.

7. The City shall be under no obligation to complete all or any portion of the procurement process described in this RFQ.

1.5 Addenda or Amendments to RFQ.

During the period provided for the preparation of responses to the RFQ, the City may issue addenda, amendments or answers to written inquiries. Those addenda will be noticed by the City and will constitute a part of the RFQ. All responses to the RFQ shall be prepared with full consideration of the addenda issued prior to the Qualification Statement submission date.

1.6 Cost of Qualification Statement Preparation.

Each Qualification Statement and all information required to be submitted pursuant to the RFQ shall be prepared at the sole cost and expense of the Respondent. There shall be no claims whatsoever against the City, its officers, officials or employees for reimbursement for the payment of costs or expenses incurred in the preparation of the Qualification Statement or other information required by the RFQ.

1.7 Qualification Statement Format.

Qualification Statements must cover all information requested in this RFQ. Qualification

Statements which in the judgment of the City fail to meet the requirements of the RFQ or which are in any way conditional, incomplete, obscure, contain additions or deletions from requested information, or contain errors may be rejected.

SECTION 2

SCOPE OF SERVICES

It is the intent of the City to solicit Qualification Statements from Respondents that have expertise in the provision of services as described below. Respondents must demonstrate that they will have the continuing capabilities to perform these services.

The Law Department of the City of Jersey City is seeking legal support from a law firm with substantial experience in Bond Counsel Law Services. Bond Counsel Services will have a close working relationship with the Law Department, the Department of Administration, and the City’s

Chief Financial Officer. Bond Counsel Services shall include, but not be limited to:

1. On an as needed basis, prepares, reviews and opines on bond ordinances related to capital projects;

2. Assists in reviews and updates of official statements associated with debt issuances;

3. Attends bid openings and assists in analyzing bids to determine final award;

4. Assists in relationship management with rating agencies;

5. Provides advice on legal and financial matters to ensure City’s fiscal strength;

6. Provides legal opinions on sale of bonds and notes; and

7. Attends meetings when requested.

Counsel may also be called upon to provide other types of legal services of a specialized nature.

SECTION 3

SUBMISSION REQUIREMENTS

3.1 General Qualifications

The Qualification Statement submitted by the Respondent must meet or exceed the professional, administrative and financial qualifications set forth in this Section 3 and shall incorporate the information requested below.

In addition to the information required as described below, a Respondent may submit supplemental information that it feels may be useful in evaluating its Qualification Statement. Respondents are encouraged to be clear, factual, and concise in their presentation of information.

3.2 Administrative Information Requirements.

The Respondent shall, as part of its Qualification Statement, provide the following information:

1. An executive summary (not to exceed two (2) pages) of the information contained in all the other parts of the Qualification Statement.

2. An executed Letter of Qualification.

3. Name, address and telephone number of the Respondent submitting a Qualification

Statement pursuant to this RFQ, and the name of the key contact person.

4. A description of the business organization (i.e., corporation, partnership, joint venture, etc.) of each Respondent, its ownership and its organizational structure.

a. Provide the names and business addresses of all Principals of the Respondent submitting the

Qualification Statement. For purposes of this RFQ, "Principals" means persons possessing an ownership interest in the Respondent. If the Respondent is a corporation, "Principals" shall include each investor who has any operational control over the

Respondent, and every stockholder having an ownership interest of 10% or more in the firm.

b. If a Respondent is a partially owned or a fully-owned subsidiary of another firm, identify the parent company and describe the nature and extent of the parents' approval rights over the activities of the Respondent submitting a Qualification Statement. Describe the approval process.

c. If the Respondent is a partnership or a joint venture or similar organization, provide comparable information as required in (b) above for each member of the partnership, joint venture or similar organization.

d. A statement that the Respondent has complied with all applicable affirmative action (or similar) requirements with respect to its business activities, together with evidence of such compliance.

5. The number of years Respondent has been in business under the present name.

6. The number of years Respondent has been under the current management.

7. Any judgments within the last three (3) years in which Respondent has been adjudicated liable for professional malpractice. If yes, please explain.

8. Whether the Respondent is now or has been involved in any bankruptcy or re- organization proceedings in the last ten (10) years. If yes, please explain.

