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Redevelopment Counsel Services - 2024
BID #: 18
ISSUED: 10/12/2023
DUE: 11/9/2023
VALUE: $150.00
100
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Executive Summary
The City of Orange Township is seeking qualification statements from respondents with expertise in providing professional legal services for Redevelopment projects. Redevelopment Counsel Services will work closely with the Law Department, the Department of Administration, and the City’s Chief Financial Officer. The services include preparing, reviewing, and providing opinions on redevelopment ordinances related to capital projects, attending meetings, and providing other specialized legal services. Qualification Statements must be received by November 9, 2023, at 11:00 a.m., and must be mailed or hand-delivered; submissions by facsimile or e-mail will not be accepted.
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Bid Postings • Redevelopment Counsel Services - 2024 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: Redevelopment Counsel Services - 2024 Category: Bids and Request for Qualification (RFQs) Status: Closed Description: It is the City’s intent to solicit Qualification Statements from Respondents that have expertise in providing professional legal services as described below and as set forth in the attached Notice of Solicitation for Responses. Respondents must demonstrate that they will have the continuing capabilities to perform these services. The Law Department of the City of Orange Township is seeking legal support for a law firm with substantial in Redevelopment Project. Redevelopment Counsel Services will have a close working relationship with the Law Department, the Department of Administration, and the City’s Chief Financial Officer. Redevelopment Counsel Services shall include, but not limited to: 1. On an as needed basis, prepares, reviews and opines on Redevelopmentordinances related to capital projects; 2. Counsel may be called upon to attend meetings 3. Counsel may also be called upon to provide other types of legal services of a specialized nature. Counsel may also be called upon to provide other types of legal services of a specialized nature. Publication Date/Time: 10/12/2023 12:00 AM Closing Date/Time: 11/9/2023 11:00 AM Contact Person: Gracia Robert Montilus City Attorney The City of Orange Township 29 North Day Street Orange, New Jersey 07050 (973) 952-6095 Qualifications: Respondents must submit an original and two (2) copies of their Qualification Statement to the Designated Contact Person: Qualification Statements must be received by the City no later than 11:00 a.m. on November 9, 2023, and must be mailed or hand-delivered. Qualification Statements forwarded by facsimile or e-mail will not be accepted. To be responsive, Qualification Statements must provide all requested information, and must be in strict conformance with the instructions set forth herein. Qualification Statements and all related information must be bound, and signed and acknowledged by the Respondent. Special Requirements: 3.1 General Requirements The Qualification Statement submitted by the Respondent must meet or exceed the professional, administrative and financial qualification set forth in this Section 3 and shall incorporate the information requested below. In addition to the information required as described below, a Respondent may submit supplemental information that it feels may be useful in evaluating its Qualification Statement. Respondents are encouraged to be clear, factual, and concise in their presentation of information. 3.2?Administrative Information Requirements. ?The Respondent shall, as part of its Qualification Statement, provide the following information: 1. An executive summary (not to exceed two (2) pages) of the information contained in all the other parts of the Qualification Statement. 2. An executed Letter of Qualification. 3. Name, address and telephone number of the Respondent submitting a Qualification Statement pursuant to this RFQ, and the name of the key contact person. 4. A description of the business organization (i.e., corporation, partnership, joint venture, etc.) of each Respondent, its ownership and its organizational structure. (a) Provide the names and business addresses of all Principals of the Respondent submitting the Qualification Statement. For purposes of this RFQ, “Principals” means person possessing an ownership interest in the Respondent. If the Respondent is a corporation, “Principals” shall include each investor who has any operational control over the Respondent, and every stockholder having an ownership interest of 10% or more in the firm. (b) If a Respondent is a partially owned or a fully-owned subsidiary of another firm, identify the parent company and describe the nature and extent of the parents’ approval rights over the activities of the Respondent submitting a Qualification Statement. Describe the approval process. (c) If the Respondent is a partnership or a joint venture or similar organization, provide comparable information as required in (b) above for each member of the partnership, joint venture or similar organization. (d) A statement that the Respondent has complied with all applicable affirmative action (or similar) requirements with respect to its business activities, together with evidence of such compliance. 5. The number of years Respondent has been in business under the present name. 6. The number of years Respondent has been under the current management. 7. Any judgments within the last three (3) years in which Respondent has been adjudicated liable for professional malpractice. If yes, please explain. 8. Whether the Respondent is now or has been involved in any bankruptcy or reorganization proceeding in the last ten (10) years. If yes, please explain. 9. Confirm appropriate federal and state licenses to perform activities. 10. An executed letter of intent. 3.3 Professional Information Requirements a.?Respondent shall submit a description of its overall experience in providing the type of services sought in the RFQ. At a minimum, the following information on past experience should be included as appropriate to the RFQ: 1. Description and scope of work by Respondent. 2. Name, address and contact information of references. 3. Explanation of perceived relevance of the experience to the RFQ. b.?Brief description of Respondent’s relevant clients including municipal government clients during the last three (3) years. c.?Resumes of key employees. d.?Names and resumes of attorneys who will be assigned to provide legal services to the City. e.?A narrative statement of the Respondent’s understanding of the City’s needs and goals. f.?Limits of Malpractice insurance coverage. g.?List all immediate relatives of Principal(s) of Respondent who are City employees or elected officials of the City. For purposes of the above, “immediate relative” means a spouse, parent, stepparent, brother, sister, child, stepchild, direct-line aunt or uncle, grandparent, grandchild and in-laws. h.?Proof by way of a Certificate of Insurance reflecting the firm’s coverage for a minimum of $500,000 of Professional Liability Insurance. i.?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. Related Documents: REQUEST FOR QUALIFICATION - Redevelopment Counsel Services - 2024 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: REQUEST FOR QUALIFICATION - Redevelopment Counsel Services - 2024 ---
REQUEST FOR QUALIFICATIONS
REDEVELOPMENT COUNSEL SERVICES
CITY OF ORANGE TOWNSHIP
SUBMISSION DEADLINE
11:00 a.m.
