cumberland Microsoft Word - 26-39 RFQ Survey Services.pdf

COUNTY OF CUMBERLAND

BRIDGETON, NEW JERSEY

RFQ # 26-39

REQUEST FOR QUALIFICATIONS FOR

PROVIDING SURVEY SERVICES FOR THE

CUMBERLAND COUNTY PLANNING BOARD AND

ENGINEERING DEPARTMENT

RFQ OPENING: THURSDAY, SEPTEMBER 17, 2026

PREVAILING TIME: 2:30 PM

FINANCE DEPARTMENT, PURCHASING DIVISION

CUMBERLAND COUNTY ADMINISTRATION BUILDING

164 WEST BROAD STREET

BRIDGETON, NEW JERSEY 08302

(856) 453-2132 Phone

(856) 451-0967 Facsimile

Please note some of the forms have been updated.

Please review all forms, follow instructions and complete them as required.

RFQ # 26-39 Survey Services Page 1 of 57

REQUEST FOR QUALIFICATIONS

RFQ # 26-39

PROVIDING SURVEY SERVICES FOR THE

CUMBERLAND COUNTY PLANNING BOARD AND ENGINEERING DEPARTMENT

The County of Cumberland is soliciting proposals through a fair and open process in accordance with N.J.S.A.

19:44A-20.4 et seq.

Sealed Request for Qualifications (RFQ) responses will be received by the Finance Department, Purchasing Division, on Thursday, September 17, 2026, at 2:30 P.M. prevailing time in the Cumberland County Finance Department, Purchasing Division, Cumberland County Administration Building, 164 West Broad Street, Bridgeton, New Jersey, 08302, at which time and place responses will be opened for:

Providing Survey Services for the Cumberland County Planning Board and Engineering Department, RFQ # 26-39.

RFQ Documents may be downloaded at: https://cumberlandprocure.org

RFQ Portal Commodity Code(s):

1) Survey Services

2) Professional Services

Respondents are required to comply with the requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 Affirmative Action and P.L. 1977, c. 33, as amended by P.L. 2016, c. 43, N.J.S.A. 52:25-24.2 Corporate Disclosure.

Respondents are required to comply with the requirements of P.L. 1999, c. 238, (N.J.S.A. 34:11-56 et seq.)

where applicable.

By order of the Board of County Commissioners of the County of Cumberland.

David C. DeWoody Purchasing Agent

RFQ # 26-39 Survey Services Page 2 of 57

TABLE OF CONTENTS

RFQ INVITATION 2

TABLE OF CONTENTS 3

RFQ CHECKLIST 4-5

OFFICIAL PROPOSAL SHEET (EXHIBIT A) 6

STATEMENT OF AUTHORITY (EXHIBIT B) 7

RFQ EXCEPTIONS FORM (EXHIBIT C) 8-9

STATEMENT OF CORPORATE OWNERSHIP (EXHIBIT D) 10-11

EEO/AFFIRMATIVE ACTION COMPLIANCE NOTICE (EXHIBIT E) 12-14

AMERICANS WITH DISABILITIES ACT LANGUAGE (EXHIBIT F) 15

CERTIFICATION REGARDING DEBARMENT (EXHIBIT G) 16-17

NON-COLLUSION AFFIDAVIT (EXHIBIT H) 18

ACKNOWLEDGEMENT OF RECEIPT OF ADDENDA (EXHIBIT I) 19

REQUEST FOR REFERENCE FORM (EXHIBIT J) 20

VENDOR INFORMATION SHEET (EXHIBIT K) 21

BIDDERS DATA SHEET AND QUESTIONNAIRE (EXHIBIT L) 22

INSURANCE REQUIREMENTS (EXHIBIT M) 23-25

DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN (EXHIBIT N) 26-27

CONFLICT OF INTEREST POLICY AND DOCUMENT (EXHIBIT O) 28-30

FORM W-9 (EXHIBIT P) 31-36

RUSSIA BELARUS BUSINESS PROHIBITION FORM (EXHIBIT Q) 37

GENERAL INSTRUCTIONS AND CONDITIONS 38-50

TECHNICAL SPECIFICATIONS 51-57

RFQ # 26-39 Survey Services Page 3 of 57

RFQ CHECKLIST

Failure by the Bidder to submit with their RFQ all of the items that are checked below may cause the RFQ to be considered non-responsive.

