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Auditing Services 2025 - RFP
BID #: 58
ISSUED: 1/15/2025
DUE: 1/29/2025
VALUE: TBD
100
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Executive Summary
The City of Orange is seeking proposals from qualified firms or individuals to provide auditing/consultant services. The selected firm will conduct an audit of the City's individual funds and account groups, including annual audits of departments and agencies, single audits to satisfy federal requirements, reviews of the annual budget and financial statements, and audits of deferred compensation plans, municipal court funds, and community development grants. Proposals will be evaluated based on qualifications, experience, knowledge of the City, and cost analysis. The contract term is from January 1, 2025, through December 31, 2025, and the submission deadline is January 29, 2025, at 11:00 AM.
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Bid Postings • Auditing Services 2025 - RFP Skip to Main Content EMERGENCY ALERT SNAP Recipients - Find Food Sources Near You Read On... Create a Website Account - Manage notification subscriptions, save form progress and more. Website Sign In Search Residents Business UEZ Program How Do I... City Government Departments Home Bid Postings Print Sign up to receive a text message or email when new bids are added! Print Bid Title: Auditing Services 2025 - RFP Category: Bids and Request for Proposals (RFPs) Status: Closed Description: The City of Orange is requesting submissions from qualified individuals and/or firms to provide Auditing/Consultant/services of a specialized nature to the city. Proposals will be evaluated in accordance with the criteria set forth in this RFP/Q. One or more individuals/firms may be selected to provide services. PERIOD OF CONTRACT January 1, 2025 through December 31, 2025 CONTRACT FORM The successful Respondent shall be required to execute the City’s form contract, which includes the indemnification, insurance, termination and licensing provisions. A complete copy of a draft City form contract is available upon request. It is also agreed and understood that the acceptance of the final payment by Contractor shall be considered a release in full of all claims against the City arising out of, or by reason of, the work done and materials furnished under this Contract. Publication Date/Time: 1/15/2025 12:00 AM Closing Date/Time: 1/29/2025 11:00 AM Special Requirements: Perform Annual Audit to include department and agencies pursuant to N.J.S.A. 40A:5-4. Perform Annual Single Audit to satisfy Federal requirements and the audit of grant programs. Review the Annual Budget, Financial and Debt Statement prior to their filing/adoption consistent with statutory deadlines. Perform audit of Deferred Compensation Plan. Perform audit of Municipal Court funds. Perform audit of Community Development Grants, and other grants of the City. Perform audit of Sub-grantees records as needed. Respond to inquiries concerning financial and tax matters associated with the City on an as needed basis. The audit must be done in accordance with U.S. generally accepted auditing standards and the standards applicable to financial statements contained in the Government Auditing Standards issued by the Comptroller General of the United States, the audit requirements prescribed by the Division of Local Government Services, Department of Community Affairs, State of New Jersey and the provisions of U.S. Office of Management and Budget Circular A-133, “Audits of States, Local Governments and Non-Profit Organizations” and State of New Jersey OMB Circular 04-04, “Single Audit Policy for Recipients of Federal Grants, State Grants and State Aid”. Related Documents: RFP - Auditing Services 2025 Return To Main Bid Postings Page Live Edit Bill Pay Public Notice Agendas & Minutes Job Openings Documents & Forms Notify Me® Contact Us Orange City Hall 29 North Day Street Phone: 973-952-6100 Staff Directory Quick Links Finance Forms, Permits, and License Applications Mayor's Office Public Works Vital Statistics Staff Directory /QuickLinks.aspx Helpful Links Home Site Map Contact Us Accessibility Copyright Notices Privacy Policy /QuickLinks.aspx Government Websites by CivicPlus® Loading Loading Do Not Show Again Close Arrow Left Arrow Right [] Slideshow Left Arrow Slideshow Right Arrow
Document Text
--- Document: RFP - Auditing Services 2025 ---
CITY OF ORANGE TOWNSHIP
REQUEST FOR PROPOSALS/QUALIFICATIONS FOR
AUDITING/CONSULTANT SERVICES
CITY OF ORANGE
Contract Term
JANUARY 1, 2025 through DECEMBER 31, 2025
SUBMISSION DEADLINE
11:00 A.M.
