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RFQ Posting Notice - Zoning Board of Adjustment Attorney 2024
BID #: 24
ISSUED: 11/22/2023
DUE: 12/5/2023
VALUE: TBD
100
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Executive Summary
The City of Orange Township, New Jersey is soliciting Qualification Statements from individuals and/or firms to provide general legal services to the Zoning Board of Adjustment for the calendar year 2024, spanning from January 1, 2024, to December 31, 2024. The selected firm will provide legal guidance, attend meetings, review applications, and prepare legal documents. The selection process is not subject to public bidding laws but adheres to the New Jersey Campaign Contributions and Expenditures Reporting Act.
Interested parties must submit their Qualification Statements in accordance with the RFQ's procedures and schedules, ensuring all required information is included. The Board will evaluate submissions based on experience, qualifications, and the ability to provide timely and professional services. Responses must be received no later than 10:00 AM on December 5, 2023. Submissions via fax or email are not accepted; they must be hand-delivered or sent via mail or courier in sealed envelopes, clearly marked “RFQ – 2024 Zoning Board of Adjustment Attorney”.
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Bid Postings • RFQ Posting Notice - Zoning Board of Adjustme 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: RFQ Posting Notice - Zoning Board of Adjustment Attorney 2024 Category: Bids and Request for Qualification (RFQs) Status: Closed Description: NOTICE OF REQUEST FOR QUALIFICATIONS Zoning Board of Adjustment Attorney January 1, 2024 - December 31, 2024 NOTICE IS HEREBY GIVEN that the Zoning Board of Adjustment (“Board”) of the City of Orange Township, New Jersey (“City”) is soliciting Qualification Statements from interested individuals and/or firms to provide the Board with general legal services for the 2024 calendar year. Interested individuals and/or firms must prepare and submit a Qualification Statement in accordance with the procedures and schedules set forth in the Request for Qualifications (“RFQ”), and the Board will only review submissions that include all required information (as determined in the City’s sole discretion). The Board intends to qualify individuals and/or firms that possess the professional experience, administrative and sta?ng capabilities to provide the proposed services, and agree to meet the defined terms and conditions. The selection of qualified individuals and/or firms is not subject to the bidding provisions of the Local Public Contracts Law, N.J.S.A . 40A:11-1 et seq., but is subject to the New Jersey Campaign Contributions and Expenditures Reporting Act, N.J.S.A. 19:44A-1 et seq . The City has structured a procurement process that seeks to obtain the desired results, while establishing a competitive, fair and open environment so that each individual and/or firm is provided an equal opportunity to respond to the RFQ. Publication Date/Time: 11/22/2023 12:00 AM Closing Date/Time: 12/5/2023 11:59 PM Submittal Information: RFQ Posting Notice - Zoning Board of Adjustment Attorney 2024 Contact Person: City of Orange Township Zoning Board of Adjustment ATTN: Trisha Scipio, Board Secretary 29 North Day Street, Fourth Floor Orange, New Jersey, 07050 Special Requirements: A copy of the complete RFQ may be obtained anytime via the City’s website (www.orangenj.gov) or email request to tscipio@orangenj.gov, or at the Board’s o?ces during regular business hours (M- F, 8:30a to 4:30p). Responses to the RFQ should be hand delivered or sent via mail or courier (e.g., FedEx, UPS, etc.) to: City of Orange Township Zoning Board of Adjustment ATTN: Trisha Scipio, Board Secretary 29 North Day Street, Fourth Floor Orange, New Jersey, 07050 All responses must be submitted in sealed envelopes, clearly marked “RFQ – 2024 Zoning Board of Adjustment Attorney”, and received in the Board’s o?ces no later than 10:00a on December 5, 2023, at which time all responses will be publicly opened and read aloud. Contracts shall be awarded based on factors including without limitation experience, education, and special accreditations. The Board reserves the right to reject any or all submissions, and/or to waive any immaterial defect as may be permitted by law. Submissions will not be accepted via fax or email. Miscellaneous: City of Orange Township Zoning Board of Adjustment ATTN: Trisha Scipio, Board Secretary 29 North Day Street, Fourth Floor Orange, New Jersey, 07050 All responses must be submitted in sealed envelopes, clearly marked “RFQ – 2024 Zoning Board of Adjustment Attorney”, and received in the Board’s o?ces no later than 10:00a on December 5, 2023, at which time all responses will be publicly opened and read aloud. Contracts shall be awarded based on factors including without limitation experience, education, and special accreditations. The Board reserves the right to reject any or all submissions, and/or to waive any immaterial defect as may be permitted by law. Submissions will not be accepted via fax or email. Related Documents: RFQ Posting Notice - Zoning Board of Adjustment Attorney 2024 RFQ - Zoning Board of Adjustment Attorney 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
