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2025 Planning Board Planner
BID #: 31
ISSUED: 10/24/2024
DUE: 11/15/2024
VALUE: TBD
100
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Executive Summary
The Borough of Kenilworth is seeking qualifications for a 2025 Planning Board Planner. The selected vendor will provide professional planning and technical administrative consulting services for the Planning Board/Board of Adjustment, including preparation of Master Plan and Land Use Ordinance Amendments, attendance at meetings, preparation of special planning reports, and advisory services. The contract period will commence no sooner than January 1, 2025, and terminate no later than December 31, 2025. Qualifications must be received by the Qualified Purchasing Agent no later than November 15, 2024, at 11:00 a.m. in the Council Chambers of Kenilworth Borough Hall.
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BID/RFP/RFQ Postings • 2025 Planning Board Planner Skip to Main Content Create a Website Account - Manage notification subscriptions, save form progress and more. Website Sign In Search Government Departments Community How Do I... Home BID/RFP/RFQ Postings Print Sign up to receive a text message or email when new bids are added! Print Bid Title: 2025 Planning Board Planner Category: RFP / RFQ Postings Status: Closed Publication Date/Time: 10/24/2024 8:30 AM Closing Date/Time: 11/15/2024 11:00 AM Related Documents: Kenilworth RFQ - 2025 Planning Board Planner Return To Main BID/RFP/RFQ Postings Page Live Edit Agendas & Minutes Notify Me® Report a Concern Recycling & Sanitation Online Bill Pay Legal Notices Kenilworth, New Jersey Borough Hall 567 Boulevard Kenilworth, NJ 07033 908-276-9090 Staff Directory Permits, Licenses & Applications Police Municipal Court /QuickLinks.aspx Home Contact Us Accessibility Site Map Copyright Notices /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: Kenilworth RFQ - 2025 Planning Board Planner ---
Page 1 of 26
Borough of Kenilworth
County of Union, State of New Jersey
567 Boulevard
Kenilworth, NJ 07033
THEODORE GEORGIOU,
CMFO, QPA, CTC
Qualified Purchasing Agent
REQUEST FOR QUALIFICATIONS
E-MAIL:
purchasingofficer@kenilworthnj.org
Sealed Qualifications will be received by the Qualified Purchasing Agent for the Borough of
Kenilworth on Friday, November 15, 2024 at 11:00 a.m., prevailing time, in the Council
Chambers of Kenilworth Borough Hall, 567 Boulevard, Kenilworth, N.J. 07033 at which time and
place Qualifications will be opened for:
2025 PLANNING BOARD PLANNER
Qualifications must be made on the standard Qualification forms, be enclosed in a sealed package
bearing the name and address of the vendor and labeled “2025 Planning Board Planner” on the
outside, addressed to Theodore Georgiou, QPA, Qualified Purchasing Agent at the address above.
Specifications may be obtained in-person at the Office of the Borough Clerk, online at
www.kenilworthborough.com/ or by e-mailing purchasingofficer@kenilworthnj.org.
All prospective vendors shall comply with the requirements of N.J.S.A. 10:5-31 and N.J.A.C. 17:27
et seq. regarding Equal Employment Opportunity and Affirmative Action. Small, Minority and
Women’s Business Enterprises are encouraged to obtain specifications and compete for the
contracts.
Theodore Georgiou, QPA
Qualified Purchasing Agent
Page 2 of 26
BOROUGH OF KENILWORTH
GENERAL INSTRUCTIONS
1.
INTENT OF SOLICITATION
The Borough of Kenilworth is soliciting a Request for Qualifications (RFQ) for the
provision of professional services, as more particularly described herein. Vendors
interested in providing services to the Borough through the provision of such services
must prepare and submit a Qualification inclusive of a Submission Form /
Qualification Statement in accordance with the procedure and schedule in this RFQ.
The Borough intends to qualify person(s) and/or firm(s) that: (1) possess the
professional, financial and administrative capabilities to provide the proposed services,
and (2) comply with the terms and conditions determined by the municipality to
provide the greatest benefit to the taxpayers, and operational efficiencies of the
Borough of Kenilworth.
2.