January 29, 2025
ADDRESS ALL RESPONSES TO:
FINANCE DEPARTMENT, ROOM 206
29 NORTH DAY STREET
ORANGE, NEW JERSEY 07050
1
ATTN: NILE S. CLEMENTS, QUALIFIED PURCHASING AGENT
Public Notice
Request for Proposals/Qualifications
Notice is hereby given that the City of Orange will receive Responses to the RFP/Q
on Wednesday, January 29, 2025 at 11:00 A.M. in City of Orange, City Hall, 29
North Day Street, Room 206, Orange, New Jersey for the following professional
services:
AUDITING/CONSULTANT SERVICES
Proposals are being solicited through a Fair and Open process in accordance with
N.J.S.A. 19:44A-20.4. Requests for Qualifications/Proposals (RFP/Q) may be
obtained at the City of Orange, 29 North Day Street, Orange, New Jersey 07050,
from Nile S. Clements, Qualified Purchasing Agent, between the hours of 9:00
A.M. and 4:00 p.m., Monday through Friday. All questions regarding the RFP/Q
must be made in writing and directed to the Qualified Purchasing Agent. Questions
may be faxed to (973) 6740621. Submissions must be made in the form required
by the specifications and one (1) original and five (5) copies must be delivered to
reach the Purchasing Agent prior to the time for the receipt of Proposal. All
information requested in the Request for Proposals must be provided or the
submission may be disqualified. Submissions must be sealed and plainly marked
on the outside of the sealed envelope to the services for which the Proposal is
submitted. The City of Orange Township reserves the right to reject any and all
submissions, to waive any informality in the RFP/Q process, and to accept any
submissions which, in their judgment, are most advantageous, price and other
factors considered, and will best serve the interest of the City of Orange Township.
2
Submitters are required to comply with the requirements of N.J.S.A. 10:5-31 et seq
and N.J.A.C. 17:27.
GENERAL INFORMATION & SUMMARY
ORGANIZATION REQUESTING PROPOSALS
CITY OF ORANGE TOWNSHIP
29 NORTH DAY STREET
ORANGE, NEW JERSEY 07050
CONTACT PERSON
NILE S. CLEMENTS
QUALIFIED PURCHASING AGENT
FINANCE DEPARTMENT, ROOM 206
29 NORTH DAY STREET
ORANGE, NEW JERSEY 07050
(973)952-6113
PURPOSE OF REQUEST
The City of Orange is requesting submissions from qualified individuals and/or
firms to provide Auditing/Consultant/services of a specialized nature to the city.
Proposals will be evaluated in accordance with the criteria set forth in this RFP/Q.
One or more individuals/firms may be selected to provide services.
PERIOD OF CONTRACT
January 1, 2025 through December 31, 2025
CONTRACT FORM
3
The successful Respondent shall be required to execute the City’s form contract,
which includes the indemnification, insurance, termination and licensing
provisions. A complete copy of a draft City form contract is available upon request.
It is also agreed and understood that the acceptance of the final payment by
Contractor shall be considered a release in full of all claims against the City arising
out of, or by reason of, the work done and materials furnished under this Contract.
DETAILED REQUIREMENTS OF THE
REQUEST FOR PROPOSALS/QUALIFICATIONS FOR AUDITING/CONSULTANT
SERVICES
1. CITY OF ORANGE FACTS AND FIGURES – The City of Orange is a municipal
government entity. The City was incorporated in 1806 and operates pursuant to N.J.S.A.
40A:61-1 et seq. The City’s population is approximately 35,000 and it consists of
approximately 2.2 square miles of area. The City employs approximately 400 people in
about 10 departments and agencies. It owns various municipal buildings, parks and
recreation facilities. The City’s operating budget is over $90 million. It provides
significant and diverse services to its residents, including those in the senior, disabled,
veterans and other communities.