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--- Document: RFQ Posting Notice - Zoning Board of Adjustment Attorney 2024 ---
NOTICE OF REQUEST FOR QUALIFICATIONS
Zoning Board of Adjustment Attorney
January 1, 2024 - December 31, 2024
NOTICE IS HEREBY GIVEN that the Zoning Board of Adjustment (“Board”) of the City of Orange
Township, New Jersey (“City”) is soliciting Qualification Statements from interested individuals
and/or firms to provide the Board with general legal services for the 2024 calendar year. Interested
individuals and/or firms must prepare and submit a Qualification Statement in accordance with
the procedures and schedules set forth in the Request for Qualifications (“RFQ”), and the Board
will only review submissions that include all required information (as determined in the City’s
sole discretion). The Board intends to qualify individuals and/or firms that possess the
professional experience, administrative and staffing capabilities to provide the proposed
services, and agree to meet the defined terms and conditions. The selection of qualified
individuals and/or firms is not subject to the bidding provisions of the Local Public Contracts
Law, N.J.S.A. 40A:11-1 et seq., but is subject to the New Jersey Campaign Contributions and
Expenditures Reporting Act, N.J.S.A. 19:44A-1 et seq. The City has structured a procurement
process that seeks to obtain the desired results, while establishing a competitive, fair and open
environment so that each individual and/or firm is provided an equal opportunity to respond to
the RFQ.
A copy of the complete RFQ may be obtained anytime via the City’s website (www.orangenj.gov) or
email request to tscipio@orangenj.gov, or at the Board’s offices during regular business hours (M-
F, 8:30a to 4:30p). Responses to the RFQ should be hand delivered or sent via mail or courier (e.g.,
FedEx, UPS, etc.) to:
City of Orange Township Zoning Board of Adjustment
ATTN: Trisha Scipio, Board Secretary
29 North Day Street, Fourth Floor Orange, New Jersey, 07050
All responses must be submitted in sealed envelopes, clearly marked “RFQ – 2024 Zoning Board
of Adjustment Attorney”, and received in the Board’s offices no later than 10:00a on December 5,
2023, at which time all responses will be publicly opened and read aloud. Contracts shall be awarded
based on factors including without limitation experience, education, and special accreditations.
The Board reserves the right to reject any or all submissions, and/or to waive any immaterial defect
as may be permitted by law. Submissions will not be accepted via fax or email.
--- Document: RFQ - Zoning Board of Adjustment Attorney 2024 ---
SUBMISSION DEADLINE
Department of Planning and Economic Development
Zoning Board of Adjustment
Trisha Scipio, Board Secretary
Municipal Building
29 North Day Street, Fourth Floor
Orange, New Jersey 07050
REQUEST FOR
QUALIFICATIONS
Zoning Board of Adjustment Attorney
January 1, 2024 - December 31, 2024
RFQ: Zoning Board of Adjustment Attorney
January 1, 2024 - December 31, 2024
Page 1
I.
ABOUT THE CITY OF ORANGE TOWNSHIP
The City of Orange Township (“City”) is located in Essex County, New Jersey, and is home to approximately
31,000 residents across 4 wards (North, South, East and West). City government is organized and administered in
accordance with to the Mayor Council Plan of the Optional Municipal Charter Act, N.J.S.A. 40:69A-1 et seq., with an
elected Mayor and 7-member Municipal Council (1 member from each ward and 3 at-large members), and day-to-
day operations delegated to the City’s several departments. The Department of Planning and Economic
Development (“Department”) is responsible for advising the Mayor, Municipal Council, and land use boards on
all matters affecting physical and economic development. The Department is also responsible for preparing,
maintaining, and updating the City’s Master Plan, development regulations (i.e., zoning ordinance) and
redevelopment plans.
