Invitation for Bid ADA Roll-In Showers.pdf
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- Attached to
- ADA Roll-In Shower Installation
- Solicitation number
- IFB-2026-21
- Issued by
- Hudson County, New Jersey
About this file
This is an Invitation for Bid document issued by the Housing Authority of the City of Hoboken for ADA Roll-In Shower Installation services. The project involves the removal and installation of sixteen (16) ADA roll-in showers at various locations within the Housing Authority's properties. The work includes careful demolition of existing bathtubs, plumbing fixtures, ceramic tile, gypsum board, and associated accessories, with reuse and modification of existing plumbing systems where feasible. A non-mandatory pre-bid meeting and facility walk-through is scheduled for Wednesday, September 9, 2026, at 11:00 a.m. at 400 Harrison Street, Hoboken, New Jersey. Sealed bids will be received until 2:00 p.m. on September 25, 2026, at the Housing Authority office. The successful contractor must commence work within a specified timeframe and complete all work within ninety (90) calendar days after the Notice to Proceed. Bid documents must be obtained directly from the Housing Authority by emailing nvillafane@myhhanj.com beginning August 31, 2026.
Bidders must submit one original and one PDF copy of all required documentation, including a bid bond or certified check based on bid amount (10% for bids up to $200,000; $20,000 for bids $200,000–$400,000; 5% for bids over $400,000), a Consent of Surety from a New Jersey-licensed surety company, and numerous certifications and affidavits. The Housing Authority actively encourages participation by small businesses, minority business enterprises, women business enterprises, and Hoboken-area-based concerns, with a stated goal of at least 5% participation by such entities. All work must comply with Davis-Bacon wage requirements, the New Jersey Public Works Contractor Registration Act, and applicable state business registration provisions. Bidders must provide statements of ownership, subcontractor certificates, non-collusion affidavits, and Site Inspection Affidavits. The contract is governed by New Jersey statutes and includes compliance with federal housing requirements, affirmative action obligations, and prevailing wage determinations as specified in the bid documents.
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Text version
BID DOCUMENTS & DETAILED SPECIFICATIONS FOR:
ADA ROLL-IN SHOWER INSTALLATION
Barbara Reyes, Chair
Erica Seitzman, Vice Chair
David Edwards
Anthony Forbes
Jean Rodriguez
Matthew Testa
Carmen Vega
Marc Recko, Executive Director
Housing Authority of the City of Hoboken
400 Harrison Street
Hoboken, New Jersey 07030
August 31, 2026
HOUSING AUTHORITY OF THE CITY OF HOBOKEN
TABLE OF CONTENTS
Section Page
Table of Contents 2
Invitation to Bid 3
Bid Document Submission Checklist 5
Bid Form 7
Acknowledgement of Receipt of Any Notice of Revisions or Addenda to the Bid Documents 9
Bid Bond/Guarantee 10
Performance and Payment Bond 13
Consent of Surety 15
Bidder’s Statement of Ownership 16
Subcontractor Certificate 18
Non-Collusion Affidavit 20
Bidder’s Affidavit 22
Qualification Questionnaire 23
Statement of Compliance 25
Affirmative Action Affidavit 26
Site Inspection Affidavit 29
Voluntary Act and Deed Acknowledgement Affidavit 30
Political Contribution Disclosure Forms 31
HUD Form 2530 – Previous Participation Certification 33
HUD Form 5369-A – Representations, Certifications, and Other Statements of Bidders 38
Form of Contract 42
Wage Rate Determinations 46
Scope Of Work 55
ADA Roll-In Shower Installation Listing 57
ADA ROLL-IN SHOWER INSTALLATION
INVITATION TO BID
The Housing Authority of the City of Hoboken (the “Authority) will receive sealed bids for ADA Roll-In
Shower Installations, in accordance with contract documents prepared together with such addenda as may be issued prior to the date of receipt of bids. Complete the following scope of work inclusive of all materials
(majority provided by Owner), and equipment. Removal and installation of (16) six ADA Roll-In showers included on listing.
The bid opening will be held at 2:00PM (prevailing time) on September 25, 2026 at 400 Harrison
Street, Hoboken, New Jersey, at which time bids will be opened and publicly read. LATE BIDS WILL
NOT BE ACCEPTED. PHOTOCOPIES OR FACSIMILES OF THE BID DOCUMENTS WILL NOT BE
ACCEPTED IN LIEU OF THE BID MATERIALS. BIDS DETERMINED BY THE OWNER TO BE
LATE WILL BE RETURNED TO THE BIDDER, UNOPENED.
Bids for the contract must be on the forms provided in Bid Materials and must be completed in the manner designated therein. The bidder shall not change the wording of or any wording to the bid form.
Unauthorized conditions, limitations, or provisions attached to a bid will be cause for rejection of that bid.
Bids must be enclosed in sealed envelopes bearing the name and address of the bidder, and must be delivered to the Housing Authority of the City of Hoboken, 400 Harrison Street, Hoboken, New Jersey
07030, properly marked “ADA Roll-In Shower Installations” bearing the name of the project, prior to the
September 25, 2026 deadline.
A non-mandatory pre-bid meeting and walk-through of the facilities will be conducted Wednesday
September 9, 2026 at 11:00am, 400 Harrison St, Hoboken, New Jersey. Bidders are strongly encouraged to attend. Access to buildings at any other time is restricted, wholly at the Authority’s discretion.
