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2026 Chevrolet Tahoe PPV and SSV SUVs
BID #: N/A
DUE: 5/15/2026
VALUE: TBD
85
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Executive Summary
The Township of Barnegat is soliciting bids for the purchase of three (3) 2026 Chevrolet Tahoe vehicles: two (2) PPV (9C1) 4WD SUVs and one (1) SSV 4WD SUV. The bid opening is scheduled for May 15, 2026, at 10:00 AM at the Municipal Clerk's Office, 900 West Bay Avenue, Barnegat, NJ 08005. Detailed specifications for both PPV and SSV models are provided, including engine type, transmission, drivetrain, suspension, braking system, electrical components, interior features, and warranty information. Bidders must adhere to all submission requirements and certifications, including those related to Iran investment, Russia/Belarus activities, and political contributions, as outlined in the accompanying documents.
Web Content
Bids BarnegatTwp 2026-04-01T14:22:21-04:00 NOTICE TO BIDDERS Iran Investment Disclosure Statements Certification of Non-Involvement in Prohibited Activities in Russia or Belarus Fair and Open contract forms Non Fair and Open contract forms REQUEST FOR PRICING 2026 CHEVROLET TAHOE TOTAL OF THREE (3) QTY 2 2026 Chevrolet Tahoe PPV (9C1) 4WD SUVS QTY 1 2026 Chevrolet Tahoe SSV 4WD SUV Bid Opening will be on May 15, 2026 no later than 10:00 AM, 900 West Bay Avenue, Barnegat NJ Specs for total of three (3) Chevy Tahoes Competitive Price Quote for Barnegat Township For: 2025 Ford Ranger XLT Crew Cab 4×4 2025 FORD RANGER XLT CREW ADVERTISEMENT _______________________________________________________________________________________ BID RESULTS PRICE QUOTE FOR FLYGT PUMPS Barnegat Municipal Police Complex_Bid Opening of 08_27_20
Document Text
--- Document: Iran Investment Disclosure Statements ---
PHILIP D. MURPHY
Governor
SHEILA Y. OLIVER
Lt. Governor
FAL OF THE STATE OF
JERSEY
State of New Jersey
DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
OFFICE OF THE DIRECTOR
33 WEST STATE STREET
P. O. Box 039
TRENTON, NEW JERSEY 08625-0039
https://www.njstart.gov
Telephone (609) 292-4886 / Facsimile (609) 984-2575
ELIZABETH MAHER MUOIO
State Treasurer
MAURICE A. GRIFFIN
Acting Director
The following list represents entities determined, based on credible information available to the public,
to be engaged in prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25"):
1. AK Makina Ltd.
2. Amona
3. Bank Markazi Iran (Central Bank of Iran)
4. Bank Mellat
5. Bank Melli Iran
6. Bank Saderat PLC
7. Bank Sepah
8. Bank Tejarat
9. China International United Petroleum & Chemicals Co., Ltd. (Unipec)
10. China National Offshore Oil Corporation (CNOOC)
11. China National Petroleum Corporation (CNPC)
12. China National United Oil Corporation (ChinaOil)
13. China Oilfield Services Limited
14. China Petroleum & Chemical Corporation (Sinopec)
15. China Precision Machinery Import-Export Corp. (CPMIEC)
16. Indian Oil Corporation
17. Kingdream PLC
18. Naftiran Intertrade Company (NICO)
19. National Iranian Tanker Company (NITC)
20. Oil and Natural Gas Corporation (ONGC)
21. Oil India Limited
22. Persia International Bank
23. Petroleos de Venezuela (PDVSA Petróleo, SA)
24. PetroChina Company, Ltd.
25. Sameh Afzar Tajak Co. (SATCO)
26. Shandong Fin Cnc Machine Company, Ltd.
27. Sinohydro Co., Ltd.
28. SK Energy Co. Ltd.
29. SKS Ventures
30. Som Petrol AS
31. Zhuhai Zhenrong Company
List Date: January 4, 2021
TOWNSHIP OF BARNEGAT
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
PART 1: CERTIFICATION
BIDDERS MUST COMPLETE PART 1 BY CHECKING EITHER BOX.
FAILURE TO CHECK ONE OF THE BOXES MAY RENDER THE PROPOSAL NON-RESPONSIVE.
Pursuant to Public Law 2012, c. 25, any person or entity that submits a bid or proposal or otherwise proposes to enter into or renew a
contract must complete the certification below to attest, under penalty of perjury, that neither the person or entity, nor any of its
parents, subsidiaries, or affiliates, is identified on the Department of Treasury's Chapter 25 list as a person or entity engaging in
investment activities in Iran. The Chapter 25 list is found on the State of New Jersey, Department of Treasury, Division of Purchase
and Property website at http://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf. Bidders must review this list prior to
completing the below certification. Failure to complete the certification may render a bidder's bid proposal non-responsive. If the
Township of Barnegat determines that a person or entity has submitted a false certification concerning its engagement in investment
activities in Iran pursuant to section 4 of P.L. 2012, c.25 (C.52:32-58), the local contracting unit shall report to the New Jersey
Attorney General the name of that person or entity, and the Attorney General shall determine whether to bring a civil action against the
person to collect the penalty prescribed in paragraph (1) of subsection a. of section 5 of P.L. 2012, c.25 (C.52:32-59). The Township of
Barnegat may also report to the municipal attorney or county counsel, as appropriate, the name of that person, together with its
information as to the false certification, and the municipal attorney or county counsel, as appropriate, may determine to bring such civil
action against the person to collect such penalty.
PLEASE CHECK THE APPROPRIATE BOX:
I certify, pursuant to Public Law 2012, c. 25, that neither the bidder listed above nor any of the bidder's parents, subsidiaries, or
affiliates is listed on the N.J. Department of the Treasury's list of entities determined to be engaged in prohibited activities in Iran
pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). I further certify that I am the person listed above, or I am an officer or representative
of the entity listed above and I am authorized to make this certification on its behalf. I will skip Part 2 and sign and complete the
Certification below.
OR
I am unable to certify as above because the bidder and/or one or more of its parents, subsidiaries, or affiliates is listed on
the Department's Chapter 25 list. I will provide a detailed, accurate and precise description of the activities in Part 2 below
and sign and complete the Certification below. Failure to provide such will result in the proposal being rendered as nonresponsive
and appropriate penalties, fines and/or sanctions will be assessed as provided by law.
PART 2: PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN You
must provide a detailed, accurate and precise description of the activities of the bidding person/entity, or one of its parents,
subsidiaries or affiliates, engaging in the investment activities in Iran outlined above by completing the boxes below.
PROVIDE INFORMATION RELATIVE TO THE ABOVE QUESTIONS. PLEASE PROVIDE THOROUGH ANSWERS
TO EACH QUESTION. IF YOU NEED TO MAKE ADDITIONAL ENTRIES, ATTACH ADDITIONAL PAGES.
Name
Description of Activities
Relationship to Bidder/Offeror_
of Engagement_
Anticipated Cessation Date_
Bidder/Offeror Contact Name_
Contact Phone Number
Duration
TOWNSHIP OF BARNEGAT
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
Certification:
I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any
attachments thereto to the best of my knowledge are true and complete. I attest that I am authorized to
execute this certification on behalf of the above-referenced person or entity. I acknowledge that the
Township of Barnegat is relying on the information contained herein and thereby acknowledge that I am
under a continuing obligation from the date of this certification through the completion of any contracts
with the Township of Barnegat to notify the Township of Barnegat in writing of any changes to
the answers of information contained herein. I acknowledge that I am aware that it is a criminal offense
to make a false statement or misrepresentation in this certification, and if I do so, I recognize that I am
subject to criminal prosecution under the law and that it will also constitute a material breach of my
agreement(s) with the Township of Barnegat and that the Township of Barnegat at its option may
declare any contract(s) resulting from this certification void and unenforceable.
I, being duly sworn upon my oath, hereby represent and state that the foregoing
information and any attachments thereto to the best of my knowledge are true and
complete. I attest that I am authorized to execute this certification on behalf of the
above-referenced person or entity.
Bidder:
Signature:
Print Name:
Title:
Date:
--- Document: Certification of Non-Involvement in Prohibited Activities in Russia or Belarus ---
CERTIFICATION OF NON‐INVOLVEMENT IN PROHIBITED ACTIVITIES
IN RUSSIA OR BELARUS PURSUANT TO P.L.2022, c.3
NJ Rev. 3.29.2022
CONTRACT / BID SOLICITATION TITLE
CONTRACT / BID SOLICITATION No.
CHECK THE APPROPRIATE BOX
I, the undersigned , am authorized by the person or entity seeking to enter into or renew the contract identified
above, to certify that the Vendor/Bidder is not engaged in prohibited activities in Russia or Belarus as such
term is defined in P.L.2022, c.3,1 section 1.e, except as permitted by federal law.
I understand that if this statement is willfully false, I may be subject to penalty, as set forth in P.L.2022, c.3,
section 1.d.
OR
I, the undersigned am unable to certify above because the person or entity seeking to enter into or renew the
contract identified above, or one of its parents, subsidiaries, or affiliates may have engaged in prohibited
activities in Russia or Belarus. A detailed, accurate and precise description of the activities is provided below.
Failure to provide such description will result in the Quote being rendered as non-responsive, and the
Department/Division will not be permitted to contract with such person or entity, and if a Quote is accepted or
contract is entered into without delivery of the certification, appropriate penalties, fines and/or sanctions will be
assessed as provided by law.
Description of Prohibited Activity
Attach Additional Sheets If Necessary.
If you certify that the bidder is engaged in activities prohibited by P.L. 2022, c. 3, the bidder shall have 90 days to cease
engaging in any prohibited activities and on or before the 90th day after this certification, shall provide an updated
certification. If the bidder does not provide the updated certification or at that time cannot certify on behalf of the entity that
it is not engaged in prohibited activities, the State shall not award the business entity any contracts, renew any contracts,
and shall be required to terminate any contract(s) the business entity holds with the State that were issued on or after the
effective date of P.L. 2022, c. 3.
Signature of Authorized Representative
Date
Print Name and Title of Authorized Representative
Vendor Name
1 Engaged in prohibited activities in Russia or Belarus” means (1) companies in which the Government of Russia or Belarus has any direct equity share;
(2) having any business operations commencing after the effective date of this act that involve contracts with or the provision of goods or services to the
Government of Russia or Belarus; (3) being headquartered in Russia or having its principal place of business in Russia or Belarus, or (4) supporting,
assisting or facilitating the Government of Russia or Belarus in their campaigns to invade the sovereign country of Ukraine, either through in-kind support
or for profit.