9. Confirm appropriate federal and state licenses to perform activities.

10. An executed letter of intent.

3.1 Professional Information Requirements.

1. Respondent shall submit a description of its overall experience in providing the type of services sought in the RFQ. At a minimum, the following information on past experience should be included as appropriate to the RFQ:

a. Description and scope of work by Respondent.

b. Name, address and contact information of Respondent’s references.

c. Explanation of perceived relevance of the experience to the RFQ.

2. Brief description of Respondent's relevant clients, including municipal government clients, during the last three (3) years.

3. Resumes of key employees.

4. A narrative statement of the Respondent’s understanding of the City’s needs and goals.

5. List all immediate relatives of Principal(s) of Respondent who are City employees or elected officials of the City. For purposes of the above, "immediate relative" means a spouse, parent, stepparent, brother, sister, child, stepchild, direct-line aunt or uncle, grandparent, grandchild and in-laws.

6. Limits of Malpractice insurance coverage.

7. A listing of all other engagements where services of the types being proposed were provided in the past five (5) years. This should include other municipal governments and other levels of government. Contact information for the recipients of the similar services must be provided. The

City may obtain references from any of the parties listed.

8. Respondents must demonstrate a proven record of cases tried before the Federal District Court for the District of New Jersey and/or demonstrate a proven record of cases tried or argued at the trial level and in the Appellate Divisions of the Superior Court of New Jersey.

9. Respondents must list all cases where they represented the City or in which they sued the City or in which they represented a client that sued the City.

SECTION 4

INSTRUCTION TO RESPONDENTS

Submission of Qualification Statements.

Respondents must submit: 1 original (physical and in a USB or flash drive), and 2 copies of their Qualification Statement to the City’s Purchasing Agent.

Qualification Statements should be received by the City no later than 4 p.m. prevailing time on

April 29th, 2025, and must be mailed or hand-delivered to the dedicated lockbox located at the Division of Purchasing, 280 Grove Street, 1st Floor, Room 116, Jersey City, NJ 07302.

Qualification Statements forwarded by facsimile or e-mail will not be accepted.

To be responsive, Qualification Statements must provide all requested information, and must be in strict conformance with the instructions set forth herein. Qualification Statements and all related information must be bound, and signed and acknowledged by the Respondent.

SECTION 5

EVALUATION

The City’s objective in soliciting Qualification Statements is to enable it to select a Respondent that will provide high quality and cost-effective services to the citizens of Jersey City. The City will consider Qualification Statements only from Respondents that, in the City's sole judgment, have demonstrated the capability and willingness to provide high quality services to the citizens of the

City in the manner described in this RFQ.

Qualification statements will be evaluated by the City and Qualified Respondents will be selected based on the evaluation factors set forth below:

1. Experience and reputation in the field;

2. Knowledge of the City's Law Department;

3. Availability to accommodate the required meetings of the City;

4. Experience in the areas of law described in Section 2 of this RFQ;

5. Pertinent government experience;

6. Commitment to Equal Opportunity, Affirmative Action and Diversity Programs; Support of, and utilization of Minority and Women Owned Business Enterprises (MBE/WBE), and/or Local Owned Business Enterprises (LBE) consistent with the established Federal, State and City’s Policies; and

7. Other factors demonstrated to be in the best interests of the City.

Each Qualification Statement must satisfy the objectives and requirements detailed in this RFQ.

The City will select the most advantageous Qualification Statements based on all of the evaluation factors set forth in this RFQ. Successful Respondents shall be determined by an evaluation of the total content of the Qualification Statement submitted. The City reserves the right to:

1. not select any of the Qualification Statements;

2. award a contract for the requested services at any time within the qualification period.

Every Qualification Statement should be valid through this time period.

The City shall not be obligated to explain the results of the evaluation process to any Respondent.

SECTION 6

GENERAL TERMS AND CONDITIONS

1. The City reserves the right to reject any or all Qualification Statements, if necessary, or to waive any informalities in the Qualification Statements, and, unless otherwise specified by the Respondent, to accept any item, items or services in the Qualification statement should it be deemed in the best interest of the City to do so.