REQUIREMENTS FOR SUBMISSION
A. Proper and Timely Receipt – Submissions considered timely shall be submitted and
received, in hand, no later than Friday, November 15, 2024 at 11:00 a.m. as listed in
the public notice of this solicitation to the attention of:
Theodore Georgiou
Qualified Purchasing Agent
567 Boulevard
Kenilworth, New Jersey 07033
B. Number of Copies Required - One (1) originally signed (in ink) copy along with
one (1) digital copy (via CD or USB drive) of each Qualification shall be submitted.
Vendors should not submit more than the required number of copies as outlined herein.
C. Transmittal Instructions - Qualifications must be submitted in sealed envelopes
clearly marked with the vendor name as well the service for which the Qualification is
being submitted. Each Qualification must be provided on a Submission Form /
Qualification Statement as supplied in the package, and signed by the professional
services entity or principal thereof. Submission Forms / Qualification Statements, as
part of the submission as a whole, must also be accompanied by a completed RFQ
checklist, a statement of ownership disclosure, a non-collusion affidavit, the required
EEO/Affirmative
Action
evidence
and
signed
compliance
notice,
Acknowledgement of Americans with Disabilities Act Language of 1990, a disclosure
of prohibited activities in Russia and Belarus and investment activities in Iran, an
insurance requirement acknowledgement form, the New Jersey Business Registration
Certificate of the Vendor, and a W-9 of the vendor. All prices and amounts must be
written in ink or, preferably, typewritten. Each signatory to the submission must initial
all erasures or
Page 3 of 26
corrections. The Borough of Kenilworth explicitly prohibits transmittal of
Qualifications by way of facsimile.
The Borough of Kenilworth strongly urges vendors to verify the completeness of
their submissions by carefully reviewing the submission checklist herein.
The Borough of Kenilworth will not be responsible for submissions forwarded through the
U.S. Mail or any delivery service if lost in transit at any time before submission opening,
or if hand-delivered to an incorrect location.
D. Withdrawal of Qualification - Submissions forwarded to the Borough of Kenilworth
before the time of opening of Qualifications may be withdrawn upon written request of the
professional services entity who shall be required to produce evidence showing that they are
or represent the principal(s) involved in the submission. Submissions may not be withdrawn
within twenty-four (24) hours of the stipulated time of opening of submissions. Once
submissions have been opened, they must remain firm for a period of sixty (60) days.
E.Discrepancy in Cost Qualifications - If applicable, in the event there is a discrepancy
between the unit prices and the extended totals, the unit prices shall govern or if between the
correct sum of the extended totals and the total submission submitted, the correct sum shall
govern. Amounts written in words shall govern over the amounts written in numerals.
F. One Qualification Per Entity - More than one (1) submission from an individual, firm,
partnership, corporation, or association of principals under the same or different names
shall not be considered. Should more than one (1) submission be so received by an entity,
it shall disqualify the entity from consideration.
2.
SCOPE OF SOLICITATION
The Borough of Kenilworth seeks to receive Qualifications for 2025 Planning Board
Planner for the contract period commencing no sooner than January 1, 2025 and
terminating no later than December 31, 2025. Pursuant to the New Jersey Local Public
Contracts Law, no language herein shall be construed so as to contemplate award of
a professional services contract for a period of time greater than twelve (12)
consecutive months.
3.
SCOPE
OF
WORK,
MINIMUM
VENDOR
REQUIREMENTS
&
SELECTION CRITERIA
A. Scope of Work - The Borough of Kenilworth intends to procure certain services as
part of this solicitation, the scope of work for such services should be understood, at a
minimum, as follows:
(1) Perform professional planning and technical administrative consulting
services for the Planning Board/Board of Adjustment, upon authorization,
including preparation of Master Plan and Land Use Ordinance
Page 4 of 26
Amendments; attendance at Planning Board/Board of Adjustment, or other
special meetings; preparation of special planning reports; assistance to the
Planning Board/Board of Adjustment and other staff personnel on
administrative and technical matters, as required; and professional planning
advisory services, as requested.
(2) Attend regular, special and emergency meetings of the Planning
Board/Board of Adjustment;
(3) Interact with applicable Borough personnel and other governmental
agencies, as required.