November 9, 2023
ADDRESS ALL QUALIFICATIONS STATEMENTS TO:
Gracia Robert Montilus
City Attorney
The City of Orange Township
29 North Day Street
Orange, New Jersey 07050
(973) 952-6095
GENERAL INFORMATION & SUMMARY
ORGANIZATION REQUESTING PROPOSAL
The City of Orange Township
29 North Day Street
Orange, New Jersey 07050
CONTACT PERSON
Gracia Robert Montilus
City Attorney
29 North Day Street
Orange, New Jersey 07050
INTRODUCTION AND PURPOSE
The City of Orange Township (hereinafter the “City”) is requesting qualification
statements from qualified individual to provide Redevelopment Counsel Services.
Qualification Statements will be evaluated in accordance with the criteria set forth in this
Request for Qualifications (RFQ). One or more individuals/firms may be selected to
provide services. If selected, the governing body will approve a resolution awarding a
contract to the attorney based on an hourly rate of compensation not to exceed $150.00
and for a sum not to exceed a specified amount.
Redevelopment Counsel shall be a licensed attorney at least five (5) years.
As to the compensation for these services: For services rendered in connection
with issuance of temporary and/or permanent obligations, Redevelopment Counsel will
receive a transactional fee. Please include in the response the proposed base fee for each
type of transaction, as well as any additional increment which may apply in relationship
to the par amount of the obligations.
Services rendered that do not result in the issuance of temporary and/or permanent
obligations shall be compensated on an hourly basis. Please set forth the cost details in
the response, including the hourly rates of each of the individuals who will perform
services and time estimates for each individual, all expenses and the total cost of a “not to
exceed” amount.
PERIOD OF QUALIFICATION
January 1, 2024 – December 31, 2024.
FORM AS TO SELECTION
If selected to provide services, the successful Respondent shall be required to
execute a form contract, which includes indemnification, insurance, termination and
licensing provisions. A complete copy of a draft City contract is available upon request.
It is also agreed and understood that the acceptance of the final payment shall be
considered a release representation 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.
GLOSSARY
The following definitions shall apply to and are used in this Request for
Qualifications (RFQ):
“City” – refers to the City of Orange Township.
“Qualification Statement” – refers to the complete responses to this RFQ
submitted by the Respondents.
“Qualified Respondent” – refers to those Respondents who (in the sole judgment
of the City) have satisfied the qualification criteria set forth in this RFQ.
“RFQ” – refers to this Request for Qualifications, including any amendments
thereof or supplements thereto.
“Respondent” or “Respondents” – refers to the interested persons and/or firm(s)
that submit a Qualification Statement.
“Period of Qualification” – refers to the period (January 1, 2024 – December 31,
2024) during which a successful Respondent will remain eligible for services under the
terms of this RFQ.
SECTION I
INTRODUCTION AND GENERAL INFORMATION
1.1
Introduction and Purpose
The City of Orange Township is soliciting Qualification Statements from
interested persons and/or firms to provide professional services, as more particularly
described herein. Through a Request for Qualification process described herein, person
and/or firms interested in assisting the City with the provision of such services must
prepare and submit a Qualification Statement in accordance with the procedure and
schedule in this RFQ. The City of Orange Township will review Qualification
Statements only from those persons and/or firms that submit a Qualification Statement
which includes all information required to be included as described herein (in the sole
judgment of the City). The City intends to qualify person(s) and/or firm(s) that (a)
possess the professional, financial and administrative capabilities to provide the proposed
services, and (b) will agree to work under the level of compensation, terms and
conditions determined by the City to provide the greatest benefit to the taxpayers of the
City.
