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Lead Closed
This opportunity is no longer accepting submissions.
Request For Proposal For The Provision Of Clothing Bins
BID #: 35
ISSUED: 2/11/2026
DUE: 3/10/2026
VALUE: TBD
100
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Executive Summary
The Borough of New Providence is soliciting proposals for the provision and maintenance of two clothing collection bins for the benefit of the New Providence Municipal Alliance. The selected vendor will be responsible for placing and maintaining the bins, ensuring compliance with Borough Ordinance 2013-12, indemnifying the Borough, providing annual proof of insurance, and making quarterly royalty payments to the Municipal Alliance. The intended contract period is from April 1, 2026, to March 31, 2029.
Respondents are required to demonstrate satisfactory experience, provide a detailed financial proposal outlining the monthly royalty payment, and submit various certifications including an Affirmative Action Statement and Non-Collusion Affidavit. Proposals will be evaluated based on qualifications, experience, knowledge of the Borough, similar engagements, completeness of the proposal, and the reasonableness of the cost proposal.
All proposals must be delivered to the Office of the Borough Clerk, Denise Brinkofski, at 360 Elkwood Avenue, New Providence, New Jersey 07974. The submission deadline for this Request for Proposal, which is currently closed, was March 10, 2026, at 11:00 AM.
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Bid Postings • REQUEST FOR PROPOSAL FOR THE PROVISION OF CLO Skip to Main Content Create a Website Account - Manage notification subscriptions, save form progress and more. Website Sign In Government Services Community How Do I... Search Home Bid Postings Print Sign up to receive a text message or email when new bids are added! Print Bid Title: REQUEST FOR PROPOSAL FOR THE PROVISION OF CLOTHING BINS Category: Request for Proposal Status: Closed Description: The BOROUGH OF NEW PROVIDENCE (the "BOROUGH") is soliciting Proposals from interested persons and/or firms for the provision of Two (2) Clothing collection bins for the benefit of the New Providence Municipal Alliance from the time period April 1, 2026 to March 31, 2029, as more particularly described herein. Publication Date/Time: 2/11/2026 12:00 AM Closing Date/Time: 3/10/2026 11:00 AM Related Documents: Clothing Collection Bin RFP Return To Main Bid Postings Page Live Edit Forms & Documents Garbage / Recycling Online Business & Payments Community Activities Contact Us Notify Me® Public Notices Facebook Instagram Contact Us 360 Elkwood Avenue New Providence, NJ 07974 Phone: 908-665-1400 Fax: 908-665-9272 Regular Hours: Monday through Friday 8:30 AM to 4:30 PM Summer Hours: Friday before Memorial Day - Labor Day Monday through Thursday 8:30 AM - 4:30 PM Friday 8:30 AM - 1:00 PM Quick Links Smart 911 Links & Resources Property Information FAQs Calendar Film Ready /QuickLinks.aspx Helpful Links Home Site Map Contact Us (Directory) Accessibility Disclaimer Terms of Use & 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: Clothing Collection Bin RFP ---
BOROUGH OF NEW PROVIDENCE
REQUEST FOR PROPOSAL
FOR THE PROVISION OF
CLOTHING BINS
ISSUE DATE: February 11, 2026
SUBMISSION DEADLINE: March 10, 2026
ADDRESS ALL PROPOSALS TO:
OFFICE OF THE BOROUGH CLERK
Municipal Building
360 Elkwood Avenue
NEW PROVIDENCE, NEW JERSEY 07974
2
GENERAL INFORMATION & SUMMARY
ORGANIZATION REQUESTING QUALIFICATIONS
BOROUGH OF NEW PROVIDENCE
360 ELKWOOD AVENUE
NEW PROVIDENCE, NEW JERSEY 07974
CONTACT PERSON
BERNADETTE CUCCARO ADMINISTRATOR
908-665-1400
PURPOSE OF REQUEST
The BOROUGH OF NEW PROVIDENCE (the "BOROUGH") is soliciting Proposals
from interested persons and/or firms for the provision of Two (2) Clothing collection bins for the
benefit of the New Providence Municipal Alliance from the time period April 1, 2026 to March
31, 2029, as more particularly described herein. Through a Request for Proposal process
described herein, persons and/or firms interested in assisting the BOROUGH with the provision
of such services must prepare and submit a Proposal in accordance with the procedure and
schedule in this RFP. The BOROUGH will review Proposals only from those persons and/or
firms that submit a Proposal which includes all the information required to be included as
described herein, as determined in the sole and absolute discretion of the BOROUGH. The
BOROUGH intends to qualify persons and/or firms that (a) possess the professional, financial
and administrative capabilities to provide the proposed services, and (b) will agree to work under
the compensation terms and conditions determined by the BOROUGH to provide the greatest
benefit to the taxpayers of New Providence. The services of successful Respondents may be
procured as soon as April 1, 2026.