The Zoning Board of Adjustment (“Board”) is 1 of the City’s 3 land use boards, and has 7 regular and 4 alternate
members, all residents of the City appointed by the Municipal Council. The Board’s jurisdiction, as set forth under
Chapter 210 of the Orange Municipal Code, is derived from the Municipal Land Use Law, N.J.S.A. 40:55D-1 et
seq., and more specifically N.J.S.A. 40:55D-70 and N.J.S.A. 40:55D-76, and extends only to sections of the City that the
Municipal Council has not designated as an area in need of redevelopment and/or rehabilitation under the
Local Redevelopment and Housing Law, N.J.S.A. 40A:12A-1 et seq. Land use matters involving properties within
redevelopment/rehabilitation areas fall within the jurisdiction of the City’s Planning Board and Municipal Council.
II.
NATURE | SCOPE OF SERVICE
The City is requesting Qualification Statements from licensed individuals and/or firms with demonstrated
knowledge and technical expertise in zoning and land use law, wishing to serve as attorney to the Board. The
successful individual and/or firm shall be required to execute the City’s form agreement, which includes
indemnification, insurance, termination and licensing provisions. A draft agreement is available for review upon
request.
A. General Statement of Duties
The selected individual or firm will work with the Board, its staff (i.e., Board Secretary, professional consultants), and
the Director of Planning and Economic Development to provide the necessary services and resources on a
timely basis. The scope of work shall broadly include all general, non-litigation legal services the Board may
require, including without limitation:
providing general legal guidance to the Board on matters related to jurisdiction, governance, procedure
and compliance;
attendance at Board meetings and Technical Review Committee meetings as required (the Board
typically meets on the 4th Monday of every month);
legal review and analysis of applications for development before the Board; and,
preparation of resolutions and other legal documents related to or required for Board action on
applications for development or for the Board to fulfill other official duties.
The selected individual or firm would also be responsible for working with the City’s Department of Law on any
Board matters involving legal issues that affect the City as a whole and/or any litigation brought against the
City and/or the Board pertaining to Board action.
Qualification Statements shall be evaluated by the Board based on the following criteria:
proposed use of personnel and approach to role of Board Attorney;
experience, qualifications and reputation providing similar services to other public entities;
experience with and knowledge and familiarity of the City and its Development Regulations (see Orange
Mun. Code, Ch. 210);
resources available to the individual and/or firm, as well as availability to attend required meetings;
ability to provide services in a timely, efficient and professional manner, without
subcontracting; and,
other factors shown to be beneficial to the City or determined to be relevant.
RFQ: Zoning Board of Adjustment Attorney
January 1, 2024 - December 31, 2024
Page 2
B. Term of Appointment
The selected individual and/or firm shall be appointed for a 12-month period—January 1, 2024, through and
including December 31, 2024—with an option to renew said appointment for an additional 12 months.
C. Compensation
The selected individual and/or firm shall be compensated as follows:
a flat fee of $625.00 per public meeting of the Board during the Agreement Term, which shall include all
general and non-Application-related legal services rendered to the Board before, during and after said
meeting, subject to an annual hard cap of $7,500.00; plus,
an hourly fee of $150.00 for all application-related legal services, billed to and paid entirely from escrows
collected from each applicant.
III. MANDATORY MINIMUM QUALIFICATIOINS
The selected individual and/or firm must demonstrate the following:
1.
at least 10 years of experience providing professional legal services in zoning and land use matters, of
which, at least 7 years shall be in providing such services to governmental entities;
2.
possession of a valid license to practice law in the State of New Jersey; and,
3.
demonstrated knowledge of the City’s current zoning initiatives.
IV. SUBMISSION REQUIREMENTS
Qualification Statements shall include, at minimum, the following information:
a.
a description of the individual and/or firm’s experience, particularly in providing land use/zoning-related legal
services to municipalities, economic development and/or housing authorities, and other governmental
entities, with special attention to the individual and/or firm’s experience working specifically with urban
municipal governments;
b.
a description of the individual and/or firm’s business organization (e.g., corporation, LLC, partnership,
etc.), as well as its ownership and organizational structure;
c.
the number of years the individual and/or firm has been conducting business under the present name;
d. resumes of all principals, attorneys and professional staff who would work directly with the City, as well as copies
of Certificates of Good Standing issued by the New Jersey Board of Bar Examiners within the immediately
preceding 90 days for each attorney;
e.
references who can attest to the individual and/or firm’s prior municipal or other governmental experience,
including:
name of municipality or government entity;
contact person and title; and,
telephone number and email address;
f.
a list of any judgments, claims or suits pending or outstanding against individual and/or firm, with
explanations regarding the nature and status of each;
g.