1.2
Procurement Process and Schedule
The selection process is in accordance with the “New Jersey Local Unit Pay-to-
Play”, Law and municipal ordinances establishing the “pay-to-play” criteria. The City
has structured a procurement process that seeks to obtain the desired results described
above, while establishing a competitive fair and open process to assure that each person
and/or firm is provided an equal opportunity to submit a Qualification Statement in
response to the RFQ. Qualification Statements will be evaluated in accordance with the
criteria set forth in Section 2 of this RFQ, which will be applied in the same manner to
each Qualification Statement received.
Qualification Statements will be reviewed and evaluated by the City Attorney of
the City of Orange Township. The Qualification Statements will be reviewed to
determine if the Respondent has met the minimum professional, administrative and
financial areas described in this RFQ. Based upon the totality of the information
contained in the Qualification Statement, including information about the reputation and
experience of each Respondent, the City Attorney will evaluate and determine which
Respondents are qualified (professionally, administratively and financially) to be
submitted to the Municipal Council for approval.
The RFQ process commences with the issuance of this RFQ. The steps involved
in the process and the anticipated completion dates are set forth in Table 1, Procurement
Schedule. The City reserves the right to, among other things, amend, modify or alter the
Procurement Schedule upon notice to all potential Respondents.
All communications concerning this RFQ or the RFQ process shall be directed to
the City’s Designated Contact Person, in writing.
Qualification Statements must be submitted to, and be received by the Office of
Procurement, via mail or hand delivery, by 11:00 a.m. on November 9, 2023.
Qualification Statements will not be accepted by facsimile or e-mail transmissions.
Qualification Statement shall be opened in the City Attorney’s Office, located on the 2nd
floor of Orange City Hall, Orange, New Jersey.
TABLE I
ANTICIPATED PROCUREMENT SCHEDULE
ACTIVITY DATE
1.
Publication of Request for Qualifications October 12, 2023.
2.
Commence Issuance of Request for Qualification Packages October 12, 2023.
3.
Receipt of Qualification Statement November 9, 2023.
1.3. Conditions Applicable to RFQ.
Upon submission of a Qualification Statement in response to this RFQ, the
Respondent acknowledges and consents to the following conditions relative to
the submission and review and consideration of its Qualification Statement:
This document is an RFQ and does not constitute a Request for Proposals
(RFP).
This RFQ does not commit the City to issue an RFQ.
All costs incurred by the Respondent in connection with responding to this
RFQ shall be borne solely by the Respondent.
The City reserves the right (in its sole judgment) to reject for any reason any
and all responses and to eliminate any and all Respondents responding to this
RFQ from further consideration for this procurement.
The City reserves the right, without prior notice, to supplement, amend, or
otherwise modify this RFQ, or otherwise request additional information.
All Qualification Statements shall become the property of the City and will
not be returned.
All Qualification Statements will be made available to the public at the
appropriate time, as determined by the City (in the exercise of its sole
discretion) in accordance with law.
The City may request Respondents to send representatives to the City for
interviews.
Any and all Qualification Statements not received by the City’s Law
Department Procurement by 11:00 a.m. on November 9, 2023, will be
rejected.
Neither the City, nor its officers, officials or employees shall be liable for any
claims or damages resulting from the solicitation or preparation of the
Qualification Statement, nor will there be any reimbursement to Respondents
for the cost of preparing and submitting a Qualification Statement or for
participating in this procurement process.
1.4. Rights of City.
The City reserves the right to reject any and all submissions, if necessary, or to waive
any informalities in submissions and to accept any item, items or services in the
submissions that are in the best interest of the City. The City of Orange Township
reserves the right to terminate services upon notice to the submitter.
1.5 Addenda or Amendments to RFQ
During the period provided for the preparation of responses to the RFQ, the City may
issue addenda, amendments or answers to written inquiries. Those addenda will be
noticed by the City and will constitute a part of the RFQ. All responses to the RFQ shall
be prepared with full consideration of the addenda issued prior to the Qualification
Statement submission date.
1.6 Qualification Statement Format.
Qualification Statements must cover all information requested in this RFQ.
Qualification Statements which in the judgment of the City fail to meet the requirements
of the RFQ or which are in any way conditional, incomplete, obscure, contain additions
or deletions from requested information, or contain errors may be rejected.
SECTION 2
SCOPE OF SERVICES
It is the City’s intent to solicit Qualification Statements from Respondents that
have expertise in providing professional legal services as described below and as set forth
in the attached Notice of Solicitation for Responses. Respondents must demonstrate that
they will have the continuing capabilities to perform these services.
The Law Department of the City of Orange Township is seeking legal support for
a law firm with substantial in Redevelopment Project. Redevelopment Counsel Services
will have a close working relationship with the Law Department, the Department of
Administration, and the City’s Chief Financial Officer. Redevelopment Counsel Services
shall include, but not limited to:
1. On an as needed basis, prepares, reviews and opines on Redevelopment
ordinances related to capital projects;
2. Counsel may be called upon to attend meetings
3. Counsel may also be called upon to provide other types of legal services of a
specialized nature.
Counsel may also be called upon to provide other types of legal services of a
specialized nature.
