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Executive Summary
The City of Summit is soliciting Qualification Statements from interested firms or individuals for the provision of legal services as Tax Appeal Counsel. The selected firm or individual will need to demonstrate expertise and capability in performing these services to benefit the taxpayers of Summit. The RFQ outlines the procurement process, schedule, and submission requirements. All communications regarding this RFQ should be directed to Mr. Michael Rogers, City Administrator, in writing. Completed Qualification Statements must be received by the City no later than November 27, 2017, at 4:00 p.m. either by hand delivery, delivery service, or US Postal Service delivery.
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Document Text
--- Document: RFQ Tax Appeal Counsel 2018_ ---
CITY OF SUMMIT
REQUEST FOR QUALIFICATIONS
FOR THE PROVISION OF LEGAL SERVICES – TAX APPEAL COUNSEL
ISSUE DATE: October 27, 2017
DUE DATE: November 27, 2017
2
NOTE: The City of Summit will consider proposals only from firms or organizations that have demonstrated the
capability and willingness to provide high quality services in the manner described in this Request for Qualifications
GLOSSARY
The following definitions shall apply to and are used in this Request for Qualifications:
"City" - refers to the City of Summit.
"Principals" means persons possessing an ownership interest in the Respondent. If the Respondent is a corporation,
"Principals" shall include each investor who would have any amount of operational control over the Respondent and every
stockholder having an ownership interest of ten percent (10%) or more in the firm.
"Qualification Statement" - refers to the complete responses to this RFQ submitted by the Respondents.
"Qualified Respondent" - refers to those Respondents who (in the sole judgment of the City) have satisfied the
qualification criteria set forth in this RFQ.
"Respondent" or "Respondents" - refers to the interested firm(s) that submit a Qualification Statement.
“Review Team” – Members of the City Administration and its legal advisor/s and/or financial advisor/s and/or designated
staff as appropriate who shall review the Qualification Statements.
"RFQ" - refers to this Request for Qualifications, including any amendments thereof or supplements thereto.
3
SECTION 1
INTRODUCTION AND GENERAL INFORMATION
Section 1.1.
Introduction and Purpose.
The City is soliciting Qualification Statements from interested persons and/or firms for the provision of LEGAL SERVICES –
TAX APPEAL COUNSEL, as more particularly described herein. Through this Request for Qualification process, persons
and/or firms interested in providing the City with such services must prepare and submit a Qualification Statement in
accordance with the procedures and schedules in this RFQ. The City will review Qualification Statements only from those
firms that submit a Qualification Statement which includes all the information required to be included as described herein
(in the sole judgment of the City). The City intends to qualify person(s) and/or firm(s) that: (a) possesses 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 City to provide the greatest benefit to the taxpayers of Summit.
Section 1.2.
Procurement Process and Schedule.
The selection of Qualified Respondents is not subject to the bidding provisions of the Local Public Contracts Law, N.J.S.A.
40A:11-1 et seq. The selection is subject to the New Jersey Local Unit Pay-to-Play Law, N.J.S.A. 19:44A-20.4 et seq. The
City has structured a procurement process that seeks to obtain the desired results described above, while establishing a
competitive process to assure that each person and/or firm is provided with an equal opportunity to submit a
Qualification Statement in response to the RFQ. Qualification Statements will be evaluated in accordance with the criteria
set forth in Section 5 of this RFQ, which will be applied in the same manner to each Qualification Statement received.
Respondents agree to at all times abide by all requirements of New Jersey law, including, but not limited to the
aforementioned “Pay to Play” laws, as well as any and all relevant Executive Orders and the New Jersey Election Law
Enforcement Commission disclosure requirements.
Qualification Statements will be reviewed and evaluated by the City Administration and its legal advisor/s and/or financial
advisor/s and/or designated staff as appropriate (collectively, the "Review Team"). The Qualification Statements will be
reviewed to determine if the Respondent has met the minimum professional, administrative and financial criteria
described in this RFQ. Under no circumstances will a member of the Review Team review responses to an RFQ for a
position which they or their firm submitted a response. Based upon the totality of the information contained in the
Qualification Statement, including information about the reputation and experience of each Respondent, the City will (in
its sole judgment) determine which Respondents are qualified from professional, administrative and financial standpoints.