It is the bidder’s responsibility to see that bids are presented to the Authority on or before the hour and at the place designated. Bids may be hand delivered or mailed; however, the Authority disclaims any responsibility for bids forwarded by regular or express mail or common carrier.
Commencing on August 31, 2026, all bid documents must be obtained directly by emailing nvillafane@myhhanj.com
Each bid shall be accompanied by a Bid Bond issued by a New Jersey Licensed Surety Company which is listed in the most recently published U.S. Treasury Circular No. 570, or by certified check in the amount called for in the Specifications, made out to the Housing Authority of the City of Hoboken. Bids must also be accompanied by all the materials required by the bid documents. Regardless of whether the Bid Bond or Certified Check is submitted for bid guarantee, each bidder must submit a Consent of Surety also from a New Jersey Licensed Surety Company which is listed in the most recently published U.S. Treasury
Circular No. 570, stating that it will issue the necessary performance bond should the bidder enter into contract for this work with the Owner.
mailto:nvillafane@myhhanj.com
This Invitation for Bid and the contract awarded pursuant to it is intended to comply with the fair and open process, established and further defined by N.J.S.A. 19:44A-20.7. Consequently, the provisions of N.J.S.A.
19:44A-20.5 and N.J.S.A. 19:44A-20.26, as to campaign contributions, do not apply to the Invitation to Bid and the contract to be awarded hereunder.
Each bidder must submit, with its bid, security in the amount indicated below. No Bidder may withdraw its Bid for a period of sixty (60) days after the actual date of opening thereof.
Amount of Bid Bid Guarantee
Up to $200,000 10% of Bid $200,000 to $400,000 $20,000
Over $400,000 5% of Bid
The Owner seeks to encourage participation by respondents who are small businesses, minority business enterprises, women business enterprises, or business concerns which are located in or owned in substantial part by persons residing in the Hoboken area and has a goal of minimum participation by such entities of at least 5% participation.
All bidders are hereby notified that compliance with the most recently published and applicable Davis-
Bacon Wage Requirements will be required in the performance of any contract awarded; that compliance with the New Jersey Public Works Contractor Registration Act, N.J.S.A. 34:11-56.48, et seq., will be required at the time of bid submission; and that compliance with the business registration provisions of P.L.
2004, c.57 will be required at time of contract execution. All bidders, including corporations, limited liability companies, partnerships, and sole proprietorships, must submit a Statement of Ownership. During the performance of this Contract, the contractor agrees to comply with P.L. 1975, c. 127 (N.J.A.C. 17:27), “Law Against Discrimination”, current regulations.
The Owner reserves the right to reject any or all bids, waive any identified informalities or technicalities in the bidding, sever or make awards of all or parts of any bids to one of more responsible bidders if it is in the best interest of the Owner to do so. No bid shall be withdrawn for a period of sixty (60) days subsequent to the bid opening without the consent of the Owner.
MARC A. RECKO, Executive Director
Housing Authority of the City of Hoboken
August 31,2026
ADA ROLL-IN SHOWER INSTALLATION
BID DOCUMENT SUBMISSION CHECKLIST
PLEASE SUBMIT ONE ORIGINAL & ONE PDF COPY OF BID
DOCUMENTS
A. Failure to submit the following documents at the time of bid submission is a mandatory cause for the bid to be rejected. (N.J.S.A. 40A:11-23.2)
Initial Each Item as
Submitted with Bid
(Bidder’s Initials)
Bid Bond/Guarantee, pursuant to N.J.S.A. 40A:11-21
Consent of Surety, pursuant to N.J.S.A. 40A:11-22
Statement of Ownership, pursuant to N.J.S.A. 52:25-24.2 (must be signed and notarized)
Subcontractor Certificate, pursuant to N.J.S.A. 40A:11-16
State of New Jersey Department of Labor Public Works Contractor
Registration Act Certificate, pursuant to N.J.S.A. 34-11-56.48
If applicable, Acknowledgement of Receipt of Any Notice of
Revisions or Addenda to the Bid Documents
B. Failure to submit the following documents may be a cause for the bid to be rejected. (N.J.S.A.
40A:11-23.1b)
Initial Each Item as
Submitted with Bid
(Bidder’s Initials)
Bid Document Submission Checklist
Bid Form
Business Registration Certificate or Certificate and Registration for Individuals, pursuant to N.J.S.A. 40A:11-16 and 52:32-44 for both the Bidder and all Subcontractors required to be listed in this
Bid, as referenced above
Performance and Payment Bond (Certificate from a Surety
Company that, if your Bid is accepted, they will furnish the
Performance Bond)
Previous Participation Certificate (HUD-2530)
Non-Collusion Affidavit (Must be Signed and Notarized)
Bidder’s Affidavit (Must be Signed and Notarized)
Qualification Questionnaire (Must be Signed and Notarized)
Statement of Compliance
Affirmative Action Affidavit (Must be Signed and Notarized)
Site Inspection Affidavit (Must be Signed and Notarized)
Voluntary Act and Deed Acknowledgement Affidavit
(Must be Signed and Notarized)
Political Contribution Disclosure
Representations, Certifications and Other Statements of Bidders
(HUD 5369-A)
