WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE

Transcription

1 NOTICE TO BIDDERS Borough of Medford Lakes, NJ PLEASE TAKE NOTICE that sealed bids must be received by the Borough of Medford Lakes, Burlington County, New Jersey on or before November 27, 2018 at 10:00 a.m. in the Office of the Borough Clerk located at 1 Cabin Circle, Medford Lakes, NJ at which time they will be open and read in public for the following: WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE A bid package consisting of this Notice to Bidders, Instructions to Bidders, Bid Form, Affidavit of Non-Collusion, Scope of Work, Affirmative Action Affidavit, and Affidavit of Stockholder Disclosure may be obtained at the office of the Municipal Clerk, Borough of Medford Lakes at 1 Cabin Circle, Medford Lakes, NJ between the hours of 8:30 a.m. and 4:30 p.m., Monday through Friday, or by request to the Clerk at clerk@medfordlakes.com Proposals must be submitted on the Bid Form provided by the Borough of Medford Lakes and placed in a sealed envelope addressed to the Borough of Medford Lakes bearing the name and address of the bidder and clearly marked Wastewater Treatment Plant Chemical LIQUID ALUMINUM SULFATE or they will not be considered. Proposals shall be mailed or delivered to: Borough Clerk Borough of Medford Lakes 1 Cabin Circle Medford Lakes, New Jersey The Borough of Medford Lakes assumes no responsibility for bids returned by mail or delivered after the deadline for submission of bids. Contractor shall be required to provide a copy of its business registration certificate pursuant to N.J.S.A. 40A: upon award of contract. Respondents are required to comply with applicable statutory requirements set forth in the bid specifications including but not limited to the NJ Public Contracts Law, related Procurement Laws and Truth in Contracting, P.L. 1999, c440, P.L. 1975, c127, N.J.S.A. 10:5-31 et seq., N.J.A.C. 17:27-1 et seq. and P.L. 1963, c. 150 (Prevailing Wage), Title 11 of the Americans With Disabilities Act of 1990 (42 U.S.C. S et seq.) and N.J.S.A. 19:44A et seq. (Pay to Play) The right is reserved to reject any or all proposals, in whole or in part, or to make awards to such bidder or bidders who, in the judgment of the Borough of Medford Lakes makes the most advantageous bid and to waive such informalities as may be permitted by law. Mark J. McIntosh, RMC Borough Clerk Page 1 of 24

2 COVER SHEET WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE Borough of Medford Lakes Bid Package All of the following documents jointly constitute the Bid Documents for WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE: 1. Notice to Bidders 2. Cover Sheet Including Bid Checklist 3. Instructions to Bidders; 4. Scope of Work 5. Technical Detailed Specifications 6. Bid Form Proposal 7. Non-Collusion Affidavit 8. Mandatory Equal Opportunity Language 9. Affirmative Action Affidavit 10. Americans with Disability Act of Stockholders Disclosure Statement of Ownership Certification 12. Political Contribution Disclosure Form 13. Statement of Qualifications 14. Disclosure of Investment Activities in Iran Bid Checklist The following documents must be submitted to the Borough in order for a bid to be accepted: Bid Form Proposal Proposal Certification Bid Security Consent of Surety (Form to be Supplied by Surety Company) Non-Collusion Affidavit Affirmative Action Affidavit Stockholders Disclosure Statement of Ownership Certification Political Contribution Disclosure Form New Jersey Business Registration Certificate (at signing of contract) Americans with Disabilities Affidavit Statement of Qualifications Specimen Contract Sample Disclosure of Investment Activities in Iran Political Contribution Disclosure Form Check Page 2 of 24