a statement regarding whether the individual and/or firm is now or was ever involved in any bankruptcy
or reorganization proceedings in the last 10, with explanations of any such circumstances;
h.
a signed Equal Employment Opportunity statement, as well as a copy of either a completed AA-302
Employee Information Report or a Certificate of Employee Information Report;
i.
a completed Non-Collusion Affidavit;
j.
a completed Business Ownership Disclosure;
k.
a completed Political Contribution Disclosure for each individual and/or each principal with 10% or
greater ownership interest in the firm; and,
l.
proof of errors and omissions insurance with a policy limit of at least $1,000,000.00 per occurrence (the
successful individual and/or firm will be required to provide a Certificate of Insurance naming the City as an
additional insured).
RFQ: Zoning Board of Adjustment Attorney
January 1, 2024 - December 31, 2024
Page 3
Each respondent must submit 1 bound original, 5 paper copies, and a digital copy of the complete Qualification
Statement, no later than 10:00 AM on December 5, 2023, addressed to:
City of Orange Township
Zoning Board of Adjustment
ATTN: Trisha Scipio, Board Secretary
29 North Day Street, Fourth Floor
Orange, New Jersey 07050
Electronic or fax submissions are not permitted, and Qualification Statements received after the submission
deadline will not be accepted. All questions regarding this RFQ must be submitted in writing to the Board Secretary,
at the address above.
REQUEST FOR QUALIFICATIONS
Zoning Board of Adjustment Attorney
January 1, 2024 - December 31, 2024
SUBMISSION CHECKLIST
This checklist must be completed and submitted along with all Qualification Statements. A submission that does
not contain all items listed in the checklist will be rejected.
Qualification Statement
Mandatory Equal Employment Opportunity Statement
AA-302 Employee Information Report or Certificate of Employee Information Report Non-
Collusion Affidavit
Business Ownership Disclosure Political
Contribution Disclosure
New Jersey Business Registration Certificate*
Authorized signatures on all documents (and notarized, as applicable)
1 bound original, 5 paper copies, and 1 electronic copy of entire submission
* NOTE: N.J.S.A. 52:32-44 prohibits the City from entering any contract for goods or services unless the other party to
the contract provides a copy of valid business registration certificates for itself and any subcontractors it intends to
utilize in providing services.
The undersigned hereby acknowledges the above listed requirements.
For
(Individual or Firm Name)
By:
____________________________________
(Signature)
(Date)
___________________________________________________
(Printed Name)
___________________________________________________
(Title)
SIGN
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE
N.J.S.A. 10:5-31 et seq. (P.L.1975, c.127); N.J.A.C. 17:27
Goods, Professional Service and General Service Contracts
During the performance of this contract,
, (“contractor” or “subcontractor”,
as appropriate), 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, 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 county employment goals established in accordance with N.J.A.C. l7:27-5.2.
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, 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 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,
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 or subcontractor shall submit to the public agency, after notification of award but prior to
execution of a goods and services contract, 1 of the following 3 documents:
1.
Federal Letter of Approval of Equal Employment Opportunity Policies;
2.
Certificate of Employee Information Report; or,
3.
Completed Employee Information Report Form AA302.
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE (cont’d)
N.J.S.A. 10:5-31 et seq. (P.L.1975, c.127); N.J.A.C. 17:27
Goods, Professional Service and General Service Contracts
The contractor or subcontractor shall furnish such reports or other documents to the City as may be requested from
time to time in order to carry out the purposes of these regulations, and the City may furnish such information as
may be requested by the New Jersey Division of Purchase & Property, Contract Compliance Administration Unit,
EEO Monitoring Program for purposes of conducting a compliance investigation pursuant to N.J.A.C. 17:27-10 et seq.
The undersigned hereby acknowledges the above listed requirements.
For
(Individual or Firm Name)
By:
____________________________________
(Signature)
(Date)
___________________________________________________
(Printed Name)
___________________________________________________
(Title)
SIGN
NON-COLLUSION AFFIDAVIT
STATE OF NEW JERSEY
:
COUNTY OF
: ss.
I,
, on behalf of the firm of
, upon my
oath or affirmation, hereby depose and say:
1.
That I executed the documents submitted herein with full authority so to do;
2.
That neither I nor the firm has 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 contract;
3.