SECTION 3
SUBMISSION REQUIREMENTS
3.1
General Requirements
The Qualification Statement submitted by the Respondent must meet or exceed
the professional, administrative and financial qualification set forth in this Section 3 and
shall incorporate the information requested below.
In addition to the information required as described below, a Respondent may
submit supplemental information that it feels may be useful in evaluating its Qualification
Statement. Respondents are encouraged to be clear, factual, and concise in their
presentation of information.
3.2
Administrative Information Requirements.
The Respondent shall, as part of its Qualification Statement, provide the
following information:
1.
An executive summary (not to exceed two (2) pages) of the information
contained in all the other parts of the Qualification Statement.
2.
An executed Letter of Qualification.
3.
Name, address and telephone number of the Respondent submitting a
Qualification Statement pursuant to this RFQ, and the name of the key contact
person.
4.
A description of the business organization (i.e., corporation, partnership, joint
venture, etc.) of each Respondent, its ownership and its organizational
structure.
(a) Provide the names and business addresses of all Principals of the
Respondent submitting the Qualification Statement. For purposes of this
RFQ, “Principals” means person possessing an ownership interest in the
Respondent. If the Respondent is a corporation, “Principals” shall include
each investor who has any operational control over the Respondent, and
every stockholder having an ownership interest of 10% or more in the
firm.
(b) If a Respondent is a partially owned or a fully-owned subsidiary of
another firm, identify the parent company and describe the nature and
extent of the parents’ approval rights over the activities of the Respondent
submitting a Qualification Statement. Describe the approval process.
(c) If the Respondent is a partnership or a joint venture or similar
organization, provide comparable information as required in (b) above for
each member of the partnership, joint venture or similar organization.
(d) A statement that the Respondent has complied with all applicable
affirmative action (or similar) requirements with respect to its business
activities, together with evidence of such compliance.
5.
The number of years Respondent has been in business under the present name.
6.
The number of years Respondent has been under the current management.
7.
Any judgments within the last three (3) years in which Respondent has been
adjudicated liable for professional malpractice. If yes, please explain.
8.
Whether the Respondent is now or has been involved in any bankruptcy or
reorganization proceeding in the last ten (10) years. If yes, please explain.
9.
Confirm appropriate federal and state licenses to perform activities.
10.
An executed letter of intent.
3.3 Professional Information Requirements
a.
Respondent shall submit a description of its overall experience in
providing the type of services sought in the RFQ. At a minimum, the following
information on past experience should be included as appropriate to the RFQ:
1. Description and scope of work by Respondent.
2. Name, address and contact information of references.
3. Explanation of perceived relevance of the experience to the RFQ.
b.
Brief description of Respondent’s relevant clients including municipal
government clients during the last three (3) years.
c.
Resumes of key employees.
d.
Names and resumes of attorneys who will be assigned to provide legal
services to the City.
e.
A narrative statement of the Respondent’s understanding of the City’s
needs and goals.
f.
Limits of Malpractice insurance coverage.
g.
List all immediate relatives of Principal(s) of Respondent who are City
employees or elected officials of the City. For purposes of the above, “immediate
relative” means a spouse, parent, stepparent, brother, sister, child, stepchild, direct-line
aunt or uncle, grandparent, grandchild and in-laws.
h.
Proof by way of a Certificate of Insurance reflecting the firm’s coverage
for a minimum of $500,000 of Professional Liability Insurance.
i.
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.
SECTION 4
INSTRUCTIONS TO RESPONDENTS
Submission of Qualification Statements
Respondents must submit an original and two (2) copies of their Qualification Statement
to the Designated Contact Person:
Qualification Statements must be received by the City no later than 11:00 a.m. on
November 9, 2023, and must be mailed or hand-delivered. Qualification Statements
forwarded by facsimile or e-mail will not be accepted.
To be responsive, Qualification Statements must provide all requested information, and
must be in strict conformance with the instructions set forth herein. Qualification
Statements and all related information must be bound, and signed and acknowledged by
the Respondent.
SECTION 5
EVALUATION
The City’s objective in soliciting Qualification Statements is to enable it to select a
Respondent that will provide high quality and cost effective services to the citizens of
City of Orange Township. The City will consider Qualification Statements only from
Respondents that, in the City’s sole judgment, have demonstrated the capability and
willingness to provide high quality services to the citizens of the City in the manner
described in this RFQ.
Qualification Statements will be evaluated by the City on the basis of which is the most
advantageous, experience and other factors considered. The evaluation will consider:
1.
Experience and reputation in the field;
2.
Knowledge of the municipal corporation;
3.
Availability to accommodate the required meetings of the City;
4.
Experience in the areas of law described in Section 2 of this RFQ;
5.
Pertinent government experience; and
6.
Other factors demonstrated to be in the best interest of the City.
The City will select the most advantageous Qualification Statements based on all of the
evaluation factors set forth in the RFQ. The City will make the award(s) that is in the
best interest of the City.