C. SIGNATURE: The undersigned hereby acknowledges and has submitted the above listed requirements.
Name of Bidder:
By Authorized Representative:
Signature:
Printed Name and Title:
Date:
BID FORM
BIDDER’S NAME:
ADDRESS:
TELEPHONE NO.:
FACSIMILE NO.:
E-MAIL ADDRESS:
TO: HOUSING AUTHORITY OF THE CITY OF HOBOKEN
(the “AUTHORITY” and/or the “OWNER”)
ADDRESS: 400 Harrison Street
Hoboken, New Jersey 07030
TELEPHONE NO.: (201) 798-0370
E-MAIL ADDRESS: mrecko@myhhanj.com
ATTENTION: Mr. Marc A. Recko, Executive Director
Pursuant to and in accordance with your Invitation to Bid for work described above and in accordance with the Instructions for Bidders relating thereto, the undersigned hereby agrees to furnish all plant, labor, materials, supplies, equipment, and other facilities necessary or proper for, or incidental to, or as required by the Bid Materials for the above project, TOTAL BID AMOUNT
Dollars
(Words)
(Numerals) mailto:mrecko@myhhanj.com
All blank spaces for bid prices must be filled in, in ink or typewritten, in both words and figures. If there is a discrepancy between the Total Bid Amount expressed in words and the Total Bid Amount expressed in numerals, the Total Bid Amount expressed in words shall control, unless the Authority were to determine that the intention of the bidder was clearly otherwise.
In submitting this bid, I have received and considered addenda, if any, listed in the Acknowledgment of
Receipt of Any Revisions or Addenda to the Bid Documents.
It is agreed that the Authority shall be permitted to accept this bid within the period stipulated without further cost to the Authority. It is further agreed that the Authority is not bound to accept the lowest bid of any submitted and can waive any informalities in any bid.
It is agreed that the successful bidder, upon his failure or refusal to execute and deliver the contract and bonds required within ten (10) days after he had received notice of the acceptance of his bid, shall forfeit to the Housing Authority, as liquidated damages for such failure or refusal, the security deposit with his bid.
If the bid is made by a corporation, it shall be signed by the President or other authorized officer AND attested by the Secretary.
If the bid is made by a partnership, it shall be signed in firm or partnership name AND also by two or more of the partners or members of the firm in their individual names.
If the bid is made by a limited liability company, it shall be signed by the Managing Member or other authorized officer AND also by two or more of the partners or members of the firm in their individual names.
If the bid is made by an individual, it shall be signed by the individual.
Submitted by:
Legal Name of Bidder
Signed by: Title:
Attest: Title:
ACKNOWLEDGEMENT OF RECEIPT OF ANY NOTICE
OF REVISIONS OR ADDENDA TO THE BID DOCUMENTS
In accordance with N.J.S.A. 40A:11-23.1(a), the undersigned bidder hereby acknowledges receipt of the following notices, revisions, or addenda to the bid advertisement, specifications or bid documents. By indicating date of receipt, bidder acknowledges that the submitted bid takes into account the provisions of the notice, revision or addendum. Note that the Housing Authority of the
City of Hoboken’s record of notice to bidders shall take precedence and that failure to include provisions of changes in a bid proposal may be subject for rejection of the bid. Moreover, you must provide the following information when submitting the bid. Failure to do so shall render a bidder’s bid proposal unresponsive, and shall constitute a fatal defect that cannot be cured by a governing body, and shall cause the bid to be rejected without opportunity to cure the defect.
Title of Addendum/Revision How Received Date Received
(Mail, Fax, Pick-up, etc.)
Acknowledgement by Bidder:
BID BOND/GUARANTEE
In accordance with N.J.S.A. 40A:11-21, provide the following information when submitting the bid.
Failure to do so shall render a bidder’s bid proposal unresponsive, and shall constitute a fatal defect that cannot be cured by a governing body, and shall cause the bid to be rejected without opportunity to cure the defect. Moreover, letters of credit are not acceptable as bid guarantees.
KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned, as Principal and as SURETY are held and firmly bound unto the Housing Authority of the City of Hoboken, hereinafter called the
“Authority”, in the penal sum of % of the bid.
Dollars, lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these present.
THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the Principal has submitted the accompanying bid, dated , for .
NOW THEREFORE, if the Principal shall not withdraw said bid within the period of sixty (60) days after the said opening, and shall within the period specified therefore, give bond with good and sufficient surety or sureties, as may be required, for the faithful performance and proper fulfillment of such contract; or in the event of the withdrawal of said bid within the period specified or the failure to give such bond within the time specified, it the
Principal shall pay the Authority the difference between the amount specified in said bid and the amount for which the Authority may procure the required work or supplies or both, if the latter amount be in excess of the former, then the above obligation shall be void and of no effect, otherwise to remain in full force and virtue.
IN WITNESS WHEREOF, the above bounded parties have executed this instrument under their several seals this day of , 2026, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body.
In the presence of:
(Seal)
(Individual Principal)
(Address) (Business Address)
ATTEST:
(Corporate Principal)
(Affix Corporate Seal)
(Business Address)
BY:
ATTEST
(Corporate Surety)
(Power of Attorney for person signing for the surety company must be attached to bond.)
ADA ROLL-IN SHOWER INSTALLATION
PERFORMANCE AND PAYMENT BOND
(1) Individual sureties, partnerships, or corporations not in the surety business will not be acceptable.
(2) The name of the Principal shall be shown exactly as it appears in the Contract.
(3) The penal sum shall be not less than the contract amount.
(4) If the Principals are partners or joint venturers, each member shall execute the bond as an individual, with his place of residence shown.
(5) If the Principal is a corporation, the bond shall be executed under its corporate seal. If the corporation has no corporate seal, the fact shall be stated, in which case a scroll or adhesive seal shall be affixed following the corporate name.