EXHIBIT G
LOTTERY RFP 2023
--- Document: Fair and Open contract forms ---
N??.. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT DOCUMENT CHECKLIST"
H Read Only
€ Provide the Required Form(s)
*This form need not be submitted. It is provided for bidder's use in assuring compliance with
all required documentation.
BDC-1
Required
by owner
Submission Requirement
lnitial each
required entry
and if required
submit the item
a
Non-Collusion Affidavit - [Pg. P-1]
a
New Jersey Business Registration
(must be submitted prior to contract award) - [Pg. P-2]
a
References - [Pg. P-3]
a
Mandatory Affirmative Action Language (Pg. AA1 -AA2)
[Pg. P-4 & P-5]
s
Americans with Disabilities Act of 1990 Language
(Pg. AD-1 ) - [P-6]
a
Insurance Certificates - [P-7]
a
Disclosure of Investment - Activities in lran - [Pg. P-8 & P-9]
a
W-9 Request for Taxpayer ldentification Number and
Certification - [Pg. P-10
a
Fair & Open Contribution Prohibition Language
[Pg. P-1 1]
a
Business Entity Disclosure Form - [Pg. P-12 & P-13]
a
Political Contribution Disclosure Certification
[Pg. P-14 & P-17]
a
Stockholder Disclosure Statement - [Pg. P-18 & P-19]
a
Reporting to the Office of the New Jersey State Comptroller
[Pg. P-20
?N.J.S.A. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT
NON-COLLUSION STATEMENT
Upon request, the bidder will be expected to amplify the foregoing statements as necessary to
satisfy the Township concerning his ability to successfully perform the work in a satisfactory
manner.
The undersigned bidder submitting this proposal or bid certifies and affirms that such bid is
genuine and is not the result of collusion. Said bidder has not colluded, conspired, connived. or
agreed, directly or indirectly, with any bidder or person, to put in a false bid, or that such other
persons shall refrain from bidding. Said bidder has not in any manner, directly or indirectly, sought
by agreement or collusion, or communication or conference, with any person, to fix overhead, profit
or cost element of said bid price, or that of any other bidder, or to secure any advantage against
the Township or any person interested in the proposed contract. Further, such bidder has not,
directly or indirectly, submitted this bid, or the contents thereof, or divulged information or data
relative thereto to any association or to any member or agent thereof; and, that no Township
official or employee is interested directly or indirectly in the bid or in any portion of the bid, nor in
the contract or in any part of the contract which may be awarded the undersigned on the basis of
such bid.
Signed this
day of
(Bidder)
BV
Signature of Authorized Individual,
Partner or Officer Signing the Proposal
Print Name:
Title:
Date:
P-1
N?j??.. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT
BIIS?NFSS REGISTRATION CERTIF?CATE
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Reforms to the Business Registration Certificate Filing: permits filing prior to award of contracts if
not filed with bid. Effective with bids received and contracts awarded after January 18, 2010, this law
removes the requirement of the Local Public Contracts Law (N.J.S.A. 40A:11-23.2) that required a
bid to be rejected if the bidder failed to include a BRC with the bid, even though it may have been
the otherwise Iowest responsible bid. The Iaw now allows the BRC to be filed any time prior to
award of the contract and the bidder had to have obtained the BRC prior to receipt of bids. This
permits the BRC to be required with a bid, or submitted subsequently. If a BRC is required in a bid,
but not submitted with the bid, it would an immaterial defect; curable by being filed prior to award of
the contract. A BRC is obtained from the New Jersey Division of Revenue. Information on obtaining
a BRC is available on the internet at www.nj.gov/njbgs or by phone at (609) 292-1730.
N.J.S.A. 52:32-44 imposes the following requirements on contractors and all subcontractors that
knowingly provide goods or perform services for a contractor fulfilling this contract:
1) The contractor shall provide written notice to its subcontractors and suppliers to submit proof of
business registration to the contractor;
2) Subcontractors through all tiers of a project must provide written notice to their subcontractors
and suppliers to submit proof of business registration and subcontractors shall collect such
proofs of business registration and maintain them on file;
3) Prior to receipt of final payment from a contracting agency, a contractor must submit to the
contacting agency an accurate Iist of all subcontractors or attest that none was used;
4) During the term of this contract, the contractor and its affiliates shall collect and remit, and shall
notify all subcontractors and their affiliates that they must collect and remit to the Director, New
Jersey Division of Taxation, the use tax due pursuant to the Sales and Use Tax Act, (N.J.S.A.
54:32B-1 et seq.) on all sales of tangible personal property delivered into this State.
A contractor, subcontractor or supplier who fails to provide proof of business registration or
provides false business registration information shall be liable to a penalty of $25 for each day of
violation, not to exceed $50,000 for each business registration not properly provided or maintained
under a contract with a contracting agency. Information on the Iaw and its requirements is available
by calling (609) 292-1730.
P-2
N?.. 19:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT
REFERENCES
Please Iist three (3) references below:
1.
2.
3.
Signature:
Print Name:
Title:
Date:
P-3
?N.J.S.A. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
(REVISED 4/1 0)
TOWNSHIP OF BARNEGAT
EXHIBIT A
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE
N.J.S.A. 10:5-31 et seq. (P.L. 1975, C. 127)
N.J.A.C. 17:27
GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS
During the performance of this contract, the contractor agrees as follows:
The contractor or subcontractor, where applicable, will not discriminate against any employee or
applicant for employment because of age, race, creed, color, national origin, ancestry, marital
status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.
Except with respect to affectional or sexual orientation and gender identity or expression, the
contractor will ensure that equal employment opportunity is afforded to such applicants in
recruitment and employment, and that employees are treated during employment, without regard
to their age, race, creed, color, national origin, ancestry, marital status, affectional or sexual
orientation, gender identity or expression, disability, nationality or sex. Such equal employment
opportunity shall include, but not be Iimited to the following: employment, upgrading, demotion, or
transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of
compensation; and selection for training, including apprenticeship. The contractor agrees to post in
conspicuous places, available to employees and applicants for employment, notices to be provided
by the Public Agency Compliance Officer setting forth provisions of this nondiscrimination clause.
The contractor or subcontractor, where applicable will, in all solicitations or advertisements for
employees placed by or on behalf of the contractor, state that all qualified applicants will receive
consideration for employment without regard to age, race, creed, color, national origin, ancestry,
marital status, affectional or sexual orientation, gender identity or expression, disability, nationality
or sex.
The contractor or subcontractor will send to each labor union, with which it has a collective
bargaining agreement, a notice, to be provided by the agency contracting officer, advising the labor
union of the contractor's commitments under this chapter and shall post copies of the notice in
conspicuous places available to employees and applicants for employment.
The contractor or subcontractor, where applicable, agrees to comply with any regulations
promulgated by the Treasurer pursuant to N.J.S.A. 10:5-31 et seq., as amended and
supplemented from time to time and the Americans with Disabilities Act.
The contractor or subcontractor agrees to make good faith efforts to meet targeted county
employment goals established in accordance with N.J.A.C. 17:27-5.2.
The contractor or subcontractor agrees to inform in writing its appropriate recruitment agencies
including, but not limited to, employment agencies, placement bureaus, colleges, universities, and
labor unions, that it does not discriminate on the basis of age, race, creed, color, national origin,
ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability,
nationality or sex, and that it will discontinue the use of any recruitment agency, which engages in
direct or indirect discriminatory practices.
P-4
??N.J.S.A. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
(REVISED 4/1 0)
TOWNSHIP OF BARNEGAT
EXHIBIT A continued
The contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to
assure that all personnel testing conforms with the principles of job related testing, as established
by the statutes and court decisions of the State of New Jersey and as established by applicable
Federal law and applicable Federal court decisions.
In conforming to the targeted employment goals, the contractor or subcontractor agrees to review
all procedures relating to transfer, upgrading, downgrading and layoff to ensure that all such
actions are taken without regard to age, race, creed, color, national origin, ancestry, marital status,
affectional or sexual orientation, gender identity or expression, disability, nationality or sex,
consistent with the statutes and court decisions of the State of New Jersey, and applicable Federal
law and applicable Federal court decisions.
The contractor shall submit to the public agency, after notification of award but prior to
execution of a goods and services contract, one of the following three documents:
@
Letter of Federal Affirmative Action Plan Approval
*
Certificate of Employee Information Report
*
Employee Information Report Form AA302 (electronically provided by the Division
and distributed to the public agency through the Division's website at
www.state.nj.us/treasury/contract compliance)
The contractor and its subcontractors shall furnish such reports or other documents to the Division
of Purchase & Property, CCAU, EEO Monitoring Program as may be requested by the office from
time to time in order to carry out the purposes of these regulations, and public agencies shall
furnish such information as may be requested by the Division of Purchase & Property, CCAU, EEO
Monitoring Program for conducting a compliance investigation pursuant to Subchapter 10 of the
Administrative Code at N.J.A.C. 17:27.
Company
Signature
Title
Date
P-s
N?j??.. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT
APPENDIX A
AMERICANS WITH DISABILITIES ACT OF 1990
Equal Opportunity for Individuals with Disability
The contractor and the Township of Barnegat, (hereafter "owner") do hereby agree that the
provisions of Title 11 of the Americans With Disabilities Act of 1990 (the "Act") (42 ?. 8121 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 owner pursuant to this contract, the contractor agrees that the
performance shall be in strict compliance with the Act. In the event that the contractor, its agents,
servants, employees, or subcontractors violate or are alleged to have violated the Act during the
performance of this contract, the contractor shall defend the owner in any action or administrative
proceeding commenced pursuant to this Act. The contractor shall indemnify, protect, and save
harmless the owner, its agents, servants, and employees from and against any and all suits,
claims, losses, demands, or damages, of whatever kind or nature arising out of or claimed to arise
out of the alleged violation. The contractor shall, at its own expense, appear, defend, and pay any
and all charges for legal services and any and all costs and other expenses arising from such
action or administrative proceeding or incurred in connection therewith. In any and all complaints
brought pursuant to the owner's grievance procedure, the contractor agrees to 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 owner shall, as soon as practicable after a claim has been made against it, give written notice
thereof to the contractor along with full and complete particulars of the claim, If any action or
administrative proceeding is brought against the owner or any of its agents, servants, and
employees, the owner shall expeditiously forward or have forwarded to the contractor every
demand, complaint, notice, summons, pleading, or other process received by the owner or its
representatives.