Each Qualification Statements must satisfy the objectives and requirements detailed in
this RFQ except as otherwise stated. Successful Respondents shall be determined by an
evaluation of the total content of the Qualification Statement submitted. The City
reserves the right to not select any of the Qualification Statements.
The City shall not be obligated to explain the results of the evaluation process to any
Respondent.
SECTION 6
GENERAL TERMS AND CONDITIONS
1. The City reserves the right to reject any or all Qualification Statements, if
necessary, or to waive any information in the Qualification Statements, and,
unless otherwise specified by the Respondent, to accept any item, items or
services in the Qualification statement should it be deemed in the best interest of
the City to do so.
2. Each Qualification Statement must be signed by the person authorized to do so.
3. Qualification Statements may be hand delivered or mailed consistent with the
provisions of the legal notice to Respondents. In the case of mailed Qualification
Statements, the City assumes no responsibility for Qualification Statements
received after the designated date and time and will return late Qualification
Statements unopened. Qualification Statements will not be accepted by facsimile
or e-mail.
4. 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 numbers or complete Affirmative
Action employee information report (form AA-302). Also, during the period of
engagement, the respondent for contractor wherever stated agrees as follows: (a)
the respondent 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 respondent 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 respondent agrees to post in conspicuous places, available to
employees and applicants for employment, notice to be provided by the Public
Agency Compliance Officer setting forth provisions of this nondiscrimination
clause; (b) the respondent, where applicable, will in all solicitations or
advertisements for employees placed by or on behalf of the respondent, 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 respondent, where applicable, will send to each labor union or
representative or workers with which it has a collective bargaining agreement or
other respondent understanding, a notice, to be provided by the agency
contracting officer advising the labor union or worker’s representative of the
respondent’s commitments under this act and shall post copies of the notice; (d)
the contractor, 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.
5. 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.
6. 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 respondents or any other person.
7. Should any difference arise between the contracting parties as to the meaning or
intent of these instructions or specifications, the City’s decision shall be final and
conclusive.
8. The City shall not be responsible for any expenditure of monies or other expenses
incurred by the Respondent in making its proposal.
9. The award of a contract will be subject to City of Orange’s “Contractor Pay-to-
Play Reform” Ordinance §4-70, et seq.
10. Pursuant to N.J.S.A. 52:32-44, Respondents should submit a copy of their
Business Registration Certificate with their Qualification Statement.
END OF GENERAL INSTRUCTIONS
REQUIRED ADMINISTRATIVE FORMS
Please place the checklist and the required forms which follow at the front of your
packet to facilitate the review of your submission.
CITY OF ORANGE TOWNSHIP
PROJECT:
REDEVELOPMENT COUNSEL SERVICES
RESPONENT:
______________________________________________________
RESPONDENT’S
CHECKLIST
Item
Respondent
Initials
AA/EEO
Review
A. Non-Collusion Affidavit properly notarized
B. Public Disclosure Statement
C. Mandatory Affirmative Action Language
D. Affirmative Action Compliance Notice
E. Employee Information Report
F. Americans with Disabilities Act
G. MWBE Questionnaire (2 Copies)
H. Business Registration Certificate
I. Letter of Qualification
J. Letter of Intent
K. Hold Harmless Agreement
L. Price Proposal
M. Certification of Compliance (Ord. §4-70 et seq).
N. Original signature(s) on all required forms.
NON-COLLUSION AFFIDAVIT
State of _________________________
County of __ ss:
____________________________________________, being first duly sworn deposes
and says
(Name of Affiant)
that he is ______________________________ of _______________________________,
(Sole owner, a Partner, President, Secretary, etc.)
(Name of Business
Entity)
the party making the fore-going Qualification Statement or bid, that such bid is genuine
and not collusive or sham; that said bidder has not colluded, conspired, connived, or
agreed, directly or indirectly, with any bidder or person, to put in a sham bid, or that such
person shall refrain from bidding, and has not in any manner, directly or indirectly sought
by agreement or collusion or communication or conference, with any person, to fix the
bid price of affiant or any other bidder, or to fix any other bidder, or person interested in
the proposed contract; and that all statements contained in said Qualification Statement or
bid are true; and further, that such bidder has not, directly or indirectly submitted this bid,
or the contents thereof, or divulged information of data relative thereto to any association
or to any member or agent thereof.
______________________________________
(Affiant)
Sworn to and subscribed before me
this ____ day of______________,20_____.
__________________________________________
Notary Public in and for
________________________County,
this ____ day of______________,20____
Item B. Public Disclosure Information
Chapter 33 of the Public Laws of 1977 provides that no Corporation or Partnership shall
be awarded any State, City, Municipal or Schools District contracts for the performance
of any work or the furnishing of any materials or supplies, unless prior to the receipt of
the bid or accompanying the bid of said corporation or partnership there is submitted a
public disclosure information statement. The statement shall set forth the names and
addresses of all stockholders in the corporation or partnership who own ten percent
(10%) or more of its stock of any class, or of all individual partners in the partnership
who own a ten percent (10%) or greater interest therein.