(6) The official character and authority of the persons executing the bond for the Principal, whether individual, partnership, or corporation, shall be certified by individual, partner or, in the case of a corporation, by the secretary or assistant secretary thereof under the corporate seal, or there may be attached copies of so much of the records of the corporation as will evidence the official character and authority of the officer signing, duly certified by the secretary or assistant secretary, under the corporate seal, to be true copies. If a corporation, president or vice president should sign for same, secretary of corporation should attest to signature of signing officer.
(7) The current power-of-attorney of the persons signing for the surety company must be attached to the bond.
(8) The date of bond must not be prior to the date of contract.
(9) The following information must be placed on the bond by the surety company:
a. The rate of premium in dollars per thousand, and
b. The total dollar amount of premium charged.
(10) The signature of a witness shall appear in the appropriate place, attesting to the signature of each party to the bond.
(11) Type or print the name underneath each signature appearing in the bond.
(12) An executed copy of the bond must be attached to each copy of the contract (original counterpart) intended for signing.
(13) The Performance and Payment Bond is generally of the type that will be required, but it is subject to such modification in form as may be required by the Housing Authority of the City of Hoboken.
PERFORMANCE AND PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS, That we, the undersigned, as PRINCIPAL and as SURETIES, are hereby held and firmly bound into the Housing Authority of the City of Hoboken (the
“AUTHORITY”), in the penal sum of
Dollars, for the payment of which well and truly to executors, administrators, successors and assigns.
Signed this day of , 20 .
The condition of the above obligation is such that whereas, the above-named PRINCIPAL was awarded, on the day of , 20 a contract with the AUTHORITY for
, which said contract, consisting of Invitation, Bid and Award, is made a part of this Bond, the same as though set forth herein:
Now, if the said
SHALL WELL AND FAITHFULLY DO AND PERFORM THE THINGS AGREED BY
to be done and performed according to the terms of said contract, and shall pay all lawful claims of sub-labor performed or materials, provisions, provender or other supplies or teams, fuels, oils, implements, or machinery furnished, used or consumed in the carrying forward, performing or completing of said contract, we agreeing and assenting that this undertaking shall be for the benefit of any subcontractor, materialmen, laborer, person firm or corporation having a just claim, as well as for the oblige herein; then this obligation shall be void, otherwise the same shall remain in full force and effect; it being expressly understood and agreed that the liability of the surety for any and all claims hereunder shall in no event exceed the penal amount of this obligation as herein stated.
The said surety hereby stipulates and agrees that no modifications, omissions, or additions in or to the terms of said contract or in or to the specifications therefore shall in anywise effect the obligation of said surety on its bond.
IN WITNESS WHEREOF, the above parties have executed this instrument under their several seals this day of , 20 , the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative pursuant to authority of its governing body.
In the presence of:
(Corporate Principal)
(Business Address)
ATTEST
(Corporate Surety)
(Power of Attorney for person signing for the surety company must be attached to bond.)
CONSENT OF SURETY
In accordance with N.J.S.A. 40A:11-22, provide the following information when submitting the bid. Failure to do so shall render a bidder’s bid proposal unresponsive, and shall constitute a fatal defect that cannot be cured by a governing body, and shall cause the bid to be rejected without opportunity to cure the defect.
The undersigned hereby certify that they are the duly authorized agents of duly authorized to do business in the State of New Jersey, and agree to furnish to a surety bond for the financial performance of any and all provisions contained in the specifications and contract. The maximum amount that we will be surety for is
Secretary
The terms of the Surety Company for furnishing the bond are hereby accepted.
Name of Bidder
By:
Title
IMPORTANT: THIS FORM MUST BE EXECUTED BY SURETY AND BIDDER. SUBMISSION OF A CERTIFIED
CHECK TO FULFILL THE BID SECURITY REQUIREMENTS DOES NOT RELIEVE THE BIDDER FROM
SUBMISSION OF THIS CONSENT OF SURETY BY A SURETY COMPANY LICENSED TO ISSUE SURETY BONDS
IN THE STATE OF NEW JERSEY AND APPROVED IN U. S. TREASURY CIRCULAR NO. 570.
ADA ROLL-IN SHOWER INSTALLATION
BIDDER’S STATEMENT OF OWNERSHIP
In accordance with N.J.S.A. 52:25-24.2, provide the following information when submitting the bid.
Failure to do so shall render a bidder’s bid proposal unresponsive, and shall constitute a fatal defect that cannot be cured by a governing body, and shall cause the bid to be rejected without opportunity to cure the defect.
PART I – If the bidder is a Corporation:
Name of Corporation
State of Incorporation
Date of Incorporation
For those individuals* who own 10 percent or more of any class of its stock:
NAMES ADDRESS
PART II – If the bidder is a Partnership:
Name of Partnership
County in which Certificate of Tradename is filed
For those individuals* who own 10 percent or more of the interest in the Partnership:
PART III – If the bidder is a Limited Liability Company:
Name of Limited Liability Company
State of Formation
For those individuals* who own 10 percent or more of the interest in the Limited Liability Company:
PART IV – If the bidder is a Sole Proprietorship:
, hereby certifies that I am the sole owner of
, the bidder herein.
Signature of person who completed Part I, II or III above
* If any of the “individuals” listed above is a Corporation, Partnership, or Limited Liability Company, a separate sheet should be attached giving the same information requested above for each such Corporation, Partnership, or Limited
Liability Company. Similarly, if any additional entity is a Corporation, Partnership, or Limited Liability Company, information must be provided to the level of ownership required to document ultimate ownership in persons (not
Corporations, Partnerships, or Limited Liability Companies).