3 INSTRUCTIONS TO BIDDERS Borough of Medford Lakes Submission of Bids The Borough of Medford Lakes (hereinafter, the Borough ), Burlington County, New Jersey invites sealed bids, pursuant to the Notice to Bidders. All the terms and conditions of the Notice to Bidders are incorporated herein by reference. A. Sealed bids will be received by the designated representative at the time and place stated in the Notice to Bidders, and at such time and place will be publicly opened and read aloud. B. The bid proposal form shall be submitted: (1) in a sealed envelope; (2) addressed to Borough Clerk Borough of Medford Lakes, Cabin Circle, Medford Lakes, New Jersey 08055;(3) bearing the name and address of the bidder written on the face of the envelope; and (4) clearly marked WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE. C. It is the bidder s responsibility to see that bids are presented to the Borough on the hour stated at the place designated. Bids may be hand delivered or mailed; however, the Borough disclaims any responsibility for bids forwarded by regular or overnight mail. Bids received after the designated time and date will be returned unopened. D. Sealed bids forwarded to the Borough of before the time of opening of bids may be withdrawn upon written application of the bidder who shall be required to produce evidence showing that the individual is or represents the principal or principals involved in the bid. Once bids have been opened, they must remain firm for a period of sixty (60) calendar days. E. All prices shall be F.O.B. Destination, freight prepaid, delivered to Medford Lakes Borough Wastewater Treatment Facility, 14 Stokes Road, Medford Lakes, NJ and amounts must be written in ink or preferably typewritten. Bids containing any conditions, omissions, unexplained erasures or alterations, items not called for in the bid proposal form, attachment of additive information not required by the specifications, or irregularities of any kind, may be rejected by the Borough. Any changes, whiteouts, strikeouts, etc. on the proposal page must be initialed in ink by the person responsible for signing the bid. F. Each bid proposal form must give the full business address of the bidder and be signed by an authorized representative. Bids by partnerships must be signed in the partnership name by one of the members of the partnership or by an authorized representative, followed by the signature and designation of the person signing. Bids by corporations must be signed in the legal name of the corporation, followed by the name of the State in which incorporated and must contain the signature and designation of the president, secretary or other person authorized to bind the corporation in the matter. When requested, satisfactory evidence of the authority of the officer signing shall be furnished. Bid Documents and Submissions Each bid shall be made on the prescribed official bid forms and must be accompanied by the items specified in the Bid Checklist. Failure to provide these items will be a cause for rejecting a bid. Page 3 of 24

4 Bid Security Accompanying each bid shall be cash, certified check, cashier s check or a Bid Bond in an amount equal to 10% or $20,000.00, whichever is less. When submitting a Bid Bond, it shall contain Power of Attorney for the full amount of the Bid Bond from a surety company authorized to do business in the State of New Jersey and acceptable to the Borough. The cash, certified check, cashier s check or Bid Bond of the unsuccessful bidder(s) shall be returned as prescribed by law. The cash, certified check, cashier s check or Bid Bond of the bidder to whom the bid is awarded shall be retained unless a lease is fully executed. The cash, certified check, cashier s check or Bid Bond of the successful bidder shall be forfeited if the bidder fails to enter into a contract pursuant to N.J.S.A. 40A:11-2(t). Performance Bond and Consent of Surety Within thirty (30) days of full execution of a contract between the lowest successful bidder and the Borough said bidder shall deliver to the Borough a Performance Bond issued by a reputable bonding company authorized to issue such bonds in the State of New Jersey in the amount of One Hundred and Twenty (120%) Percent of the estimated delivery costs. The Performance Bond shall guarantee the Borough that the bidder shall deliver WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE in accordance with the terms of these bid specifications. At such time as the contract has been completed and accepted, the Borough shall return the Performance Bond to said Bidder, and same may be cancelled. Each Bid shall be accompanied by a signed Consent of Surety on the surety company s form, which shall certify that if the bidder is awarded the bid, the surety company shall issue a performance bond in the amount and for the purposes set forth herein. Right to Reject Bids The Borough reserves the right to reject any and all bids or parts thereof and to waive any informality, if deemed in the best interests of the Borough. Award of Bids The lowest responsible bidder as tabulated by the Borough Engineer and/or the Licensed Wastewater Treatment Plant Operator will be awarded the contract. SCOPE OF WORK FOR DELIVERY OF WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE: SCOPE OF WORK: The intent of this bid is to secure WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE for the Borough s use in the wastewater facility for a contract period of twenty-four (24) months. The conditions and requirements of these specifications are intended to be open and non-restrictive for the purpose of obtaining adequate participation of interested vendors, uniformity in the submission of bids and selection of the lowest responsible bidder. The Borough shall be the sole judge concerning the merits of all bids and samples. The Borough may, at its discretion, award bids for the foregoing items either individually or as a group, whichever is in the best interest of the Borough to meet its need and purpose. Page 4 of 24