Required with Item Read, Initialed Receipt of RFQ and Submitted

X Official RFQ Sheet (Exhibit A) ____________

X Statement of Authority (Exhibit B) ____________

X RFQ Exceptions Form (Exhibit C) ____________

X Statement of Corporate Ownership ____________ Pursuant to N.J.S.A. 52:25-24.2 (Exhibit D)

X EEO/Affirmative Action Compliance ____________ Notice Pursuant to N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 (Exhibit E)

X Certification Regarding Debarment ____________ (Exhibit G)

X Non-Collusion Affidavit (Exhibit H) ____________

X Acknowledgement of Receipt of ____________ Addenda Form Pursuant to

N.J.S.A. 40A:11-23.2.e. (Exhibit I)

X Request for References Form (Exhibit J) ____________

X Vendor Information Sheet (Exhibit K) ____________

X Bidders Data Sheet and Questionnaire ____________ (Exhibit L)

X Professional Land Surveyor’s License

The items that are checked below shall be submitted no later than the time period indicated.

Required Prior to Item Read, Initialed Contract Award Shall Submit

X Disclosure of Investment Activities In Iran (Exhibit N) (Due prior to award)

X W-9 Form (Exhibit P) ___________ (Due prior to award

X Russia Belarus Disclosure ___________ (Exhibit Q) (Due prior to award)

X New Jersey Business Registration ____________ Certificate (Due prior to Award)

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X Certificate(s) of Insurance as specified ____________ in the RFQ Document (Exhibit M) (Due with executed contract)

The items that are checked below are to be reviewed by the Bidders.

Review Required Item Read and Initialed

X Americans with Disabilities _____________ Act Language – (Exhibit F)

X Conflict of Interest Policy _____________ And Document (Exhibit O)

Pages 28-30

X General Instruction/Conditions _____________ Pages 38-50

X Technical Specifications _____________ Pages 51-57

THE ITEMS AND/OR FORMS INDICATED ABOVE SHALL BE REVIEWED AND/OR SUBMITTED WITH

YOUR RFQ. THIS CHECKLIST IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY. ALL

REQUIRED DOCUMENTATION MAY NOT BE LISTED ABOVE AND IT SHALL BE THE

RESPONSIBILITY OF THE BIDDER TO CAREFULLY REVIEW THE COMPLETE RFQ PACKAGE,

FAMILIARIZE THEMSELVES WITH THE REQUIREMENTS OF THIS RFQ, AND TO SUBMIT WITH

THEIR RFQ ALL REQUIRED DOCUMENTATION.

SIGNATURE

The undersigned hereby acknowledges that they have submitted and/or reviewed the above listed requirements:

Name of Company:_____________________________________________________________

Signature:_____________________________________________________________________

Print Name:___________________________________________________________________

Title:_________________________________________________________________________

Date:_________________________________________________________________________

END OF RFQ CHECKLIST

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EXHIBIT A

PROPOSAL DOCUMENT

TO THE CUMBERLAND COUNTY BOARD OF COUNTY COMMISSIONERS:

The undersigned declares that he/she has read the Notice, Instructions, Affidavits and Scope of Services attached, that he/she has determined the conditions affecting the proposal and agrees, if this proposal is accepted, to provide the materials and services described and proposed herein for the following:

Name of Service:

REQUEST FOR QUALIFICATIONS FOR PROVIDING SURVEY SERVICES FOR THE

CUMBERLAND COUNTY PLANNING BOARD AND ENGINEERING DEPARTMENT; RFQ # 26-39.

Respondent shall include with their proposal submission a detailed description of any and all costs associated with performing the requirements of this contract whether such costs are in the form of an all-inclusive total annual fee not to exceed a specific amount, a per hour fee and/or a schedule of fees, including an hourly rate schedule the County shall be charged when services are provided by other members of your staff.

Respondents shall include with their proposal submission a detailed description of any and all reimbursable expenses, including but not limited to, mileage, tolls, reproduction of documents, etc., that they may charge the County while performing the requirements of this contract.

Are you a professional land surveyor licensed in the State of New Jersey for a minimum of ten (10) years with a minimum of five (5) years’ experience in the surveying of land for the Farmland Preservation Program and the New Jersey Agricultural Development Committee? Yes____ No____. If no, your proposal may be rejected as non-responsive.

Have you included with your proposal submission of all of the items listed on the RFQ Checklist? Yes_____ No_____. If no, your proposal may be rejected as non-responsive.

