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C. 211 POLITICAL CONTRIBUTION DISCLOSURE FORM Part I - Vendor Information Required Pursuant To N.J.S.A. 19:44A-20.26 This form or its permitted facsimile must be submitted to the local unit no later than 10 days prior to the award of the contract. Vendor Name: I Granite Telecommunications, LLC Address: I 100 Newport Avenue Extension <strong>City</strong>: I Quincy I State: MA I Zip: 02171 The undersigned being authorized to certify, hereby certifies that the submission provided herein represents compliance with the provisio NJ.S.A. 19:44A-20.26 and as represented by the Instructions accompanying this form. , Part II - Contribution Disclosure -14"' CwRIl,..L. Printed Name co () Title Disclosure requirement: Puruant to NJ.S.A. 19:44A-20.26 this disclosure must include all reportable political contrbutions (more than $300 per election cycle) over the 12 months prior to submission to the committees of the governent entities 'listed on the form provided by the local unit. o Check here if disclosure is provided in electronic form. , , '- D Check here if Contributor Name , I i I 1\ /\ I I Ii \ \ I - , I I I . I \ I 1 L _\ , , , , the inforration is continued on subsequent page(s) Recipient Name Date Dollar Amount $ " . , ,
Page -' of -- Vendor Name: D Check here if , ., \ Continuation Page C.211 POLITICAl CONTRIBUTION DISCLOSURE FORI Required Pursuat To NJ.S.A. 19:44A-20.26, Contributor Name Recipient Name Date Dollar Amount $ 1 I I , J .,. I f\ I I J\ '. \ I I i \ \ I 1 \ \ ., I I \ I '., , \ I "" \ J I v \ , I ., . ,¡ ,. , , , the infonnation is continued on subsequent page(s) , , .
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Resolution of the City of Jersey Ci
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Continuation of Resolution City Cle
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City Clerk File No. Res. 10-446 Age
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LICENSE AGREEMENT This AGREEMENT is
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City Clerk File No. Res. 10-448 Age
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This summary sheet is to be attache
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.E OF FET IIi 'JY ~ SA w is' . 71 N
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This summary sheet is to be attched
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City of, JERSEY CITY Office of Risk
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Central Avenue Special Improvement
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n.t:tJVli Vi ULL t:i;iUr ~ B.a Meet
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Keport ot Uirectors 8.f Meeting 07/
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n.l:fJUll UI ULL t;l.lUI:S 8.r Meet
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8.q Meeting 07/14/10 CITY OF JERSEY
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ORDINANCEffSOLUTION FACT SHEET Date
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FULL TITLE OF RESOLUTION: RESOLUTIO
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EEO/AFFIRMATIVE ACTION REQUIREMENTS
Page 63 and 64: EXHfflT A (Cont) orientation, gende
Page 65 and 66: MinoritylWoman Business Enterprise
Page 67 and 68: P.L. 2004, c. 57 (N.J.S.A. 52:32-44
Page 69 and 70: .r~ER1~~1 Taxpaye. Identification#
Page 71 and 72: Resolution of the City of Jersey Ci
Page 73 and 74: FULL TITLE OF RESOLUTION: RESOLUTIO
Page 75 and 76: ... -.'t EXHIT A MAATORY EQUAL E!IL
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Page 79 and 80: ... " ..' ;....--p..~....'i.i;..:.-
Page 81 and 82: :ilimii',W£¡¡l1¡;'-~~':~¡¡iwJ
Page 83 and 84: ' '- CHS CHRlSTll C-overnar KI GUAD
Page 85 and 86: Continuatfon of Resolution City Cle
Page 87 and 88: ~ .EEO/ AFFIRMATIVE ACTION REQUIREM
Page 89 and 90: EXHiBIT A (Cont) orientation, gende
Page 91 and 92: MinoritylWoman Business Enterprise
Page 93 and 94: ¡ ::~~ ¡ l L ::"= j ¡ ¡ ."~= I
Page 95 and 96: Department of Labor and Workforce D
Page 97 and 98: REQUEST FOR' ,i'~d~ OFJERS.EYCITY .