ADA ROLL-IN SHOWER INSTALLATION
SUBCONTRACTOR CERTIFICATE
In accordance with N.J.S.A. 40A:11-16, provide the following documentation and/or information when submitting the bid. Failure to do so shall render a bidder’s bid proposal unresponsive, and shall constitute a fatal defect that cannot be cured by a governing body, and shall cause the bid to be rejected without opportunity to cure the defect.
The Bidder says as follows:
A. I am (a partner or officer of the firm of, etc.) of the party making the foregoing proposal or bid;
B. In preparing the foregoing bid, the Bidder solicited and received price quotes for the subcontracted work, set forth below;
C. The Bidder has provided true copies of the New Jersey Department of Labor Public Works
Contractor Certificates for each of the below listed subcontractors with the foregoing bid;
D. The Bidder shall provide true copies of the New Jersey Business Registration Certificates for each of the below listed subcontractors at the time of execution of contract; and
E. If awarded a contract for this project, the Bidder shall award a contract to each of the below listed subcontractors.
1. PLUMBING, GAS FITTING, AND ALL KINDRED WORK
Name of Subcontractor:
Address:
Telephone No.:
Facsimile:
N. J. License No. (if applicable):
Name of Licensee (if applicable):
N.J. Public Works Contractor Certificate No.:
N.J. Business Registration Certificate No. (if available):
Scope of work for which price quote was submitted:
2. STEAM POWER PLANTS, STEAM AND HOT WATER HEATING AND VENTILATING
APPARATUS AND ALL KINDRED WORK
Name of Subcontractor:
Address:
Telephone No.:
Facsimile:
N. J. License No. (if applicable):
Name of Licensee (if applicable):
N.J. Public Works Contractor Certificate No.:
3. ELECTRICAL WORK
Address:
Telephone No.:
Facsimile:
N. J. License No. (if applicable):
Name of Licensee (if applicable):
N.J. Public Works Contractor Certificate No.:
4. STRUCTURAL STEEL AND ORNAMENTAL IRON WORK
Address:
Telephone No.:
Facsimile:
N. J. License No. (if applicable):
Name of Licensee (if applicable):
N.J. Public Works Contractor Certificate No.:
NON-COLLUSION AFFIDAVIT
State of )
County of )
) :SS
, being first duly sworn, deposes and says:
I am the (title) of the party making the foregoing bid, that such bid is genuine and not collusive or sham, that said bidder has not colluded, conspired, connived or agreed, directly or indirectly, with any bidder or person, to put in a sham bid or to refrain from bidding and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication or conference with any person, to fix the bid price of affiant or of any bidder, or to fix any overhead, profit or cost element of said bid price, or of that of any other bidder, or to secure any advantage against the HOUSING AUTHORITY OF
THE CITY OF HOBOKEN or any person interested in the proposed contract; and that all statements in said bid are true.
Signature of:
Bidder, if the bidder is an individual;
Partner, if the bidder is a partnership;
Managing Member, if the bidder is an LLC;
Officer, if the bidder is a corporation.
Subscribed and sworn to before me this day of , 20 .
My commission expires , 20 .
BIDDER’S AFFIDAVIT
I reside at , that I, in the capacity of (title) of the Bidder, signed the above Bid, that I am duly authorized to sign, that the Bid is the true offer of the Bidder, that the seal attached is the seal of the
Bidder, and that all the declarations and statements contained in the Bid are true to the best of my knowledge and belief.
Partner, if the bidder is a partnership;
Officer, if the bidder is a Corporation.
ADA ROLL-IN SHOWER INSTALLATION
QUALIFICATION QUESTIONAIRRE
All questions must be answered. The data given must be clear and comprehensive. This statement must be notarized.
1. Name of bidder
2. Business address
3. Date organized
4. Where incorporated
5. How many years have you been engaged in the contracting business under your present firm or trading name?
6. Financial statement (ATTACH SEPARATE SHEET)
7. Credit available for this contract: $
(ATTACH LETTER)
8. Contracts now on hand, gross amount: $
(ATTACH LETTER)
9. List your latest five projects - attach separate list if necessary.
1.
2.
3.
4.
5.
10. Number of employees and their trades - attach separate list.
11. Have you ever refused to sign a contract at your original bid?
12. Have you ever defaulted on a contract?
13. Remarks on # 11 & # 12 - attached separate letter.
14. Will you, upon request, furnish any other information that the Local Authority may require?
15. Please list, on a separate sheet, all chemicals and equipment to be used in the performance of this Contract.
16. The undersigned hereby authorizes and requests any person to furnish any information requested by the Local Authority in verification of the recitals comprising this Statement of
Bidder's Qualifications.
Corporation.
Signature of:
Bidder, if the bidder is an individual;
Partner, if the bidder is a partnership;
Officer, if the bidder is a
ADA ROLL-IN SHOWER INSTALLATION
STATEMENT OF COMPLIANCE
This is to certify that all persons employed by the undersigned will be paid full weekly wages earned, less permissible deductions for income taxes, social security, etc., and that no rebates have been or will be made either directly or indirectly to the undersigned from the full weekly wages earned by any person in its employ, and further that all employees will be paid as defined in Regulations, Part 3 (29 C.F.R., Part 3) issued by the Secretary of Labor under the
Copeland Act, as amended (43 Stat. 948, 63 Stat. 108, 72 Stat. 927; 40 U.S.C. 276c), and described on said payroll; that said payroll is correct and complete; that the wage rates contained in said payroll for laborers, and mechanics pursuant to the Contract under which such work was performed; and that the classification set forth for each laborer or mechanic conforms with the work he performed.