That all statements contained in the documents submitted herewith, and in this Affidavit are true and correct,
and made with full knowledge that the City of Orange Township will rely upon the truth of the statements
contained therein in making determinations regarding award of this contract; 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 proposer. See N.J.S.A. 52:34-25.
The undersigned hereby acknowledges the above listed requirements.
For
(Individual or Firm Name)
By:
____________________________________
(Signature)
(Date)
___________________________________________________
(Printed Name)
___________________________________________________
(Title)
Sworn before me on this
day of
, 2023.
Notary Public
SIGN
BUSINESS OWNERSHIP DISCLOSURE
Pursuant to N.J.S.A. 52:25-24.2, the City of Orange Township (“City”) is prohibited from awarding a contract to
any business entity unless, the business entity provides the City with a statement setting forth the names and
addresses of all individuals with 10.00% or more ownership interest therein at the time of proposal.
A. Business Entity Name & Organization
Legal Name of Business Entity:
Type of Entity:
“C” Corporation
“S” Corporation
Limited Liability Company
General Partnership
Limited Partnership
Limited Liability Partnership
B. Ownership Information
No person or entity has 10.00% or greater ownership interest in the business entity.
Names and addresses for all persons or entities with at least 10.00% ownership interest in the business entity, along with
corresponding ownership interest percentages, are as follows (attach additional sheets as necessary):
Name
Address
Ownership %
If any owner identified above is a business entity list the names and addresses of all persons and/or entities owning at
least 10.00% of each such entity, repeating this process until the names and addresses of all non-businesses owning at
least 10.00% of the business and all related entities are disclosed (attach additional sheets as necessary):
Name
Address
Ownership %
If the business entity has a direct or indirect parent entity which is publicly traded, and any person holds a 10.00% or
greater beneficial interest in the publicly traded parent entity as of the last annual federal Security and Exchange
Commission (“SEC”) or foreign equivalent filing, ownership disclosure can be met by providing links to the
website(s) containing the last annual filing(s) with the SEC (or foreign equivalent) that contain the name and
address of each person holding a 10.00% or greater beneficial interest in the publicly traded parent entity, along with
the relevant page numbers of the filing(s) that contain the information on each such person (attach additional sheets if
necessary):
URL of Last Annual SEC (or foreign equivalent) Filing
Page #
BUSINESS OWNERSHIP DISCLOSURE CERTIFICATION (cont’d)
C. General Disclosures
The following questions must be answered as to the business entity and all parties identified in Part B above
(“owner”). To the extent the answer to any question is “yes”, a separate explanation identifying the relevant
party(ies) and the circumstances involved must be appended to this Disclosure.
Has the business or any owner been a party in litigation brought within the last 5 years involving laws
governing hours of labor, minimum wage standards, discrimination in wages or child labor?
Yes
No
Has the business or any owner ever been charged with, convicted of, under indictment, on
parole, on probation or a plaintiff in, any criminal or civil offense other than a minor motor
vehicle violation?
Yes
No
Has the business or any owner ever been subject to, or have pending, any disciplinary action by
any administration, governmental or regulatory body?
Yes
No
Has the business or any owner ever been subject to any order resulting from any criminal, civil
or administrative proceeding brought by any administrative governmental, or regulatory
agency?
Yes
No
Has the business or any owner ever been denied any license on the grounds of moral turpitude by
any administrative, governmental or regulatory agency?
Yes
No
Has the business or any owner been informed that it/he/she is the target of any current
investigation with respect to possible violations of state or federal securities, antitrust or criminal
laws?
Yes
No
Has the business or any owner ever been denied a business-related license or had any such
license suspended or revoked by any administrative, governmental or regulatory agency?
Yes
No
Has the business or any owner ever been debarred, suspended or disqualified from contracting
with any federal, state or municipal agency?
Yes
No
Has the business or any owner ever been in receivership or adjudicated bankrupt?
Yes
No
Has the business or any owner ever been in default on a personal or business loan?
Yes
No
D. Certification
I hereby certify that the foregoing information and any attachments hereto are true and complete. I acknowledge
that: (a) I am authorized to execute this certification on behalf of the business entity and all parties listed in Parts
A and B above; (b) the City will rely on the information contained herein and the business and all owners are under a
continuing obligation to notify the City in writing of any changes to the information contained herein; and, (c) I am
aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if I do, the
City will reject this submission and I may be subject to prosecution.