B. Minimum Vendor Requirements – The Borough of Kenilworth intends to procure
certain services as part of this solicitation from a vendor with the following minimum
requirements understood:
(1) Proposer must have a minimum of ten (10) years’ experience in providing
professional planning type services and a minimum of ten (5) years
servicing municipalities and other local governmental entities;
It is expected that a vendor will expand upon these minimum requirements in their
Qualifications Statement by setting forth a variety of information inclusive of: (1) the
name and roles of the individuals who will perform services and the descriptions of
the individuals’ experience including their education and certifications; (2)
professional references and a demonstrated records of success providing the same
service; (3) description of ability to provide the services desired in a timely fashion
(including staffing levels and familiarity with subject matter); (4) cost details.
C. Selection Criteria - The selection criteria to be used in awarding contracts shall
include the following:
(1) Meeting “Minimum Vendor Requirements” as stated in the forgoing
solicitation; (2) Qualifications of the individuals who will perform the
services/tasks and the amounts of their respective participation; (3) Experience
and references; (4) Ability to perform the services/tasks in a timely fashion,
including staffing and familiarity with the subject matter, including familiarity
with the Borough of Kenilworth; (5) Cost considerations, including, but not
limited to, historical costs for similar professional services, expertise involved,
and comparable costs for comparable public entities; (6) Experience in
appearing before the Office of Administrative Law and the State Superior
Court; and, (7) Possessing demonstrable experience in the representation of
public bodies, including but not limited to, Counties, Municipalities and the
State of New Jersey.
4.
EVALUATION AND AWARD
A. Time for Contract Award - The Borough of Kenilworth shall award a contract, or reject
all submissions, within such time as may be specified in the invitation for submission, but
in no case more than sixty (60) days, except that the submissions of any professional
Page 5 of 26
services entities who consent thereto may, at the request of the contracting unit, be held for
consideration for such longer period as may be agreed.
The right is reserved by the Borough of Kenilworth to award submissions on a "service by
service" basis, "per project" basis, in-part or in-whole as determined by the Borough.
B. Restrictions on Award – A contract award for this service will not be made unless the
Borough’s Chief Financial Officer has certified the necessary funds in a lawful manner.
C. Evaluation of Qualifications - Qualifications submitted by vendors will be evaluated by
the Borough of Kenilworth in consideration of factors most advantageous to the Borough
including managerial competency, qualifications as submitted, and price. After initial
review to determine legal responsiveness, interviews of prospective vendors may be
conducted by the governing body or any committee or designee thereof. It is particularly
noted that any vendor who submits a Qualification in connection with the forgoing
solicitation explicitly consents to such an interview process should the governing body
choose to exercise such an option.
Upon completion of the evaluation process, the matter of contract award shall be publicly
considered in the form of a Resolution of the governing body.
The Borough of Kenilworth reserves the right to reject all Qualifications for any reason.
The Borough of Kenilworth expressly reserves the right to waive any informality in any
submission, and to accept the submission, which in the Borough’s judgment serves its best
interests.
5.
PRICE QUALIFICATIONS
Prospective vendors must include a schedule of prices with their Qualification. Such
Qualification shall include hourly rates or a flat fee for services rendered. If the latter option
is chosen by the prospective vendor, it is understood that payments by the Borough of
Kenilworth will be made on a pro-rated monthly basis for services provided. Hourly price
Qualifications shall indicate the vendor’s minimum billing units (i.e. tenths of an hour,
quarters of an hour, etc…).
The Borough of Kenilworth reserves the right to consider cost Qualifications that are, in its
sole discretion, the most advantageous. Furthermore, the Borough of Kenilworth reserves
the right to enter into negotiations with prospective vendors, as it relates to prices for
professional services as permitted by N.J.S.A. 40A:11-5.
NOTE: The Borough will not compensate or reimburse a vendor for routine and
reoccurring expenses that relate to doing business with the Borough; including, but not
limited to: copying, scanning, and faxing documents, and vehicle mileage for travel to or
from meetings.
6.