Each Respondent that meets the requirements of the RFQ (in the sole judgment of the City) will be designated as a
Qualified Respondent and will be given the opportunity to participate in the selection process determined by the City.
The RFQ process commences with the issuance of this RFQ. The steps involved in the process and the anticipated
completion dates are set forth in Table 1, Procurement Schedule. The City reserves the right to, among other things,
amend, modify or alter the Procurement Schedule upon notice to all potential Respondents.
All communications concerning this RFQ or the RFQ process shall be directed to the City’s Designated Contact Person, in
writing.
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Designated Contact Person:
Mr. Michael Rogers, City Administrator
City of Summit
512 Springfield Avenue
Summit, NJ 07901
Qualification Statements must be submitted to and received by the City, either by hand delivery, delivery service, or US
Postal Service delivery, no later than 4:00 p.m. prevailing time on November 27, 2017. Qualification Statements will not
be accepted by facsimile transmission or e-mail.
Subsequent to issuance of this RFQ, the City (through the issuance of addenda to all firms that have received a copy of the
RFQ) may modify, supplement or amend the provisions of this RFQ in order to respond to inquiries received from
prospective Respondents or as otherwise deemed necessary or appropriate by, and in the sole judgment of, the City.
TABLE 1
PROCUREMENT SCHEDULE
ACTIVITY
DATE
1.
Issuance of Request for Qualifications
October 27, 2017
2.
Receipt of Qualification Statements
November 27, 2017
3.
Evaluation by Review Team, Recommendations; City Review
December 4, 2017
4.
Consideration of Contract Award Resolution by Common Council
December 19, 2017
Section 1.3.
Conditions Applicable to RFQ.
Upon submission of a Qualification Statement in response to this RFQ, the Respondent acknowledges and consents to the
following conditions relative to the submission and review and consideration of its Qualification Statement:
This document is an RFQ and does not constitute an RFP.
This RFQ does not commit the City to issue an RFP.
The City may or may not award a contract as a result of this RFQ. If a contract is awarded, the successful
Respondent will be required to comply with all local, State and Federal laws as applicable to the contracted
services, including but not limited to: N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 (Affirmative Action); 42 USC
S12101 et seq. (Americans w/ Disabilities Act); N.J.S.A. 52:32-44 (Business Registration), N.J.S.A. 19:44A-20.27
(“Pay-to-Play” Law), N.J.A.C. 17:44-2.2 (Document Retention), and any subsequent amendments thereto; and the
City’s current Minimum Standard Vendor Insurance Requirements as adopted by Common Council.
All costs incurred by the Respondent in connection with responding to this RFQ shall be borne solely by the
Respondent.
The City reserves the right, in its sole judgment, to reject for any reason, any and all responses and components
thereof and to eliminate any and all Respondents responding to this RFQ from further consideration for this
procurement.
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The City reserves the right, in its sole judgment, to reject any Respondent that submits incomplete responses to
this RFQ, or a Qualification Statement that is not responsive to the requirements of this RFQ.
The City reserves the right, without prior notice, to supplement, amend, or otherwise modify this RFQ, or
otherwise request additional information.
All Qualification Statements shall become the property of the City and will not be returned.
All Qualification Statements will be made available to the public at the appropriate time, as determined by the
City, in the exercise of its sole discretion, in accordance with applicable law.
The City may request Respondents to send representatives to the City for interviews.
Any and all Qualification Statements not received by the City by 4:00 p.m. prevailing time on November 27, 2017
will be rejected.
Neither the City, its consultants or advisors, nor their respective staffs, including, but not limited to, the Review
Team, shall be liable for any claims or damages resulting from the solicitation or preparation of the Qualification
Statement, nor will there be any reimbursement to Respondents for the cost of preparing and submitting a
Qualification Statement or for participating in this procurement process.
Section 1.4.
Rights of City.
The City reserves, holds and may exercise, at its sole discretion, the following rights and options with regard to this RFQ
and the procurement process in accordance with the provisions of applicable law:
•
To determine that any Qualification Statement received complies or fails to comply with the terms of this
RFQ.
•
To supplement, amend or otherwise modify the RFQ through issuance of addenda to all prospective
Respondents who have received a copy of this RFQ.