5 The Bidder shall also be responsible to apply for and obtain, at its own cost and expense, all Governmental Approvals, which are required from any Federal State, County or local municipal authority in order to deliver the WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE Page 5 of 24

6 TECHNICAL DETAILED SPECIFICATIONS FOR DELIVERY OF WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE LIQUID ALUMINUM SULFATE (AKA- FILTER ALUM) TYPICAL PROPERTIES: Color: Clear Appearance: Liquid AL 203Content: 8.3% Minimum Approximate Composition: AL2 (SO4) 3 14H20 Bulk Density: 11.1 lbs. /gal Total Soluble AL203: 8.3% Minimum Insoluble s: 0.005% Maximum Solution Concentration: 48% Product shall meet all specifications of the American Water Works Association for Filter Alum. GENERAL SPECIFICATIONS: To be delivered on a DOT approved tank truck approximately 4500 gallons, using 2 cam-lock coupling. All material ordered shall be delivered and unloaded at the Alum Storage Tank located at the Borough of Medford Lakes Wastewater Treatment Plant, 14 Stokes Road, Medford Lakes, NJ The approximate quantity for one (1) year is 72 tons dry weight. The Borough for each delivery will order a minimum of approximately 10 tons dry weight. All related delivery, insurance and fuel surcharges will be included. A Manufacturer supplied Material Safety Data Sheet (MSDS) is required to be filed in the Facility s Central File. The MSDS is to be delivered prior to or as part of first shipment. Page 6 of 24

7 INSURANCE REQUIREMENTS: The successful Bidder shall purchase liability insurance at its own expense and maintain such insurance and provide proof of insurance through the term of the contract. Such insurance shall name the Borough of Medford Lakes as additional insured. Such insurance shall be issued by a company licensed to do business in New Jersey and who are Best s Rated A or better, and cover the following: A. Claims under workers compensation, disability benefit and other similar employee benefit acts; B. Claims for damages because of bodily injury, occupation sickness or disease, or death of any person other than employees; C. Claims from damages insured by usual personal injury liability coverage which are sustained by any person as a result of an offence directly or indirectly related to the employment of such person by the contractor or by any other person; D. Claims for damages other than to the work itself because of injury to or destruction of tangible property, including loss of use resulting there from; and E. Claims for damages because of bodily injury or death of any person or property damage arising out of the ownership, maintenance or use of any motor vehicle. Workers compensation and employers liability coverage as required by New Jersey law shall be provided. Limits shall not be less than $1,000,000 combined single limit, $5,000,000 aggregate. Automobile liability insurance shall include owned, non-owned and hired vehicle coverage. Limits shall not be less than $2,000,000 combined single limit. Bidder is responsible for all deductibles. Any questions regarding the proposal or the terms and conditions should be directed to: Borough Manager Cabin Circle Medford Lakes, NJ Proposals will be received by mail, commercial carrier or hand delivery on the proposal forms provided in the manner designated herein, and clearly marked on the outside of the envelope: WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE Must be received no later than November 27, 2018 at 10:00 a.m. Page 7 of 24

8 BID FORM WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE PROPOSAL The Total Price, as correctly determined from the sum of the Base Bid and Add Alternates will be considered to be the amount bid for the project, and the correct total price will control in awarding the Contract. (Amount shall be shown in both words and figures. In case of discrepancy, the amount shown in words shall govern.) DATE: SUBJECT: SULFATE WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM NAME OF BIDDER: Acknowledge is hereby made of the following Addenda received since the issuance of Bidder Documents. Addendum No. Date Addendum No. Date Addendum No. Date Addendum No. Date Work of this project which the Bidder proposes to sublet and the full names and address of the proposed sub-contractors are. The full names and residences of all persons and parties interested in the foregoing bid as Principals are as follows: NAME AND TITLE ADDRESS FULL BID: A. LIQUID ALUMINUM SULFATE [AKA] FILTER ALUM [Per Dry Ton]: $ (Set forth-full price in dollars) (Set forth-full price in words) BID - TIME PERIOD January 1, 2019 TO December 31, 2020 Twenty-four (24) Month Contract I (we) will deliver all items and/or perform all work as set forth in the specifications without additional cost or exceptions of any kind, for the prices set forth above with a total price as defined. Signature Print Name & Title Page 8 of 24