It is expressly agreed and understood that any approval by the owner of the services provided by
the contractor pursuant to this contract will not relieve the contractor of the obligation to comply
with the Act and to defend, indemnify, protect, and save harmless the owner pursuant to this
paragraph.
It is further agreed and understood that the owner assumes no obligation to indemnify or save
harmless the contractor, its agents, servants, employees and subcontractors for any claim which
may arise out of their performance of this Agreement. Furthermore, the contractor expressly
understands and agrees that the provisions of this indemnification clause shall in no way limit the
contractor's obligations assumed in this Agreement, nor shall they be construed to relieve the
contractor from any liability, nor preclude the owner from taking any other actions available to it
under any other provisions of the Agreement or otherwise at .law.
Company
Signature
Title
Date
P-6
?.. 19:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT
INSURANCE CERTIF?CATES
Name of Bidder:
Address:
The Bidder is required to submit actual Certificate(s) of Insurance
establishing Insurance coverage of the type and amount required in
accordance with the procedure set forth by the Contract Documents.
(Documents to be submitted prior to the resolution of award)
a
1, GENERAL L?ABILITY INSURANCE
General liability insurance shall be provided with Iimits of not Iess than $1,000,000.00 any one
person and $1,000,000.00 any one accident for bodily injury and $1,000,000.00 aggregate for
property damage, and shall be maintained in full force during the Iife of the contract.
[I]
2. AUTOMOTIVE LIAB?LITY INSURANCE
Automotive Iiability insurance covering contractor for claims arising from owned, hired and non-
owned vehicles with limits of not less than $1,000,000.00 any one person and $1,000,000.00 any
one accident for bodily injury and $1,000,000.00 each accident for property damage, shall be
maintained in full force during the life of the contract.
P-7
?.. 19:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT
DISCLOSURE OF INVESTMENT ACTMTIES IN IRAN
l PART 1: CERTIFICATION
l
r
BIDDERS MUST COMPLETE PART I BY CHECKING EITHER BOX.
FAILURE TO CHECK ONE OF THE BOXES MAY RENDER THE PROPOSAL NON-RESPONSIVE.
1
Pursuant to Public Law 2012, c. 25, any person or entity that submits a bid or proposal or otherwise proposes to enter
into or renew a contract must complete the certification below to attest, under penalty of perjury, that neither the person
or entity, nor any of its parents, subsidiaries, or affiliates, is identified on the Department of Treasury's Chapter 25 Iist as
a person or entity engaging in investment activities in Iran. The Chapter 25 Iist is found on the State of New Jersey,
Department of Treasury, Division of Purchase and Property website at:
http://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf. Bidders must review this Iist prior to completing the
below certification. Failure to complete the certification may render a bidder's bid proposal non-responsive. If the
Township of Barnegat determines that a person or entity has submitted a false certification concerning its engagement in
investment activities in Iran pursuant to section 4 of P.L. 2012, c.25 (C.52:32-58), the Iocal contracting unit shall report to
the New Jersey Attorney General the name of that person or entity, and the Attorney General shall determine whether to
bring a civil action against the person to collect the penalty prescribed in paragraph (1 ) of subsection a. of section s of
P.L. 2012, c.25 (C.52:32-59). The Township of Barnegat may also report to the municipal attorney or county counsel, as
appropriate, the name of that person, together with its information as to the false certification, and the municipal attorney
or county counsel, as appropriate, may determine to bring such civil action against the person to collect such penalty.
PLEASE CHECK THE APPROPRIATE BOX:
€ l certify, pursuant to Public Law 2012, c. 25, that neither the bidder Iisted above nor any of the bidder's parents,
subsidiaries, or affiliates is Iisted on the N.J. Department of the Treasury's Iist of entities determined to be engaged in
prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). l further certify that l am the person Iisted
above, or I am an officer or representative of the entity listed above and I am authorized to rriake this certification on its
behalf. I will skip Part 2 and sign and complete the Certification below.
OR
€ I am unable to certify as above because the bidder and/or one or more of its parents, subsidiaries, or affiliates is
Iisted on the Department's Chapter 25 Iist. I will provide a detailed, accurate and precise description of the activities in
Part 2 below and sign and complete the Certification below. Failure to provide such will result in the proposal being
rendered as nonresponsive and appropriate penalties, fines and/or sanctions will be assessed as provided by Iaw.
!? PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTMTIES IN IRAN
You must provide a detailed, accurate and precise description of the activities of the bidding person/entity, or
one of its parents, subsidiaries or affiliates, engaging in the investment activities in Iran outlined above by
completing the boxes below.
PROVIDE INFORMAT?ON RELATIVE TO THE ABOVE QUESTIONS. PLEASE PROVIDE THOROUGH ANSWERS
TO EACH QUESTION. IF YOU NEED TO MAKE ADDIT?ONAL ENTRIES, ATTACH ADD?TIONAL PAGES.
Name
Relationship to Bidder/Offeror
Description of Activities
Duration of Engagement
Anticipated Cessation Date
Bidder/Offeror Contact Name
Contact Phone Number
P-8
?N.J.S.A. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP BARNEGAT
DISCLOSURE OF INVESTMENT ACTMTIES IN IRAN
iCertification:
l
I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments
thereto to the best of my knowledge are true and complete. I attest that I am authorized to execute this certification on
behalf of the above-referenced person or entity. I acknowledge that the Township of Barnegat is relying on the
information contained herein and thereby acknowledge that l am under a continuing obligation from the date of this
certification through the completion of any contracts with the Township of Barnegat to notify the Township of Barnegat
in writing of any changes to the answers of information contained herein. l acknowledge that I am aware that it is a
criminal offense to make a false statement or misrepresentation in this certification, and if I do so, I recognize that l
am subject to criminal prosecution under the law and that it will also constitute a material breach of my agreement(s)
with the Township of Barnegat and that the Township of Barnegat at its option may declare any contract(s) resulting
from this certification void and unenforceable.
1, being duly sworn upon my oath, hereby represent and state that the foregoing information and
any attachments thereto to the best of my knowledge are true and complete. l attest that I am
authorized to execute this certification on behalf of the above-referenced person or entity.
Bidder:
Signature:
Print Name:
Title:
Date:
P-9
? 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF
BARNEGAT
Form W-9
lRev.August20l3)
Depanmen} ol lhe Tyeasury
Inteinal Revenue Service
r
Name (as ahown on your income }ax-re}um)
N
j;f
X[
'jl
. l Business name7aisreqatded en(Ity name, if d?lleieni krom'ab:ive
Nl
ffl i +5-l:n;i'v7d:l/'s-oa-lawprWp'-ri'e:'7a= aE]-a:;oa:oa';a'::on a - ,,p..=., a Parjnership a -,..-..,l.
i!Busn""name/d'egadedenl"am"Idllerenl
Clty, state, and ZIP code
Mdress (number, s}reel, and apl. or suile no.)
[] Olher (see insLruchonsl >
0 Limi}ed liability company. Emer the tax classijicatlon (C-C coyporaiion, 8-S cotpoyaiion, P=par(nership) k
Exemptions (see instruciions):
Exempt payee code lil any)
Exemp}ion from FATCA repoding
code {il any)
f
'trsi account number(s) here (opi:onai)
s Taxpayer Identification Number (T IN)
Enler your TIN m the appropriaje box The TIN provided mus} match the name given on the Name Iine 800181 80ckl(lbl num5er
aa -ag -m
10 aVoid backup withholding. For individuals, this :s your 80cial secUlity number (SSN). HoweVer. for a
resldem alien, sole pyoprietor, or disreqan:Ied en(ffly. see (he Pan l instructions on paqe 3. For o{hey
enti}ies, i! is your employer identiiication number (EIN). If you do not have a number. see How lo gel a
TIN on par;le 3.
Note. If the account is in more than one name, see the chark on page 4.loy guidelines on whose
iEmployer identi{ication number
number to enter.
Give Form to the
requesier. Do not
send to the IRS.
Request for Taxpayer
Identification Number and Certification
l==es""am0andad'essio"lona)
l
I
l
l
fl certif}cation
under penalties of perjury, l certify }hat:
1 . The number shown on }his form is my cotyect taxpayev iden}iiication number (or l am waiting jor a number to be issued to me), and
2. l am not subject (o backup withholding because: (a) I am exsmpt from backup withholding. or (b) I have not been no}ified by the Intsrnal Revenue
Service (lRSj tha} l am su61ect to backup wlthhokjing as a resu:t oj a failure to repork all inieresi or dividends. or (c) the IRS has no(ified me that I am
no Ionger sub%ct lo backup wIthholding, and
3. l am a u.s. cItizen or other u.s. person (defined below). and
4. The FATCA cods[s) entered on this form (if any) indlca}ing }hat l am exempt from FATCA reporting is correct.
Certlficatlon instructions. You must cyoss out item 2 above if you have been notified by the IRS tha} you are currently subiect to backup withholding
because you heive failed to report all in}erest and dividerids on your tax return. For real e'ita}e transactions, item 2 does not-apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation ol debI contribu}ions lo an individual vetireman( arrangement (ICIA). and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on paqe 3.
Sign
Here l
8ignature of
u.s. peraon k
General Instructions
Seckion yelerences ate ko (he ln(emal Revenue Code unless okherslse noked.
Future developments. The IRS has ctea{ed a paqe on lRS.gov lot imormation
about Foym W-9, al wwwlrs.govlw9. lnforma(ion ;iboul anyjukure developmenks
allec{lnq Fotm W-9 (such as legisla}ion enacted ajter we release R) will be pos}ed
on that page.
Purpose of Form
A person who is yequited lo lile an ir?lotma{iors return wIth }he IRS must ob(ain youy
coyyact {axpayey identijica}ion number [T IN) }o reporj. ior example. income paid to
you, paymen(s made to you in sel(lemen( of paymem card and (hird par{y nekwork
{lansac{iOn9. 1081 esmke Iransaclionsi morlgage inleresl 9011 paid. acquisiliOn 01
abandonmem ol secured pyopayty, cancellation ol deb}, or contributions you made
ko an IRA.
Use Foym W-9 only 11 you aye a u.s. psson llncluding a yesiden{ allen), to
pyovlde 4oul collecl TIN 10 lhe pelson requea}ing 11 (lha requester) and. when
applicable, lo:
S . Ceriily tha( the TIN you aye gMng is coyyoct {oy you ata waiilng (oy a number
to be issui).