Name of Company:_____________________________________________________________

Signature:_____________________________________________________________________

Print Name:___________________________________________________________________

Title:_________________________________________________________________________

Date:_________________________________________________________________________

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EXHIBIT B

STATEMENT OF AUTHORITY

RFQ SUBMITTED FOR:

COMPANY: ____________________________________________________________

ADDRESS: _____________________________________________________________

RFQ SUBMITTED BY: ____________________________________________________

(Print Name of Company Officer)

SIGNATURE: ___________________________________________________________

(Signature of Company Officer) ***

TITLE: _____________________________________ DATE: _____________________

TELEPHONE: _______________________________ EXTENSION: _______________

FACSIMILE: ____________________________________________________________

EMAIL ADDRESS:_______________________________________________________

TAXPAYER IDENTIFICATION NUMBER: __________________________________

*** This Exhibit must be signed by a Company Officer, who has the legal authority to bind the Company to a contract, in order to be accepted by the County as a valid bid.

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EXHIBIT C

RFQ EXCEPTIONS FORM

Exceptions, if any, to the RFQ specifications, shall be noted and described below.

Please note that RFQ received without any exceptions noted and described below shall be assumed to be in complete compliance with the RFQ specifications.

Please note that failure by the Bidder to note and describe below exceptions to the RFQ specifications shall in no way provide relief to contractors supplying products or materials which do not meet the RFQ specifications.

Contractors supplying products or materials which are not noted and identified below shall be subject to legal action.

Do you have any exceptions to the specifications? Yes No . If yes, note and describe below your exceptions.

EXCEPTION # 1: Describe here with specificity the exact nature of your Exception # 1:

Describe here with specificity how with Exception # 1 your RFQ still meets the requirements of this specification:

EXCEPTION # 2: Describe here with specificity the exact nature of your Exception # 2:

Describe here with specificity how with Exception # 2 your RFQ still meets the requirements of this specification:

EXCEPTION # 3: Describe here with specificity the exact nature of your Exception # 3:

Describe here with specificity how with Exception # 3 your RFQ still meets the requirements of this specification:

EXCEPTION # 4: Describe here with specificity the exact nature of your Exception # 4:

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Describe here with specificity how with Exception # 4 your RFQ still meets the requirements of this specification:

EXCEPTION # 5: Describe here with specificity the exact nature of your Exception # 5:

Describe here with specificity how with Exception # 5 your RFQ still meets the requirements of this specification:

EXCEPTION # 6: Describe here with specificity the exact nature of your Exception # 6:

Describe here with specificity how with Exception # 6 your RFQ still meets the requirements of this specification:

IF YOU HAVE MORE EXCEPTIONS, MAKE COPIES OF THIS EXCEPTION FORM, COMPLETE

THE FORMS AND ATTACH THEM TO THE FRONT OF YOUR RFQ SUBMISSION

Form Completed by: ______________________________________________________ (Print Name)

(Signature)

Title:_____________________________________ Date:_________________________

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EXHIBIT D

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. Please read and review the General Instructions and Conditions section related to this Statement.

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)

PartnershipLimited 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, or of all beneficiaries in an established trust or association who hold 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, or no beneficiary in an established trust or association holds 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 Legal Entity Address

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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, beneficiary or member owning a 10 percent or greater interest in any corresponding corporation, partnership and/or limited liability company (LLC) , trust, association, or other legal entity 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, natural person, and/or 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, or is otherwise disclosed that there is no further breakdown of beneficial owners greater than or equal to 10 percent. Attach additional sheets if more space is needed. PLEASE REVIEW

THE GENERAL INSTRUCTIONS AND CONDITIONS SECTION RELEVANT TO THIS FORM.

Stockholder/Partner/Member/Beneficiary 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 County of Cumberland 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 County of Cumberland to notify the County of Cumberland 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 County of Cumberland to declare any contract(s) resulting from this certification void and unenforceable.

Full Name (Print): Title:

Signature: Date:

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EXHIBIT E

MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE

N.J.S.A. 10:5-31 et seq. (P.L. 1975, C. 127) N.J.A.C. 17:27 et seq.

GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS

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

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

recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency Compliance Officer setting forth provisions of this nondiscrimination clause.