AFFIRMATIVE ACTION AFFIDAVIT
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 or sex. Except with respect to 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, affectional or sexual orientation or sex. Such action shall include, but not be limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates or 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 non-discrimination 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 or sex.
The contractor or subcontractors, where applicable, will send 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 workers’ representative of the contractor’s commitments under this act and shall post copies of the notice in conspicuous places available to employees and applicants for employment.
The contractor and subcontractor, where applicable, agrees to comply with the 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 and subcontractor agrees to attempt in good faith to employ minority and female workers consistent with the applicable county employment goals established in accordance with N.J.S.A. 17:27-5.2, or a binding determination of the applicable county employment goals determined by the Division, pursuant to N.J.S.A. 17:27-5.2.
The contractor and subcontractor agrees to inform in writing its appropriate recruitment agencies including, but not limited to, employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate on the basis or age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, or sex, and that it will discontinue to use of any recruitment agency which engages in direct or indirect discriminatory practices.
The contractor and 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.
The contractor shall submit to the public agency, after notification of award but prior to execution of a goods and services contract, one of the following three documents:
Letter of Federal Affirmative Action Plan Approval
Certificate of Employee Information Report
Employee Information Report Form AA302
The contractor and its subcontractor shall furnish such reports or other documents to the
Division of Contract Compliance & EEO as may be requested by the Division 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 Contract Compliance & EEO for conducting a compliance investigation pursuant to Subchapter 10 of the Administrative Code at N.J.A.C.
17:27.
Partner, if the bidder is a partnership;
ADA ROLL-IN SHOWER INSTALLATIONS
SITE INSPECTION AFFIDAVIT
I am the (title) of the party making the foregoing bid, and that the above captioned locations were inspected by
, estimator, in an effort to arrive at the enclosed bid amount.
[name of firm]
Partner, if the bidder is a partnership;
VOLUNTARY ACT AND DEED ACKNOWLEDGEMENT AFFIDAVIT
I am the (title) of the party making the foregoing proposal or bid, and that the (partners or officers of the firm of, etc.)
of the party making the foregoing bid have voted to present their bid proposal to the HOUSING AUTHORITY OF THE CITY OF
HOBOKEN as their own voluntary act and deed.
Partner, if the bidder is a partnership;
ADA ROLL-IN SHOWER INSTALLATIONS
NEW JERSEY
POLITICAL CONTRIBUTION DISCLOSURE FORM
This form or its permitted facsimile must be submitted to the Authority, with each proposal.
Part I – Proposer Information
Name:
Street Address:
City: State: Zip:
The undersigned being authorized to certify, herby certifies that the submission provided herein represents compliance with the provisions of N.J.S.A. 19:44A-20.26 and the Pay to Play Policy of the Housing Authority of The City of Hoboken.
(Print name)
(Title)
Part ll – Contribution Disclosure
Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable political contributions (more than $300 per election cycle) over the 12 months prior to submission to the Housing Authority of the City of Hoboken.
Contributor Name Recipient Name Date Dollar Amount
Check here if the information is continued on subsequent page(s)
ADA ROLL-IN SHOWER INSTALLATIONS
FEDERAL
POLITICAL CONTRIBUTION DISCLOSURE FORM
This form or its permitted facsimile must be submitted to the Authority, with each proposal.
Part I – Proposer Information
Name:
Street Address:
City: State: Zip:
The undersigned being authorized to certify, herby certifies that the submission provided herein represents compliance with the provisions of N.J.S.A. 19:44A-20.26 and the Pay to Play Policy of the Housing Authority of The City of Hoboken.
(Print name)
Part ll – Contribution Disclosure
Disclosure requirement: This disclosure must include all reportable political contributions over the
12 months prior to submission to the Housing Authority of the City of Hoboken. Contributors covered are the RFP Offeror and all entities and individuals described in Section IV. J. above. This will require detailed review by those included in their reportable contributions. Recipients are candidates for President and Vice President of the United States, United States Senators from New
Jersey and Members of the United States House of Representative whose district encompasses any part of the City of Hoboken.
Contributor Name Recipient Name Date Dollar Amount
Check here if the information is continued on subsequent page(s)
Previous editions are obsolete ref 24 CFR 200 Subpart H Form HUD-2530 (10/2016)
Previous Participation Certification OMB Approval No. 2502-0118
(Exp. 01/31/2026 )
US Department of Housing and Urban Development US Department of Agriculture Office of Housing/Federal Housing Commissioner Farmers Home Administration
Part I to be completed by Controlling Participant(s) of Covered Projects
(See instructions) Reason for submission:
For HUD HQ/FmHA use only
1. Agency name and City where the application is filed 2. Project Name, Project Number, City and Zip Code
3. Loan or Contract amount $ 4. Number of Units or Beds 5. Section of Act 6. Type of Project (check one) Existing Rehabilitation Proposed (New)
7. List all proposed Controlling Participants and attach complete organization chart for all organizations showing ownership % Name and address ( Last, First, Middle Initial) of controlling participant(s) proposing to participate 8 Role of Each Principal in Project 9. SSN or IRS Employer Number (TIN)
1. Schedule A contains a listing, for the last ten years, of every project assisted or insured by HUD, USDA FmHA and/or State and local government housing finance agencies in which the controlling participant(s) have participated or are now participating.