CONTRACTUAL GUIDANCE
A. Payment Processing - Checks are processed by the Borough of Kenilworth’s Finance
Department on approximately the first and third Thursday of each month. It is necessary
that approved, signed Borough of Kenilworth vouchers be accompanied by an invoice and
submitted in advance of these dates to:
Page 6 of 26
Borough of Kenilworth
Finance Department - Accounts Payable
567 Boulevard
Kenilworth, New Jersey 07033
B.No Guaranteed Minimum Payments - Nothing provided within these specifications shall
be construed so as to imply or guarantee any minimum payments by the Borough of
Kenilworth to a vendor in receipt of a contract award. The Borough of Kenilworth shall
only remit payment for receipt of services actually rendered and received.
C. Termination of Contract - The Borough of Kenilworth reserves the right to terminate
any contract entered into upon thirty (30) calendar days’ written notice within its sole
discretion, with or without cause.
D. Transitional Period - In the event that a new contract has not been awarded prior to the
contract expiration date, it shall be incumbent upon the professional services entity to
continue the contract under the same terms and conditions until a new contract can be
completely operational. At no time shall this transitional period extend more than ninety
(90) days beyond the expiration date of the contract.
BOROUGH OF KENILWORTH
Page 7 of 26
SUBMISSION CHECKLIST
THE FOLLOWING ITEMS, AS INDICATED BELOW
, SHALL BE PROVIDED
WITH THE RECEIPT OF SEALED SUBMISSIONS
Initial
Here
Completed RFQ Checklist
Completed Submission Form / Qualification Statement
Statement of Ownership Disclosure
Non-Collusion Affidavit
Required EEO/Affirmative Action Evidence & Signed Compliance Notice
Acknowledgement of Americans with Disabilities Act Language of 1990
Disclosure of Investment Activities in Iran
Insurance Requirement Acknowledgement Form
New Jersey Business Registration Certificate of Vendor
W-9 of Vendor
This checklist is provided for vendor’s use in assuring compliance with required documentation; however,
it does not include all submission requirements and does not relieve the vendor of the need to read and
comply with the RFQ.
Name of Vendor:
Date:
Signature: X.
Print Name:
Title:
BOROUGH OF KENILWORTH
Page 8 of 26
SUBMISSION FORM / QUALIFICATION STATEMENT
(ATTACH ADDITIONAL SHEETS AS NECESSARY,
BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS
AND TYPE/WRITE: “SEE ATTACHED”)
1. Names and roles of the individuals who will perform the services and description of their education
and experience with projects similar to the services contained herein:
SUBMISSION FORM / QUALIFICATION STATEMENT
(CONTINUED)
(ATTACH ADDITIONAL SHEETS AS NECESSARY,
BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS
AND TYPE/WRITE: “SEE ATTACHED”)
Page 9 of 26
2. References and record of success of same or similar service:
SUBMISSION FORM / QUALIFICATION STATEMENT
(CONTINUED)
(ATTACH ADDITIONAL SHEETS AS NECESSARY,
BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS
AND TYPE/WRITE: “SEE ATTACHED”)
Page 10 of 26
3. Description of ability to provide the services in a timely fashion (including staffing, familiarity and
location of key staff):
SUBMISSION FORM / QUALIFICATION STATEMENT
(CONTINUED)
(ATTACH ADDITIONAL SHEETS AS NECESSARY,
BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS
AND TYPE/WRITE: “SEE ATTACHED”)
Page 11 of 26
4. Cost details, including the annual fee for primary duties and the hourly rates of each of the
individuals who will perform services, and all expenses for any work that is not included in the
primary duties:
CERTIFICATION OF
QUALIFICATION
(Sign Below)
Firm:
Date:
Authorized Representative (Print):
Signature:
Title:
Telephone No.:
Fax No.:
BOROUGH OF KENILWORTH
Page 12 of 26
STATEMENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43)
THIS STATEMENT SHALL BE COMPLETED, CERTIFIED TO, AND INCLUDED WITH ALL
BID AND QUALIFICATION SUBMISSIONS. FAILURE TO SUBMIT THE REQUIRED
INFORMATION
IS
CAUSE
FOR
AUTOMATIC
REJECTION
OF
THE
BID
OR
QUALIFICATION.