•
To waive any technical non-conformance with the terms of this RFQ.
•
To change or alter the schedule for any events called for in this RFQ upon the issuance of notice to all
prospective Respondents who have received a copy of this RFQ.
•
To conduct investigations of any or all of the Respondents, as the City deems necessary or convenient, to
clarify the information provided as part of the Qualification Statement and to request additional
information to support the information included in any Qualification Statement.
•
To suspend or terminate the procurement process described in this RFQ at any time in the City’s sole
discretion. If terminated, the City may determine to commence a new procurement process or exercise
any other rights provided under applicable law without any obligation to the Respondents.
The City shall be under no obligation to complete all or any portion of the procurement process described in this RFQ.
Section 1.5
Addenda or Amendments to RFQ.
During the period provided for the preparation of responses to the RFQ, the City may issue addenda, amendments or
answers to written inquiries. Those addenda will be noticed by the City and will constitute a part of the RFQ. All
responses to the RFQ shall be prepared with full consideration of the addenda issued prior to the proposal submission
date.
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Section 1.6
Cost of Proposal Preparation.
Each proposal and all information required to be submitted pursuant to the RFQ shall be prepared at the sole cost and
expense of the respondent. There shall be no claims whatsoever against the City, its staff, its consultants or such
consultants’ staff, for reimbursement for the payment of costs or expenses incurred in the preparation of the Qualification
Statement or other information required by the RFQ.
Section 1.7
Proposal Format.
Responses should cover all information requested in the questions to be answered in this RFQ.
Responses which in the judgment of the City fail to meet the requirements of the RFQ or which are in any way conditional,
incomplete, obscure, contain additions or deletions from requested information, or contain errors may be rejected.
SECTION 2
SCOPE OF SERVICES
It is the intent of the City to solicit Qualification Statements from Respondents that have expertise in the provision of
LEGAL SERVICES – TAX APPEAL COUNSEL. Firms and/or persons responding to this RFQ shall be able to demonstrate that
they will have the continuing capabilities to perform these services.
SECTION 3
SUBMISSION REQUIREMENTS
Section 3.1
General Requirements.
The Qualification Statement submitted by the Respondent must meet or exceed the professional, administrative and
financial qualifications set forth in this Section 3 and shall incorporate the information requested below.
In addition to the information required as described below, a Respondent may submit supplemental information that it
believes may be useful in evaluating its Qualification Statement. Respondents are encouraged to be clear, factual, and
concise in their presentation of information.
Section 3.2
Administrative Information Requirements.
The Respondent shall, as part of its Qualification Statement, provide the following information:
1.
An executive summary (not to exceed two (2) pages) of the information contained in all the other parts of
the Qualification Statement.
2.
An executed Letter of Qualification (See Appendix A to this RFQ).
3.
Name, address and telephone number of the firm or firms submitting the Qualification Statement
pursuant to this RFQ, and the name of the key contact person.
4.
A description of the business organization (i.e., corporation, partnership, joint venture, etc.) of each firm,
its ownership and its organizational structure.
(a)
Provide the names and business addresses of all Principals of the firm or firms submitting the
Qualification Statement. For purposes of this RFQ, "Principals" means persons possessing an
ownership interest in the Respondent. If the Respondent is a corporation, "Principals" shall
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include each investor who would have any amount of operational control over the Respondent
and every stockholder having an ownership interest of ten percent (10%) or more in the firm.
(b)
If a firm is a partially owned or a fully-owned subsidiary of another firm, identify the parent
company and describe the nature and extent of the parents' approval rights over the activities of
the firm submitting a Qualification Statement. Describe the approval process.
(c)
If the Respondent is a partnership or a joint venture or similar organization, provide comparable
information as required in (b) above for each member of the partnership, joint venture or similar
organization.
(d)
A statement that the Respondent complies with all applicable local, State and Federal laws,
regulations and requirements with respect to its business activities.
5.
An executed Letter of Intent (See Appendix B).
6.
An executed Payment Conditions and Rate Schedules Form (See Appendix C).
7.
A completed Business Entity Disclosure Form, Political Contribution Disclosure Form & a Stockholder
Disclosure Certification (Appendices D, E, & F).
8.
The number of years the business organization has been in business under its present name.
9.
The number of years the business organization has been under its current management.