2. For the period beginning 10 years prior to the date of this certification, and except as shown on the certification:
a. No mortgage on a project listed has ever been in default, assigned to the Government or foreclosed, nor has it received mortgage relief from the mortgagee;
b. The controlling participants have no defaults or noncompliance under any Conventional Contract or Turnkey Contract of Sale in connection with a public housing project;
c. There are no known unresolved findings as a result of HUD audits, management reviews or other Governmental investigations concerning the controlling participants or their projects;
d. There has not been a suspension or termination of payments under any HUD assistance contract due to the controlling participant’s fault or negligence;
e. The controlling participants have not been convicted of a felony and are not presently the subject of a complaint or indictment charging a felony. (A felony is defined as any offense punishable by imprisonment for a term exceeding one year, but does not include any offense classified as a misdemeanor under the laws of a State and punishable by imprisonment of two years or less);
f. The controlling participants have not been suspended, debarred or otherwise restricted by any Department or Agency of the Federal Government or of a State Government from doing business with such Department or
Agency;
g. The controlling participants have not defaulted on an obligation covered by a surety or performance bond and have not been the subject of a claim under an employee fidelity bond;
3. All the names of the controlling participants who propose to participate in this project are listed above.
4. None of the controlling participants is a HUD/FmHA employee or a member of a HUD/FmHA employee's immediate household as defined in Standards of Ethical Conduct for Employees of the Executive Branch in 5 C.F.R. Part 2635 (57 FR 35006) and HUD's Standard of Conduct in 24 C.F.R. Part 0 and USDA's Standard of Conduct in 7 C.F.R. Part 0 Subpart B.
5. None of the controlling participants is a participant in an assisted or insured project as of this date on which construction has stopped for a period in excess of 20 days or which has been substantially completed for more than 90 days and documents for closing, including final cost certification, have not been filed with HUD or FmHA.
6. None of the controlling participants have been found by HUD or FmHA to be in noncompliance with any applicable fair housing and civil rights requirements in 24 CFR 5.105(a). (If any controlling participants have been found to be in noncompliance with any requirements, attach a signed statement explaining the relevant facts, circumstances, and resolution, if any).
7. None of the controlling participants is a Member of Congress or a Resident Commissioner nor otherwise prohibited or limited by law from contracting with the Government of the United States of America.
8. Statements above (if any) to which the controlling participant(s) cannot certify have been deleted by striking through the words with a pen, and the controlling participant(s) have initialed each deletion (if any) and have attached a true and accurate signed statement (if applicable) to explain the facts and circumstances.
I/We, the undersigned, certify under penalty of perjury that the information provided above is true and correct. WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802).
Name of Controlling Participant Signature of Controlling Participant
Certification Date (mm/dd/yyyy)
Area Code and Tel. No.
This form prepared by (print name) Area Code and Tel. No.
Previous editions are obsolete ref 24 CFR 200 Subpart H Form HUD-2530 (10/2016)
Previous Participation Certification OMB Approval No. 2502-0118
(Exp. 01/31/2026 )
Schedule A: List of Previous Projects and Section 8 Contracts. Below is a complete list of the controlling participants’ previous participation projects and participation history in covered projects as per 24 CFR, part 200 §200.214 and multifamily Housing programs of FmHA, State and local Housing Finance Agencies, if applicable. Note: Read and follow the instruction sheet carefully. Make full disclosure. Add extra sheets if you need more space. Double check for accuracy. If no previous projects, write by your name, “No previous participation, First Experience”.
1. Controlling Participants’ Name (Last, First) 2. List of previous projects (Project name, project ID and, Govt. agency involved)
3.List Participants’ Role(s)
(indicate dates participated, and if fee or identity of interest participant)
4. Status of loan
(current, defaulted, assigned, foreclosed)
5.Was the Project ever in default during your participation Yes No If yes, explain
6. Last MOR rating and
Physical Insp. Score and date
Part II- For HUD Internal Processing Only Received and checked by me for accuracy and completeness; recommend approval or refer to Headquarters after checking appropriate box.
Date (mm/dd/yyyy) Tel No. and area code
A. No adverse information; form HUD-2530 approval C. Disclosure or Certification problem recommended.
B. Name match in system D. Other (attach memorandum)
Staff Processing and Control
Signature of authorized reviewer Signature of authorized reviewer Approved
Yes No
Date (mm/dd/yyyy)
Instructions for Completing the Previous Participation Certificate, form HUD-2530
Carefully read these instructions and the applicable regulations. A copy of the regulations published at 24 C.F.R. part 200, subpart H, § 200.210-200.222 can be obtained on-line at www.gpo.gov and from the Account Executive at any HUD Office. Type or print neatly in ink when filling out this form. Incomplete form will be returned to the applicant.
Attach extra sheets as you need them. Be sure to indicate "Continued on Attachments" wherever appropriate. Sign each additional page that you attach if it refers to you or your record. Carefully read the certification before you sign it. Any questions regarding the form or how to complete it can be answered by your HUD Account Executive.
Purpose: This form provides HUD/USDA FmHA with a certified report of all previous participation in relevant HUD/USDA programs by those parties submitting the application. The information requested in this form is used by HUD/USDA to determine if you meet the standards established to ensure that all controlling participants in HUD/USDA projects will honor their legal, financial and contractual obligations and are of acceptable risks from the underwriting standpoint of an insurer, lender or governmental agency. HUD requires that you certify and submit your record of previous participation, in relevant projects, by completing and signing this form, before your participation can be approved.