DEFINED TERMS
The following definitions shall apply to and are used in this Request for Qualifications:
"BOROUGH" - refers to the BOROUGH OF NEW PROVIDENCE.
"Proposal" - refers to the complete responses to this RFP submitted by the Respondents.
"Qualified Respondent" - refers to a Respondent who (in the sole and absolute discretion of
the BOROUGH) has satisfied the qualification criteria set forth in this RFP.
"RFP" - refers to this Request for Proposals, including any amendments thereof or
supplements thereto.
"Respondent" or "Respondents" - refers to the interested persons and/or firm(s) that submit a
Proposal.
3
CONTRACT FORM
If selected, a respondent shall be required to execute the BOROUGH's form contract,
which includes, among other things, indemnification, insurance, termination and licensing
provisions. A complete copy of a draft BOROUGH form contract is available upon request.
It is also agreed and understood that the acceptance of the final payment by a vendor shall
be considered a release in full of all claims against the BOROUGH arising out of, or by reason
of, the work done and materials furnished under the contract.
REQUIREMENTS OF THE PROPOSALS
Clothing Collection Bins
1.
BOROUGH OF NEW PROVIDENCE FACTS AND FIGURES – The BOROUGH
OF NEW PROVIDENCE is a legal, governmental entity. The BOROUGH was incorporated in
1899 and operates under N.J.S.A 40A:60-1, et seq., the borough form of government. The
BOROUGH is governed by a mayor and borough council. The Borough Council sets policy,
adopts the operating and capital budgets for the BOROUGH, enacts ordinances and sets the
direction of how the BOROUGH OF NEW PROVIDENCE will provide government services.
The Mayor is elected and is the chief executive. The Borough Administrator carries out the
policies adopted by the Mayor and Borough Council.
The BOROUGH's population is approximately 13,650 and it consists of approximately
4 square miles of area. The BOROUGH provides a full range of municipal services.
The BOROUGH's operating budget is approximately $27 million.
2.
NATURE/ SCOPE OF SERVICES – The BOROUGH hereby solicits Proposals from
Respondents that have expertise in providing Clothing Collection Bins. The specifics of the
program are set forth as follows:
The Borough is seeking proposals from organizations to provide two (2) Clothing Collection
Bins, to be located on the property of the New Providence Rescue Squad. In exchange for the
Clothing Collection Bin placement, the respondent will provide a royalty payment to benefit the
New Providence Municipal Alliance. The New Providence Municipal Alliance serves as an
advisory committee to the New Providence Borough Council.
The proposal shall include the royalty payment made to the New Providence Municipal Alliance
for the deployment of said clothing bins. The monthly royalty per month shall be provided.
Payments are to be made on a quarterly basis at least fifteen days in advance of the quarter.
1. All bins must comply with Borough Ordinance 2013-12 regulating clothing bins, attached
hereto for reference.