10.
Any judgments, claims or suits within the last three (3) years in which Respondent has been adjudicated
liable for professional malpractice. If yes, please explain.
11.
Whether the business organization is now or has been involved in any bankruptcy or re-organization
proceedings in the last ten (10) years. If yes, please explain.
12.
Confirm appropriate federal and state licenses to perform activities. Submit a copy of the Firm’s State of
New Jersey Business Registration Certificate
Section 3.3
Professional Information Requirements.
1.
Respondent shall submit a description of its overall experience in providing the type of services sought in
the RFQ. At a minimum, the following information on past experience should be included as appropriate
to the RFQ:
a.
Description and scope of work by Respondent;
b.
Name, address and contact information of a minimum of 2 references; and
c.
Explanation of perceived relevance of the experience to the RFQ.
2.
Describe the services that Respondent would perform directly.
3.
Describe those portions of the Respondent’s services, if any, that are sub-contracted out. Identify all
subcontractors the Respondent anticipates using in connection with this project.
4.
Does the Respondent normally employ union or non-union employees?
5.
Resumes of key employees.
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6.
A narrative statement of the Respondent’s understanding of the City’s needs and goals.
7.
List all immediate relatives of Principal(s) of Respondent who are City employees or elected officials of
the City. For purposes of the above, “immediate relative” means a spouse, parent, stepparent, brother,
sister, child, stepchild, direct-line aunt or uncle, grandparent, grandchild, and in-laws by reason of
relation.
SECTION 4
INSTRUCTIONS TO RESPONDENTS
Section 4.1
Submission of Qualification Statements.
Respondents must submit an original and one (1) copy of their Qualification Statement to the Designated Contact Person:
Mr. Michael Rogers, City Administrator
City of Summit
512 Springfield Avenue
Summit, NJ 07901
Qualification Statements must be received by the City no later than 4:00 p.m. (prevailing time) on November 27, 2017 by
hand delivery, delivery service, or US Postal Service delivery. Qualification Statements forwarded by facsimile or e-mail
will not be accepted.
To be responsive, Qualification Statements must provide all requested information, and must be in strict conformance
with the instructions set forth herein. Qualification Statements and all related information must be signed and
acknowledged by the Respondent.
SECTION 5
EVALUATION
The City’s objective in soliciting Qualification Statements is to enable it to select a firm or organization that will provide
high quality and cost effective services to the citizens of Summit. The City will consider Qualification Statements only from
firms or organizations that, in the City’s judgment, have demonstrated the capability and willingness to provide high
quality services to the citizens of the City in the manner described in this RFQ.
Proposals will be evaluated by the City on the basis of the most advantageous, all relevant factors considered. The
evaluation will consider:
1.
Experience and reputation in the field;
2.
Knowledge of the City and the subject matter addressed under the RFQ;
3.
Availability to accommodate the required meetings of the City; and
4.
Other factors demonstrated to be in the best interest of the City.
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APPENDIX A
LETTER OF QUALIFICATION
(Note: To be typed on Respondent's Letterhead. No modifications may be made to this letter)
[INSERT DATE]
Attn: Mr. Michael Rogers, City Administrator
City of Summit
512 Springfield Avenue
Summit, NJ 07901
Dear Mr. Rogers:
The undersigned has reviewed its Qualification Statement submitted in response to the Request for Qualifications (RFQ)
issued by the City of Summit ("City"), dated October 27, 2017, in connection with the City’s need for LEGAL SERVICES –
TAX APPEAL COUNSEL.
We affirm that the contents of our Qualification Statement (which Qualification Statement is incorporated herein by
reference), are accurate, factual and complete to the best of our knowledge and belief and that the Qualification
Statement is submitted in good faith upon the express understanding that any false statement may result in the
disqualification of (Name of Respondent).
[Respondent shall sign and complete the spaces provided below. If a joint venture, appropriate officers of each
company shall sign.]