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

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

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

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

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

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

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

The contractor shall submit to the public agency, after notification of award but prior to execution of a goods and services contract, one of the following three documents:

1. Letter of Federal Affirmative Action Plan Approval

2. Certificate of Employee Information Report

3. Employee Information Report Form AA302 (electronically provided by the Division and distributed to the public agency through the Division’s website at www.state.nj.us/treasury/contract_compliance)

The contractor and its subcontractors shall furnish such reports or other documents to the Division of Purchase & Property, CCAU, EEO Monitoring Program as may be requested by the office from time to time in order to carry out the purposes of these regulations, and public agencies shall furnish such information as may be requested by the Division of Purchase & Property, CCAU, EEO Monitoring Program for conducting a compliance investigation pursuant to N.J.A.C. 17:27-1.1 et seq.

RFQ # 26-39 Survey Services Page 13 of 57

EEO/AFFIRMATIVE ACTION COMPLIANCE NOTICE

N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq.

GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS

All successful bidders are required to submit evidence of appropriate affirmative action compliance to the County and Division of Public Contracts Equal Employment Opportunity Compliance. During a review, Division representatives will review the County files to determine whether the affirmative action evidence has been submitted by the vendor/contractor. Specifically, each vendor/contractor shall submit to the County, prior to execution of the contract, one of the following documents:

Goods and General Service Vendors

1. Letter of Federal Approval indicating that the vendor is under an existing Federally approved or sanctioned affirmative action program. A copy of the approval letter is to be provided by the vendor to the County and the Division. This approval letter is valid for one year from the date of issuance.

Do you have a federally-approved or sanctioned EEO/AA program? Yes No If yes, please submit a photostatic copy of such approval.

2. A Certificate of Employee Information Report (hereafter “Certificate”), issued in accordance with N.J.A.C.

17:27-1.1 et seq. The vendor shall provide a copy of the Certificate to the County as evidence of its compliance with the regulations. The Certificate represents the review and approval of the vendor’s Employee Information Report, Form AA-302 by the Division. The period of validity of the Certificate is indicated on its face.

Certificates shall be renewed prior to their expiration date in order to remain valid.

Do you have a State Certificate of Employee Information Report Approval? Yes No If yes, please submit a photostatic copy of such approval.

3. The successful vendor shall complete an Initial Employee Report, Form AA-302 and submit it to the Division with $150.00 Fee and forward a copy of the Form to the County. Upon submission and review by the Division, this report shall constitute evidence of compliance with the regulations. Prior to execution of the contract, the EEO/AA evidence shall be submitted.

The successful vendor may obtain the Affirmative Action Employee Information Report (AA302) on the Division website www.state.nj.us/treasury/contract_compliance.

The successful vendor(s) shall submit the AA302 Report to the Division of Public Contracts Equal Employment Opportunity Compliance, with a copy to Public Agency.

The undersigned vendor certifies that he/she is aware of the commitment to comply with the requirements of N.J.S.A. 10:5-31 and N.J.A.C. 17:27 and agrees to furnish the required forms of evidence.

The undersigned vendor further understands that his/her bid shall be rejected as non-responsive if said contractor fails to comply with the requirements of N.J.S.A. 10:5-31 and N.J.A.C. 17:27.

COMPANY: ____________________________ SIGNATURE: __________________________

PRINT NAME: __________________________ TITLE: ________________________________

DATE: ____________________

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EXHIBIT F

AMERICANS WITH DISABILITIES ACT MANDATORY LANGUAGE

Equal Opportunity for Individuals with Disabilities

The CONTRACTOR and the OWNER do hereby agree that the provisions of Title II of the Americans With Disabilities Act of 1990 (the “Act”) (42 U.S.C. s12101 et seq.), which Prohibits discrimination on the basis of disability by public entities in all services, programs, and activities provided or made available by public entities, and the rules and regulations promulgated pursuant thereunto, are made a part of this contract. In providing any aid, benefit, or service on behalf of the OWNER pursuant to this contract, the CONTRACTOR agrees that the performance shall be in strict compliance with the Act. In the event that the CONTRACTOR, its agents, servants, employees, or subcontractors violate or are alleged to have violated the Act during the performance of this contract, the CONTRACTOR shall defend the OWNER in any action or administrative proceeding commenced pursuant to this Act. The CONTRACTOR shall indemnify, protect, and save harmless the OWNER, its agents, servants, and employees from and against any and all suits, claims, losses, demands, or damages of whatever kind or nature arising out of or claimed to arise out of the alleged violation. The CONTRACTOR shall, at its own expense, appear, defend, and pay any and all charges for legal services and any and all costs and other expenses arising from such action or administrative proceeding or incurred in connection therewith. In any and all complaints brought pursuant to the OWNER’S grievance procedure, the CONTRACTOR agrees to aRFPe by any decision of the OWNER, which is rendered pursuant to, said grievance procedure. If any action or administrative proceeding results in an award of damages against the OWNER or if the OWNER incurs any expense to cure a violation of the ADA which has been brought pursuant to its grievance procedure, the CONTRACTOR shall satisfy and discharge the same at its own expense.