2. Bins must be maintained in clean condition and the area around the bins must be
monitored regularly by the respondent to assure that excess material des not accumulate.
4
3. Failure to maintain a neat and clean areas, including responding immediately to concerns
about excess material may result in termination of this agreement.
4. Upon termination of the agreement, bins to be removed within 30 days.
5. Determination of bin placement will be as directed by the Borough Administrator of New
Providence in consultation with the leadership of the New Providence Municipal
Alliance.
6. The New Providence Municipal Alliance logo may be placed on the bins at the expense
of the provider.
7. The successful respondent must provide a hold harmless agreement indemnifying the
Borough of New Providence, its officer and assigns.
8. Annual proof of insurance shall be provided as.
3.
SUBMISSION REQUIREMENTS – Respondents must demonstrate satisfactory
experience in providing the program which the proposal seeks. Respondents should submit a
Proposal that contains the following:
A.
The name of the Respondent, the principal place of business and, if different, the
place where the services will be provided;
B.
A description of Respondent's overall experience in providing the type of services
sought in the RFP. At a minimum, the following information on past experience
should be included as appropriate to the RFP: (i) description and scope of work by
Respondent; (ii) explanation of perceived relevance of the experience to the RFP;
and (iii) the education, qualifications, experience, and training of all persons who
would be assigned to provide services along with their names and titles;
C.
A narrative statement of the Respondent's understanding of the BOROUGH's
needs and goals;
D.
A listing of all other engagements where services of the types being proposed
were provided in the past five (5) years. Contact information for the recipients of
the similar services must be provided. The BOROUGH may obtain references
from any of the parties listed;
E.
A listing of all immediate relatives of the officers, directors or managing agents of
Respondent who are BOROUGH employees or elected officials of the
BOROUGH. 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;
An Affirmative Action Statement (sample language attached);
A completed Non-Collusion Affidavit (copy of form attached);
A completed Owner Disclosure Information form (copy of form attached);
A completed Disclosure Statement (copy of form attached);
A statement that the Respondent will comply with the General Terms and Conditions
required by the BOROUGH and enter into the BOROUGH's standard Contract;
A copy of the Respondent's Business Registration Certification.
5
4.
FINANCIAL PROPOSAL – Respondents should submit a financial proposal that
responds to the services requested in the RFP and includes the form as indicated herein.
Quarterly royalty payment for two (2) bins to be paid to the
New Providence Municipal Alliance in advance of each quarter.
2026
2027
2028
5.
EVALUATION – The BOROUGH has structured a procurement process that seeks to
obtain the desired results described herein, while establishing a competitive process to assure that
each person and/or firm is provided an equal opportunity to submit a Proposal in response to the
RFP. The BOROUGH will select the most advantageous proposal(s), if any and as determined
in its sole and absolute discretion, based on all of the evaluation factors set forth at the end of this
RFP.
Proposals will be reviewed and evaluated by the BOROUGH and its legal and/or financial
advisors (collectively, the "Review Team"). The Proposals will be reviewed to determine if the
Respondent has met the minimum professional, administrative and financial areas and other
requirements described in this RFP. Each Respondent must satisfy the objectives and
requirements detailed in this RFP. The successful Respondent shall be determined by an
evaluation of the total content of the Proposal submitted. Under no circumstances will a member
of the Review Team review responses to an RFP for an appointment that he/she or his/her firm
submitted a response. Based upon the totality of the information contained in the Proposal,
including, without limitation, information about the reputation and experience of each
Respondent, the BOROUGH will (in its sole and absolute discretion) determine which
Respondents are qualified from a professional, administrative and financial perspective. Each
Respondent that meets the requirements of the RFP (determined in the sole and absolute
discretion of the BOROUGH) will be designated as a Qualified Respondent and may then be
given an opportunity to provide services to the BOROUGH.