(Signature of Chief
Executive Officer)
(Typed Name and Title)
(Type Name of Respondent/Firm)
Dated: ___________________
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APPENDIX B
LETTER OF INTENT
(Note: To be typed on Respondent's Letterhead. No modifications may be made to this letter)
[INSERT DATE]
Attn: Mr. Michael Rogers, City Administrator
City of Summit
512 Springfield Avenue
Summit, NJ 07901
Dear Mr. Rogers:
The undersigned, as Respondent, has (have) submitted the attached Qualification Statement in response to a Request for
Qualifications (RFQ), issued by the City of Summit ("City"), dated October 27, 2017 in connection with the City’s need for
LEGAL SERVICES – TAX APPEAL COUNSEL.
(Name of Respondent) HEREBY STATES:
1.
The Qualification Statement contains accurate, factual and complete information.
2.
(Name of Respondent) agrees (agree) to participate in good faith in the procurement process as described
in the RFQ and to adhere to the City's procurement schedule.
3.
(Name of Respondent) acknowledges (acknowledge) that all costs incurred by it (them) in connection with
the preparation and submission of the Qualification Statement and any proposal prepared and submitted in response to
the RFQ, or any negotiation which results therefrom shall be borne exclusively by the Respondent.
4.
(Name of Respondent) hereby declares (declare) that the only persons participating in this Qualification
Statement as Principals are named herein and that no person other than those herein mentioned has any participation in
this Qualification Statement or in any contract to be entered into with respect thereto. Additional persons may
subsequently be included as participating Principals, but only if acceptable to the City. (Name of Respondent) declares
that this Qualification Statement is made without connection with any other person, firm or parties who has submitted a
Qualification Statement, except as expressly set forth below and that it has been prepared and has been submitted in
good faith and without collusion or fraud.
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5.
(Name of Respondent) acknowledges and agrees that the City may modify, amend, suspend and/or
terminate the procurement process (in its sole judgment). In any case, the City shall not have any liability to the
Respondent for any costs incurred by the Respondent with respect to the procurement activities described in this RFQ.
6.
(Name of Respondent) acknowledges that any contract executed with respect to the provision of LEGAL
SERVICES – TAX APPEAL COUNSEL must comply with all applicable local, State and Federal laws, regulations and
requirements. Respondent hereby agrees to take such actions as are required in order to comply with all such applicable
laws, regulations and requirements.
(Respondent shall sign and complete the space provided below. If a joint venture, appropriate officers of each
company shall sign.)
(Signature of Chief Executive Officer)
(Typed Name and Title)
(Type Name of Firm)
Dated: ________________
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APPENDIX C
PAYMENT CONDITIONS AND RATE SCHEDULES
1.
The hourly rate for 2017 LEGAL SERVICES – TAX APPEAL COUNSEL shall be One Hundred and Eighty Dollars
($180.00) an hour for attorneys and One Hundred Dollars ($100.00) an hour for paralegals and clerks.
2.
Counsel shall be reimbursed at cost for expenses incurred for duplication, filing fees, court reporters and other
reasonable out-of-pocket expenses advanced and/or incurred by counsel. Counsel shall be reimbursed for direct charges
including disbursements that are actual expenses incurred by the Professional and or/their associated Firm in connection
with the services provided, and shall include, but not be limited to:
a.
Telegrams, faxes and long distance (Out-of-State) telephone calls;
b.
Payment of filing, application fees, review fees and similar charges;
c.
Computer expenses including time and proprietary program charges;
d.
Outside printing, reproduction, binding, collating and other graphic services;
e.
Messenger service, postage and handling of drawing and specifications, reports,
contracts and other bulky items.
3.
Monthly invoices shall be submitted detailing all services performed.
Signature: The undersigned hereby acknowledges and accepts the established payment terms.
Name of Respondent/Firm:__________________________________
Print name and title:________________________________________
Signature:________________________________________________ Date: ______________
ATTEST:
________________________________
Witness
Comment [CM1]: Does MR want to specify that
Mileage/tolls/travel time expenses shall not be
reimbursable? I know it was an issue with someone
last year or so…
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APPENDIX D
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 Company
Limited Liability Partnership
Name of Stock or Shareholder
Home Address
Part 3 – Signature and Attestation:
The undersigned is fully aware that if I have misrepresented in whole or part this affirmation and certification, I and/or the
business entity, will be liable for any penalty permitted under law.
Name of Business Entity: ___________________________________________
Signed: ________________________________
Title: __________________________________
Print Name: ____________________________
Date: __________________________________
Subscribed and sworn before me this ___ day of ___________, 2 __.
