INVITATION FOR BIDS Trash Chute Maintenance.pdf

Bid Documents & Detailed Specifications For:

Trash Chute Maintenance Services

Andrew Jackson Gardens NJ 15-1

Christopher Columbus Gardens NJ 15-2

Harrison Gardens NJ 15-3

Monroe and Adams Gardens NJ 15-4A and 15-4B

Fox Hill Gardens NJ 15-5

Prepared for:

Marc Recko, Executive Director

Barbara Reyes, Chair

Erica Seitzman, Vice Chair

David Edwards

Anthony Forbes

Jean Rodriguez

Matthew Testa

Carmen Vega

The Housing Authority of the City of Hoboken

400 Harrison Street Hoboken, New Jersey 07030

July 6, 2026

HOUSING AUTHORITY OF THE CITY OF HOBOKEN

TRASH CHUTE MAINTENANCE SERVICES

TABLE OF CONTENTS

Section Page

Table of Contents 2

Invitation to Bid 3

Bid Document Submission Checklist 5

Bid Form 7

Supplemental Schedule 9

Acknowledgement of Receipt of Any Notice of Revisions or Addenda to the Bid Documents 13

Bidder’s Statement of Ownership 14

Subcontractor Certificate 16

Non-Collusion Affidavit 19

Bidder’s Affidavit 20

Qualification Questionnaire 21

Statement of Compliance 23

Affirmative Action Affidavit 24

Voluntary Act and Deed Acknowledgement Affidavit 27

Political Contribution Disclosure Forms 28

HUD Form 2530 – Previous Participation Certification 30

HUD Form 5369-A – Representations, Certifications, and Other Statements of Bidders 35

Form of Contract 39

Prevailing Wage Rates 43

Form of Proposal 44

Scope Of Work 45

THE HOUSING AUTHORITY OF THE CITY OF HOBOKEN

INVITATION TO BID

The Housing Authority of the City of Hoboken (the “Owner) will receive sealed bids for a 1 year Contract for the Provision of Trash Chute Maintenance Services with a 1 year option extend at the Owner’s discretion in accordance with contract documents prepared together with such addenda as may be issued prior to the date of receipt of bids.

The bid opening will be held at 2:30PM (prevailing time) on July 29, 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.

If alterations by erasure or interlineation are made for any reason, the bidder must explain over such erasure or interlineation, with a signed statement from the bidder.

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 bearing the name of the project, prior to the July 29, 2026 deadline.

It is the bidder’s responsibility to see that bids are presented to the Owner on the hour and at the place designated. Bids may be hand delivered or mailed; however, the Owner disclaims any responsibility for bids forwarded by regular or express mail or common carrier.

Commencing on July 6, 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.

This Invitation for Bid and the contract awarded to it 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.

mailto:nvillafane@myhhanj.com

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 Bidder understands that a breach of this certification is a violation of the Equal Opportunity Provisions of applicable Federal Law. As used in this certification, the term “segregated facilities” means any waiting rooms, work areas, restroom and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, and parking.

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. The Owner also reserves the right to reject the bid of any respondent who has previously failed to perform properly, or to complete on time any contract work of a similar nature or who is not in a position to perform the contract. 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

TRASH CHUTE MAINTENANCE SERVICES

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 Form

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

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

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

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)

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:

HOUSING AUTHORITY OTHE CITY OF HOBOKEN

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 LUMP SUM SINGLE CONTRACT BID FOR ONE YEAR

WITH A ONE YEAR OPTION TO EXTEND

For the sum of: Dollars

(Words)

(Numerals)

All blank spaces for bid prices must be filled in, in ink or typewritten, in both words and figures. In the event of a discrepancy between the bid sum expressed in words and the bid sum expressed in numerals, mailto:mrecko@myhhanj.com the sum 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 form ACBD of the Bid

Materials.

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:

1.1 UNIT PRICES

Unit prices are being provided for informational purposes. Proposals to correct deficiencies will be based on unit prices listed.

A Removal of and replacement of complete trash chute door assembly 14" x 18" stainless steel

Dollars ($ ) per unit

B Removal of and replacement of complete trash chute door assembly 13.5" x 12" cast iron

C Removal of and replacement of complete trash chute T handle

D Removal of and replacement of complete trash chute closer

E Removal of and replacement of complete trash chute latch bolt

F Removal of and replacement of complete trash chute baffle

G Removal of and replacement of complete trash chute outer frame for door assembly A

H Removal of and replacement of complete trash chute outer frame for door assembly B

TRASH CHUTE MAINTENANCE SERVICES

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:

TRASH CHUTE MAINTENANCE SERVICES

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).

TRASH CHUTE MAINTENANCE SERVICES

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 .

TRASH CHUTE MAINTENANCE SERVICES

BIDDER’S AFFIDAVIT

State of )

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.

TRASH CHUTE MAINTENANCE SERVICES

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

TRASH CHUTE MAINTENANCE SERVICES

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;

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;

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)

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 participate in any action contrary to subparagraphs (a)(l) through (a)(3) above.