9 SPECIMEN CONTRACT - DO NOT EXECUTE AGREEMENT THIS AGREEMENT, made this day of,20 between Borough of Medford Lakes, "Owner", a body corporate and politic with principal offices located at Medford Lakes, New Jersey ( hereafter, Borough of Medford Lakes), and (hereafter, "Contractor") WITNESSETH: Contractor agrees to furnish the WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE in accordance with the Specification, its Proposal, the Notice to Bidders, Instructions to Bidders, and the General and Supplemental Conditions, which are incorporated herein, upon which Contractor submitted a bid and was awarded a contract for the aforementioned goods and services. Annexed hereto is the performance security and proof of insurance coverage of Contractor as and if called for in the Specifications, Instructions to Bidders, and General and Supplemental Conditions, as may be applicable. Contractor, by its signature on this Agreement, specifically warrants that said security and insurance coverage shall remain in force throughout the term of this Agreement. Contractor further specifically agrees, as and if called for in the Specifications, Instructions to Bidders, and Specifications, as may be applicable, to extend any and all required warranties and guarantees against defects in materials and workmanship to Borough of Medford Lakes as set forth therein. Contractor further agrees that, in the event of breach of any condition of this Agreement by Contractor, Borough of Medford Lakes may obtain substitute goods and services under such terms and conditions as Borough of Medford Lakes may find advisable under the circumstances, and may recover from Contractor, in addition to any other remedies provided by law, any and all expenses incurred in obtaining such substitute goods and the difference between the cost of said substitute goods and the amount of Borough of Medford Lake s obligation to Contractor hereunder. The Contractor shall deliver the WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE not later than. Inasmuch as the exact amount of damage and loss to the Owner which will result from failure of the Contractor to complete the work within the time herein specified and any extensions thereof, is difficult to ascertain, the damages to the Owner for delay in case of such failure on the part of the Contractor shall be liquidated in the amount of One Hundred Dollars ($100.00) for each consecutive calendar day (Sundays and Holiday included) by which such Contractor shall fail to deliver the equipment under this Contract, in accordance with the provisions thereof. Such liquidated damages shall be deductible from any funds due or thereafter to become due to the Contractor under this Contract. If such funds shall not be available or be insufficient, the Contractor or its surety shall pay the balance of such damages to the Owner. Contractor agrees to replace or correct any item that is marked in the Technical Specifications as being fully compliant that is found to be not fully compliant on the delivered vehicle within 30 days. If the Contractor does not replace the non compliant item within the time specified, the Borough will replace the non complaint item and deduct the cost (labor & materials) from any funds due or thereafter to become due to the Contractor under this Contract. If such funds shall not be available or be insufficient, the Contractor or its surety shall pay the balance of such cost to the Owner. Contractor agrees to indemnify and hold harmless Borough of Medford Lakes and their agents and employees, from and against all claims, damages, losses, and expenses, including reasonable attorney's fees in case it shall be necessary to defend or file an action, arising out of performance of the work herein, which is (1) for bodily injury, illness or death, or for property damage, including loss of use, and (2) caused in whole or in part by Contractor s negligent act or omission, or that of a subcontractor, or that of anyone employed by them or for whose acts Contractor or subcontractor may be liable. This indemnification and agreement shall apply in all instances whether Borough of Medford Lakes is made a direct party to the initial action or claim or is Page 9 of 24

10 subsequently made a party to the action by third-party in-pleading or is made a party to a collateral action arising, in whole or in part, from any of the issues emanating from the original cause of action or claim. Contractor agrees to comply with the Affirmative Action specifications attached. Upon execution and submission of a properly executed Voucher, the faithful performance of this Contract and all covenants and agreements made herein, and the acceptance of the goods and/or services described herein by Borough of Medford Lakes, Borough of Medford Lakes agrees to pay to Contractor the sum of Dollars upon the formal approval of said payment by the governing body of the Borough of Medford Lakes. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed the day and year first set forth above. ATTEST: BOROUGH OF MEDFORD LAKES Mark J. McIntosh, RMC BY: William R. Fields, MAYOR CONTRACTOR: ATTEST: (NAME) BY: [affix corporate seal, if applicable] [TITLE] Page 10 of 24