My Commission expires:
_________________________________
(Affiant)
________________________________
(Print name & title of affiant) (Corporate Seal)
Comment [CM2]: This is last year’s, only this top
section changes tho
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BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR NON-FAIR AND OPEN CONTRACTS
Required Pursuant To N.J.S.A. 19:44A-20.8
CITY OF SUMMIT
The following is statutory text related to the terms and citations used in the Business Entity Disclosure Certification
form.
“Local Unit Pay-To-Play Law” (P.L. 2004, c.19, as amended by P.L. 2005, c.51)
19:44A-20.6 Certain contributions deemed as contributions by business entity.
5. When a business entity is a natural person, a contribution by that person's spouse or child, residing therewith,
shall be deemed to be a contribution by the business entity. When a business entity is other than a natural person,
a contribution by any person or other business entity having an interest therein shall be deemed to be a
contribution by the business entity.
19:44A-20.7 Definitions relative to certain campaign contributions.
6. As used in sections 2 through 12 of this act:
“business entity" means any natural or legal person, business corporation, professional services corporation,
limited liability company, partnership, limited partnership, business trust, association or any other legal
commercial entity organized under the laws of this State or of any other state or foreign jurisdiction;
“interest" means the ownership or control of more than 10% of the profits or assets of a business entity or 10% of
the stock in the case of a business entity that is a corporation for profit, as appropriate;
Temporary and Executing
12. Nothing contained in this act shall be construed as affecting the eligibility of any business entity to perform a public
contract because that entity made a contribution to any committee during the one-year period immediately preceding
the effective date of this act.
~~~~~~~~~~~~~~~~~~~~~
The New Jersey Campaign Contributions and Expenditures Reporting Act (N.J.S.A. 19:44A-1 et seq.)
19:44A-3 Definitions. In pertinent part…
p. The term "political party committee" means the State committee of a political party, as organized pursuant to
R.S.19:5-4, any county committee of a political party, as organized pursuant to R.S.19:5-3, or any municipal
committee of a political party, as organized pursuant to R.S.19:5-2.
q. The term "candidate committee" means a committee established pursuant to subsection a. of section 9 of
P.L.1973, c.83 (C.19:44A-9) for the purpose of receiving contributions and making expenditures.
r. the term "joint candidates committee" means a committee established pursuant to subsection a. of section 9 of
P.L.1973, c.83 (C.19:44A-9) by at least two candidates for the same elective public offices in the same election in a
legislative district, county, municipality or school district, but not more candidates than the total number of the
same elective public offices to be filled in that election, for the purpose of receiving contributions and making
expenditures. For the purpose of this subsection: …; the offices of member of the board of chosen freeholders
and county executive shall be deemed to be the same elective public offices in a county; and the offices of mayor
and member of the municipal governing body shall be deemed to be the same elective public offices in a
municipality.
19:44A-8 and 16 Contributions, expenditures, reports, requirements.
While the provisions of this section are too extensive to reprint here, the following is deemed to be the pertinent
part affecting amounts of contributions:
“The $300 limit established in this subsection shall remain as stated in this subsection without further adjustment
by the commission in the manner prescribed by section 22 of P.L.1993, c.65 (C.19:44A-7.2)
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APPENDIX E
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Contractor Instructions
Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a “fair
and open” process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of P.L. 2005, c. 271, s.2 (N.J.S.A.
19:44A-20.26). This law provides that 10 days prior to the award of such a contract, the contractor shall disclose
contributions to (see reverse for listing):
any State, county, or municipal committee of a political party
any legislative leadership committee*
any continuing political committee (a.k.a., political action committee)
any candidate committee of a candidate for, or holder of, an elective office:
o
of the public entity awarding the contract
o
of that county in which that public entity is located
o
of another public entity within that county
o
or of a legislative district in which that public entity is located or, when the public entity
is a county, of any legislative district which includes all or part of the county
The disclosure must list reportable contributions to any of the committees that exceed $300 per election cycle that
were made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more
details on reportable contributions.
N.J.S.A. 52:34-25(b) itemizes the parties from whom contributions must be disclosed when a business entity is not a
natural person. This includes the following:
individuals with an “interest:” 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
all principals, partners, officers, or directors of the business entity or their spouses
any subsidiaries directly or indirectly controlled by the business entity
IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business
entity and filing as continuing political committees, (PACs).