2. Each Qualification Statement must be signed by the person authorized to do so.

3. Qualification Statements may be hand delivered or mailed consistent with the provisions of the legal notice to Respondents. In the case of mailed Qualification Statements, the City assumes no responsibility for Qualification Statements received after the designated date and time and will return late Qualification Statements unopened. Qualification Statements will not be accepted by facsimile or e-mail.

4. In accordance with Affirmative Action Law, P.L. 1975/ c. 127 (N.J.A.C. 17:27) with implementation of July 10, 1978, successful Respondents must agree to submit individual employer certifications and numbers or complete Affirmative Action employee information report (form AA-302). Also, during the performance of this contract, the contractor agrees as follows: (a) The contractor or subcontractor where applicable, will not discriminate against any employee because of age, race, creed, color, national origin, ancestry, marital status or affectional or sexual orientation. 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, sex or handicap. Such action 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 section for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notice to be provided by the Public Agency

Compliance Officer setting forth provisions of this nondiscrimination clause: (b) 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, sex or handicap; (c) the contractor or subcontractor, where applicable, will sent to each labor union or representative or 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 worker’s representative of the contractor’s commitments under this act and shall post copies of the notice; (d) the contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the treasurer pursuant to the P.L. 1975, c. 127, as amended and supplemented from time to time.

5. No Respondent shall influence, or attempt to influence, or cause to be influenced, any

City officer or employee to use his/her official capacity in any manner which might tend to impair the objectivity or independence of judgment of said officer or employee.

6. No Respondent shall cause or influence, or attempt to cause or influence, any City officer or employee to use his/her official capacity to secure unwarranted privileges or advantages for the respondents or any other person.

7. Should any difference arise between the contracting parties as to the meaning or intent of these instructions or specifications, the City attorney’s decision shall be final and conclusive.

8. The City shall not be responsible for any expenditure of monies or other expenses incurred by the Respondent in making its Qualification Statement.

9. Pursuant to N.J.S.A. 52:32-44, Respondents should submit a copy of their Business

Registration Certificate with their Qualification Statement.

10. The contract will be awarded in accordance with the provisions of the City’s Disclosure of Lobbyist Representative Status Ordinance §3-9.1 et seq. adopted on June 12, 2002.

The Respondent will be required to certify that the Respondent either did not retain the services of a lobbyist to lobby on behalf of the Respondent for the award of this contract, or if a lobbyist was retained by the Respondent for such purposes, the Respondent’s lobbyist, prior to commencing his/her lobbying activities, shall have filed a notice of lobbyist representative status form with the City Clerk. The Respondent whose lobbyist failed to comply with the provisions of Ordinance §3-9.1 et seq., following notice and an opportunity to be heard, shall be disqualified from entering into contracts with the City for a period of two (2) years for each violation.

END OF GENERAL INSTRUCTIONS

Item J. Letter of Qualification

Note: To be typed on Respondent's

Letterhead. No Modifications may be made to this letter.

[Insert date]

Attn: Raquel Tosado, Director, QPA

Division of Purchasing

280 Grove Street, 1st Floor, Room 116

Dear Mrs. Tosado:

The undersigned have reviewed the Statement of Qualification submitted in response to the

Request for Qualifications (RFQ) issued by the City of Jersey City (City), dated

, in connection with the City's need for Bond Counsel Services.

We affirm that the contents of our Statement of Qualifications (which Statement of Qualification is incorporated herein by reference) are accurate, factual and complete to the best of our knowledge and belief and that the Statement of Qualification is submitted in good faith upon express understanding that any false statement may result in the disqualification of (Name of

Respondent).

(Respondent shall sign and complete the spaces provided below. If a joint venture, appropriate officers of each company shall sign.)

Signature of Chief Executive Officer Dated:

Typed Name and Title

Typed Name of Firm

Signature of Financial Officer Dated

*If a joint venture, partnership, or other formal organization is submitting a Statement of

Qualifications, each participant shall execute this Letter of Qualification.

Item K. Letter of Intent

(Note: To be typed on Respondent's Letterhead. No Modifications may be made to this letter.)