Page 99 and 100: CITY OF JERSEY CIT RESOLUTION: ¡ V
Page 101 and 102: PUBLIC DISCLOSURE INFORMTION Chapte
Page 103 and 104: MAATORY EQUAL EMPLOYMENT OPPORTUNIT
Page 105 and 106: AMRICANS WITH DISABILITIES ACT OF 1
Page 107 and 108: MINORITYIWOM. BUSINESS ENTERPRISE (
Page 109 and 110: INSTRUCTIONS FOR COMPLETING THE EMP
Page 111 and 112: ITEM 16 .. Print or tye the name of
Page 113: , BUSINESS REGISTRATION LANGUAGE AN
Page 117 and 118: Name of Business: STOCKHOLDER DISCL
Page 119 and 120: .,~jR Cl'Ty OF JERSEY'CITY DIVISION
Page 121 and 122: EXHIBIT A MANDATORY EQUAL EMPWYMENT
Page 123 and 124: APPENIX A AMCAN WI DISABIL ACf OF 1
Page 125 and 126: Resolution of the City òf Jersey C
Page 127 and 128: Continuation ofResolution City Cler
Page 131 and 132: INTERDEPARTMENTAL MEMORANDUM OFFICE
Page 133 and 134: INTERDEPARTMENTAL MEMORANDUM ~ OFFI
Page 135 and 136: Edward Toloza (/ To: Subject: Maure
Page 137 and 138: JUN, LS, L010 3:03PM JC j A NO. 811
Page 139 and 140: INTERDEPARTMENTAL MEMORANDUM OFFICE
Page 141 and 142: 1 " ,/ L R .,/ :: ~ ~~ g; "o:.i. I-
Page 143 and 144: : 'f., '1652,.2 ,\~f: j..' -.'-- !/
Page 147 and 148: LEGISLATIVE FACT SHEET This summary
Page 149 and 150: Continuation of Resolution City Cle
Page 153 and 154: y . (J 'l/l/'d:J 11 ,.- ri1J~ r2UUV
Page 155 and 156: NON COLLUSION AFFIDAVIT STATE OF NE
Page 157 and 158: MANDA TORY EQUAL EMPLOYMENT OPPORTU
Page 159 and 160: AMERICANS WITH DISABILITIES ACT OF
Page 161 and 162: MINORITY/WOMAN BUSINESS ENTERPRISE
Page 163 and 164: STATE OF NEW JERSEY Division of Pub
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THIS SHALL ONLY INCLUDE EMPLOYMENT
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Vendor must submit one of the follo
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I I I I - - - - - - - - - - l l - l
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CERTIFICATION OF COMPLIANCE WITHTHE
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Page_of Vendor Name: 'Continuation
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LEGISLATIVE FACT SHEET This summary
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TITLE: Resolution of the City of Je
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l" oo .. l"oo ~ Certification 32390
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EXHIBIT A (Cont). The contrctor or
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Jul 09 2010 5:26PM HP LASERJET FAX
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Continuation of Resolution , City C
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RESOLUTION FACT SHEET This summary
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:"'. ;. ,.ClOfNSiGRÐ:Ç'llUHS"C:ON
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Ex;æß'ET .~'.' (ContJ ,. ""'~~~::
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~~I~ll(ClJnt) i~ Îlplementín.g-,t
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.-..~ FOï&M-20i STAXJ¡OFN1E,Yf JE
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'. ,Form MtVs;.aContractor's;cômii
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Stimulus Re.,orting Weare pleased t
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PROJECT: MUNICIPALITY: COUNTY: --t\
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'"'-':',' COUNTY: BIDDER: ;-vduon .
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DATE: J. 7 Ie, !to , ..Ó~" 01. ~~U
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NO. DATE SCHEDULE OF EMERGING SMAL
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---- .- T íliÐyer Identificat/on#
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3. The service is of such a special
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137/08/20113 ¡, I ~ r ..... I' . .
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07/08/2010 13: 57 FROM ; DRCOLi:N ~
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07/08/2010 13:57 Ci~ File No. O"J.
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07/138/213113 " 13:57 ~otClloi M.la
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87/08/2818 13:57 NO.891 ~øn ole/\
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07/08/2010 FROM : ORCOLAN ~ /,1 i:i
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