The RFP process commences with the issuance of this RFP. It is anticipated that certain
Qualified Respondents will be selected to begin providing services to the BOROUGH as soon as
April 1, 2026. There can be no assurance, however, that any Qualified Respondent will be
selected.
All communications concerning this RFP or the RFP process shall be directed, in writing,
to the BOROUGH's designated contact person:
Denise Brinkofski, Clerk
BOROUGH OF NEW PROVIDENCE
360 Elkwood Avenue,
New Providence, New Jersey 07974
6
6.
RESERVATION OF RIGHTS – The BOROUGH reserves the right to:
a.
Not select any of the proposals;
b.
Select only portions of a particular Respondent's proposal for further
consideration (however, Respondents may specify portions of a proposal that they
consider "bundled");
c.
Supplement, amend or otherwise modify the RFP through issuance of addenda to
all prospective Respondents who have received a copy of this RFP;
d.
Change or alter the schedule for any events called for in this RFP upon the
issuance of notice to all prospective Respondents who have received a copy of
this RFP;
e.
Conduct investigations of any or all of the Respondents, as the BOROUGH
deems necessary or convenient, to clarify the information provided as part of the
Proposal and to request additional information to support the information included
in any Proposal; and
f.
Suspend or terminate the procurement process described in this RFP at any time
(in its sole and absolute discretion). If terminated, the BOROUGH may determine
to commence a new procurement process or exercise any other rights provided
under applicable law without any obligation to the Respondents.
The BOROUGH shall be under no obligation to complete all or any portion of the
procurement process described in this RFP.
The BOROUGH shall not be obligated to explain the results of the evaluation process to
any person or entity, including, without limitation, any Respondent.
The BOROUGH may require Respondents to demonstrate any services described in their
proposal prior to award.
7.
LIMITATIONS – This RFP is not an offer, order or contract and should not be
regarded as such, nor shall any obligation or liability be imposed on the BOROUGH by issuance
of this RFP. The BOROUGH reserves the right at the BOROUGH's sole discretion to refuse any
submission. This RFP does not constitute a Request for Proposal ("RFP") and does not commit
the BOROUGH to issue an RFP.
8.
USE OF INFORMATION – Any specifications, drawings, sketches, models, samples,
data, computer programs, documentation, technical or business information and the like
("Information") furnished or disclosed by the BOROUGH to the respondent in connection with
this RFP shall remain the property of the BOROUGH. When in tangible form, all copies of such
Information shall be returned to the BOROUGH upon request. Unless such Information was
previously known to the respondent, free of any obligation to keep it confidential, or has been or
7
is subsequently made public by the BOROUGH or a third party, it shall be held in confidence by
the respondent, shall be used only for the purposes of this RFP, and may not be used for other
purposes except upon such terms and conditions as may be mutually agreed upon in writing.
9.
GENERAL TERMS AND CONDITIONS –
A.
The BOROUGH reserves the right to reject any Proposal in whole or in part or to
waive any informalities in a Proposal, and, unless otherwise specified by the
respondent, to accept any item, items or services in the proposals should it be
deemed in the best interest of the BOROUGH to do so.
B.
In case of the failure by a successful respondent to perform, the BOROUGH may
procure the articles or services from other sources, deduct the cost of the
replacement from money due to the respondent under the contract and hold the
respondent responsible for any excess cost occasioned thereby.
C.
The respondent shall maintain sufficient insurance to protect against all claims
under Workmen's Compensation, General, Professional and Automobile Liability.
D.
Each Proposal must be signed by the person authorized to do so.
E.
Proposals shall be hand delivered or mailed consistent with the provisions of the
legal notice to respondents. In the case of mailed proposals, the BOROUGH
assumes no responsibility for Proposals received after the designated date and
time and will return late Proposals unopened. Proposals will not be accepted by
facsimile or e-mail. Proposals shall be in a sealed envelope, marked "CLOTHING
COLLECTION BIN SERVICES." To be considered, proposals shall be delivered
to or received by the BOROUGH Clerk no later than 11 a.m. on March 10, 2026.