2. NATURE/ SCOPE OF SERVICES – The City of Orange is requesting submissions from
qualified individuals and/or firms to provide Auditing/Consultant Services. The
Respondent will be required to conduct an audit of the individual funds and the account
group of the City of Orange, New Jersey. The Respondent will be required to perform,
but not be limited to, the following services:
3. Perform Annual Audit to include department and agencies pursuant to N.J.S.A. 40A:5-4.
4. Perform Annual Single Audit to satisfy Federal requirements and the audit of grant
programs.
5. Review the Annual Budget, Financial and Debt Statement prior to their filing/adoption
consistent with statutory deadlines.
6. Perform audit of Deferred Compensation Plan.
7. Perform audit of Municipal Court funds.
8. Perform audit of Community Development Grants, and other grants of the City.
9. Perform audit of Sub-grantees records as needed.
4
10.Respond to inquiries concerning financial and tax matters associated with the City on an
as needed basis.
The audit must be done in accordance with U.S. generally accepted auditing standards and the
standards applicable to financial statements contained in the Government Auditing Standards
issued by the Comptroller General of the United States, the audit requirements prescribed by the
Division of Local Government Services, Department of Community Affairs, State of New Jersey
and the provisions of U.S. Office of Management and Budget Circular A-133, “Audits of States,
Local Governments and Non-Profit Organizations” and State of New Jersey OMB Circular
04-04, “Single Audit Policy for Recipients of Federal Grants, State Grants and State Aid”.
3. STANDARD REQUIREMENTS OF TECHNICAL QUALIFICATIONS – Respondents
should submit technical qualifications which contain the following:
a. The name of the Respondent, the principal place of business and, if different, the place
where the services will be provided.
b. Respondent must have a minimum of fifteen (15) years, experience, as an auditor, and a
minimum of ten (10) years, experience, servicing the City of Orange or other
governmental entities.
c. The education, qualifications, experience, and training of all persons who would be
assigned to provide services along with their names and titles.
1.
The Respondent must be both a Certified Public Accountant and a
Registered Municipal Accountant.
d. A listing of all other engagements where services of the types being proposed were
provided in the past five (5) years. This should include other municipal governments
and other levels of government. Contact information for the recipients of the similar
services must be provided. The City may obtain references from any of the parties
listed.
1.
A description of all other areas of Auditing/Consultant services of the
Respondent, with emphasis on a description of those services of interest to a
municipal government client.
5
e. A Statement that neither the firm nor any individuals assigned to this engagement are
suspended, or otherwise prohibited from professional practice by any federal, state, or
local agency.
f. An Affirmative Action Statement (copy of form attached).
g. A completed Non-Collusion Affidavit (copy of form attached).
h. A statement that the Respondent will comply with the General Terms and Conditions
required by the City and enter into the City’s standard Professional Services Contract. i.
A copy of the Respondent’s Business Registration Certificate.
4. COST ANALYSIS - Respondents should submit a cost analysis which would include any
proposed retainer, the services to be provided for the retainer, if services will be provided at a
flat rate, if all or any services will be billed through hourly rates and what are the established
rate(s). The City does not provide payment for or reimbursement for travel expenses.
5. SUBMISSION EVALUATION – The City will select the most advantageous submission based
on all of the evaluation factors set forth at the end of this RFP/Q. The City will make the
award(s) that is in the best interest of the City.
Each submission must satisfy the objectives and requirements detailed in this RFP/Q. The
successful Respondent shall be determined by an evaluation of the total content of the
submission. The City reserves the right to:
a. Not select any of the submissions.
b. Select only portions of a particular Respondent’s submission for further consideration.
(However, Respondents may specify portions of the submission that they consider
“bundled”.)
c. Award a contract for the requested services at any time within 90 days of the selection
of the most advantageous submission; every submission should be valid through this
time period.
d. The City shall not be obligated to explain the results of the evaluation process to any
Respondent.
e. The City may require Respondents to demonstrate any services described in their
submission prior to award.