11 BOROUGH OF MEDFORD LAKES STATEMENT OF QUALIFICATIONS The Borough requests that bidders provide information as to locations where similar materials to the one on which bids are sought here in which the bidder has provided during the past five years. Provision of this information is voluntary on the bidder's part. CHEMICAL LOCATION YEARS NAME ADDRESS CONTACT PHONE # IN SERVICE ADDITIONAL RELEVANT INFORMATION AS TO THE BIDDER'S EXPERIENCE AND QUALIFICATIONS: Page 11 of 24

12 Borough of Medford Lakes WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE NON-COLLUSION AFFIDAVIT STATE OF NEW JERSEY) ) SS: COUNTY OF ) I,, having offices at, in the County of _, State of, of full age and being duly sworn according to law on my oath depose and say that: I am the of the bidder making the proposal for the above-named, and that I executed the said proposal and this Affidavit, with full authority to do so; 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; and that all statements contained in said proposal and in this Affidavit are true and correct, and made with full knowledge that the Borough of relies upon the truth of the statements contained in said proposal and in the statements contained in this Affidavit in awarding said Bid. 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. Signature: Name (Printed): _ Title: Sworn and Subscribed to before me, this day of, 201_ Notary Public of _ My Commission Expires Page 12 of 24

13 MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE N.J.S.A. 10:5-31 et seq., N.J.A.C. 17:27 GOODS AND SERVICES AND GENERAL SERVICE CONTRACTS During the performance of this contract, the contractor agrees as follows: The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for employment because of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation or sex. Except with respect to affectional orientation, the contractor will take affirmative action to ensure that such applicants are recruited and employed, and that employees are treated during employment, without regard to their age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation or sex. Such action shall include, but not be limited to the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and 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 the 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 or sex. The contractor or subcontractor, where applicable, will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency contracting officer advising the labor union or workers representative of the contractor s commitments under this act and shall post copies of the notice in conspicuous places available to employees and applicants for employment. The contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer pursuant to N.J.S.A. 10:5-31 et seq., as amended and supplemented from time to time and the Americans with Disabilities Act. The contractor or subcontractor agrees to make good faith efforts to employ minority and women workers consistent with the applicable county employment goals established in accordance with N.J.A.C. 17:27-5.2, or a binding determination of the applicable county employment goals determined by the Division pursuant to N.J.A.C. 17: The contractor or subcontractor agrees to inform in writing appropriate recruitment agencies including, but not limited to, employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate on the basis of age, creed, color, national origin, ancestry, marital status, affectional or sexual orientation or sex, and that it will discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices. The contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to assure that all personnel testing conforms with the principles of job-related testing, as established by the statutes and court decisions of the State of New Jersey and as established by applicable federal law and applicable federal court decisions. In conforming with the applicable employment goals, the contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and layoff to ensure that all such actions are taken without regard to age, creed, color, national origin, ancestry, marital status, affectional or sexual orientation 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 and its subcontractors shall furnish such reports or other documents to the Division of Contract Compliance & EEO 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 Page 13 of 24