F.
Respondents are required to comply with the requirements of N.J.S.A. 10:5-31 et
seq. See attached Exhibit A.
G.
By submission of a Proposal, the respondent certifies that the service to be
furnished will not infringe upon any valid patent, trademark or copyright and a
successful respondent shall, at its expense, defend any and all actions or suits
charging such infringement, and will save the BOROUGH harmless in any case
of any such infringement.
H.
No respondent shall influence, or attempt to influence, or cause to be influenced,
any BOROUGH 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.
I.
No respondent shall cause or influence, or attempt to cause or influence, any
BOROUGH officer or employee to use his/her official capacity to secure
unwarranted privileges or advantages for the respondent or any other person.
8
J.
Should any difference arise between the contracting parties as to the meaning or
intent of these instructions or specifications, the Borough Counsel's decision shall
be final and conclusive.
K.
All costs incurred by the Respondent in connection with responding to this RFP
shall be become solely by the Respondent. The BOROUGH OF NEW
PROVIDENCE shall not be responsible for any expenditure of monies or other
expenses incurred by the Respondent.
L.
The checklist, affidavits, notices and the like presented at the end of this RFP are
a part of this RFP and shall be completed and submitted as part of a Proposal.
M.
All Proposals shall become the property of the BOROUGH and will not be
returned.
N.
All Proposals will be made available to the public at the appropriate time, as
determined by the BOROUGH (in the exercise of its sole and absolute discretion)
and in accordance with law.
O.
The BOROUGH may request Respondents to send representatives to the
BOROUGH for interviews with less than 24 hours advance notice.
P.
Neither the BOROUGH, nor their respective staffs, consultants or advisors
(including, but not limited to, the Review Team) shall be liable for any claims or
damages resulting from the solicitation or preparation of the Proposal, nor will
there be any reimbursement to Respondents for the cost of preparing and
submitting a Proposal or for participating in this procurement process.
END OF GENERAL INSTRUCTIONS
9
BASIS OF AWARD
A contract, if any, shall be awarded based upon the following factors:
EVALUATION FACTORS
A.
Relevance
and
Extent
of
Qualifications,
Experience,
Reputation and Training of Personnel to be assigned
B.
Knowledge of the BOROUGH OF NEW PROVIDENCE and the
subject matter to be addressed under this Request for
Proposals
C.
Relevance and Extent of Similar Engagements performed
D.
Proposal contains all required information
E.
Reasonableness of Cost Proposal
10
PROPOSAL CHECKLIST
THIS CHECKLIST MUST BE COMPLETED, INITIALED, SIGNED AND SUBMITTED
WITH
YOUR
PROPOSAL.
A
PROPOSAL
SUBMITTED
WITHOUT
THE
FOLLOWING DOCUMENTS IS CAUSE FOR REFUSAL.
INITIAL BELOW
_________
_________
_________
_________
_________
_________
A.
An original signed and sealed complete proposal
B.
Affirmative Action Statement
C.
Non-Collusion Affidavit, properly notarized
D.
Owners Disclosure Information, properly notarized, listing
the names of all persons owning ten (10%) percent or more
of the proposing entity
E.
Disclosure Statement
F.
Authorized signatures on all forms
G.
Business Registration Certificate(s)
_________
Note: N.J.S.A 52:32-44 provides that the BOROUGH shall not enter into a contract for goods or
services unless the other party to the contract provides a copy of its business registration
certificate and the business registration certificate of any subcontractors at the time that it
submits its proposal. The contracting party must also collect the state use tax where applicable.