Name of Organization:
Organization Address:
Part I
Check the box that represents the type of business organization:
Sole Proprietorship (skip Parts II and III, execute certification in Part IV)
Non-Profit Corporation (skip Parts II and III, execute certification in Part IV)
For-Profit Corporation (any type)
Limited Liability Company (LLC)
Partnership
Limited Partnership
Limited Liability Partnership (LLP)
Other (be specific):
Part II
The list below contains the names and addresses of all stockholders in the corporation who own
10 percent or more of its stock, of any class, or of all individual partners in the partnership who
own a 10 percent or greater interest therein, or of all members in the limited liability company
who own a 10 percent or greater interest therein, as the case may be. (COMPLETE THE LIST
ON THE NEXT PAGE IN THIS SECTION)
OR
No one stockholder in the corporation owns 10 percent or more of its stock, of any class, or no
individual partner in the partnership owns a 10 percent or greater interest therein, or no member
in the limited liability company owns a 10 percent or greater interest therein, as the case may be.
(SKIP TO PART IV)
STATEMENT OF OWNERSHIP DISCLOSURE
(Continued)
Page 13 of 26
(Please attach additional sheets if more space is needed):
Name of Individual or Business Entity
Home Address (for Individuals) or Business Address
Part III
DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS
OR LLC MEMBERS LISTED IN PART II
If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10
percent 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 federal Securities and
Exchange Commission (or foreign equivalent) that contain the name and address of each person holding a
10% 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 more space
is needed.
Website (URL) containing the last annual SEC (or foreign equivalent) filing
Page #’s
Please list the names and addresses of each stockholder, partner or member owning a 10 percent or greater
interest in any corresponding corporation, partnership and/or limited liability company (LLC) listed in Part
II other than for any publicly traded parent entities referenced above. The disclosure shall be continued
until names and addresses of every noncorporate stockholder, and individual partner, and member
exceeding the 10 percent ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed.
Attach additional sheets if more space is needed.
Stockholder/Partner/Member and
Corresponding Entity Listed in Part II
Home Address (for Individuals) or Business Address
STATEMENT OF OWNERSHIP DISCLOSURE
(Continued)
Page 14 of 26
Part IV
Certification
I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto
to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this
certification on behalf of the bidder/proposer; that the Borough of Kenilworth is relying on the information
contained herein and that I am under a continuing obligation from the date of this certification through the
completion of any contracts with the Borough of Kenilworth to notify the Borough of Kenilworth in writing
of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false
statement or misrepresentation in this certification, and if I do so, I am subject to criminal prosecution under
the law and that it will constitute a material breach of my agreement(s) with the, permitting the Borough of
Kenilworth to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print):
Title:
Signature:
Date:
BOROUGH OF KENILWORTH
Page 15 of 26
NON-COLLUSION AFFIDAVIT
State of
County of
ss:
I, of the City of in
the County of and State of full age, being duly
sworn according to law on my oath depose and say that:
I am
of the firm of
(Title or Position)
(Name of Firm)
the bidder making this Qualification for the above named project, and that I executed the said Qualification
with full authority so to do; that said bidder has not, directly or indirectly entered into any agreement, participated
in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the
above named project; and that all statements contained in said Qualification and in this affidavit are true and
correct, and made with full knowledge that the Borough of Kenilworth relies upon the truth of the statements
contained in said Qualification and in the statements contained in this affidavit in awarding the contract for
the said project.
I further warrant that no person or selling agency has been employed or retained to solicit or secure
such contract upon an agreement or understanding for a commission, percentage, brokerage, or contingent fee,
except bona fide employees or bona fide employees or bona fide established commercial or selling agencies
maintained by (name of contractor).
Subscribed and sworn to
before me this day
of , .
X.
Signature
(Type or print name of affiant under signature)
Notary public of
BOROUGH OF KENILWORTH
Page 16 of 26
My Commission expires
BOROUGH OF KENILWORTH
Page 17 of 26
AFFIRMATIVE ACTION COMPLIANCE NOTICE
N.J.S.A. 10:5-31 and N.J.A.C. 17:27
GOODS, PROFESSIONAL SERVICE
AND GENERAL SERVICE CONTRACTS
This form is a summary of the successful bidder’s requirement to comply with the requirements of N.J.S.A. 10:5-31
and N.J.A.C. 17:27-1 et seq.
