~~It V~e' - . 0, , - Jersey City

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List of Agencies with Elected Officials Required for Political Contribution Disclosure N.J.S.A.19:44A-20.26 County Name: Hudson State: Governor, and Legislative Leadership Committee Legislative Distrct #s: 31, 32, & 33 State Senator and two members of the General Assembly per distrct. County: Freeholders County Executive County Clerk Surogate Sheriff Registrar of Deeds Municipalities (Mayor and members of governng body, regardless oftitle): Bayonne City East Newark Borough Guttenberg Town Harson Town Hoboken City Jersey City Kearny Town North.Bergen Township Secaucus Town Union City City Weehawken Township West New York Town Boards of Education (Members ofthe Board): East Newark Borough Guttenberg TòWn Hoboken City KearyTòwò North Bergen Township Secaucus Town Weehawken Township Fire Distrcts (Board of Fire Commissioner): (None)
Name of Business: STOCKHOLDER DISCLOSURE CERTIFICATION ~ 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 IJ I certify that no one stockholder own 10% or more of the issued and outstanding stock of the undersigned. Check the box that represents the type of business organization: (J Partnership IJ Corporation IJ Limited Partnership JE Limited Liability Corporation (J Subchapter S Corporation IJ Sole Proprietorship IJ Limited Liability Partership Sign and notarize the form below, and, if necessary, complete the stockholder list belowo Stockholders: Name: Robert T. Hale, Jr. Name: Judith Hale Home Address: 8 Olmsted Drive Hingham, MA 02043 Name:' Name: Home Address: 440 River Road Westport, MA 02790 Home Address: Home Address: Name: Name: Home Address: Home Address: l' Subsc~ and swQ! before me this JL day of l' ~ Ut, 2 fJ/f) d _ ./~ 0_ Q. ~ .~r -- TlMOTHV JOHN FRENCH (Notary Public) Notarv Public Y ommission expires: l"ff . M C .. .' I fJ /'5 Mv Commlliion Expire. Deember 15 2011 /4 COMMONWEALTH OF MASACHUSETS iw Q I'ui,d_ 'fi (Print n~ & title of affant)
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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
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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 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
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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 and 114: , BUSINESS REGISTRATION LANGUAGE AN
Page 115: Page -' of -- Vendor Name: D Check
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
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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
Page 165 and 166: THIS SHALL ONLY INCLUDE EMPLOYMENT
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Vendor must submit one of the follo
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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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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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