The OWNER shall, as soon as practicable after a claim has been made against it, give written notice thereof to the CONTRACTOR along with full and complete particulars of the claim. If any action or administrative proceeding is brought against the OWNER or any of its agents, servants, and employees, the OWNER shall expeditiously forward or have forwarded to the CONTRACTOR every demand, complaint, notice, summons, pleading, or other process received by the OWNER or its representatives.

It is expressly agreed and understood that any approval by the OWNER of the services provided by the CONTRACTOR pursuant to this contract will not relieve the CONTRACTOR of the obligation to comply with the Act and to defend, indemnify, protect, and save harmless the OWNER pursuant to this paragraph.

It is further agreed and understood that the OWNER assumes no obligation to indemnify or save harmless the CONTRACTOR, its agents, servants, employees and subcontractors for any claim which may arise out of their performance of this Agreement. Furthermore, the CONTRACTOR expressly understands and agrees that the provisions of this indemnification clause shall in no way limit the CONTRACTOR’S obligations assumed in this Agreement, nor shall they be construed to relieve the CONTRACTOR from any liability, nor preclude the OWNER from taking any other actions available to it under any other provisions of this Agreement or otherwise at law.

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EXHIBIT G

CERTIFICATION REGARDING THE DEBARMENT

SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION

I am _________________________ of the firm of ______________________________, (Your Title) (Name of your Organization)

(Address of your Organization)

CHOOSE ONE OF THE FOLLOWING

( ) A. I hereby certify on behalf of _______________________________ (Name of your Organization) that neither it nor its principals are included on the State Treasurer’s and Economic Development Authority’s or the Federal Government’s List of Debarred, Suspended, or Disqualified Bidders as a result of action taken by any State or Federal Agency.

( ) B. I am unable to certify to any of the statements set forth in this certification. I have attached an explanation to this form.

(Signature)

(Typed or Printed Name and Title)

(Date)

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INSTRUCTIONS FOR CERTIFICATION

1. By signing and submitting this certification, the contracting firm is providing the certification as set out below.

2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the contracting firm knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government and/or State Government, the County of Cumberland may pursue available remedies including suspension and/or debarment.

3. The contracting firm shall provide immediate written notice to the County of Cumberland if at any time it learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

4. The terms "covered transaction", "debarred", "suspended", "ineligible", "lower tier covered transaction", "participant", "person", "primary covered transaction", "principal", and "voluntarily excluded", as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the County for assistance in obtaining a copy of those regulations.

5. The contracting firm agrees by submitting this certification that, should the covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction.

6. The contracting firm further agrees by submitting this certification that it will include the clause titled

"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all subcontracts to this agreement as authorized by the County of Cumberland.

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EXHIBIT H

NON-COLLUSION AFFIDAVIT

State of _________________________________

SS:

County of _______________________________

I, ____________________________residing in_________________________________ (Name of Affiant) (Name of Municipality) in the County of ______________and the State of ____________________, of full age, being duly sworn according to law on my oath depose and say that:

I am _________________________ of the firm _________________________________ (Title or Position) (Name of Firm) the Bidder making the proposal for the above named project, and that I executed the said proposal with full authority so to do; 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 County of Cumberland in the State of New Jersey relies upon the truth of 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 Contractor)

(N.J.S.A. 52:34-15).