The successful bidder shall submit to the public agency, after notification of award but prior to execution of this
contract, one of the following three documents as forms of evidence:
a)
A photocopy of a valid letter that the contractor is operating under an existing Federally approved
or sanctioned affirmative action program (good for one year from the date of the letter);
OR
b)
A photocopy of a Certificate of Employee Information Report approval, issued in accordance with
N.J.A.C. 17:27-4;
OR
c)
A photocopy of an Employee Information Report (Form AA302) provided by the Division and
distributed to the public agency to be completed by the contractor in accordance with N.J.A.C.
17:27-4.
The successful vendor may obtain the Affirmative Action Employee Information Report (AA302) from the contracting
unit during normal business hours.
The successful vendor(s) must submit the copies of the AA302 Report to the Division of Contract Compliance and
Equal Employment Opportunity in Public Contracts (Division). The Public Agency copy is submitted to the public
agency, and the vendor copy is retained by the vendor.
The undersigned vendor certifies that he/she is aware of the commitment to comply with the requirements of N.J.S.A.
10:5-31 and N.J.A.C. 17:27.1 et seq. and agrees to furnish the required forms of evidence.
The undersigned vendor further understands that his/her bid shall be rejected as non-responsive if said contractor fails
to comply with the requirements of N.J.S.A. 10:5-31 and N.J.A.C. 17:27-1 et seq.
COMPANY:
SIGNATURE:
PRINT NAME:
TITLE:
DATE:
BOROUGH OF KENILWORTH
Page 18 of 26
EXHIBIT A
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE
N.J.S.A. 10:5-31 et seq. (P.L. 1975, C. 127)
N.J.A.C. 17:27
GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS
During the performance of this contract, the contractor agrees as follows:
The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant
for employment because of age, race, creed, color, national origin, ancestry, marital status, affectional or
sexual orientation, gender identity or expression, disability, nationality or sex. Except with respect to
affectional or sexual orientation and gender identity or expression, the contractor will ensure that equal
employment opportunity is afforded to such applicants in recruitment and employment, and that employees
are treated during employment, without regard to their age, race, creed, color, national origin, ancestry,
marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.
Such equal employment opportunity shall include, but not be 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 Borough 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, 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
Page 19 of 26
EXHIBIT A
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE
N.J.S.A. 10:5-31 et seq. (P.L. 1975, C. 127)
N.J.A.C. 17:27
GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS
(Continued)
without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual
orientation, gender identity or expression, disability, nationality or sex, consistent with the statutes and court
decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions.
The contractor shall submit to the public agency, after notification of award but prior to execution of a
goods and services contract, one of the following three documents:
Letter of Federal Affirmative Action Plan Approval
Certificate of Employee Information Report
Employee Information Report Form AA302 (electronically provided by the Division and distributed to
the public agency through the Division’s website at ww.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.
BOROUGH OF KENILWORTH
Page 20 of 26
AMERICANS WITH DISABILITIES ACT OF 1990
Equal Opportunity for Individuals with Disability
The Contractor and the Owner, do hereby agree that the provisions of Title 11 of the Americans with
Disabilities Act of 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.
The undersigned vendor consents to the full understanding of the forgoing Americans with Disabilities Act
Language of 1990:
Bidder/Vendor:
Signature:
Full Name (Print):
Title:
Date
BOROUGH OF KENILWORTH
Page 21 of 26
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
PART 1: CERTIFICATION
BIDDERS MUST COMPLETE PART 1 BY CHECKING EITHER BOX.
Pursuant to Public Law 2012, c. 25, any person or entity that submits a bid or Qualification or otherwise
proposes to enter into or renew a contract must complete the certification below to attest, under penalty of
perjury, that neither the person or entity, nor any of its parents, subsidiaries, or affiliates, is identified on the
Department of Treasury’s Chapter 25 list as a person or entity engaging in investment activities in Iran. The
Chapter
25
list
is
found
on
the
Division’s
website
at
http://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf. Bidders must review this list prior to
completing the below certification. Failure to complete the certification will render a bidder’s Qualification
non-responsive.