THE UNDERSIGNED HEREBY ACKNOWLEDGES
THE ABOVE LISTED REQUIREMENTS
NAME OF RESPONDENT:
___________________________________________________________________________________
Person, Firm or Corporation
___________________________________________________________________________________
BY: (NAME)
(TITLE)
11
(REVISED 4/10)
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 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 or 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 of subcontractor will send to each labor union, with which it has a collective
bargaining agreement, a notice, to be provided by the agency contracting officer, advising the
labor union of the contractor’s commitments under this chapter and shall post copies of the
notice in conspicuous places available to employees and applicants for employment.
The contractor or subcontractor, where applicable, agrees to comply with any regulations
promulgated by the Treasurer pursuant to N.J.S.A. 10:5-31 et seq., as amended and
supplemented from time to time and the Americans with Disabilities Act.
The contractor or subcontractor agrees to make good faith efforts to meet targeted county
employment goals established in accordance with N.J.A.C. 17:27-5.2.
The contractor or subcontractor agrees to inform in writing its appropriate recruitment agencies
including, but not limited to, employment agencies, placement bureaus, colleges, universities,
and labor unions, that it does not discriminate on the basis of age, race, creed, color, national
origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression,
12
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, race, creed, color, national origin, ancestry, marital
status, affectional or sexual orientation, gender identity or expression, disability, nationality or
sex, consistent with the statutes and court decisions of the State of New Jersey, and applicable
Federal law and applicable Federal court decisions.
The contractor shall submit to the public agency, after notification of award but prior to
execution of a goods and services contract, one of the following three documents:
Letter of Federal Affirmative Action Plan
Approval Certificate of Employee Information Report
Employee Information Report Form AA302 (electronically provided by the Division and
distributed
to
the
public
agency
through
the
Division’s
website
at
www.state.nj.us/treasury/contract_compliance)
The contractor and its subcontractors shall furnish such reports or other documents to the
Division of Public Contracts Equal Employment Opportunity as may be requested by the
Division from time to time in order to carry out the purposes of these regulations, and public
agencies shall furnish such information as may be requested by the Division of Public Contracts
equal Employment Opportunity Compliance for conducting a compliance investigation pursuant
to Subchapter 10 of the Administrative Code at N.J.A.C. 17:27.
13
NON-COLLUSION AFFIDAVIT
STATE OF NEW JERSEY )
) ss:
COUNTY OF __________ )
I, ______________________ of the City of _______________________ in the County of
____________________ and the State of ______________________ of full age, being duly
sworn according to the law on my oath depose and say that:
I am ________________________ of the firm of __________________________, the
respondent submitting the Proposal, and that I executed the said Proposal with full authority so to
do; and that said respondent 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 Proposal; and that all statements contained in said Proposal and in
this Affidavit are true and correct, and made with full knowledge that the State of New Jersey
relies upon the truth of the statements contained in said Proposal and in the statements contained
in this Affidavit in awarding any contract for the named services.
I further warrant that no person or selling agency has been employed or retained to solicit or
secure such contract upon an agreement or understanding for a commission, percentage,
brokerage or contingent fee, except bona fide employees or bona fide established commercial or
selling agencies maintained by
________________________________________ (N.J.S.A. 52:34-15)
________________________________________
(Also type or print name of Affiant under signature)
Subscribed and sworn to before me this ____
day of _______________, 20___.
___________________________________
A Notary Public of ______________
My Commission Expires: ________________
14
OWNER DISCLOSURE INFORMATION
Set forth below are the names and addresses of all owners of 10% or more of the proposing
business entity.
Name: ____________________________
Name: ____________________________
Address: __________________________
Address: __________________________
__________________________
__________________________
Name: ____________________________
Name: ____________________________
Address: __________________________
Address: __________________________
__________________________
__________________________
Name: ____________________________
Name: ____________________________
Address: __________________________
Address: __________________________
__________________________
__________________________
Name: ____________________________
Name: ____________________________
Address: __________________________
Address: __________________________
__________________________
__________________________
___________________________
NAME OF BUSINESS ENTITY
__________________________________________________________________________
SIGNATURE
TITLE
_________________________________
Notary Public of
My Commission Expires: _____________, 20___.