14 Contract Compliance & EEO for conducting a compliance investigation pursuant to Subchapter 10 of the Administrative Code at N.J.A.C. 17:27. AFFIRMATIVE ACTION AFFIDAVIT STATE OF NEW JERSEY) ) SS: COUNTY OF ) Re: Borough of Medford Lakes WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE BID. I., of _, in the State of New Jersey, being of full age, duly sworn, and duly authorized, hereby duly swear according to law, on my oath depose and say: 1. I am employed by ( Contractor ), the successful bidder for the delivery of WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE at, Borough Medford Lakes, New Jersey. 2. This Affidavit is submitted in support of and as part of the contract with the Borough of Medford Lakes. 3. During the performance of the contract, the Contractor agrees to the terms and conditions set forth herein. 4. The Contractor will not discriminate against any employee or applicant for employment because of age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation. The Contractor will take affirmative action to ensure that such applicants are recruited and employed, and that employees are treated during employment, without regard to their age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation. Such action shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to pose in conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency Compliance Office setting forth provisions of this nondiscrimination clause. 5. The Contractor 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, sex, affectional or sexual orientation. 6. The Contractor will send to each labor union or representative or workers with which it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency contracting officer advising the labor union or workers representative of the Contractor s commitments under this Act and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 7. The Contractor agrees to comply with the regulations promulgated by the Treasurer pursuant to P.L. 1975, C. 127, as amended and supplemented from time to time and the Americans with Disabilities Act. 8. The Contractor agrees to attempt in good faith to employ minority and female workers consistent with the applicable county employment goals prescribed by N.J.A.C. 17:275.2 promulgated by the Treasurer pursuant to P.L. 1975, C. 127, as amended and supplemented from time to time or in accordance with a binding determination of the applicable county employment goals determined by the Affirmative Action Office pursuant to N.J.A.C. 17: promulgated by the Treasurer pursuant to P.L. 1975, C. 127, as amended and supplemented from time to time. 9. The Contractor agrees to inform in writing appropriate recruitment agencies in the area, including employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate on the basis of age, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation, and that it will discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices. 10. The Contractor 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. Page 14 of 24

15 11. The Contractor agrees to review all procedures relating to transfer, upgrading, downgrading, and layoff to ensure that all such actions are taken without regard to age, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation, and confirm with the applicable employment goals, consistent with the statutes, Court decisions of the State of New Jersey, and applicable Federal law and applicable Federal Court decisions. 12. The Contractor shall furnish such reports or other documents to the Affirmative Action Office 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 Affirmative Action Office for conducting a compliance investigation pursuant to Subchapter 10 of the Administrative Code, (N.J.A.C. 17:27). By: Print Name and Title Sworn and subscribed to before me this day of, 201_. Notary Public of My Commission Expires Page 15 of 24

16 AMERICANS WITH DISABILITIES ACT OF 1990 Equal Opportunity for Individuals with Disability The CONTRACTOR and the BOROUGH do hereby agree that the provisions of Title II of the Americans With Disabilities Act of 1990 (the "ACT") (42 U.S.C 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 thereunto, are made a part of this contract. In providing any aid, benefit, or service on behalf of the BOROUGH 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 BOROUGH n any action or administrative proceeding commenced pursuant to this Act. The Contractor shall indemnify, protect, and save harmless the BOROUGH, 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 BOROUGH grievance procedure, the CONTRACTOR agrees to abide by any decision of the BOROUGH which is rendered pursuant to said grievance procedure. If any action or administrative proceeding results in an award of damages against the BOROUGH or if the BOROUGH 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 BOROUGH 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 proceedings is brought against the BOROUGH or any of its agents, servants, and employees, the BOROUGH shall expeditiously forward or have forwarded to the CONTRACTOR every demand, complaint, notice, summons, pleading, or other process received by the BOROUGH or its representatives. It is expressly agreed and understood that any approval by the BOROUGH 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 BOROUGH pursuant to this paragraph. It is further agreed and understood that the BOROUGH 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 BOROUGH from taking any other actions available to it under any other provisions of the Agreement or otherwise at law. Contractor: Signature Name & Title Page 16 of 24

17 STATEMENT OF OWNERSHIP DISCLOSURE N.J.S.A. 52: (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 proposal submissions. Failure to submit the required information is cause for automatic rejection of the bid or proposal. 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 BELOW 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) (Please attach additional sheets if more space is needed): Name of Individual or Business Entity Home Address (for Individuals) or Business Address Page 17 of 24

18 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: 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 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 MEDFORD LAKES is relying on the information contained herein and that I am under a continuing obligation from the date of Page 18 of 24

19 this certification through the completion of any contracts with BOROUGH OF MEDFORD LAKES to notify the BOROUGH OF MEDFORD LAKES 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 MEDFORD LAKES to declare any contract(s) resulting from this certification void and unenforceable. Full Name (Print): Signature: Title: Date: Page 19 of 24

