Vendor_Submission_Forms_(also_available_in_DocuSign).pdf
PDF 2 MB Posted
- Attached to
- Lead Paint Analyzers
- Solicitation number
- 2023-55
- Issued by
- Essex County, New Jersey
About this file
This file contains a collection of vendor submission forms for a City of Newark, New Jersey contract opportunity for Lead Paint Analyzers (Bid 2023-55). The forms include mandatory documentation such as Equal Employment Opportunity Language (Exhibit A), Americans with Disabilities Act compliance (Attachment C), a Statement of Ownership Disclosure, a Bidder Qualification Questionnaire, a Political Contribution Disclosure Form, and various compliance certifications. The bid is scheduled to be received until 10:15 am on Tuesday, December 19, 2023, with electronic submissions only accepted through the City's e-Procurement Portal.
The documents outline various compliance requirements for potential vendors, including non-discrimination policies, disability access commitments, ownership transparency, criminal background disclosures, and political contribution reporting. Vendors must complete detailed forms addressing business organization type, stockholder information, criminal convictions, and certifications regarding investment activities, sweatshop conditions, and record retention. The forms emphasize the City of Newark's commitment to ethical procurement practices, requiring vendors to disclose potential conflicts of interest, political contributions, and adherence to various local ordinances and state regulations.
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Text version
ATTACHMENT C
AMERICANS WITH DISABILITIES ACT OF 1996
Equal Opportunity for Individuals with Disability
The contractor and the owner do hereby agree that the provisions of Title 11 of the Americans with Disabilities Act of 199 (the "Act") (42 U.S.C. S121 01 et seq.), which prohibits discrimination on the basis of disability by public entities in all services, programs, and activities provided or made available by public entities, and the rules and regulations promulgated pursuant there unto, are made a part of this contract. In providing any aid, benefit, or service on behalf of the City of Newark pursuant to this contract, the contractor agrees that the performance shall be in strict compliance with the Act. In the event that the contractor, its agents, servants, employees, or subcontractors violate or are alleged to have violated the Act during the performance of this contract, the contractor shall defend the City of Newark in any action or administrative proceeding commenced pursuant to this Act. The contractor shall indemnify, protect, and save harmless the City, its agents, servants, and employees from and against any and all suits, claims, losses, demands, or damages, of whatever kind or nature arising out of or claimed to arise out of the alleged violation. The contractor shall, at its own expense, appear, defend, and pay any and all charges for legal services and any and all costs and other expenses arising from such action or administrative proceeding or incurred in connection therewith. In any and all complaints brought pursuant to the owner’s grievance procedure, the contractor agrees to abide by any decision of the owner which is rendered pursuant to said grievance procedure. If any action or administrative proceeding results in an award of damages against the owner, or if the owner incurs any expense to cure a violation of the ADA which has been brought pursuant to its grievance procedure, the contractor shall satisfy and discharge the same at its own expense.
The City of Newark shall, as soon as practicable after a claim has been made against it, give written notice thereof to the contractor along with full and complete particulars of the claim, if any action or administrative proceeding is brought against the City of Newark or any of its agents, servants, and employees, the City of Newark shall expeditiously forward or have forwarded to the contractor every demand, complaint, notice, summons, pleading, or other process received by the owner or its representatives.
It is expressly agreed and understood that any approval by the City of Newark of the services provided by the contractor pursuant to this contract will not relieve the contractor of the obligation to comply with the Act and to defend, indemnify, protect, and save harmless the City of Newark pursuant to this paragraph.
It is further agreed and understood that the City of Newark assumes no obligation to indemnify or save harmless the contractor, its agents, servants, employees and subcontractors for any claim which may arise out of their performance of this Agreement. Furthermore, the contractor expressly understands and agrees that the provisions of this indemnification clause shall in no way limit the contractor’s obligations assumed in this Agreement, nor shall they be construed to relieve the contractor from any liability, nor preclude the City of Newark from taking any other actions available to it under any other provisions of the Agreement or otherwise at law.
Date Signature
SWEATSHOPS
Ordinance 6 PH S&FH 080499
Pursuant to Ordinance 6 PH S&FH 080499, the City of Newark shall not purchase, lease, rent or take on the consignment of goods or services produced under sweatshop conditions.
Compliance I, the undersigned, have read, understand and comply with all aspects of Ordinance 6 PH S&FH 080499. I agree that if either I or the company I represent am found to be in non-compliance with any aspect of this Ordinance, the immediate termination of any established contract will be reasonable and justified.