2. Cer!lty }hai you are not sublect }o backuD wl}hholding. oy
3...Claim exemptIon lyom backup.wl}hholding if you aye a u.s. exempt payee. 11
applicable. you ayo also certl{yliig thai as a u.s. person, youy allocable share ol
any partnershIp income lyom a u.s. {tade oy business is no{ subiect to the
Ca(. No. I0231X
0aka k
wilhholdlng lax on loreign parlners' shale 01 e{fecliVely connecled Income. and
4. Ceyiily that FATCA codels) enlered on }his Ioym (ij any) indlca(ing tha} you ate
exempj lrom the FATCA repoffing, is coyyecl.
Note. 11 you are a u.s. peyson and a reques(er gives you a lorm o}her }han Form
W-9 to tequest your Tl?ll, you must use Ihe teieskey's lorm ?k it is subskam(ally
similar }o }his Form W-9.
Definition of a u.s. person. For lederal Iax purgoses. you aye oonsldered a u.s.
person il you are:
* An individual who Is a u.s. cnizen OI u.s. residen} alien,
* A par}nerghip, coipora}ion. com(>any, oy associa{ion creatad oy organized in the
Llnlied Sta}es'or under jhe Iaws or the Uni}ed Siates,
* An esia}e (other than a loteign esbkeJ, or
* A domestic {nisl las deiined in Regula}ions sction 301 .7701-7}.
Special rules lor partnershIps. Parknerships tha! cr>nduc} a lrade or business in
kt'le untied Siates aye generajly required }o pay a wi}hholding lax under section
1446 on any loreign parkneisa share oj elledivaly connected }axable Income lrom
such business. Fur}her. in certain casea where a Form W-9 has not been teceiverl,
the rules under section 1446 yequka a parinershlp (o pnasume khat a parhier is a
koyeklts person. and pay the section 1446 wi}hhoiding'tax. Theyelore. !l you are a
lJ.S. -person that is a par}nsi in a par}nership conduciliig a (rade ot bus!ness In }he
at is a par}nsi i
provIde Form 'W-9'io the paanershlp (o es}abllsh your u.s. $ta}us
Uni}ed States,
and avoid sed!on 1446 withholdiiig on your share 'ol par}ngshlp-Income.
Fom W19 lRev.-El-2013)
P-1 0
Nj????3.. 19:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2€ll9
Fair and Open Contract Contribution Prohibition Language
Required pursuant to N.J.S.A. 1 9:44A-8 or 1 9:44A-16
rownship of Barnegat
Political Contribution Disclosure. This contract has beeri awarded to
based on the merits and abilities of
Contractor Name
Contractor Name
provide the goods or services as described herein. This contract was not awarded
through a "fair and open process" pursuant to N.J.S.A. 1 9:44A-20.4 et seq. As
such, the undersigned does hereby attest that
it's
Contractor Name
subsidiaries, assigns or principals controlling in excess of 10% of the company has
neither made a contribution, that is repoitable pursuant to the Election Law
Enforcement Commission pursuant to N.J.S.A. 19:44A-8 or 19:44A-16, in the one (1 )
year period preceding the award of the contract that would, pursuant to P.L. 2004,
c.19, affect its eligibility to perform this contract, nor will it make a reportable
contribution during the term of the contract to any political party committee in the
Township of Barnegat/Ocean County, if a member of that political party is serving in
an elective public office of that Township of Barnegat/Ocean County when the
contract is awarded, or to any candidate committee of any person serving in an
elective public office of that Township of Barnegat/Ocean County when the contract
is awarded.
P-1 1
??N.J.S.A. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR FAIR AND OPEN CONTRACTS
Required Pursuant To N.J.S.A. 19:44A-20.8
TOWNSHIP OF BARNEGA T
Part I- Vendor Affirmation
The undersigned, being authorized and knowledgeable of the circumstances, does hereby certify that the
<name of business entity> has not made and will not
make any reportable contributions pursuant to N.J.S.A. 19:44A-1 et seq. that, pursuant to P.L. 2004, c. 19
would bar the award of this contract in the one year period preceding
(date
of award scheduled for approval of the contract by the governing body) to any of the following named
candidate committee, joint candidates committee; or political party committee representing the elected
officials of the TOWNSHIP OF BARNEGAT as defined pursuant to N.J.S.A. 1 9:44A-3(p), (q) and (r).
r
l
l
l
l
l
r
l
l
r
l
l
l
l
l
Part ll- Ownership Disclosure Certification
€al certify that the Iist below contains the names and home addresses of all owners holding 1 0% or more
of the issued and outstanding stock of the undersigned.€
Check the box that represents the type of business entity:
€Partnership €Corporation €€SoleProprietorship €SubchapterSCorporation
€Limited Partnership €Limited Liability Corporation €Limited Liability Partnership
Part 3 - Signature and Attestation:
The undersigned is fully aware that if l have misrepresented in whole or part this affirmation and
certification, I and/or the business entity, will be liable for any penalty permitted under Iaw.
Name of Business Entity:
Signature of Affiant:
Name of Affiant:
Title
Date
P-1 2
Name of Stock or Shareholder
Home Address
Subscribed and sworn before me this day of
,2 .
(Witnessed or attested by)
My Commission expires:
(Seal)
?.. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
BI ISINFSS ENTITY DISCLOSURE CERTIFICAT?ON
FOR FAIR AND OPEN CONTRACTS
Required Pursuant To N.J.S.A. 19:44A-20.8
TOWNSHIP OF BARNEGA T
The following is statutory text related to the terms and citations used in the Business Entity
Disclosure Certification form.
"Local Unit Pay-To-Play Law" (P.L. 2004, c.19, as amended by P.L. 2005, c.51)
19:44A-20.6 Certain contributions deemed as contributions by business entity.
s. When a business entity is a natural person, a contribution by that person's spouse or child, residing
therewith, shall be deemed to be a contribution by the business entity. When a business entity is other
than a natural person, a contribution by any person or other business entity having an interest therein shall
be deemed to be a contribution by the business entity.
19:44A-20.7 Definitions relative to certain campaign contributions.
6. As used in sections 2 through 12 of this act: "business entity" means any natural or Iegal person,
business corporation, professional services corporation, Iimited Iiability company, partnership, limited
partnership, business trust, association or any other Iegal commercial entity organized under the laws of
this State or of any other state or foreign jurisdiction: "interest" means the ownership or control of more
?han 10% of the prof!?s or assets of a business en}!}7 0r 10% of ?he s?ock in the case of a bus!ness entit7
that is a corporation for profit, as appropriate;
Temporary and Executing
12. Nothing contained in this act shall be construed as affecting the eligibility of any business entity to
perform a public contract because that entity made a contribution to any committee during the one-year
period immediately preceding the effective date of this act.
The New Jersey Campaign Contributions and Expenditures Reporting Act (N.J.S.A. 19:44A-1
et seq.)
19:44A-3 Definitions. In pertinent part...
p. The term "political party committee" means the State committee of a political party, as organized
pursuant to R.S.19:5-4, any county committee of a political party, as organized pursuant to R.S.19:5-3, or
any municipal committee of a political party, as organized pursuant to R.S.19:5-2.
q. The term "candidate committee" means a committee established pursuant to subsection a. of section 9
of P.L. 1973, c.83 (C. 1 9:44A-9) for the purpose of receiving contributions and making expenditures.
r. the term 'Ioint candidates committee" means a committee established pursuant to subsection a. of
section 9 of P.L.1973, c.83 (C.19:44A-9) by at Ieast two candidates for the same elective public offices in
the same election in a Iegislative district, county, municipality or school district, but not more candidates
than the total number of the same elective public offices to be filled in that election, for the purpose of
receiving contributions and making expenditures. For the purpose of this subsection: ...; the offices of
member of the board of chosen freeholders and county executive shall be deemed to be the same elective
public offices in a county; and the offices of mayor and member of the municipal governing body shall be
deemed to be the same elective public offices in a municipality.
19:44A-8 and 16 Contributions, expenditures, reports, requirements.
While the provisions of this section are too extensive to reprint here, the following is deemed to be the
pertinent part affecting amounts of contributions:
"The $300 limit established in this subsection shall remain as stated in this subsection without further
adjustment by the commission in the manner prescribed by section 22 of P.L. 1993, c.65 (C. 19:44A-7.2)
P-1 3
?N.J.S.A. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
C. 271 POL?TICAL CONTRIBUTION DISCLOSURE FORM
Contractor Instructions
Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a "fair and
open" process (defined at ?.. 19:44A-20.7) are subject to the provisions of P.L. 2005, c. 271, s.2 (?..
19:44A-20.26). This Iaw provides that 10 days prior to the award of such a contract, the contractor shall disclose
contributions to:
any State, county, or municipal committee of a political party
any Iegislative Ieadership committee"
any continuing political committee (a.k.a., political action committee)
any candidate committee of a candidate for, or holder of, an elective office:
o
of the public entity awarding the contract
o
of that county in which that public entity is Iocated
o
of another public entity within that county
o
or of a Iegislative district in which that public entity is Iocated or, when the public entity is
a county, of any Iegislative district which includes all or part of the county
The disclosure must Iist reportable contributions to any of the committees that exceed $300 per election cycle that
were made during the 12 months prior to award of the contract. See ?.. 19:44A-8 and 19:44A-16 for more
details on reportable contributions.
*
*
*
?.. 1 9:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not
a natural person. This includes the following:
*
individuals with an "interest" ownership or control of more than 10% of the profits or assets of a business
entity or 1 0% of the stock in the case of a business entity that is a corporation for profit
all principals, partners, officers, or directors of the business entity or their spouses
any subsidiaries directly or indirectly controlled by the business entity
IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business
entity and filing as continuing political committees, (PACs).
When the business entity is a natural person, "a contribution by that person's spouse or child, residing therewith,
shall be deemed to be a contribution by the business entity." [?.. 19:44A-20.26(b)] The contributor must be
Iisted on the disclosure.
@
@
*
Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in
an amount to be determined by the Commission which may be based upon the amount that the business entity failed
to report.
The enclosed Iist of agencies is provided to assist the contractor in identifying those public agencies whose elected
official and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor's
responsibility to identify the specific committees to which contributions may have been made and need to be
disclosed. The disclosed information may exceed the minimum requirement.
The enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along with
a signed cover sheet) may be used as the contractor's submission and is disclosable to the public under the Open
Public Records Act.