20 C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM Required Pursuant To N.J.S.A. 19:44A 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 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 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 by the local unit. Check here if disclosure is provided in electronic form. Contributor Name Recipient Name Date Dollar Amount $ Check here if the information is continued on subsequent page(s) Page 20 of 24

21 BOROUGH OF MEDFORD LAKES BID GUARANTEE IF SURETY BOND IS PROVIDED, INITIAL HERE AND ATTACH SURETY BOND TO THIS PAGE. IF SURETY BOND IS NOT PROVIDED, COMPLETE AND SIGN GUARANTEE AND ATTACH CHECK FOR 10% OF THE AMOUNT BID, NOT TO EXCEED $20, Pursuant to N.J.S.A.40A:11-21, I hereby certify, on behalf of the person or entity whose name appears below as the bidder herein, that if the contract is awarded to said person or entity it will enter into a contract therefore and will furnish any performance bond or other security required, if any, as a guarantee or indemnification of Borough of Medford Lakes. A cashier's or certified check in the amount of 10% (Ten Per Cent) of the amount bid is attached hereto. I recognize, on behalf of the bidder that if the bidder fails or refuses to enter into the contract and supply the required performance bond or other security said check will be forfeited to Medford Lakes Borough. SIGNATURE OF BIDDER: DATE: NAME AND TITLE (PRINT OR TYPE): BUSINESS ADDRESS: ATTACH CASHIER'S OR CERTIFIED CHECK, PAYABLE TO BOROUGH OF MEDFORD LAKES HERE. Page 21 of 24

22 BOROUGH OF MEDFORD LAKES BID BOND This form of bond, or its legal equivalent, is to be used by all bidders providing a surety bond. Otherwise, a certified check and executed Bid Guarantee form, also included this packet, and is required. WITNESSETH: THIS BOND, made this day of 20, KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned [name of bidder] [name of surety] as Principal, and as Surety, are held and firmly bound unto BOROUGH OF MEDFORD LAKES as Owner in the penal sum of $ for the payment of which, well and truly to be made, we hereby (bond amount, 10% of bid not to exceed $20,000.00) jointly and severally bind ourselves, our heirs, administrators, successors and assigns. THE CONDITION OF THE ABOVE OBLIGATION is such that whereas the Principal has submitted a bid on a public contract with the Owner, which contract is identified as WASTEWATER TREATMENT PLANT CHEMICAL LIQUID ALUMINUM SULFATE THEREFORE, a) if such bid shall be rejected; or b) if said bid shall be accepted and the Principal shall execute and deliver a contract in the Form of Contract attached hereto, properly completed in accordance with said bid, and shall furnish all required Performance and Labor and Material Payment Bonds, and shall otherwise fulfill the obligation to enter into a contract created by the acceptance of said bid, then this obligation shall be void. Otherwise, this obligation shall remain in full force and effect, it being understood that the total obligation of the Surety hereunder shall under no circumstances exceed the penal sum of this Bond. The Surety, for value received, hereby stipulates and agrees that its obligation hereunder shall be in no way impaired or affected by any extension of time for acceptance of said bid and the Surety hereby waives notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety have set their hand and seals to this instrument the day and year first above written. By their signatures hereon, the individual signatories warrant they have sufficient authority to bind their principals as to all matters containers herein. AFFIX CORPORATE SEALS IF APPLICABLE PRINCIPAL: SURETY: (L.S.) (L.S.) Page 22 of 24

23 CERTIFICATION I hereby certify that I have read the Proposal submitted herewith and that I am authorized to make this proposal on behalf of the business entity whose name appears in it. I further certify that all items listed and all computations are accurate and have been verified. The required bid bond has been executed in favor of the Borough of Medford Lakes. I acknowledge, on behalf of the business entity submitting this proposal, that should the proposer fail to enter into a contract after award of same the bid bond or check submitted herewith shall be forfeited. I further state that I am authorized to execute this Proposal on behalf of my principal. SIGNATURE OF BIDDER: DATE: NAME AND TITLE (PRINT OR TYPE): BUSINESS ADDRESS: Page 23 of 24

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