6. SUBMISSION LIMITATIONS – This RFP/Q is not intended to be an offer, order or contract
and should not be regarded as such, nor shall any obligation or liability be imposed on the City
by issuance of this RFP/Q. The City reserves the right at the City’s sole discretion to refuse
any submission submitted.
7. USE OF INFORMATION - Any specifications, drawings, sketches, models, samples, data,
computer programs, documentation, technical or business information and the like
6
(“Information”) furnished or disclosed by the City to the Respondent in connection with this
RFP/Q shall remain the property of the City. When in tangible form, all copies of such
information shall be returned to the City upon request. Unless such information was previously
known to the Respondent, free of any obligation to keep it confidential, or has been or is
subsequently made public by the City or a third party, it shall be held in confidence by the
Respondent, shall be used only for the purposes of this RFP/Q, and may not be used for other
purposes except upon such terms and conditions as may be mutually agreed upon in writing.
8. GENERAL TERMS AND CONDITIONS –
a. The City reserves the right to reject any or all submissions, if necessary, or to waive
any informalities in the submissions, and, unless otherwise specified by the
Respondent, to accept any item, items or services in the submissions should it be
deemed in the best interest of the City to do so.
b. In case of failure by the successful Respondent, the City of Orange may procure the
articles or services from other sources, deduct the cost of the replacement from money
due to the Respondent under the contract and hold the Respondent responsible for any
excess cost occasioned thereby.
c. The Respondent shall maintain sufficient insurance to protect against all claims under
Workmen's Compensation, General, Professional and Automobile Liability. d. Each
submission must be signed by the person authorized to do so.
e. The contract shall be in effect through December 31, 2025 unless otherwise stated.
f. Sealed submissions may be hand delivered or mailed consistent with the provisions of
the legal notice to Respondents. In the case of mailed submissions, the City assumes no
responsibility for submissions received after the designated date and time and will
return late submissions unopened. Submissions will not be accepted by facsimile or
email.
g.In accordance with Affirmative Action Law, P.L. 1975, c.127 (N.J.A.C. 17:27) with
implementation of July 10, 1978, successful Respondents must agree to submit
individual employer certifications and number or complete Affirmative Action
employee information report (form AA-302). Also, during the performance of this
contract, the contractor agrees as follows: (a) the contractor or subcontractor where
applicable, will not discriminate against any employee because of age, race, creed,
color, national origin, ancestry, marital status or affectional or sexual orientation. The
contractor will take affirmative action to ensure that such applicants are recruited and
employed and that employees are treated during employment, without regard to their
age, race, creed, color, national origin, ancestry, marital status, sex or handicap. Such
action shall include, but not be limited to the following: employment, upgrading,
demotion or transfer, recruitment or recruitment advertising; layoff or termination; rates
of pay or other forms of compensation; and section for training, including
apprenticeship. The contractor agrees to post in conspicuous places, available to
employees and applicants for employment, notice to be provided by the Public Agency
7
Compliance Officer setting forth provisions of this non-discrimination clause: (b) 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, sex or handicap; (c) the contractor or
subcontractor, 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 worker's representative of the contractor's commitments under this act
and shall post copies of the notice; (d) the contractor or subcontractor, where
applicable, agrees to comply with any regulations promulgated by the treasurer
pursuant to the P.L. 1975, c.127, as amended and supplemented from time to time.
e.
By submission of the qualifications, the Respondent certifies that the service to be
furnished will not infringe upon any valid patent, trademark or copyright and the
successful Respondent shall, at its expense, defend any and all actions or suits charging
such infringement, and will hold the City harmless in any case of any such infringement.
f.
No Respondent shall influence, or attempt to influence, or cause to be influenced,
any City officer or employee to use his/her official capacity in any manner which might
tend to impair the objectivity or independence of judgment of said officer or employee.
g.
No Respondent shall cause or influence, or attempt to cause or influence, any City
officer or employee to use his/her official capacity to secure unwarranted privileges or
advantages for the Respondent or any other person.
h.