For
(Individual or Firm Name)
By:
____________________________________
(Signature)
(Date)
___________________________________________________
(Printed Name)
___________________________________________________
(Title)
SIGN
POLITICAL CONTRIBUTION DISCLOSURE
Pursuant to N.J.S.A. 19:44A-20.26, this form must be submitted not later than 10 days prior to the award of any
contract with the City of Orange Township (“City”) that may have an anticipated value exceeding $17,500.00.
A. Instructions
All persons and business entities contracting with the City must disclose contributions to:
1. any continuing political committee (i.e., political action committee); and/or,
2. any candidate committee of a candidate for, or holder of, an elective office of the City, the County of Essex,
another public entity within the County of Essex, and/or the legislative district where the City is located, (see
Part B below).
The disclosure must list reportable contributions to any of the committees that exceed $200.00 per election cycle,
made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8; N.J.S.A. 19:44A-16. For business
entities, this requirement applies to:
individuals with an ownership interest or control of more than 10.00% of the profits or assets of the business
entity;
all principals, partners, officers, or directors of the business entity and their respective spouses;
any subsidiaries directly or indirectly controlled by the business entity;
any New Jersey-based IRS Code § 527 organization, directly or indirectly controlled by the business entity and
filing as a continuing political committee (i.e., PAC).
When the contractor is a natural person, “a contribution by that person’s spouse or child, residing therewith, shall
be deemed to be a contribution [by the contractor].” N.J.S.A. 19:44A-20.26(b).
Any contractor that fails to comply with these disclosure provisions shall be subject to a fine imposed by the New
Jersey Election Law Enforcement Commission in an amount based upon the amount that the contractor failed to
report.
The enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected
official and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor’s
responsibility to identify the specific committees to which contributions may have been made and need to be
disclosed. The disclosed information may exceed the minimum requirement.
The enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along
with a signed cover sheet) may be used as the contractor’s submission and is disclosable to the public under the
Open Public Records Act, N.J.S.A. 47:1A-1 et seq.
B. List of Agencies & Elected Officials Required for Disclosure
State:
Governor, and Legislative Leadership Committees
Legislative Districts:
21, 27, 28, 29, 34, 36, and 40
1 State Senator and 2 members of the General Assembly per district
County:
County Executive; Commissioners; County Clerk; Sheriff; Surrogate; Registrar of Deeds
Municipalities (mayor and members of governing body, regardless of title):
Belleville Township
Irvington Township
City of Orange Township
Bloomfield Township
Livingston Township
Roseland Borough
Caldwell Borough
Maplewood Township
South Orange Village
Cedar Grove Township
Millburn Township
Verona Township
City of East Orange
Montclair Township
West Caldwell Township
Essex Fells Borough
City of Newark
West Orange Township
Fairfield Township
North Caldwell Borough
Glen Ridge Borough
Nutley Township
[CONTINUED ON NEXT PAGE]
POLITICAL CONTRIBUTION DISCLOSURE (cont’d)
B. List of Agencies & Elected Officials Required for Disclosure (cont’d)
Boards of Education (members of the board):
Belleville Public School District
Irvington Public School District
Roseland Public School District
Bloomfield Public School District
Livingston Public School District
South Orange-Maplewood PSD
Caldwell-West Caldwell PSD
Millburn Public School District
Verona Public School District
Cedar Grove Public School District
Newark Public School District
West Essex Regional PSD
Essex Fells Public School District
North Caldwell Public School District
West Orange Public School District
Fairfield Public School District
Nutley Public School District
Glen Ridge Public School District
Orange Public School District
C. Contractor Information
Legal Name of Business Entity:
Address:
D. Reportable Contribution Disclosure
Pursuant to N.J.S.A. 19:44A-20.26, this disclosure must include all reportable political contributions (more than $200.00
per election cycle) over the 12 months prior to submission (attach additional sheets as necessary).
No reportable contributions.
Contributor
Recipient
Date
Amount
E. Certification
The undersigned, being authorized, hereby certifies that the submission provided herein complies with the provisions
of N.J.S.A. 19:44A-20.26 and as represented by the Instructions accompanying this form.
By:
____________________________________
(Signature)
(Date)
_______________________________________________________________ _________________________________________________________
(Printed Name)
(Title)
SIGN
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Trisha Scipio
Board Secretary · Zoning Board of Adjustment
hidden@email.com
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Timeline
First Discovered
Mar 31, 2026
Last Info Update
Apr 30, 2026
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