PLEASE UTILIZE SEPARATE SHEET WITH HEADINGS IF NECESSARY
STOCKHOLERS:
Name
Address
% Owned
SIGNATURE: _______________________________________
TITLE: ______________________________________________________
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_____.
(NOTE: THIS FORM MUST BE COMPLETED, NOTARIZED AND RETURNED
WITH THIS PROPOSAL).
Item C. Mandatory Affirmative Action Language
EQUAL EMPLOYMENT OPPORTUNITY (EEO)/
AFFIRMATIVE ACTION (AA) REQUIREMENTS
FOR GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS
Questions in reference to EEO/AA requirements for
Goods, Professional Service and General Service
Contracts should be director to:
Christopher Hartwyk
EEO/AA Officer, P.A.C.O.
Department of Administration
Office of EEO/AA
29 N. Day Street
Orange, NJ 07050
Tel. (973-266-4010
Fax #973-672-2383
E-Mail Address: chartwyk@orangenj.gov
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 SERVICES 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 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 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. l7:27-5.2.
EXHIBIT A (Continuation)
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.
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 with 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; or
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.
The undersigned vendor certifies on their company’s receipt, knowledge and commitment to comply with:
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)
The undersigned vendor further agrees to furnish the required forms of evidence and understands
that their contract/company’s bid shall be rejected as non-responsible if said contractor fails to
comply with the requirements of N.J.S.A. 10:5-31 and N.J.A.C. 17:27.
Representative’s Name/Title (Print):_____________________________________________________
Representative’s Signature:_____________________________________________________________
Name of Company:___________________________________________________________________
Tel. No.:____________________
Date:________________________
APPENDIX A
AMERICANS WITH DISABILITIES ACT OF 1990
Equal Opportunity for Individuals with Disability
The contractor and the _____________ of _______________, (hereafter “owner”) do hereby
agree that the provisions of Title 11 of the Americans With Disabilities Act of 1990 (the "Act")
(42 U.S.C. S121 01 et seq.), which prohibits discrimination on the basis of disability by public
entities in all services, programs, and activities provided or made available by public entities, and
the rules and regulations promulgated pursuant there unto, are made a part of this contract. In
providing any aid, benefit, or service on behalf of the 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.
Representative’s Name/Title (Print):_____________________________________________________
Representative’s Signature:_____________________________________________________________
Name of Company:___________________________________________________________________
Tel. No.:____________________
Date:________________________
Minority/Woman Business Enterprise (MWBE)
Questionnaire for Bidders
City of Orange Township, establishes a goal of awarding a certain percentage of the amount of total city
procurement to minority and woman owned business enterprises.
To assist us in monitoring our achievement of this goal, please indicate below whether your company is or
is not a minority owned and/or woman owned business, and return this form with your bid proposal.
Business Name: ______________________________________________________________________
Address:____________________________________________________________________________
Telephone No.: ______________________________________________________________________
Contact Name:_______________________________________________________________________
Please check applicable category:
______ Minority Owned Business (MBE)
_________ Minority & Woman Owned
Business (MWBE)
______ Woman Owned business (WE)
_______ Neither
Definitions
Minority Business Enterprise
Minority Business Enterprise means a business which is a sole proprietorship, partnership or corporation at
least 51% of which is owned and controlled by persons who are African American, Hispanic, Asian
American, American Indian or Alaska native, defined as follows:
African American: A person having origins in any of the black racial groups of Africa
Hispanic:
A person of Mexican, Puerto Rican, Central or South American or other non-
European Spanish culture or origin regardless of race.
Asian:
A person having origins in any of the original peoples of the Far East, South East
Asia, Indian subcontinent, Hawaii or the Pacific Islands.
American Indian or Alaska Native: a person having origins in any of the original peoples of
North America and who maintains cultural identification through tribal affiliation or community
recognition.
Woman Business Enterprise
Woman Business Enterprise means a business which is a sole proprietorship or corporation at least 51% of
which is owned and controlled by a woman or women.
Minority/Woman Business Enterprise (MWBE)
Questionnaire for Bidders
City of Orange Township Ordinance §4-70, et seq. establishes a goal of awarding 20% of the dollar
amount of total city procurement to minority and woman owned business enterprises.
To assist us in monitoring our achievement of this goal, please indicate below whether your company is or
is not a minority owned and/or woman owned business, and return this form with your bid proposal.
Business Name: ______________________________________________________________________
Address:____________________________________________________________________________
Telephone No.: ______________________________________________________________________
Contact Name:_______________________________________________________________________
Please check applicable category:
______ Minority Owned Business (MBE)
_________ Minority & Woman Owned
Business (MWBE)
______ Woman Owned business (WE)
_______ Neither
Definitions
Minority Business Enterprise
Minority Business Enterprise means a business which is a sole proprietorship, partnership or corporation at
least 51% of which is owned and controlled by persons who are African American, Hispanic, Asian
American, American Indian or Alaska native, defined as follows:
African American: A person having origins in any of the black racial groups of Africa
Hispanic:
A person of Mexican, Puerto Rican, Central or South American or other non-
European Spanish culture or origin regardless of race.