Subscribed and sworn to Before me this day ________________ 20______ ____________________________________ (Signature of Affiant)

(Signature of Notary Public) (Typed or Printed Name of Affiant)

My Commission expires_______________________ (Month, Day, Year)

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EXHIBIT I

COUNTY OF CUMBERLAND, NEW JERSEY

ACKNOWLEDGMENT OF RECEIPT OF ADDENDA

The undersigned Bidder hereby acknowledges receipt of the following Addenda:

Addendum Number Dated Acknowledge Receipt (initial)

� No addenda were issued:

Acknowledged for: ___________________________________________________ (Name of Bidder)

By: _______________________________________________________________ (Signature of Authorized Representative)

Name: ____________________________________________________________ (Print or Type Name of Authorized Individual)

Title: ______________________________________________________________

Date: _____________________________________________________________

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EXHIBIT J

REQUEST FOR REFERENCE FORM

If able, list three (3) public agencies (other than Cumberland County) presently or previously contracted to whom you provide or have provided the items and/or services as herein specified.

1. Name of Entity_____________________________________________________

Address___________________________________________________________

Contact Name______________________________________________________

Daytime Telephone____________________ Email________________________

2. Name of Entity_____________________________________________________

3. Name of Entity_____________________________________________________

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EXHIBIT K

VENDOR INFORMATION SHEET

In order to assure that all future correspondence is directed to the correct address, assure proper ordering, and to expedite future payments, the following information shall be provided with this RFQ:

Name of Business: ________________________________________________________

Correspondence Address, including zip code:

Purchase Order Address, including zip code:

Payment Address, including zip code:

Telephone Number: __________________________________________

Facsimile Number: ___________________________________________

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EXHIBIT L

BIDDERS DATA SHEET AND QUESTIONNAIRE

Please provide the following information

How many years has your company been providing this service?____________________

Has your company ever failed to complete any contract with regard to any of the services herein described?

Yes ____ No____. If yes, provide details here:

Has your company ever had a contract terminated for non-performance? Yes ___ No . If yes, provide details here:

Has your company ever been involved in any litigation regarding the provision of the services described herein?

Yes No . If yes, provide details here:

Name and telephone numbers of personnel who can be contacted if problems or emergencies arise:

Name and telephone number of an individual who can be contacted at all times if service information is requested: _________________________________________________________________________________

END OF BIDDERS DATA SHEET AND QUESTIONNAIRE

RFQ # 26-39 Survey Services Page 22 of 57

EXHIBIT M

1 GENERAL INSURANCE REQUIREMENTS

(Required on all Bids)

1.1 The Contractor(s) shall provide and pay for insurance coverage of such type and in such amounts as will completely protect the Contractor and the County, its elected officials, officers, agents, servants employees and assigns against any and all risks of loss (including costs of defense) or liability arising out of this contract.

1.2 The insurance should be furnished by insurance companies with and "A - (Excellent) VII" or better or better rating as published in the most recent editions of Best Insurance Key Rating and shall be authorized to conduct business in the State of New Jersey.

1.3 It is recognized that in some instances that insurance may be acceptable which is underwritten by an insurance company that is not reported in the BEST GUIDE, or the coverage is extended under a self-insured program. This insurance, or self-insurance, must be in conformity with the rules and regulations of the Commissioner of Insurance of the State of New Jersey. Any insurance or self-insurance of this type is subject to the review and acceptance by the County Risk Manager or the County Counsel. Furthermore written proof of acceptability by the Office of the Commissioner of Insurance may be necessary.

1.4 The Contractor(s) shall furnish the County with Certificates of Insurance, as shown under “B” Specific Coverage Requirements, policies for General Liability must be endorsed to include the County of Cumberland, its elected officials, officers, agents, servants, employees and assigns, as an Additional Insured, a copy of ISO Endorsements CG 20 10 is required along with the certificate. The Certificates of Insurance shall set out the types of coverage, the limits of liability and describe the operation by reference to this contract. All of the Contractors deductibles or retention's shall be the sole responsibility of the contractor, those in excess of $10,000 are to be disclosed and are subject to approval by the County. If requested actual policy copies or incurred loss information may be required.

1.5 The policies and specified limits of coverage must be effective prior to the commencement of work and must remain in force until final acceptance of the work under the contract. Contracts that involve construction, installation, or maintenance repair must maintain completed operations insurance, endorsing the County as an additional insured for a term of two (2) years beginning on the date of the final acceptance. They also must include a copy of ISO Endorsement CG 20 37, or its equivalent.

1.6 The Contractor(s) shall obtain, and furnish to the County, certificates of insurance from their subcontractor(s) or sub subcontractor(s) showing policies in force with coverage and limits as described under these insurance requirements.

1.7 The Certificate of Insurance with a COPY OF THE ADDITIONAL INSURED ENDORSEMENTS, are to be signed by a person authorized by the insuring company(s) to bind coverage on its behalf.