Authorized Representative Title Date
Information to be completed by the Division of Central Purchasing
VENDOR: _______________________________________________________________________________
BID PROPOSAL: ______________________________________________________________
BID ADVERTISEMENT: ________________________________________________________
BID PROPOSAL DUE DATE: ____________________________________________________
Ord6phs Rev. 5/15/18
STATE REQUIRED RECORD RETENTION
N.J.S.A. 52:15c-14(d) and N.J.A.C. 17:44-2.2
I, THE UNDERSIGNED HAVE READ, UNDERSTAND AND COMPLY WITH ALL ASPECTS OF N.J.S.A.
52:15C-14(d) and N.J.A.C. 17:44-2.2.
I shall maintain all documentation related to products, transactions or services under this contract for a period of five years from the date of final payment. Such records shall be made available to the New Jersey Office of the State Comptroller upon request. Refusal by the company, as named below, and/or any legal change to the name, to provide information upon request by the State Comptroller, or otherwise impede or fail to cooperate with any audit or performance review, the State Comptroller may recommend to the City of Newark that the person be subject to termination of their contract, or temporarily or permanently debarred from contracting with the City of Newark.
Company Name :
Company Address:
Bid Proposal Title: ______________________________ _____________
Bid Advertisement Date: ___________________________________________
Bid Proposal Due Date: __________________________________ _________
REPUBLIC OF SUDAN
Ordinance 6 PH S&F-b112007
Pursuant to Ordinance 6 PH S&F-b112007, the City of Newark shall not accept bids for any goods, materials, supplies and services required by the City of Newark from any business entity having investments, licenses or operations in the Republic of Sudan.
Compliance I, the undersigned, have read, understand and comply with all aspects of Ordinance 6 PH S&F-b112007. I agree that if either I, or the company I represent is found to be in non-compliance with any aspect of this Ordinance, the immediate termination of any established contract will be reasonable and justified.
VENDOR: _______________________________________________________________________________
Ord6phs&F-b
DCP
REQUEST FOR CONSENT TO HOLD PRICES
Pursuant to N.J.S.A. 40A:11-24, The City of Newark and/or its Central Purchasing Division is requesting consent to hold prices from each Respondent/bidder submitting a Bid response package, in the event the contracting unit is unable to award a contract within sixty (60) days.
I, the undersigned, understand that this is a request from The City of Newark and/or its Central Purchasing Division for my company/business, submitting this Bid response package, to consent to hold prices in the event that there are any delays with the awarding of this contract and the City of Newark is unable to award the contract within sixty (60 days.
I consent/agree that the City of Newark and/or its Central Purchasing Division may hold my bid proposal for consideration until such time as an award is made, or until ____________ (Date consent expires). If no date is entered, my consent to hold prices is valid until an award is made and contract is executed.
VENDOR: ____________________________________________________________________
orm P-2ved 3/2/15
CITY OF NEWARK
POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant To Newark Contractor Pay-to-Play Ordinance 6PSF-d (s) 06/22/2021
This form or its permitted facsimile must be submitted to the City of Newark no later than ten (10) days prior to the award of the contract.
Part I – Vendor/Business Entity (BE) Information
Vendor/BE
Name:
Address:
City: State: Zip:
The undersigned being authorized to certify, hereby certifies, under penalty of perjury, that the submission provided herein represents compliance with the provisions of Newark Contractor Pay-to-Play Ordinance 6PSF-d (s)
06/22/2021 as represented by the Ordinance accompanying this form. The Ordinance has been read and the
Vendor/BE is hereby in compliance.
Signature Printed Name Title & Date
Part II – Contribution Disclosure
Disclosure requirement: Pursuant to Newark Contractor Pay-to-Play Ordinance 6PSF-d (s) 06/22/2021 this disclosure must include political contributions reportable by the recipient under P.L.1973, c.83 (C.19:44A-1 et seq.).
If you have no contributions to disclose, you must write “None” in the Contributor Name column.
Contributor Name Recipient Name Date Dollar Amount
(If no contributors, please write-in
“NONE”)
Check here if additional information is continued on separate pages. All Information should be provided in the form set forth therein.
This is an official standardized form of the City of Newark.
This form may be photocopied, but reproducing, re-formatting, revising, and similar alterations are prohibited and will not be accepted.
City Form P-2
Rev. 8.6.2021
Continuation Page
CITY OF NEWARK
POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant To Newark Contractor Pay-to-Play Ordinance 6PSF-d (s) 06/22/2021
Page ___ of ______
Vendor/BE Name: ___________________________________________
Contributor Name Recipient Name Date Dollar Amount
(If no contributors, please write-in ‘NONE’) $
Check here if the information is continued on subsequent page(s)
This is an official standardized form of the City of Newark.
This form may be photocopied, but reproducing, re-formatting, revising, and similar alterations are prohibited and will not be accepted.
City Form P-2
Rev. 8.6.2021
File details come from the government source that posted it. Updated .