PLEASE CHECK EITHER BOX:
□I certify, pursuant to Public Law 2012, c. 25, that neither the person/entity listed above nor any of the
entity’s parents, subsidiaries, or affiliates is listed on the N.J. Department of the Treasury’s list of entities
determined to be engaged in prohibited activities in Iran pursuant to P.L. 2012, c. 25 (“Chapter 25 List”). I
further certify that I am the person listed above, or I am an officer or representative of the entity listed above
and am authorized to make this certification on its behalf. I will skip Part 2 and sign and complete the
Certification below.
OR
□I am unable to certify as above because I or the bidding entity and/or one or more of its parents, subsidiaries,
or affiliates is listed on the Department’s Chapter 25 list. I will provide a detailed, accurate and precise
description of the activities in Part 2 below and sign and complete the Certification below. Failure to provide
such will result in the Qualification being rendered as non-responsive and appropriate penalties, fines and/or
sanctions will be assessed as provided by law.
PART 2
PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN
You must provide a detailed, accurate and precise description of the activities of the bidding person/entity, or
one of its parents, subsidiaries or affiliates, engaging in the investment activities in Iran outlined above by
completing the form below. (PROVIDE INFORMATION RELATIVE TO THE ABOVE QUESTIONS.
PLEASE PROVIDE THOROUGH ANSWERS TO EACH QUESTION. IF YOU NEED TO MAKE
ADDITIONAL ENTRIES, USE ADDITIONAL PAGES).
Name:
Relationship to Bidder/Vendor:
Description of Activities:
Duration of Engagement: Anticipated Cessation Date:
Bidder/Vendor:
Contact Name: Contact Phone Number:
BOROUGH OF KENILWORTH
Page 22 of 26
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
(Continued)
CERTIFICATION
I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any
attachments thereto to the best of my knowledge are true and complete. I attest that I am authorized to execute
this certification on behalf of the below-referenced person or entity. I acknowledge that the Borough of
Kenilworth is relying on the information contained herein and thereby acknowledge that I am under a
continuing obligation from the date of this certification through the completion of contracts with the Borough
of Kenilworth to notify the Borough of Kenilworth in writing of any changes to the answers or information
contained herein. I acknowledge that I am aware that it is a criminal offense to make a false statement or
misrepresentation in this certification, and if I do so, I recognize that I am subject to criminal prosecution
under the law and that it will also constitute a material breach of my agreements(s) with the Borough of
Kenilworth and that the Borough of Kenilworth at its option may declare any contract(s) resulting from this
certification void and unenforceable.
Full Name (Print):
Signature:
Title:
Date
Bidder/Vendor:
BOROUGH OF KENILWORTH
Page 23 of 26
INSURANCE REQUIREMENTS AND ACKNOWLEDGEMENT FORM
Certificate(s) of Insurance shall be filed with the Borough Clerk's Office upon award of contract by the
governing body
The minimum amount of insurance to be carried by the Professional Service Entity shall be as follows:
PROFESSIONAL LIABILITY INSURANCE
Limits shall be a minimum of $1,000,000.00 for each claim and $1,000,000.00 aggregate each policy
period.
Acknowledgement of Insurance Requirement:
SIGNATURE:
DATE:
(Printed Name & Title)
BOROUGH OF KENILWORTH
Page 24 of 26
THESE ARE SAMPLES OF THE ONLY ACCEPTABLE
BUSINESS REGISTRATION CERTIFICATES.
FAILURE TO POSSESS A NEW JERSEY BUSINESS REGISTRATION CERTIFICATE
MAY BE CAUSE FOR REJECTION OF YOUR QUALIFICATION REGARDLESS OF THE
FACT THAT A COPY MAY ALREADY BE ON FILE WITH THE
BOROUGH OF KENILWORTH
BOROUGH OF KENILWORTH
EXAMPLE W-9 FORM
Page 24 of 25
END OF DOCUMENT
Page 25 of 25
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Theodore Georgiou
Qualified Purchasing Agent
hidden@email.com
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First Discovered
Mar 19, 2026
Last Info Update
Apr 30, 2026
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