The contractor must also complete the attached Stockholder Disclosure Certification. This will assist the agency in
meeting its obligations under the Iaw. NOTE: This section does not apply to Board of Education contracts.
" ?.. 19:44A-3(s): "The term "legislative leadership committee" means a committee established, authorized to
be established, or designated by the President of the Senate, the Minority Leader of the Senate, the Speaker of the
General Assembly or the Minority Leader of the General Assembly pursuant to section 16 of P.L.1993, c.65
(C.1 9:44A-1 0.1 ) for the purpose of receiving contributions and making expenditures."
P-14
LLUA.. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
C. 271 POLIT?CAL CONTRIBUT?ON DISCLOSURE FORM
Required Pursuant To N.J.S.A. 19:44A-20.26
TOWNSHIP OF BARNEGAT
Part l- Vendor Information
Qndor Name: i
l
The undersigned being authorized to certify, hereby certifies that the submission provided herein represents
compliance with the provisions of N.J.S.A. 1 9:44A-20.26 and as represented by the Instructions accompanying
this form.
Signature
Printed Name
Title
Part ll- Con'4-w:}
4:
mlllJlllllmlon Disclosure
€ Check here if disclosure is provided in electronic form.
g Check here if the information is continued on subsequent page(s)
P-15
This form or its permitted facsimile must be submitted to the Iocal unit
no later than 10 days prior to the award of the contract.
Address: i
City: i i State: i Zip:
Disclosure requirement: Pursuant to .. 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 committees of the government entities listed on the form provided by the Iocal unit.
Contributor Name
Recipient Name
Date
Dollar Amount
$
N??.. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
Continuation Page
C. 271 POLITICAL CONTR?BUTION DISCLOSURE FORM
Required Pursuant To N.J.S.A. 19:44A-20.26
TOWNSHIP OF BARNEGAT
Page of
Vendor Name:
g Check here if the information is continued on subsequent page(s)
P-1 6
Contributor Name
Recipient Name
Date
Dollar Amount
$
N??.. 19:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
List of Agencies with Elected Officials Required for Political Contribution Disclosure
N.J.S.A. 19:44A-20.26
County Name: Ocean
State: Governor, and Legislative Leadership Committees
Legislative District #s: 9, 10, & 30
State Senator and two members of the General Assembly per district.
County:
Freeholders
County Clerk
Sheriff
Surrogate
Municipalities (Mayor and members of governing body, regardless of title):
Barnegat Light Borough
Barnegat Township
Bay Head Borough
Beach Hamn Borough
Beachwood Borough
Berkeley Township
Brick Township
Dover Township
Eagleswood Township
Harvey Cedars Borough
Island Heights Borough
Jackson Township
Lacey Township
Lakehurst Borough
Lakewood Township
Lavallette Borough
Little Egg Harbor Township
Long Beach Township
Manchester Township
Mantoloking Borough
Ocean Gate Borough
Ocean Township
Pine Beach Borough
Plumsted Township
Point Pleasant Beach Borough
Point Pleasant Borough
Seaside Heights Borough
Seaside Park Borough
Ship Bottom Borough
South Toms River Borough
Stafford Township
Surf City Borough
Tuckerton Borough
Boards of Education (Members of the Board):
Barnegat Township
Bay Head Borough
Beach Haven Borough
Berkeley Township
Brick Township
Central Regional
Eagleswood Township
Island Heights Borough
Jackson Township
Lacey Township
Lakehurst Borough
Lakewood Township
Lavallette Borough
Little Egg Harbor Township
Long Beach Island
Manchester Township
Mantoloking
Ocean Gate Borough
Ocean Township
Pinelands Regional
Plumsted Township
Point Pleasant Beach Borough
Point Pleasant Borough
Seaside Heights Borough
Seaside Park Borough
Southern Regional
Stafford Township
Toms River Regional
Tuckerton Borough
Fire Districts (Board of Fire Commissioners):
Brick Township Fire District No. 1
Brick Township Fire District No. 2
Brick Township Fire District No. 3
Dover Township Fire District No. 1
Dover Township Fire District No. 2
Jackson Township Fire District No. 1
Jackson Township Fire Distri6t No. 2
Jackson Township Fire District No. 3
Jackson Township Fire District No. 4
Lakewood Township Fire District No. 1
Little Egg Harbor Township. Fire District No. 1
Little Egg Harbor Township Fire District No. 2
Plumsted Township Fire District No. 1
P-1 7
N??.. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
STOCKHOLDER DISCLOSURE CERTIFICATION
This Statement Shall Be Included with Bid Submission
Legal Name of Bidder:
List the names and addresses of all stockholders who own ten (1 0%) percent or more of the above company's stock, and if
there are NO STOCKHOLDERS OF 10% OR MORE, simply check the second box below. If one or more such
stockholders or partner is itself a corporation or partnership, the stockholders holding 1 0% or more of that corporation's stock,
or the individual partners owning 1 0% of that corporation's stock, or the individual partners owning 1 0% or greater interest in
that partnership, as the case may be, must also be listed.
The disclosure shall be continued until names and addresses of every person who is a non-corporate stockholder,
or individual partner, exceeding the 10% ownership criteria established in this act, has been Iisted, in full
compliance with Chapter 33 of the New Jersey Public Laws of 1977.
Please check only one:
€ I certify that the list below contains the names and addresses of all stockholders holding 10%
or more of the issued and outstanding stock of the undersigned.
OR
a
l certify that no one stockholder owns 1 0% or more of the issued and outstanding stock of the
undersigned.
Publicly Traded - For publicly traded entities to comply with N.J.S.A. 52:25-24.2 they may submit the name and address of
each publicly traded entity, and the name and address of each person holding 1 0% or more beneficial interest in the publicly
traded entity as of the Iast the last annual filling with the Security Exchange Commission (SEC), or foreign equivalent
Submit here the Website (URL) providing the Iast annual Security Exchange Commission (SEC) filing, or foreign equivalent:
The requested information is available on the following page number(s) of the SEC, or foreign equivalent, filing:
Check the box that represents the type of business organization:
€Partnership
€Limited Partnership
€Limited Liability Partnership
€Corporation
€Limited Liability Company
€Subchapter S Corporation
€Sole Proprietorship
P-18
?N.J.S.A. 19:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
Sign and notarize the form below, and, if necessary, complete the stockholder Iist below.
Stockholders:
(Note: Attach additional pages if necessary)
Subscribed and sworn before me this day of
,2 .
(Notary Public)
My Commission expires:
(Affiant)
(Print name & title of affiant)
(Corporate Seal)
P-1 g
Stockholder Name:
Address:
Percentage of Ownership: %
Stockholder Name::
Address:
Percentage of Ownership: %
Stockholder Name::
Address:
Percentage of Ownership: %
Stockholder Name::
Address:
Percentage of Ownership: %
Stockholder Name:
Address:
Percentage of Ownership: %
Stockholder Name::
Address:
Percentage of Ownership: %
?N.J.S.A. 1 9:44A-20.4, et seq., - Barnegat Township -not to exceed $39,999.99 for Calendar Year 2019
TOWNSHIP OF BARNEGAT
Reporting to the Office of the State Comptroller
Office of the NJ State Comptroller (OSC): N.J.S.A. 52:15C-10 requires contracts
exceeding $2,000,000 but below $10,000,000 to be reported to the OSC within twenty
(20) days after award, and that proposed contracts exceeding $10,000,000 must be
approved by the OSC prior to awarding the contract. Contracts awarded under a
national cooperative agreement are subject to these requirements. In addition, the
OSC may audit or review contracts of any amount or type and may audit or review the
records of the vendor as well.
OSC has adopted a regulation, N.J.A.C. 1 7:44-2.2, which requires contracting units to
insert the following language into all contracts:
"The vendor shall maintain all documentation related to products, transactions or
services under this contract for a period of five (5) years from the date of final
payment. Such records shall be made available to the New Jersey Office of the State
Comptroller upon request."
Signed this
day of
(Bidder)
By
Signature of Authorized Individual,
Partner or Officer Signing the Proposal
Print Name:
Title:
Date:
P-20
--- Document: Non Fair and Open contract forms ---
PLEASE EXECUTE THIS FORM AND SUBMIT WITH THE BID PACKAGE
BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR NON-FAIR AND OPEN CONTRACT (N.J.S.A. 19:44A-20-8)
NAME OF BUSINESS:
VENDOR AFFIRMATION: The undersigned, being authorized and knowledgeable of the
circumstances, does hereby certify that <Name of Business> has not made and will not make any
reportable contributions pursuant to N.J.S.A. 19:44A-1 et seq. that, pursuant to P.L. 2004,
c.19 would bar the award of this contract in the one year period preceding (date of award scheduled for
approval of the contract by Barnegat Township) to any of the following named candidate committee, joint
committee; of political party committee representing the elected officials of the <name of entity of
elected officials> as defined pursuant to N.J.S.A. 19:44A-3(p), (q) and (r).
OWNERSHIP DISCLOSURE CERTIFICATION:
I certify that the list below contains the names and home addresses of all stockholders
holding 10% or more of the issued and outstanding stock of the undersigned.
Check the box that represents the type of business organization:
Partnership
Corporation
Sole Proprietorship
Limited Partnership
Subchapter S Corporation
Limited Liability Corporation
Limited Liability Partnership
Name of Stock or Stockholder
Home Address
SIGNATURE AND ATTESTATION:
The undersigned is fully aware that if I have misrepresented in whole or part of this
affirmation and certification, I and/or the business entity, will be liable for any penalty
permitted under law.
Name of Business Entity:
Signed:
Title:
Print Name:
Date:
Subscribed and sworn before me this
day
(Affiant)
of
20
(Print Name & Title)
My Commission expires:
(Corporate Seal)
1
CHAPTER 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Require Pursuant to N.J.S.A. 19:44A-20.26
This form or its permitted facsimile must be submitted to Barnegat Township
no later than 10 days prior to the award of the contract. Required in addition to the
Business Entity Disclosure Certification
Part I - Vendor Information
Vendor Name:
Address:
City:
State:
Zip:
The undersigned being authorized to certify, hereby certifies that the submission provided
herein represents compliance with the provisions of N.J.S.A. 19:44A-20.26 and as represented
by the Instructions accompanying this form.
Signature
Printed Name
Title
Part II - 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 committees of the government entities listed on the form provided by
Barnegat Township.
Check here if disclosure is provided in electronic form.