[insert full name of person(s) in the bidder's organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the bidder's organization];

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)(i) above have not participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) above; and

2. Contingent Fee Representation and Agreement

(a) Definitions. As used in this provision:

"Bona fide employee" means a person, employed by a bidder and subject to the bidder's supervision and control as to time, place, and manner of performance, who neither exerts, nor proposes to exert improper influence to solicit or obtain contracts nor holds out as being able to obtain any contract(s) through improper influence.

"Improper influence" means any influence that induces or tends to induce a PHA/IHA employee or officer to give consideration or to act regarding a PHA/IHA contract on any basis other than the merits of the matter.

(b) The bidder represents and certifies as part of its bid that, except for full-time bona fide employees working solely for the bidder, the bidder:

(1) [ ] has, [ ] has not employed or retained any person or company to solicit or obtain this contract; and

(2) [ ] has, [ ] has not paid or agreed to pay to any person or company employed or retained to solicit or obtain this contract any commission, percentage, brokerage, or other fee contingent upon or resulting from the award of this contract.

(c) If the answer to either (a)(1) or (a)(2) above is affirmative, the bidder shall make an immediate and full written disclosure to the

PHA/IHA Contracting Officer.

(d) Any misrepresentation by the bidder shall give the PHA/IHA the right to (1) terminate the contract; (2) at its discretion, deduct from contract payments the amount of any commission, percentage, brokerage, or other contingent fee; or (3) take other remedy pursuant to the contract.

3. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (applicable to contracts exceeding $100,000)

(a) The definitions and prohibitions contained in Section 1352 of title 31, United States Code, are hereby incorporated by reference in paragraph (b) of this certification.

Representations, Certifications, and Other Statements of Bidders

Public and Indian Housing Programs

Table of Contents

Clause Page (iii) As an agent, has not personally participated, and will

1. Certificate of Independent Price Determination 1 not participate in any action contrary to subparagraphs (a)(1)

2. Contingent Fee Representation and Agreement

(c) If the bidder deletes or modifies subparagraph (a)2 above, the

3. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions 1 bidder must furnish with its bid a signed statement setting forth in detail the circumstances of the disclosure.

4. Organizational Conflicts of Interest Certification

[ ] [Contracting Officer check if following paragraph is applicable]

5. Bidder's Certification of Eligibility

(d) Non-collusive affidavit. (applicable to contracts for construction

6. Minimum Bid Acceptance Period 2 and equipment exceeding $50,000)

7. Small, Minority, Women-Owned Business Concern Representation 2

(1) Each bidder shall execute, in the form provided by the PHA/ IHA, an affidavit to the effect that he/she has not colluded with any

8. Indian-Owned Economic Enterprise and Indian Organization Representation other person, firm or corporation in regard to any bid submitted in 2 response to this solicitation. If the successful bidder did not submit

9. Certification of Eligibility Under the Davis-Bacon Act 3 the affidavit with his/her bid, he/she must submit it within three (3)

10. Certification of Nonsegregated Facilities 3 working days of bid opening. Failure to submit the affidavit by that

11. Clean Air and Water Certification 3 date may render the bid nonresponsive. No contract award will be made without a properly executed affidavit.

12. Previous Participation Certificate

(2) A fully executed "Non-collusive Affidavit" [ ] is, [ ] is not

13. Bidder's Signature 3 included with the bid.

Previous edition is obsolete Page2 of 3 form HUD-5369-A (11/92)

(b) The bidder, by signing its bid, hereby certifies to the best of his or her knowledge and belief as of December 23, 1989 that:

(1) No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with the awarding of a contract resulting from this solicitation;

(2) If any funds other than Federal appropriated funds (includ-ing profit or fee received under a covered Federal transaction) have been paid, or will be paid, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of

Congress, an officer or employee of Congress, or an employee of a

Member of Congress on his or her behalf in connection with this solicitation, the bidder shall complete and submit, with its bid, OMB standard form LLL, "Disclosure of Lobbying Activities;" and

(3) He or she will include the language of this certification in all subcontracts at any tier and require that all recipients of subcontract awards in excess of $100,000 shall certify and disclose accordingly.

(c) Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by section 1352, title 31, United States Code. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure form to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000, and not more than

$100,000, for each such failure.

(d) Indian tribes (except those chartered by States) and Indian organizations as defined in section 4 of the Indian Self-Determina-tion and Education Assistance Act (25 U.S.C. 450B) are exempt from the requirements of this provision.

4. Organizational Conflicts of Interest Certification

The bidder certifies that to the best of its knowledge and belief and except as otherwise disclosed, he or she does not have any organizational conflict of interest which is defined as a situation in which the nature of work to be performed under this proposed contract and the bidder's organizational, financial, contractual, or other interests may, without some restriction on future activities:

(a) Result in an unfair competitive advantage to the bidder; or,

(b) Impair the bidder's objectivity in performing the contract work.

[ ] In the absence of any actual or apparent conflict, I hereby certify that to the best of my knowledge and belief, no actual or apparent conflict of interest exists with regard to my possible performance of this procurement.

5. Bidder's Certification of Eligibility

(a) By the submission of this bid, the bidder certifies that to the best of its knowledge and belief, neither it, nor any person or firm which has an interest in the bidder's firm, nor any of the bidder's subcon-tractors, is ineligible to:

(1) Be awarded contracts by any agency of the United States

Government, HUD, or the State in…