Neither approval by the County nor failure to disapprove Certificates of Insurance/ furnished by the Contractor shall release the Contractor from full responsibility for all liability including costs of defense. Insurance is required as a measure of protection and the Contractor's liability is not limited thereby.

1.8 The Certificates of Insurance must be submitted to the County and shall be subject to the review and approval of the County Counsel or Risk Manager.

RFQ # 26-39 Survey Services Page 23 of 57

1.9 If at any time during the term of this contract or any extension thereof, if any of the required policies of insurance should expire, change or be canceled, it will be the responsibility of the Contractor, prior to the expiration, change or cancellation, to furnish to the County a Certificate of Insurance indicating renewal or an acceptable replacement of the policy so that there will be no lapse in any coverage. In the event of interruption of any coverage for any reason, all payments and work under the contract shall cease and not be resumed until coverage has been restored and a current Certificate of Insurance received and approved.

1.10 Any policy of insurance that is written on a claims made basis shall, under the terms of this contract, be renewed or the coverage extended for a period of not less than three years and shall provide coverage for the period operations were performed by the contractor. Proof of such extension shall annually be presented to the Risk Manager for the County of Cumberland and indicate the retroactive date of coverage or indicate that all prior acts coverage is provided.

1.11 Insurance or Risk Funding maintained by the County shall be considered as Excess over Contractors Insurance. Insurance or Risk Funding Maintained by the County of Cumberland does not provide protection for Contractors liability.

1.12 Certificates of Insurance and Evidence of Property Forms shall show the Certificate Holder as follows:

COUNTY OF CUMBERLAND

ADMINISTRATION BUILDING

164 WEST BROAD STREET

BRIDGETON, NJ 08302

ATTN.: David C. DeWoody, Purchasing Agent

1.13 Certificates of Insurance not reading as above will not be acceptable and will delay contract signature and/or payment.

1.14 Questions regarding these insurance requirements may be directed to David C. DeWoody, Purchasing Agent at (856) 453-2132. Certificates for approval may be preliminarily submitted via fax to (856) 451-0967.

2 The following items are the minimum mandatory types of insurance coverage to be carried under the requirements as provided herein, CONTRACTORS INSURANCE REQUIREMENTS:

2.1 Workers Compensation insurance or its equivalent in accordance with the statutes of the State of New

Jersey and Employer’s Liability insurance with minimum limits of:

2.1.1 $1,000,000 each accident for bodily injury by accident

2.1.2 $1,000,000 each employee for bodily injury by disease; and

2.1.3 $1,000,000 policy limit for bodily injury by disease

2.2 General Liability in a comprehensive form, with minimum limits as follows:

2.2.1 Each Occurrence $1,000,000

2.2.2 Personal & Adv. Injury $1,000,000

2.2.3 General Aggregate $2,000,000

2.2.4 Products-Completed Operations Aggregate $2,000,000

RFQ # 26-39 Survey Services Page 24 of 57

2.3 Motor Vehicle Liability Insurance in a comprehensive form with minimum limits of $1,000,000 CSL

2.3.1 Owned Vehicles

2.3.2 Hired/Leased Vehicles

2.3.3 Non-Owned Vehicles

3 SPECIFIC COVERAGE REQUIREMENTS

3.1 PROFESSIONAL LIABILITY (Required for this Bid: Yes X No )

During the life of this contract the Contractor shall procure and maintain Professional Liability Insurance with limits of liability not less than $1,000,000 per claim/$1,000,000 annual aggregate. This insurance shall provide coverage for wrongful acts the contractor is responsible for rendering or failing to render professional services. If coverage is on “claims made” basis, Contractor must maintain comparable coverage and limits for a minimum of four (4) years following the expiration date of said contract.

3.2 POLLUTION LIABILITY INSURANCE (Required for this Bid: Yes No X )

During the life of this contract the Contractor shall procure and maintain Pollution Liability Insurance with limits of liability not less than $1,000,000 or $5,000,000 per pollution incident / $3,000,000 or $10,000,000 annual aggregate. This insurance shall provide coverage pollution incidents that cause bodily injury, including death; loss or damage to property, including loss of use of damaged property or of property that has not been physically injured; cleanup and monitoring costs; and costs and expenses incurred in the investigation, defense, or settlement of claims. If coverage is on “claims made” basis, Contractor must maintain comparable coverage and limits for a minimum of four (4) years following the expiration date of said contract.