Contributor Name
Recipient Name
Date $ Amount
Check here if the information is continued on subsequent pages(s).
Agencies with Elected Officials Required for Political Contribution Disclosure
County Name:
N.J.S.A. 19:44A-20.26
State: Governor and Legislative Leadership Committees
Legislative District #(s):
State Senator and two members of the General Assembly per district
County:
Freeholders
{County Executive}
County Clerk
Surrogate
Sheriff
Municipalities (Mayor and members of governing body, regardless of title)
2
THE TOWNSHIP OF BARNEGAT
900 WEST BAY AVENUE
BARNEGAT, NJ 08005
RIGHT TO EXTEND - TIME FOR AWARD
The Township of Barnegat is required by The Local Public Contracts Law, N.J.S.A. 40A:11-24,
to make an award on products or services within sixty (60) days of the bid opening date.
Should the Township of Barnegat require an additional thirty (30) days extension to make an
award of this bid, by signing this document you shall grant the Township of Barnegat the right
to extend this award up to ninety (90) days, if deemed necessary.
SIGNED:
TITLE:
COMPANY:
DATE:
(Signature)
(Print or Type)
TYPE OF PRODUCT OR SERVICE OFFERED:
3
PLEASE EXECUTE THIS FORM AND SUBMIT WITH THE BID PACKAGE
STOCKHOLDER DISCLOSURE STATEMENT
Name of Business:
I certify that the list below contains the names and home addresses of all stockholders
holding 10% or more of the issued and outstanding stock of the undersigned.
OR
I certify that no one stockholder owns 10% or more of the issued and outstanding stock
of the undersigned.
Check the box that represents the type of business organization:
Partnership
Corporation
Sole Proprietorship
Subchapter S Corporation
Limited Partnership
Limited Liability Corporation
Limited Liability Partnership
Sign and notarize the form below, and, if necessary, complete the stockholder list below.
STOCKHOLDERS:
Name:
Address:
Name:
Address:
Name:
Address:
Name:
Address:
Name:
Address:
Subscribed and sworn before me this
of
(Notary Public)
20
My Commission expires:
day
Name:
Address:
(Affiant)
(Print Name & Title)
(Corporate Seal)
4
PLEASE EXECUTE THIS FORM AND SUBMIT WITH THE BID PACKAGE
NON-COLLUSION AFFIDAVIT
STATE OF
COUNTY OF
1,
(Partnership, Corporation, Individual, LLC)
In the County of
of
and the State of
of full age, being duly sworn according to law on my oath depose and say that:
I am
of the firm of
the
bidder making the Proposal for the above named project, and that I executed the said Proposal
with full authority so to do; that said bidder has not, directly or indirectly, entered into any
agreement, participated in any collusion or otherwise taken any action in restraint of free,
competitive bidding in connection with the above named project; and that all statements
contained in connection with the above named project; and that all statements contained in
said Proposal and in this Affidavit are true and correct and made with full knowledge that the
State of New Jersey relies upon the truth of the statements contained in said Proposal and in
the statements contained in this affidavit in awarding the contract for the said project.
I further warrant that no person or selling agency has been employed or retained to solicit or
secure such contract upon an agreement or understanding for a commission, percentage,
brokerage or contingent fee, except bona fide employees or bona fide established commercial
or selling agencies maintained by
(N.J.S.A. 52:34-15)
Signature of Contractor_
Subscribed and Sworn to
(Name of Contractor)
Before me this
(Signature)
(Please Print Name)
day of
20
Subscribed and sworn before me this
(Notary Public)
My Commission expires:
20
day of
5
PLEASE EXECUTE THIS FORM AND SUBMIT WITH THE BID PACKAGE
N.J.S.A. 10:5-31 and N.J.A.C. 17:27
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE
Goods, Professional Services and General Service Contracts
(Mandatory Affirmative Action Language)
During the performance of this contract, the Contractor agrees as follows:
The Contractor or Sub-Contractor, where applicable, will not discriminate against any
employee or applicant for employment because of age, race, creed, color, national origin,
ancestry, marital status, affectional or sexual orientation, gender identity or expression,
disability, nationality or sex. Except with respect to affectional or sexual orientation and gender
identity or expression, the Contractor will 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, gender identity or expression, disability, nationality or sex. Such action shall
include, but not limited to the following: employment, upgrading, demotion, or transfer;
recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of
compensation; and selection for training, including apprenticeship.
The Contractor agrees to post in conspicuous places, available to employees and applicants
for employment, notices to be provided by the Public Agency Compliance Officer setting forth
provisions of this nondiscrimination clause.
The Contractor or Sub-Contractor, where applicable will, in all solicitations or advertisements
for employees placed by or on behalf of the Contractor, state that all qualified applicants will
receive consideration for employment without regard to age, race, creed, color, national origin,
ancestry, marital status, affectional or sexual orientation, gender identity or expression,
disability, nationality or sex. The Contractor or Sub-Contractor, 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 or Sub-Contractor where applicable, agrees to comply with any regulations
promulgated by the Treasurer pursuant to N.J.S.A. 10:5-31 et seq. as amended and
supplemented from time to time and the Americans with Disabilities Act.
The Contractor or Sub-Contractor agrees to make good faith efforts to employ minority and
women workers consistent with the applicable county employment goals established in
accordance with N.J.A.C. 17:27-5.2, or a binding determination of the applicable county
employment goals determined by the Division, pursuant to N.J.A.C. 17:27-5.2.
The Contractor or Sub-Contractor 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 of age, creed, color,
national origin, ancestry, marital status, affectional or sexual orientation, gender identity or
expression, disability, nationality or sex, and that it will discontinue the use of any recruitment
agency which engages in direct or indirect discriminatory practices.
6
The Contractor or Sub-Contractor agrees to revise any of its testing procedures, if necessary,
to assure that all personal testing conforms to 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.
In conforming with the applicable employment goals, the Contractor or Sub-Contractor agrees
to review all procedures relating to transfer, upgrading, downgrading and layoff to ensure that
all such actions are taken without regard to age, creed, color, national origin, ancestry, marital
status, affectional or sexual orientation, gender identity or expression, disability, nationality or
sex, consistent with the statutes and court decisions of the State of New Jersey, and
applicable Federal law and applicable Federal court decisions.
N.J.S.A. 10:5-31 and N.J.A.C. 17:27
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 Sub-Contractor 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.
Submitted by:
(Name of Firm)
Name:
Signature:
Title:
(Please Type or Print)
Date:
7
PLEASE EXECUTE THIS REQUIRED FORM AND SUBMIT WITH BID PACKAGE
NOTICE TO BIDDERS
Re:
Affirmative Action Regulations P. L. 1975, С. 127
Procurement and Service Contractors
"Affirmative Action" rules N.J.A.C. 17:27-1 et seq.
"Bidders are required to comply with the requirements of N.J.S.A. 10:5-31 et seq. and
N.J.A.C. 17:27".
CONTRACTORS/VENDORS
A.
1.
B.
Contractors and/or vendors will submit with the signed proposal Affirmative
Action evidence. The affirmative Action evidence shall be in one of the following
forms.
a. An existing federally approved or sanctioned affirmative action program.
b.
c.
A Certificate of Employee Information Report from the Treasurer Office of
the State of New Jersey.
If the Contractor/Vendor cannot present "a" or "b" - the Contractor/Vendor
is required to submit a completed Employee Information Report (Form AA-
302). This form will be made available to Contractor/Vendor by the
Township of Barnegat within seven (7) days after notification of intent to
award the contract or receipt of the contract, whichever is sooner.
THE FOLLOWING QUESTIONS MUST BE ANSWERED BY ALL PROSPECTIVE
BIDDERS:
1.
Do you have a Federally approved or sanctioned Affirmative Action Program?
YES
NO
NO
2.
Do you have a State Certificate of Employee Information Report Approval?
YES
a.
If yes, please submit a photocopy of such Certificate of Employee
Information Report with this proposal.
The undersigned Contractor certifies that he/she is aware of the commitment to comply with
the requirements of P.L. 1975, C. 127, N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27-1 et seq.
and agrees to furnish the required documentation pursuant to the law.
CONTRACTOR/VENDOR:
NOTE:
(Signature)
(Title)
A Contractor's bid shall be rejected as non-responsive, if a Contractor fails
to comply with the above requirements.
8
THE TOWNSHIP OF BARNEGAT
900 WEST BAY AVENUE
BARNEGAT, NJ 08005
ACKNOWLEDGEMENT OF RECEIPT OF ADDENDA
The undersigned Bidder does hereby acknowledge the receipt of the following Addenda issued
by the Township of Barnegat:
Addendum Number
Dated
Acknowledgement Receipt (initial)
Addenda were received:
Acknowledgement for:
(Name of Bidder)
By:
(Signature of Authorized Representative)
Name:
Title:
Date:
(Print or Type)
9
THE TOWNSHIP OF BARNEGAT
900 WEST BAY AVENUE
BARNEGAT, NJ 08005
BIDDER'S CHECKLIST
The following checklist is provided for each bidder to check off documents submitted with their
bid:
Bid Deposit in the form of a Certified Check, Cashier's Check,
Treasurer's Check or Bid Bond
Certificate from a Surety Company stating if the bid is accepted,
they will provide the required Performance Bond
Stockholders Disclosure Statement properly notarized listing stockholders
or partners owning ten percent (10%) or more of corporation or
partnership stock. (Required)
Political Contribution Disclosure Form
Business Entity Disclosure Certification (For Non-Fair & Open Contracts)
Non-Collusion Affidavit properly notarized (Required)
New Jersey Business Registration Certificate (BRC) (Required)
Affirmative Action Evidence (Required)
W-9 Form
Deviations from specifications, if applicable
Acknowledgement of Receipt of Addenda
Authorized signatures on all forms
10
THE TOWNSHIP OF BARNEGAT
900 WEST BAY AVENUE
BARNEGAT, NJ 08005
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
PART 1: CERTIFICATION
BIDDERS MUST COMPLETE PART 1 BY CHECKING EITHER BOX.
FAILURE TO CHECK ONE OF THE BOXES WILL RENDER THE PROPOSAL NON-
RESPONSIVE.