Should any difference arise between the contracting parties as to the meaning or
intent of these instructions or specifications, the City’s Law Department decision shall be
final and conclusive.
i.
The City of Orange shall not be responsible for any expenditure of monies or other
expenses incurred by the Respondent in making its submission.
j.
The checklist, affidavits, notices and the like presented at the end of this Request
for Proposals are a part of this Request for Proposals and shall be completed and
submitted as part of this submission.
END OF GENERAL INSTRUCTIONS
BASIS OF AWARD
(To be completed by City evaluation committee)
EVALUATION FACTORS
8
A.
Relevance and Extent of Qualifications, Experience, Reputation and
Training of Personnel to be assigned (30 Points)
B.
Knowledge of the City of Orange Township and the subject matter to be
addressed under this engagement (10 Points)
C.
Relevance and Extent of Similar Engagements performed (15 Points)
D.
Technical Qualifications contains all required information (15 Points) E.
Reasonableness of Cost Analysis (30 Points)
REQUEST FOR PROPOSALS CHECKLIST
9
THIS CHECKLIST MUST BE COMPLETED AND SUBMITTED WITH YOUR
QUALIFICATION PACKAGE:
Please initial below, indicating that your submission includes the itemized document.
SUBMISSIONS WITHOUT THE FOLLOWING DOCUMENTS IS CAUSE FOR REFUSAL
INITIAL BELOW
A.An original and five (5) signed copies of your complete submission.
__________
B. Non-Collusion Affidavit properly notarized
__________
C. Authorized signatures on all forms.
__________
D.Business Registration Certificate(s)
__________
E. Affirmative Action Statement
__________
Note: N.J.S.A 52:32-44 provides that the City shall not enter into a contract for goods or services
unless the other party to the contract provides a copy of its business registration certificate and
the business registration certificate of any subcontractors at the time that it submits its
qualifications. The contracting party must also collect the state use tax where applicable.
THE UNDERSIGNED HEREBY ACKNOWLEDGES
THE ABOVE LISTED REQUIREMENTS
NAME OF RESPONDENT:
______________________________________________________________________________
Person, Firm or Corporation
______________________________________________________________________________
BY: (NAME)
(TITLE)
10
EXHIBIT A
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 subcontractor, where applicable, will not discriminate against any employee or applicant
for employment because of age, race, creed, color, national origin, ancestry, marital status, affectional or
sexual orientation or sex. Except with respect to affectional or sexual orientation, the contractor will take
affirmative action to ensure that such applicants are recruited and employed, and that employees are
treated during employment, without regard to their age, race, creed, color, national origin, ancestry,
marital status, affectional or sexual orientation or sex. Such action shall include, but not be limited to the
following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff
or termination; rates 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 for the
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 or sex.
The contractor or subcontractor, 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 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 employ minority and women
workers, consistent with the applicable city employment goals established in accordance with N.J.A.C.
17:27-5.2 or a binding determination of the applicable city employment goals determined by the Division,
pursuant to 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, labor unions, that it
does not discriminate on the basis of age, creed, color, national origin, ancestry, marital status, affectional
or sexual orientation or sex, and that it will discontinue the use of any recruitment agency which engages
in direct or indirect discriminatory practices.
The contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to assure that
all personnel testing conforms with the principles of job-related testing, as established by the statutes and
11
court decisions of the State of New Jersey and as established by applicable Federal law and applicable
Federal court decisions.
Exhibit A (Continued)
In conforming with the applicable 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, creed, color, national origin, ancestry, marital status,
affectional or sexual orientation 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
The contractor and its subcontractors shall furnish such reports or other documents to the Division of
Contract Compliance and 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.