RFQ # 26-39 Survey Services Page 25 of 57

EXHIBIT N

STATE OF NEW JERSEY DIVISION OF PURCHASE AND PROPERTY

DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN

RFQ/RFP Number ______________________ Bidder/Offeror: __________________________________________

PART 1: CERTIFICATION. BIDDERS MUST COMPLETE PART 1 BY CHECKING EITHER BOX.

FAILURE TO CHECK ONE OF THE BOXES WILL RENDER THE PROPOSAL NON-RESPONSIVE.

Pursuant to Public Law 2012, c. 25, any person or entity that submits a RFQ or proposal 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, or one of the person or entity's parents, subsidiaries, or affiliates, is identified on the Department of the Treasury’s Chapter 25 list as a person or entity engaging in investment activities in Iran. The Chapter 25 list is found on the Division’s website at http://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf. Bidders must review this list prior to completing the below certification.

Failure to complete the certification will render a Bidder’s proposal non-responsive. If the Director finds a person or entity to be in violation of the principles which are the subject of this law, s/he shall take action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the person or entity.

PLEASE CHECK THE APPROPRIATE BOX:

o I certify, pursuant to Public Law 2012, c. 25, that neither the Bidder listed above nor any of the Bidder’s parents, subsidiaries, or affiliates 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 of its behalf.

OR

o I am unable to certify as above because the Bidder and/or one or more of its parents, subsidiaries, or affiliates is listed on the Department’s Chapter 25 list. I will provide a detailed, accurate and precise description of the activities in Part 2 below and sign and complete the certification below. Failure to provide such will result in the proposal being rendered as non-responsive and appropriate penalties, fines and/or sanctions will be assessed as provided by law.

PART 2: PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN

IRAN

You must provide a detailed, accurate and precise description of the activities of the bidding person/entity, or one of its parents, subsidies or affiliates, engaging in the investment activities in Iran outlined above by completing the section below. Add additional sheets if necessary to report additional activities.

Name of Entity: ____________________________________ Relationship to Bidder: ____________________________________

Description of Activities: _____________________________________________________________________________________

Duration of Engagement: _______________________________________ Anticipated Cessation Date: _______________________

Bidder/Offeror Contact Name: ______________________________________ Contact Phone: _____________________________

RFQ # 26-39 Survey Services Page 26 of 57

(EXHIBIT N Continued)

Certification: I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments thereto 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 County of Cumberland is relying on the information contained herein and thereby acknowledge that 1 am under continuing obligation from the date of this certification through the completion of any contracts with the County to notify the County 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 County of Cumberland and that the County at its option may declare any contract(s) resulting from this certification void and unenforceable.

Full Name: ______________________________________________ Signature: ________________________________________

Title: __________________________________________________ Date: ____________________________________________

RFQ # 26-39 Survey Services Page 27 of 57

EXHIBIT O

Conflict of Interest Policy – 06/15/2021

I. Purpose

The purpose of this policy is to establish conflicts of interest guidelines that meet or exceed the requirements under state law and local policy when procuring goods, services, and construction or repair projects, inclusive of those paid for in part or whole by federal funds required under 2 C.F.R. § 200.318(c)(1).

II. Policy

This policy applies when procuring all goods, services, construction or repair projects, and any other form of contract, inclusive of those funded in part or whole with federal financial assistance (direct or reimbursed). This policy also applies to any subrecipient of the funds.

The employee responsible for managing any federal, state, or other financial assistance awards shall review the notice of award to identify any additional conflicts of interest prohibitions or requirements associated with the award, and shall notify all employees, officers, and agents, including subrecipients, of the requirements of this policy and any additional prohibitions or requirements.

A. Conflicts of Interest. No officer, employee, or agent of the County of Cumberland may participate directly or indirectly in the selection, award, or administration of a contract if he or she has a real or apparent conflict of interest. A real or apparent conflict exists when any of the following parties has a financial or other benefiting interest in or receives a tangible personal benefit from a firm considered for award of a contract:

1. the employee, officer, or agent involved in the selection, award, or administration of a contract;

2. any member of his or her immediate family;

3. his or her partner; or

4. an organization which employs or is about to employ any of these parties.

Any officer, employee, or agent with an actual, apparent, or potential conflict of interest as defined in this policy shall report the conflict to his or her immediate…