HUD approval of your certification is a necessary precondition for your participation in the project and in the capacity that you propose. If you do not file this certification, do not furnish the information requested accurately, or do not meet established standards, HUD will not approve your certification.
Note that approval of your certification does not obligate HUD to approve your project application, and it does not satisfy all other
HUD program requirements relative to your qualifications.
Who Must Sign and File Form HUD-2530: Form HUD-2530 must be completed and signed by all Controlling Participants of
Covered Projects, as such terms are defined in 24 CFR part 200 §200.212, and as further clarified by the Processing Guide (HUD notice H 2016-15) referenced in 24 CFR §200.210(b) and available on the HUD website at:
http://portal.hud.gov/hudportal/HUD?src=/program offices/housing/mfh/prevparticipation.
Where and When Form HUD-2530 Must Be Filed: The original of this form must be submitted to the HUD Office where your project application will be processed at the same time you file your initial project application. This form must be filed with applications for projects listed in 24 CFR §200.214 and for the Triggering Events listed at 24 CFR §200.218.
http://www.gpo.gov/ http://portal.hud.gov/hudportal/HUD?src=/programoffices/housing/mfh/prevparticipation
Review of Adverse Determination: If approval of your participation in a HUD project is denied, withheld, or conditionally granted on the basis of your record of previous participation, you will be notified by the HUD Office. You may request reconsideration in accordance with 24 CFR §200.222 and further clarified by the Processing Guide. Request must be made in writing within 30 days from your receipt of the notice of determination.
The Department of Housing and Urban Development (HUD) is authorized to collect this information by law 42 U.S.C. 3535(d) and by regulation at 24 CFR 200.210. This information is needed so that principals applying to participate in multifamily programs can become HUD-approved controlling participants. The information you provide will enable HUD to evaluate your record with respect to established standards of performance, responsibility and eligibility. Without prior approval, a controlling participant may not participate in a proposed or existing multifamily or healthcare project. HUD uses this information to evaluate whether or not controlling participants pose an unsatisfactory underwriting risk. The information is used to evaluate the potential controlling participants and approve only individuals and organizations that will honor their legal, financial and contractual obligations.
Privacy Act Statement: The Housing and Community Development Act of 1987, 42 U.S.C. 3543 requires persons applying for a
Federally-insured or guaranteed loan to furnish his/her Social Security Number (SSN). HUD must have your SSN for identification of your records. HUD may use your SSN for automated processing of your records and to make requests for information about you and your previous records with other public agencies and private sector sources. HUD may disclose certain information to Federal, State and local agencies when relevant to civil, criminal, or regulatory investigations and prosecutions. It will not be otherwise disclosed or released outside of HUD, except as required and permitted by law. You must provide all of the information requested in this application, including your SSN. Failure to provide any of the information will result in your disapproval of participation in this HUD program. APPS SORN could be accessed in Federal Register / Vol. 81, No. 146 / Friday, July 29, 2016 / Notices ([Docket
No. FR–5921–N–10] Implementation of the Privacy Act of 1974, as Amended; Amended System of Records Notice, Active Partners
Performance System).
PRA Statement: The public reporting burden is estimated at 3 hours per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions to reduce this burden, to the Reports Management Officer, Paperwork Reduction Project, to the Office of Information Technology, US.
Department of Housing and Urban Development, Washington, DC 20410-3600. When providing comments, please refer to OMB
Approval No. 2502-0118. HUD may not conduct and sponsor, and a person is not required to respond to, a collection of information unless the collection displays a valid control number.
The collection is authorized by 12 U.S.C 1702-1715z; 42 U.S.C. 3535(d). HUD form 2530 is created to collect information as mandated by 24 CFR Part 200. The HUD-2530 form is used to protect HUD’s Multifamily Housing and Healthcare programs by comprehensively assessing industry participants’ risk. It is the Department’s policy that participants in its housing programs honor their legal, financial, and contractual obligations. Accordingly, uniform standards are established for approvals, disapprovals, or withholding actions on principals in projects, based upon their past performances as well as other relevant information. Respondents such as owners, management agents, master tenants, general contractors, and nursing home operators are subject to review. The information on this form needs to be collected by the Department to evaluate participants’ previous performance and compliance with contracts, regulations, and directives.
Previous edition is obsolete form HUD-5369-A (11/92)
U.S. Department of Housing and Urban Development
Office of Public and Indian Housing
Representations, Certifications, and Other Statements of Bidders
Public and Indian Housing Programs
Previous edition is obsolete Page1 of 3 form HUD-5369-A (11/92) through (a)(3) above.
1. Certificate of Independent Price Determination
(a) The bidder certifies that--
(1) The prices in this bid have been arrived at independently, without, for the purpose of restricting competition, any consultation, communication, or agreement with any other bidder or competitor relating to (i) those prices, (ii) the intention to submit a bid, or (iii) the methods or factors used to calculate the prices offered;
(2) The prices in this bid have not been and will not be knowingly disclosed by the bidder, directly or indirectly, to any other bidder or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a competitive proposal solicitation) unless otherwise required by law; and
(3) No attempt has been made or will be made by the bidder to induce any other concern to submit or not to submit a bid for the purpose of restricting competition.
(b) Each signature on the bid is considered to be a certification by the signatory that the signatory--
(1) Is the person in the bidder's organization responsible for determining the prices being offered in this bid or proposal, and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(l) through (a)(3) above; or
(2) (i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not…
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