Asian:
A person having origins in any of the original peoples of the Far East, South East
Asia, Indian subcontinent, Hawaii or the Pacific Islands.
American Indian or Alaska Native: a person having origins in any of the original peoples of
North America and who maintains cultural identification through tribal affiliation or community
recognition.
Woman Business Enterprise
Woman Business Enterprise means a business which is a sole proprietorship or corporation at least 51% of
which is owned and controlled by a woman or women.
LETTER OF QUALIFICATION
Date
Attn: Gracia Robert Montilus
City Attorney
City of Orange Township
29 N. Day Street
Orange, NJ 07050
RE:
Request for Qualifications
Special Legal Counsel Services (Redevelopment Counsel)
Dear Mr. Montilus:
The undersigned has reviewed our Qualification Statement submitted in response to the
Request for Qualifications (RFQ) issued by the City of Orange (“City”), dated October
12, 2023, in connection with the City’s need for Special Legal Counsel Services
(Redevelopment Matters).
We affirm that the contents of our Qualification Statement (which Qualification
Statement is incorporated herein by reference) are accurate, factual and complete to the
best of our knowledge and belief and that the Qualification Statement is submitted in
good faith upon express understanding that any false statement may result in the
disqualification of (Name of Respondent).
(Respondent shall sign and complete the spaces provided below. If a joint venture,
appropriate officers of each company shall sign.)
Signature of Chief
Signature of Chief
Executive Officer
Financial Officer
Typed Name and Title
Typed name and Title
(Type Name of Firm) *
(Type Name of Firm)*
Dated:
Dated:
*
If a joint venture, partnership or other formal organization is submitting a RFQ,
each participant shall execute this Letter of Qualification.
LETTER OF INTENT
Date
Attn: Gracia Robert Montilus
City Attorney
City of Orange Township
29 N. Day Street
Orange, NJ 07050
RE:
Request for Qualifications
Special Legal Counsel Services (Redevelopment Counsel)
Dear Mr. Montilus:
The undersigned, as Respondent, has submitted the attached Qualification Statement in response
to a Request for Qualifications (RFQ), issued by the City of Orange Township (“City”), dated
October 12, 2023, in connection with the City’s need for Special Legal Counsel Services
(Name of Respondent) HEREBY STATES:
1.
The Qualification Statement contains accurate, factual and complete information.
2.
(Name of Respondent) agrees to participate in good faith in the procurement
process as described in the RFQ and to adhere to the City’s procurement schedule.
3.
(Name of Respondent) acknowledges that all costs incurred by it in connection
with the preparation and submission of the Qualification Statement and any proposal prepared
and submitted in response to the RFQ, or any negotiation which results therefrom shall be borne
exclusively by the Respondent.
4.
(Name of Respondent) hereby declares that the only persons participating in this
Qualification Statement as Principals are named herein and that no person other than those herein
mentioned has any participation in the Qualification Statement or in any contract to be entered
into with respect thereto. Additional persons may subsequently be included as participating
Principals, but only if acceptable to the City.
5.
(Name of Respondent) declares that this Qualification Statement is made without
connection with any other person, firm or parties who has submitted a Qualification Statement,
except as expressly set forth below and that it has been prepared and has been submitted in good
faith and without collusion or fraud.
6.
(Name of Respondent) acknowledges and agrees that the City may modify,
amend, suspend and/or terminate the procurement process (in its sole judgment). In any case, the
City shall not have any liability to the Respondent for any costs incurred by the Respondent with
respect to the procurement activities described in this RFQ.
7.
(Name of Respondent) acknowledges that any letter of engagement executed
with respect to the provision of Special Legal Counsel Services (Labor/Employment
Matters) must comply with all applicable affirmative action and similar laws. Respondent
hereby agrees to take actions as are required in order to comply with such applicable laws.
(Signature of Chief Executive Officer)
(Typed Name and Title)
(Type Name of Firm)
Dated:___________
*If a joint venture, partnership or other formal organization is submitting a RFQ, each participant
shall execute this Letter of Intent.
HOLD HARMLESS AGREEMENT
The Contractor, shall defend, indemnify and hold harmless the City of Orange Township,
its agents, servants and administrators from and against any and all claims or actions at
law, whether for personal injury, property damage or liability, including any cost of
defense incurred by the City of Orange Township and any payments, recoveries and
judgments against the City of Orange Township, which arise from actions or omissions of
the Contractor, his agents or employees in the execution of the work and/or duties to be
perform under the contract.
Costs shall be deemed to include, but not limited to attorney’s fees, filing expenses,
expert witness fees, reproductions costs, and long distance travel in connection with
defense and shall bear the prevailing interest rate, where applicable.