[Insert Date]

Attn: Raquel Tosado, Director, QPA

Division of Purchasing

280 Grove Street, 1st Floor, Room 116

Dear Mrs. Tosado:

The undersigned, Respondent, has (have) submitted the attached Statement of Qualifications in response to the Request for Qualifications (RFQ), issued by the City of Jersey City (City), dated

, in connection with the City's need for Bond

Counsel Services.

hereby states:

Name of Respondent

1. The Statement of Qualifications contains accurate, factual and complete information.

2. (Name of Respondent) agrees (agree) to participate in good faith in the procurement process as described in the RFQ and to adhere to the City's procurement schedule.

3. (Name of Respondent) acknowledges/acknowledge that all costs incurred by it/them in connection with the preparation and submission of the Statement of Qualifications prepared and submitted in response to the RFQ, or any negotiation which results therefrom shall be borne exclusively by the Respondent.

4. (Name of Respondent) hereby declares/declare that only persons participating in this Statement of Qualifications as Principals are named herein and that no person other than those herein mentioned has any participation in this Statement of Qualifications or in any contract to be entered into with respect thereto. Additional persons may subsequently be included as participating Principals, but only acceptable to the City. Respondent declares that this Statement of Qualifications is made without connection with any other person, firm or parties who have submitted a Statement of

Qualifications, except as expressly set forth below and that it has been prepared and has been submitted in good faith and without collusion or fraud.

5. (Name of Respondent) acknowledges and agrees that the City may modify, amend, suspend, and/or terminate the procurement process, in its sole judgment. In any case, the City shall not have any liability to the Respondent for any costs incurred by the Respondent with respect to the procurement activities described in this RFQ.

6. (Name of Respondent) acknowledges that any contract executed with respect to the provision of

Bond Counsel Services must comply with all applicable affirmative action and similar laws.

Respondent hereby agrees to take such actions as are required in order to comply with such applicable laws.

(Respondent shall sign and complete the space provided below. If a joint venture, appropriate officers of each company shall sign.)

Signature of Chief Executive Officer Dated:

* If a joint venture, partnership or other formal organization is submitting a Statement of

Qualifications, each participant shall execute this Letter of Intent.

Item L. Hourly Rate

REQUIRED ADMINISTRATIVE FORMS

PROJECT: BOND COUNSEL SERVICES

RESPONDENT: __________________________________________________________

Please place the checklist and the required forms at the front of your proposal.

RESPONDENT=S CHECKLIST

Item

Respondent

Initials

Purchasing

Review

*Acknowledgment of Receipt of Addenda

*Statement of Ownership Disclosure

Mandatory EEO Language (Exhibit A)

Non-Collusion Affidavit (Notarized)

Americans with Disabilities Act (Appendix A)

Employee Information Report. Submit one of the three forms:

(1.) Copy of Letter of Federal Approval, valid for one year from the date of issuance.

2.) Copy of Certificate of Employee Information Report, must be renewed prior to their expiration date in order to remain valid.

(3.) Copy of Initial Employee Report, Form AA-302, if first time doing business with Jersey City. Original must be submitted to the State with a check or money order for $150.00 made payable to “Treasurer, State of NJ.”

Supplier Diversity Questionnaire

Business Registration Certificate

Letter of Intent

Letter of Qualification

Disclosure of Investment Activities in Iran Form

Original signature(s) on all required forms

*A Proposer’s failure to include these forms with its proposal will result in the rejection of the Proposal.

https://cityofjerseycity.com/

STATEMENT OF OWNERSHIP DISCLOSURE

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

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

Name of Organization:_________________________________________________________________

Organization Address:_________________________________________________________________

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

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

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

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

Partnership Limited Partnership Limited Liability Partnership (LLP)

Other (be specific): ______________________________________________

Part II

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

THE LIST BELOW IN THIS SECTION)

OR

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

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

Name of Individual or Business Entity Address

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

OR LLC MEMBERS LISTED IN PART II

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

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

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

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

Address

Part IV Certification

I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this certification on behalf of the bidder/proposer; that the CITY OF JERSEY 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 the CITY OF JERSEY CITY to notify the CITY OF JERSEY 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, CITY OF JERSEY CITY to declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print): Title:

Signature: Date:

THE CITY OF JERSEY CITY IS AN AFFIRMATIVE ACTION & EQUAL OPPORTUNITY EMPLOYER AND COMPLIES WITH ALL

LOCAL, STATE AND FEDERAL LAWS AND REGULATIONS IN EMPLOYMENT AND CONTRACTING.