DISCLOSURE STATEMENT
(To be submitted with Proposal)
(a)
Is or was anyone in your firm or company a member of the BOROUGH governing body within the
last calendar year or a member of his/her immediate family? If yes, then provide the name of the
individual below and his/her relationship.
Yes____
No____
_______________________
__________________
________________
Name
Position
Relationship
(b)
Has any principal/partner of your firm been convicted of an indictable offense? If yes, then please
provide further explanation and copies of any relative documents.
Yes____
No____
_______________________
__________________
________________
Name
Position
Relationship
(c)
Has any individual who would provide service under this contract ever been sanctioned by the
appropriate licensing board?
Yes____
No____
_______________________
__________________
________________
Name
Position
Term
Reason for censure:
(d)
Has any member of your firm ever been barred from doing business with any state, BOROUGH or
municipal government? If yes, then please provide further written explanation including date and
copies of relevant documentation.
Yes____
No____
_______________________
__________________
________________
Name
State, County or
Date
Municipality
(e)
Has your firm sued the BOROUGH OF NEW PROVIDENCE in the past five (5) years? If yes, then
please identify the matter/case and provide further written explanation including date and copies of
relevant documents.
Yes____
No____
__________________________________________
________________
Name
Date
By___________________________________
Title______________________________
#337330
16
BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR NON-FAIR AND OPEN CONTRACTS
Required Pursuant To N.J.S.A. 19:44A-20.8
Part I – Vendor Affirmation
The undersigned, being authorized and knowledgeable of the circumstances, does hereby certify that:
has not made and will not make any reportable contributions pursuant to N.J.S.A. 19:44A-1 et seq. that, pursuant to
P.L. 2023, c. 30, would bar the award of this contract in the one year period preceding January 1, 2026 to any of the
following named candidate committee or joint candidates committee representing the elected officials of the Borough
of New Providence as defined pursuant to N.J.S.A. 19:44A-3 (q) and (r).
Mayor Allen Morgan
Councilperson Nadine Geoffroy
Councilperson Matthew Cumiskey
Councilperson Alan Lerner
Councilperson Kathleen Dolan
Councilperson Lisa McKnight
Councilperson Brian Gardner
Part II – Ownership Disclosure Certification
I 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:
Partnership
Corporation
Sole Proprietorship
Subchapter S Corporation
Limited Partnership
Limited Liability Corporation
Limited Liability Partnership Limited Liability Company
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 this ___ day of
___________, 2 _____.
My Commission expires:
_________________________________
(Affiant)
____________________________
(Print name & title of affiant) (Corporate Seal)
BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR NON-FAIR AND OPEN CONTRACTS
Required Pursuant To N.J.S.A. 19:44A-20.8
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…
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 $200 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)
1 | P a g e
Borough of New Providence
Prohibited Russia-Belarus Activities & Iran Investment Activities
COMPANY, PERSON, OR ENTITY
PART 1: CERTIFICATION
COMPLETE PART 1 BY CHECKING ONE OF THE THREE BOXES BELOW
Pursuant to law, any person or enƟty that is a successful bidder or proposer, or otherwise proposes to enter into or
renew a contract, for goods or services must complete the cerƟficaƟon below prior to contract award to atest, under
penalty of perjury, that neither the person or enƟty, nor any parent enƟty, subsidiary, or affiliate, is idenƟfied on the
Department of Treasury's Russia-Belarus list or Chapter 25 list as a person or enƟty engaging in prohibited acƟviƟes in
Russia, Belarus or Iran. Before a contract for goods or services can be amended or extended, a person or enƟty must
cerƟfy that neither the person or enƟty, nor any parent enƟty, subsidiary, or affiliate, is idenƟfied on the Department of
Treasury's Russia-Belarus list. Both lists are found on Treasury’s website at the following web addresses:
htps://www.nj.gov/treasury/administraƟon/pdf/RussiaBelarusEnƟtyList.pdf www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf.