The Contractor shall be responsible for all damage to persons or property caused or
alleged to have been caused by or incident to the execution of this work, and shall defend
claims or suits arising from or incident to the work under the aforementioned contract
without expense to the City of Orange Township, its agent’s servants and/or
administrators.
By: ______________________________________
Date: __________________
Name:
Title:
On behalf of:
_____________________________________________
Name of Organization
BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR NON-FAIR AND OPEN CONTRACTS
Required Pursuant To N.J.S.A. 19:44A-20.8
CITY OF ORANGE TOWNSHIP, NEW JERSEY
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.
5. 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 legal person, business corporation, professional services corporation, limited liability
company, partnership, limited partnership, business trust, association or any other legal 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 than 10% of the profits or assets of a business entity or 10% of the stock in the
case of a business entity 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.19:44A-9) for the purpose of receiving contributions and making expenditures.
r. the term "joint 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 least two candidates for the same elective public offices in the same election in a legislative 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)
BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR NON-FAIR AND OPEN CONTRACTS
Required Pursuant To Ordinance §4-70, et seq.
CITY OF ORANGE TOWNSHIP, NEW JERSEY
Part I – Vendor Affirmation
The undersigned, being authorized and knowledgeable of the circumstances, does hereby certify that
________________________________________________________________________________________
(Contractor)
has not made and will not make any reportable contributions pursuant to Ordinance 4-70 et seq. that would bar the
award of this contract in the one year period preceding the date of reorganization to any of the following named
candidate committee, joint candidates committee; or political party committee representing the elected officials of the
CITY OF ORANGE TOWNSHIP as defined pursuant to N.J.S.A. 19:44A-3(p), (q) and (r).
Dwayne D. Warren, Esq., Mayor
Hon. Kerry J. Coley
Hon. Adrienne K. Wooten
Hon. Tency A. Eason
Hon. Clifford R. Ross
Hon. Quantavia L. Hilbert
Hon. Jamie Summers-Johnson
Hon. Weldon M. Montague
Part II – Ownership Disclosure Certification
oI certify that the list below contains the names and home addresses of all owners holding 10% or more of the
issued and outstanding stock of the undersigned.
Check the box that represents the type of business entity:
oPartnership
oCorporation
oSole Proprietorship
oSubchapter S Corporation
oLimited Partnership
oLimited Liability Corporation
oLimited Liability Partnership
Name of Stock or Shareholder
Home Address
Part 3 – Signature and Attestation:
The undersigned is fully aware that if I have misrepresented in whole or part 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 the ___________ day of
__________________________________, 20__.
My Commission expires:
_________________________________________________
(Affiant)
_________________________________________________
(Print name & title of affiant) (Corporate Seal)
VENDOR INFORMATION
Name of Business: ________________________________________________
(Print)
Name of Contact Person: ___________________________________________
(Print)
Correspondence Address (including zip code):
_______________________________________________
_______________________________________________
_______________________________________________
Purchase Order Address for signature (including zip code):
_______________________________________________
_______________________________________________
_______________________________________________
Payment Address (including zip code):
_______________________________________________
_______________________________________________
_______________________________________________
Telephone Number (including area code): ________________________________
Fax Number (including area code): ______________________________________
E-Mail Address: ____________________________________________________
Employer I.D. # or S.S. #: ____________________________________________
FAILURE TO PROVIDE ALL OF THE ABOVE INFORMATION MAY RESULT IN
REJECTION OF THIS BID.
PROPOSER’S AFFIDAVIT
State of _________________
County of _______________
I, _____________________________________
(Print Name)
certify that I am the ______________________________________
(Title)
of the business entity submitting this bid/proposal; that I have completed and signed all of the
required documents; that I am duly authorized to sign the bid/proposal on behalf of the business
entity; and that all of the declarations and statements contained in the bid/proposal document are
true and accurate to the best of my knowledge and belief.
_______________________________________ / ___________________
(Signature of Bidder) (Date)
NOTARY:
Subscribed and sworn before me
This _____day of ____________________, 20____.
My Commission expires:
CERTIFICATION OF COMPLIANCE WITH CONTRACTOR PAY-TO-PLAY
REFORM ORDINANCE §4-70.20
________________________, the Business Entity, as that term is defined in City of
Orange Township Revised Ordinance 4-70.20 (a copy of which is attached), nor any
Subcontractor, as that term is defined therein, has not made prohibited contribution in
violation thereof in the twelve (12) month period prior to the award of this contract (or
the renewal, extension, or material modification of the contract).
Name of Business Entity:
Signed________________________________
Title:
Print Name ____________________________
Date:
Subscribed and sworn before me
This _____day of ____________________, 20____.
My Commission expires:
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Gracia Robert Montilus
City Attorney · Law Department
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First Discovered
Mar 31, 2026
Last Info Update
Apr 30, 2026
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