When the 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.” [N.J.S.A. 19:44A-20.26(b)] The contributor must be
listed on the disclosure.
Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in
an amount to be determined by the Commission which may be based upon the amount that the business entity
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 or a content-consistent facsimile may be used as the contractor’s submission and is disclosable
to the public under the Open Public Records Act.
The contractor must also complete the attached Stockholder Disclosure Certification. This will assist the agency in
meeting its obligations under the law.
* N.J.S.A. 19:44A-3(s): “The term "legislative leadership committee" means a committee established, authorized to
be established, or designated by the President of the Senate, the Minority Leader of the Senate, the Speaker of the
General Assembly or the Minority Leader of the General Assembly pursuant to section 16 of P.L.1993, c.65
(C.19:44A-10.1) for the purpose of receiving contributions and making expenditures.”
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C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant To N.J.S.A. 19:44A-20.26
This form or its permitted facsimile must be submitted to the City of Summit
no later than 10 days prior to the award of the contract.
Part I – Vendor Information
Vendor Name:
Address:
City:
State:
Zip:
The undersigned being authorized to certify, hereby certifies that the submission provided herein
represents compliance with the provisions of N.J.S.A. 19:44A-20.26 and as represented by the Instructions
accompanying this form.
_________________________ _________________________ _________________________
Signature
Printed Name
Title
Part II – Contribution Disclosure
Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable
political contributions (more than $300 per election cycle) over the 12 months prior to submission to the
committees of the government entities listed on the form provided .
Contributor Name
Recipient Name
Date
Dollar Amount
$
Check here if the information is continued on subsequent page(s)
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Continuation Page
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant To N.J.S.A. 19:44A-20.26
Page ___ of ______
Vendor Name: ___________________________________
Contributor Name
Recipient Name
Date
Dollar Amount
$
Check here if the information is continued on subsequent page(s)
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List of Agencies with Elected Officials Required for Political Contribution Disclosure
N.J.S.A. 52:34-25
County Name: Union
State: Governor, and Legislative Leadership Committees
Legislative District #: 21
State Senator and two members of the General Assembly per district.
County:
Freeholders
County Clerk
Sheriff
Surrogate
Municipalities (Mayor and members of governing body, regardless of title):
Berkeley Heights Township
Clark Township
Cranford Township
Elizabeth City
Fanwood Borough
Garwood Borough
Hillside Township
Kenilworth Borough
Linden City
Mountainside Borough
New Providence Borough
Plainfield City
Rahway City
Roselle Borough
Roselle Park Borough
Scotch Plains Township
Springfield Township
Summit City
Union Township
Westfield Town
Winfield Township
Boards of Education (Members of the Board):
Berkeley Heights Township
Clark Township
Cranford Township
Elizabeth City
Garwood Borough
Hillside Township
Kenilworth Borough
Linden City
Mountainside Borough
New Providence Borough
Plainfield City
Rahway City
Roselle Borough
Roselle Park Borough
Scotch Plains-Fanwood Regional
Springfield Township
Union Township
Westfield Town
Winfield Township
Fire Districts (Board of Fire Commissioners):
None
19
APPENDIX F
STOCKHOLDER DISCLOSURE CERTIFICATION
Name of Business:
I certify that the list below contains the names and home addresses of all stockholders holding 10% or
more of the issued and outstanding stock of the undersigned.
OR
I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the
undersigned.
Check the box that represents the type of business organization:
Partnership
Corporation
Sole Proprietorship
Limited Partnership
Limited Liability Company
Limited Liability Partnership
Subchapter S Corporation
Sign and notarize the form below, and, if necessary, complete the stockholder list below.
Stockholders:
Name:
Name:
Home Address:
Home Address:
Name:
Name:
Home Address:
Home Address:
Name:
Name:
Home Address:
Home Address:
Subscribed and sworn before me this ___ day of
___________, 2 __.
(Notary Public)
My Commission expires:
_________________________________
(Affiant)
________________________________
(Print name & title of affiant)
(Corporate Seal)
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Michael Rogers
City Administrator · City of Summit
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First Discovered
Mar 19, 2026
Last Info Update
Apr 30, 2026
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