As applicable to the type of contract, the above-referenced lists must be reviewed prior to compleƟng the below
cerƟficaƟon.
A person or enƟty unable to make the cerƟficaƟon must provide a detailed, accurate, and precise descripƟon of the
acƟviƟes of the person or enƟty, or of a parent enƟty, subsidiary, or affiliate, engaging in prohibited acƟviƟes in Russia or
Belarus and/or investment acƟviƟes in Iran. The person or enƟty must cease engaging in any prohibited acƟviƟes and
provide an updated cerƟficaƟon before the contract can be entered into.
If a vendor or contractor is found to be in violaƟon of law, acƟon may be taken as appropriate and as may be provided by
law, rule, or contract, including but not limited to imposing sancƟons, seeking compliance, recovering damages, declaring
the party in default, and seeking debarment or suspension of the party.
CONTRACT AWARDS AND RENEWALS
I certify, pursuant to law, that neither the person or entity listed above, nor any parent entity, subsidiary, or
affiliate appears on the N.J. Department of Treasury’s lists of entities engaged in prohibited activities in Russia or Belarus
pursuant to P.L. 2022, c. 3 or in investment 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. (Skip Part 2 and sign and complete the Certification below.)
CONTRACT AMENDMENTS AND EXTENSIONS
I certify, pursuant to law, that neither the person or entity listed above, nor any parent entity, subsidiary, or
affiliate is listed on the N.J. Department of the Treasury’s lists of entities determined to be engaged in prohibited activities
in Russia or Belarus pursuant to P.L. 2022, c. 3. 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. (Skip Part 2 and sign
and complete the Certification below.)
2 | P a g e
Borough of New Providence
Prohibited Russia-Belarus Activities & Iran Investment Activities
IF UNABLE TO CERTIFY
I am unable to certify as above because the person or entity and/or a parent entity, subsidiary, or affiliate is listed
on the Department's Russia-Belarus list and/or Chapter 25 Iran list. I will provide a detailed, accurate, and precise
description of the activities as directed in Part 2 below, and sign and complete the Certification below. Failure to provide
such will prevent the award of the contract to the person or entity, and appropriate penalties, fines, and/or sanctions will
be assessed as provided by law.
PART 2: ADDITIONAL INFORMATION
PLEASE PROVIDE FURTHER INFORMATION RELATED TO PROHIBITED ACTIVITIES IN RUSSIA OR BELARUS AND/OR
INVESTMENT ACTIVITIES IN IRAN.
You must provide a detailed, accurate, and precise descripƟon of the acƟviƟes of the person or enƟty, or of a parent
enƟty, subsidiary, or affiliate, engaging in prohibited acƟviƟes in Russia or Belarus and/or investment acƟviƟes in Iran in
the space below and, if needed, on addiƟonal sheets provided by you.
PART 3: CERTIFICATION OF TRUE AND COMPLETE INFORMATION
I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments there,
to the best of my knowledge, are true and complete. I attest that I am authorized to execute this certification on behalf of
the above-referenced person or entity.
I acknowledge that the Borough of New Providence is relying on the information contained herein and hereby
acknowledge that I am under a continuing obligation from the date of this certification through the completion of any
contracts with the Borough of New Providence to notify the Borough of New Providence in writing of any changes to the
answers of information contained herein.
I acknowledge that I am aware that it is a criminal offense to make a false statement or misrepresentation in this
certification. If I do so, I recognize that I am subject to criminal prosecution under the law and that it will also constitute a
material breach of my agreement(s) with the Borough of New Providence and that the Borough of New Providence at its
option may declare any contract(s) resulting from this certification void and unenforceable.
Name of Company, EnƟty
Full Name (Print)
Title
Signature
Date
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First Discovered
Apr 28, 2026
Last Info Update
Apr 30, 2026
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