SUPPLIER DIVERSITY BIDDER QUESTIONNAIRE

The City of Jersey City is committed to ensuring that its utilization of vendors reflects the diversity of its community. Please complete this form to assist us with monitoring our supplier diversity performance.

Business Name: ________________________________________________________________

Address: ________________________________________________________________

Phone: ________________________________________________________________

Email: ________________________________________________________________

Contact Name: ________________________________________________________________

Please indicate if your business qualifies as any of the following: (See definitions for clarification)

� Minority Owned

� Woman Owned

� Veteran Owned

� Disability Owned

� Lesbian, Gay, Bisexual, Transgender Owned

� None

Please indicate if your business is currently certified by an authorized certifying body as any of the following:

� Minority Business Enterprise

� Woman Business Enterprise

� Veteran Business Enterprise

� Disability Owned Business Enterprise

� Lesbian, Gay, Bisexual, Transgender Business Enterprise

� Disadvantaged Business Enterprise

� Small Business Enterprise

� None

THE CITY OF JERSEY CITY IS AN AFFIRMATIVE ACTION & EQUAL OPPORTUNITY EMPLOYER AND COMPLIES WITH ALL

LOCAL, STATE AND FEDERAL LAWS AND REGULATIONS IN EMPLOYMENT AND CONTRACTING.

SUPPLIER DIVERSITY DEFINITIONS

Minority Owned- a business which is a sole proprietorship, partnership or corporation at least 51% of which is owned and controlled by persons who are African American, Hispanic, Asian American, American Indian or Alaskan Native, defined as follows:

African American: a person having origins in any of the black racial groups of Africa.

Hispanic: a person of Mexican, Puerto Rican, Central or South American or other non-European Spanish culture or origin regardless of race.

Asian: a person having origins in any of the original peoples of the Far East, South East Asia, Indian subcontinent, Hawaii or the Pacific Islands.

American Indian or Alaskan Native: a person having origins in any of the original peoples of North America and who maintains cultural identification through tribal affiliation or community recognition.

Woman Owned- a business which is a sole proprietorship, partnership or corporation at least 51% of which is owned and controlled by a woman or women.

Veteran Owned- a business which is a sole proprietorship, partnership or corporation at least 51% of which is owned and controlled by a person or persons who are veterans.

"Veteran" means any citizen and resident of this State now or hereafter honorably discharged or released under honorable circumstances who served in any branch of the Armed Forces of the United States or a Reserve component thereof for at least 90 days and shall include disabled veterans.

Disability Owned- a business which is a sole proprietorship, partnership or corporation at least 51% of which is owned and controlled by a person or persons with a disability.

Lesbian, Gay, Bisexual, Transgender Owned- a business which is a sole proprietorship, partnership or corporation at least 51% of which is owned and controlled by an LGBT person or persons.

The Certification form requires the insertion of contracting unit identification information which should be filled in (in italics on the form) prior to its use.

STANDARD BID DOCUMENT REFERENCE

Name of Form DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN

Statutory Reference

N.J.S.A. 52:32-55 et seq.

N.J.S.A. 40A:11-2.1

N.J.S.A. 18A:18A-49.4

Applicability

Y/N Mandatory Optional N/A

LPCL Y

Goods and Services

X

PSCL Y Construction

X

Instructions Reference

Description P.L. 2012, c.25 prohibits the awarding of State and local public contracts for goods and services with persons or entities engaging in certain investment activities in energy or finance sectors of Iran. Prior to contract award, vendors and contractors must certify that neither they nor any parent entity, subsidiary, or affiliate is listed on the New Jersey 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").

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.

OR

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

Part 2: Additional Information

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 of Jersey 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 of Jersey City to notify the City of Jersey 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 of Jersey

City and that the City of Jersey City at its option may declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print)

Title

Signature Date