Pursuant to Public Law 2012, c. 25, any person or entity that submits a bid or proposal or
otherwise proposes to enter into or renew a contract must complete the certification below to
attest, under penalty of perjury, that neither the person or entity, nor any of its parents,
subsidiaries, or affiliates, is identified on the Department of Treasury's Chapter 25 list as a
person or entity engaging in investment activities in Iran. The Chapter 25 list is found on the
State of New Jersey, Department of Treasury, Division of Purchase and Property website at:
http://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf. Bidders must review this list
prior to completing the below certification. Failure to complete the certification will render a
bidder's bid proposal non-responsive. If the Township of Barnegat determines that a person or
entity has submitted a false certification concerning its engagement in investment activities in
Iran pursuant to section 4 of P.L.2012, c.25 (C.52:32-58), the local contracting unit shall report
to the New Jersey Attorney General the name of that person or entity, and the Attorney
General shall determine whether to bring a civil action against the person to collect the penalty
prescribed in paragraph (1) of subsection a. of section 5 of P.L.2012, c.25 (C52:32-59). The
Township of Barnegat may also report to the municipal attorney or county counsel, as
appropriate, the name of that person, together with its information as to the false certification,
and the municipal attorney or county counsel, as appropriate, may determine to bring such civil
action against the person to collect such penalty.
PLEASE CHECK THE APPROPRIATE BOX:
OR
I certify, pursuant to Public Law 2012, c.25 that neither the bidder listed above nor any
of the bidder's parents, subsidiaries, or affiliates is listed on the New Jersey Department
of the Treasury's list of entities determined to be engaged in prohibited activities in Iran
pursuant to P.L.2012, с.25 ("Chapter 25 List"). I further certify that I am the person listed
above, or I am an officer or representative of the entity listed above and am authorized
to make this certification on its behalf. I will skip to Part 2 and sign and complete the
Certification below.
I am unable to certify as above because the bidder and/or one or more of its parents,
subsidiaries, or affiliates is listed on the Department's Chapter 25 list. I will provide a
detailed, accurate and precise description of the activities in Part 2 below and sign and
complete the Certification below. Failure to provide such will result in the proposal being
rendered non-responsive and appropriate penalties, fines and/or sanctions will be
assessed as provided by law.
11
PART 2: PLEASE PROVIDE FURTHER INFORMATION REALTED TO INVESTMENT
ACTIVITIES IN IRAN
You must provide a detailed, accurate and precise description of the activities of the bidding
person/entity, or one of its parents, subsidiaries or affiliates, engaging in the investment
activities in Iran outlined above by completing the following information:
PROVIDE INFORMATION RELATIVE TO THE ABOVE QUESTIONS. PLEASE PROVIDE
THOROUGH ANSWERS TO EACH QUESTION. IF YOU NEED TO MAKE ADDITIONAL
ENTRIES, ATTACH ADDITIONAL PAGES.
Name:
Description of Activities:
Duration of Engagement:
Anticipated Cessation Date:
Relationship to Bidder/Offeror:
Bidder/Offeror Contact Name:
Contact #:
12
THE TOWNSHIP OF BARNEGAT
900 WEST BAY AVENUE
BARNEGAT, NJ 08005
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
CERTIFICATION:
1,
being duly sworn upon my oath, hereby represent and state
that the foregoing information and any attachments thereto to the best of knowledge are true
and complete. I attest that I am authorized to execute this certification on behalf of the above-
referenced person or entity. I acknowledge that the Township of Barnegat is relying on the
information contained herein and thereby acknowledge that I am under a continuing obligation
from the date of this certification through the completion of any contracts with the Township of
Barnegat to notify the Township of Barnegat in writing of any changes to the answers of
information contained herein. I acknowledge that I am aware that it is a criminal offense to
make a false statement or misrepresentation in this certificate, and if I do so I recognize that I
am subject to criminal prosecution under the law and that it will also constitute a material
breach of my agreements(s) with the Township of Barnegat and that the Township of Barnegat
at its option may declare any contract(s) resulting from this certification void and
unenforceable.
I, being duly sworn upon my oath, hereby represent and state that the foregoing information
and any attachments thereto to the best of knowledge are true and complete. I attest that I am
authorized to execute this certification on behalf of the above-referenced person or entity.
Bidder:
Date:
(Signature)
(Print Name)
(Title)
13
ENTITIES DETERMINED TO BE ENGAGED IN PROHIBITED ACTIVITIES IN IRAN
PURSUANT TO P.L. 2012, С.25 (“CHAPTER 25")
LIST DATED AS OF FEBRUARY 5, 2016
1.
Bank of Markazi Iran (Central Bank of Iran)
2.
Bank Mellat
3.
Bank Melli Iran
4.
Bank Tejarat
5.
National Iranian Tanker Company (NITC)
6.
Amona
7.
Bank Saderat PLC
8.
Bank Sepah
9.
Belaz
10.
Belneftkhim (Belarusneft)
11.
12.
China International United Petroleum & Chemicals Co., Ltd. (Unipec)
China National Offshore Oil Corporation (CNOOC)
13. China National Petroleum Corporation (CNPC)
14.
China National United Oil Corporation (ChinaOil)
15. China Petroleum & Chemical Corporation (Sinopec)
16.
China Precision Machinery Import-Export Corporation (CPMIEC)
17.
18.
19.
20.
Grimley Smith Associates
Indian Oil Corporation
Kingdream PLC
Maire Tecnimont SpA
21.
Naftiran Intratrade Company (NICO)
22.
Oil and Natural Gas Corporation (ONGC)
23.
Oil India Limited
24.
Persia International Bank
25.
PetroChina Company, Ltd.
26.
Petroleos de Venezuela (PDVSA Petróleo, SA)
27.
Sameh Afzar Tajak Co. (SATCO)
28.
Shandong FIN CNC Machine Company, Ltd.
29.
Sinohydro
30.
SK Energy
31.
SKS Ventures
32.
Som Petrol AS
33.
Zhuhai Zhenrong Company
14
AGENCIES IN OCEAN COUNTY NEW JERSEY WITH ELECTED OFFICIALS
REQUIRED FOR POLITICAL CONTRIBUTION DISCLOSURE
N.J.S.A. 19:44A-20.26
COUNTY NAME: OCEAN COUNTY
STATE: Governor and Legislative Leadership Committee
Legislative District #s: 9, 10 & 30
State Senator and two members of the General Assembly per district
County:
Freeholders
County Clerk Sheriff
Surrogate
Municipalities (Mayor and members of the governing body, regardless of title):
Barnegat Light Borough
Jackson Township
Lacey Township
Lakehurst Borough
Lakewood Township
Lavallette Borough
Barnegat Township
Bay Head Borough
Beach Haven Borough
Beachwood Borough
Berkeley Township
Brick Township
Dover Township
Eagleswood Township
Harvey Cedars Borough
Island Heights Borough
Little Egg Harbor Township
Long Beach Island Township
Manchester Township
Mantoloking Borough
Ocean Gate Borough
Ocean Township
Boards of Education (Members of the Board):
Barnegat Township
Bay Head Borough
Beach Haven Borough
Berkeley Township
Brick Township
Central Regional
Eagleswood Township
Island Heights Borough
Jackson Township
Lacey Township
Lakehurst Borough
Lakewood Township
Lavallette Borough
Little Egg Harbor Township
Long Beach Township
Manchester Township
Mantoloking Borough
Ocean Gate Borough
Ocean Township
Pinelands Regional
Fire Districts (Board of Fire Commissioners):
Brick Township Fire District No. 1
Brick Township Fire District No. 2
Brick Township Fire District No. 3
Dover Township Fire District No. 1
Dover Township Fire District No. 2
Jackson Township Fire District No. 1
Jackson Township Fire District No. 2
Pine Beach Borough
Plumsted Township
Point Pleasant Beach Borough
Point Pleasant Borough
Seaside Heights Borough
Seaside Park Borough
Ship Bottom Borough
South Toms River Borough
Stafford Township
Surf City Borough
Tuckerton Borough
Plumsted Township
Point Pleasant Beach Borough
Point Pleasant Borough
Seaside Heights Borough
Seaside Park Borough
Southern Regional
Stafford Township
Toms River Regional
Tuckerton Borough
Jackson Township Fire District No. 3
Jackson Township Fire District No. 4
Lakewood Township Fire District No. 1
Little Egg Harbor Township Fire District No. 1
Little Egg Harbor Township Fire District No. 2
Little Egg Harbor Township Fire District No. 3
Plumsted Township Fire District No. 1
15
--- Document: Specs for total of three (3) Chevy Tahoes ---
NOTICE IS HEREBY GIVEN that sealed bids will be received by the
Township of Barnegat, County of Ocean, State of New Jersey, for the following
contract: 2 QTY of 2026 CHEVROLET TAНОЕ PPV (9C1) 4WD SUVS.
1 QTY of 2026 CHEVROLET TAHOE SSV 4WD SUV.
REQUEST OF BIDS
Bids shall be submitted to the Office of the Municipal Clerk, 900 West Bay Avenue,
Barnegat, New Jersey 08005. Each bid shall be contained in a sealed envelope and
shall have a written statement on the face of said enveloped.
All bids must be addressed to:
Donna M. Manno, RMC
Office of the Municipal Clerk
900 West Bay Avenue
Barnegat, New Jersey 08005
All proposals must be received no later than 10:00 a.m. on May 15, 2026.
QTY 2-2026 CHEVROLET TAHOE PPV (9C1) 4WD SUVS
QTY 1-2026 CHEVROLET TAHOE SSV 4WD SUV
PPV Standard equipment per specifications
Exterior color-Black
5.3L V8 engine (355hp/383 lb.-ft of torque)
10-speed automatic transmission with dash-mounted gear selector
4WD Autotrac with Terrain Mode
20-inch Firestone Firehawk Pursuit tires with heavy-duty steel wheels
900 cold-cranking amps primary battery
760 cold-cranking amps auxiliary battery with 70-amp hour rating
1,600-lbs max. payload
6,000-lbs max. trailering capacity
Heavy-duty police-rated brake system with front Brembo calipers on 16 inch
rotors
Heavy-duty police rated suspension
High-output 250-amp alternator and 100-amp rear power supply
Hill start assist
Independent rear suspension
Skid plate, front
StabiliTrak Electronic Stability Control System with Proactive Roll
Avoidance and Traction control
HD Rear Vision Camera (8-inch diagonal display)
OnStar-embedded hardware, includes 3 month trial of Safety & Security and
3-month trial of Driver Remote Access
Rear Park Assist
4G LTE Wi-Fi Hotspot capable, includes 1-month trial or 3GB of $G LTE
data (whichever comes first)
10 Way police-specific power driver seat
40/20/40 three-passenger split-folding front bench seat with center fold-
down armrest.