NON-COLLUSION AFFIDAVIT
STATE OF NEW JERSEY
COUNTY OF ESSEX
ss:
I AM _______________________________
OF THE FIRM OF ______________________________________
UPON MY OATH, I DEPOSE AND SAY:
1. THAT I EXECUTED THE SAID SUBMISSION WITH FULL AUTHORITY SO TO DO;
2. THAT THIS RESPONDENT HAS NOT, DIRECTLY OR INDIRECTLY ENTERED INTO ANY
AGREEMENT, PARTICIPATED IN ANY COLLUSION, OR OTHERWISE TAKEN ANY
ACTION IN RESTRAINT OF FAIR AND OPEN COMPETITION IN CONNECTION WITH THIS
ENGAGEMENT;
3. THAT ALL STATEMENTS CONTAINED IN SAID SUBMISSION AND IN THIS AFFIDAVIT
ARE TRUE AND CORRECT, AND MADE WITH FULL KNOWLEDGE THAT THE CITY OF
12
ORANGE RELIES UPON THE TRUTH OF THE STATEMENTS CONTAINED IN SAID
SUBMISSION AND IN THE STATEMENTS CONTAINED IN THIS AFFIDAVIT IN
AWARDINGTHE CONTRACT FOR THE SAID ENGAGEMENT; AND
4. THAT NO PERSON OR SELLING AGENCY HAS BEEN EMPLOYED TO SOLICIT OR
SECURE THIS ENGAGEMENT AGREEMENT OR UNDERSTANDING FOR A
COMMISSION, PERCENTAGE, BROKERAGE OR CONTINGENT FEE, EXCEPT BONA
FIDE EMPLOYEES OR BONA FIDE ESTABLISHED COMMERCIAL SELLING AGENCIES
OF THE RESPONDENT.
(N.J.S.A.52: 34-25)
SUBSCRIBED AND SWORN TO
BEFORE ME THIS ______________ DAY
OF _______________ 20_____
_______________________________________
(Type or Print Name of Affiant under Signature)
_____________________________________
NOTARY PUBLIC OF
MY COMMISSION EXPIRES: ___________, 20_____.
OWNER DISCLOSURE and POLITICAL CONTRIBUTION CERTIFICATION
This Statement MUST BE INCLUDED with RFP Submissions
OWNER DISCLOSURE SECTION
Name of Business______________________________________________________
p
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
p
I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the
undersigned. OR
p
I certify that there are no stockholders
Check the box that represents the type of business organization:
13
p p p
Partnership
Corporation
Sole
Proprietorship
p p p
Limited Partnership
Limited Liability Corporation
Limited
Liability Partnership
p p
Subchapter S Corporation
Other (describe) ___________________
AND
POLITICAL CONTRIBUTION DISCLOSURE SECTION
(The following section must be completed)
p
I hereby attest that the undersigned business entity, its subsidiaries, assigns or principals controlling
in excess of 10% of the company has neither made a contribution, that is reportable 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 City of Orange and/or County of Essex, if a member
of that political party is serving in an elective public office of that City of Orange and/or County of
Essex when the contract is awarded, or to any candidate committee of any person serving in an
elective public office of that City of Orange and/or County of Essex when the contract is awarded.
OR
p
I hereby attest that the undersigned business entity, its subsidiaries, assigns or principals controlling
in excess of 10% of the company has made reportable political contributions (more than $300 per
election cycle) over the 12 months prior to submission to the committees of the government entities listed
below:
14
Sign and notarize the form below, and, if necessary, complete the stockholder list below.
Stockholders:
Name:
Name:
______________________________ _____________________________
Home Address:
Home Address:
______________________________ _____________________________
Name:
Name:
______________________________ _____________________________
Home Address:
Home Address:
______________________________ _____________________________
Subscribed and sworn before me
_____________________________
This ___ day of ___________, 2
Affiant
Contributor Name
Recipient Name
Date
Dollar Amount
$
15
________________________________
(Notary Public)
(Print name & title of affiant)
My Commission expires:
______________________
(Corporate Seal
16
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NILE S. CLEMENTS
QUALIFIED PURCHASING AGENT · FINANCE DEPARTMENT
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Timeline
First Discovered
Mar 31, 2026
Last Info Update
Apr 30, 2026
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