60/40 split-folding rear bench seat, manual
120-volt power outlet (2)
Apple Car Play and Android Auto capable, wireless
Black rubberized-vinyl floor covering
Bluetooth wireless technology for select phones
Chevrolet Infotainment System with 8-inch diagonal color touch screen
Class IV trailering receiver
Keyless Open and Start with Remote Keyless Entry
Matching full-size underbody spare tire with programmable Tire Pressure
Monitor
Protected Idle
Rear air conditioning, driver-controlled
Steering wheel switches for emergency equipment
Surveillance mode interior and exterior lighting calibrations
USB charging-only ports (2) on dash.
3 years/36,000 miles Bumper to Bumper warranty
5 years/100,000 miles powertrain limited warranty
Optional equipment by RPO code
GBA Exterior color-Black
AMF Remote Keyless Entry Package
AU7 Key, Common
BTV Remote Start
DRZ Rear Camera Mirror
7X3 Spot lamp, left-hand
6E2 Fleet Key Calibration
5J1 Calibration, keyless remote panic button and exterior lights/horn
disable
9G8 Headlamps, Daytime Running Lamps and automatic headlamp control
delete
V76 Recovery hooks, 2front, frame-mounted
Page 2
SSV Standard equipment per specifications
Exterior color-Dark Ash Metallic
5.3L V8 engine (355hp/383 lb.-ft of torque)
10-speed automatic transmission with dash-mounted gear selector
4WD Autotrac with Terrain Mode
20-inch Firestone Firehawk Pursuit tires with heavy-duty steel wheels
900 cold-cranking amps primary battery
760 cold-cranking amps auxiliary battery with 70-amp hour rating
1,600-lbs max. payload
6,000-lbs max. trailering capacity
Heavy-duty police-rated brake system with front Brembo calipers on 16 inch
rotors
Heavy-duty police rated suspension
High-output 250-amp alternator and 100-amp rear power supply
Hill start assist
Independent rear suspension
Skid plate, front
StabiliTrak Electronic Stability Control System with Proactive Roll
Avoidance and Traction control
HD Rear Vision Camera (8-inch diagonal display)
OnStar-embedded hardware, includes 3 month trial of Safety & Security and
3-month trial of Driver Remote Access
Rear Park Assist
4G LTE Wi-Fi Hotspot capable, includes 1-month trial or 3GB of $G LTE
data (whichever comes first)
10 Way police-specific power driver seat
40/20/40 three-passenger split-folding front bench seat with center fold-
down armrest.
60/40 split-folding rear bench seat, manual
120-volt power outlet (2)
Apple Car Play and Android Auto capable, wireless
Black rubberized-vinyl floor covering
Bluetooth wireless technology for select phones
Chevrolet Infotainment System with 8-inch diagonal color touch screen
Class IV trailering receiver
Keyless Open and Start with Remote Keyless Entry
Matching full-size underbody spare tire with programmable Tire Pressure
Monitor
Protected Idle
Rear air conditioning, driver-controlled
Page 3
Steering wheel switches for emergency equipment
Surveillance mode interior and exterior lighting calibrations
USB charging-only ports (2) on dash.
3 years/36,000 miles Bumper to Bumper warranty
5 years/100,000 miles powertrain limited warranty
Optional equipment by RPO code
GBA Exterior color-
AMF Remote Keyless Entry Package
AU7 Key, Common
BTV Remote Start
DRZ Rear Camera Mirror
7X3 Spot lamp, left-hand
6E2 Fleet Key Calibration
5J1 Calibration, keyless remote panic button and exterior lights/horn
disable
9G8 Headlamps, Daytime Running Lamps and automatic headlamp control
delete
V76 Recovery hooks, 2front, frame-mounted
Page 4
--- Document: 2025 FORD RANGER XLT CREW ADVERTISEMENT ---
WATER & SEWER UTILITIES
900 WEST BAY AVENUE
BARNEGAT, NEW JERSEY 08005-1298
Township of Barnegat
COUNTY OF OCEAN
1846
BAR
NEGAT TOWNSHIP
OFFICES: (609) 698-6185
FAX #: (609) 698-6223
Visit Our Website: www.barnegatwatersewer.com
COMPETITIVE PRICE QUOTE FOR BARNEGAT TOWNSHIP FOR:
2025 FORD RANGER XLT CREW CAB 4X4
STANDARD EQUIPMENT:
2.3 LITER ECOBOOST ENGINE WITH AUTO START-STOP TECHNOLOGY
10 SPPED AUTO TRANSMISSION
P255/70R16" A/S BSW
FULL SIZE SPARE TIRE
6' BED
ELECTRONIC ON THE FLY 4X4
ABS BRAKING
TIRE PRESSURE MONITORING SYSTEM Power Windows Front Doors, Power Locks 18
GALLON FUEL TANK
DAYTIME RUNNING LIGHTS
REAR STEP BUMPER
MANUAL AIR CONDITIONING
AM/FM STEREO W/BLUETOOTH 4 SPEAKERS Glove Box
Center Console
Driver & Passenger Front Airbags
Hill Launch Assist
ELECTRONIC POWER ASSIST STERRING EASY FUEL-CAPLESS FUEL FILLER
STEEL BUMPER FRONT AND REAR - BLACK 3 Point Seat Belts
Vinyl Sun Visor
Tilt and Telescoping Steering Wheel
COLOR - VELOCITY BLUE
INTERIOR - BLACK CLOTH
OPTIONS FROM THE FACTORY:
60H BACK UP ALARM
17B MUD FLAPS
17A ALL WEATHER MATS
76E SPORT APPEARANCE PACKAGE
86S SPRAY IN BED LINER
DELIVERY MUST BE MADE WITHIN 30 DAYS
ALL PRICE QUOTES MUST BE IN A SEALED ENVELOPE DELIVERED OR MAILED
TO: 900 WEST BAY AVENUE, BARNEGAT, NJ 08005, ATTN: CLERKS OFFICE.
BIDS WILL BE OPENED ON APRIL 14TH AT 1:00PM
--- Document: PRICE QUOTE FOR FLYGT PUMPS ---
WATER & SEWER UTILITIES
900 WEST BAY AVENUE
BARNEGAT, NEW JERSEY 08005-1298
Township of Barnegat
COUNTY OF OCEAN
1846
BA
NEGAT
Fair and Open Price quote for:
XYLEM FLYGT CONCERTOR 10 HP PUMP (2EA)
SHIP
TOWNS
OFFICES: (609) 698-6185
FAX #: (609) 698-6223
Visit Our Website: www.barnegatwatersewer.com
Qty
Part Number
2
6020.091-0007
2
748 18 25
2
540 13 05
2
613 68 04
BRACKET, GUIDE BAR UPPER 2" 316
2
442 18 16
Description
NX-4 MT/HC 10/380-480/3/CH FM+ 65' WC FLS
KIT, SLIDING BRACKET DN100 ANSI
CONNECTION, DISCH 4X4" CI
SLING, CHAIN UNIT SS WIRE 10M
1
620 09 00
GRIP EYE UNIT
2
40-50 10 98
MINI-CASII 120V
2
14-40 70 97
80
14-49 01 03
SOCKET, 11 PIN OCTAL DIN MOUNT
TS3162 FEET 2"GUIDE RAIL 316SS
1
14-69 00 09A
START UP, FLYGT, NO TAX
1-TP MODELS: 3000,7000,8000
1
14-69 98 30N
SHIPPING AND HANDLING-NO TAX
DELIVERY IN 60 DAYS
FLYGT CONCERTOR 10 HP PUMPS (2EA) PRICE $
--- Document: Barnegat Municipal Police Complex_Bid Opening of 08_27_20 ---
Bid Opening for BMPC/New Municipal Building, Barnegat Township, NJ: Thursday, 08/27/20, 1:00 PM, at existing Barnegat Municipal Building, Barnegat, NJ
Bidders
Frankoski
H&S
Niram
Ogren
Wallace
Alna
Epic
Hall
Ben Harvey
Dandrea
G&P Parlamas
Base Bid Contract Sum
$12,964,000
$13,274,000
$13,333,000
$13,366,000
$13,870,000
$13,966,000
$13,981,000
$14,195,000
$14,420,000
$16,637,000
$16,947,000
$14,268,455
Unit Price #1: Remove & Replace Unsuitable Fill Materials
$70
$55
$60
$68
$75
$38
$85
$55
$65
$40
$75
$62
Bidding Docs
Average
Bidder’s Checklist
Bid Form
Bid Security/Bid Bond
Consent of Surety
Surety Disclosure
Affidavit of Non-Collusion
Bidder Disclosure Statement
Ownership Disclosure Statement
List of Subcontractors
Prevailing Wage Act Form
Disclosure of Investment Activities in Iran
Addenda
Acknowledge: Addendum #1
x
x
x
x
x
x
x
x
x
x
x
Acknowledge: Addendum #2
x
x
x
x
x
x
x
x
x
x
x
Acknowledge: Addendum #3
x
x
x
x
x
x
x
x
x
x
x
Listed Subcontractors
Structural Steel
Amount
Concrete
Amount
General Construction
Amount
Plumbing & Gas
Amount
HVAC Work
Amount
Electrical Work
Amount
Frankoski
H&S
Niram
Ogren
Wallace
Alna
Epic
Hall
Ben Harvey
Dandrea
G&P Parlamas
$0
$4,250,000
$8,500,000
$12,750,000
$17,000,000
Base Bid Contract Sum
1
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performance bond
Evidence Detected
"...heck, Cashier's Check, Treasurer's Check or Bid Bond Certificate from a Surety Company stating if the bid is accepted, they will provide the required Performance Bond Stockholders Disclosure Statement properly notarized listing stockholders or partners owning ten percent (10%) or more of corporation or partnership..."
liquidated damages
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Quick Actions
Visit Bid PortalIran Investment Disclosure StatementsCertification of Non-Involvement in Prohibited Activities in Russia or BelarusFair and Open contract formsNon Fair and Open contract formsSpecs for total of three (3) Chevy Tahoes2025 FORD RANGER XLT CREW ADVERTISEMENTPRICE QUOTE FOR FLYGT PUMPSBarnegat Municipal Police Complex_Bid Opening of 08_27_20
Contacts
Donna M. Manno, RMC
Municipal Clerk · Office of the Municipal Clerk
Explore More
Timeline
First Discovered
May 29, 2026
Last Info Update
May 29, 2026
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