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

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ITEM 17 - Enter the physical location where the form is being completed. Include City, State, Zip Code and Phone Number. ~ TYPE OR PRINT IN SHARP BALL POINT PEN The vendor is to complete the employee information report form (AA302) and retain copy for the vendor's own fies. The vendor is to submit a copy to the public agency awarding the contract and forward a copy to: NJ Department of the Treasury Division of Contract Compliance & Equal Employment Opportunity P.O. Box 209 Trenton, New Jersey 08625-0209 Telephone No. (609) 292-5475 Form: http://nj .gov /treasury /contract_ compliance/pdf/aa302. pdf Instructions: http://nj .gov/treasury/contract compliance/pdf/aa302ins.pdf Note that the sample form shown on the following page is for ilustrative purposes only and should not be submitted. Use the state website links above to obtain the actual form. If you have any questions on EEO/AA forms and/or requirements, please contact: Jeana F. Abuan, Affirmative Action Officer, lublic Agency Compliance Officer Department of Administration, Offce of Equal Opportnity/Affirmative Action 280 Grove Street Room- 103 Jersey City NJ 07302 TeL. #201-547- 4533 Fax# 201-547-5088 E-mail Address: abuanJ(ãjcnj.org
Vendor must submit one of the following 3 documents: Letter of Federal Affirmative Action Plan Approval Certificate of Employee Information Report Employee Information Report Form AA302 (submitted to NJ State Dept of u. S. Dopart..nt of i.r Iqløynt sta Mi.tAUon Offici Of pidenl COlltr.ct COl1uc. Pr N...rk Ar.. oU1c. 134 avrgreen Plac.. Pourth 'loor aa.t CranSe, KJ 0'7011 Februar 2'7, 19_ Iiply to thi attonUoi of i Pr..14et Doar CD Our recet cøl1aica rlvlo" of your utG11lhait'. _1 'lllcit oprtlU1ty pol1c:.. and pr.cUce. ... _lat.d OI ,.bru 2'. U_' Mi fowd DO appar.llt d.Uc1onc1.. or v101aUoi of IIOClt1v. Ordr 11246, .. ..ndod. ..cUon 503 of the .ohaUtaUoz Act of un or of 31 tie 2012 (th. Y1otD. Ira V.tor..... loadj.._t aa.1.tanc. Act). Acc:rdY, yo .ltGl10hlit 11 diaa to bo 1A ""lwci with thoao iaWl bo..d CO thi at.rial rohwod. Thi OfUce of Podrai CCtract COl1ai.. ProgO'1 .1ncorely aprec1atod the coration &ld coOl1.. .xtendo br yo an your .taU c1dDg tbo c:ct of thi cøUalic. rev1... lincerely, Aroi oU1.. Director Treasury)
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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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l r¡i1. .. L P.S.28 F.P. -/989 (c.
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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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o 0.$. ¡)ep.i,U1rnctr i;r'tr"lllRp
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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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I ''I';;;'lJV1.. Vi L.II '"''..,..,
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I """tJVI Il Vi LJII '"'V\,'VI_ 8.p
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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
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MinoritylWoman Business Enterprise
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P.L. 2004, c. 57 (N.J.S.A. 52:32-44
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.r~ER1~~1 Taxpaye. Identification#
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FULL TITLE OF RESOLUTION: RESOLUTIO
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... -.'t EXHIT A MAATORY EQUAL E!IL
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:ilimii',W£¡¡l1¡;'-~~':~¡¡iwJ
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' '- CHS CHRlSTll C-overnar KI GUAD
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Continuatfon of Resolution City Cle
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~ .EEO/ AFFIRMATIVE ACTION REQUIREM
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EXHiBIT A (Cont) orientation, gende
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MinoritylWoman Business Enterprise
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¡ ::~~ ¡ l L ::"= j ¡ ¡ ."~= I
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Department of Labor and Workforce D
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REQUEST FOR' ,i'~d~ OFJERS.EYCITY .
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CITY OF JERSEY CIT RESOLUTION: ¡ V
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PUBLIC DISCLOSURE INFORMTION Chapte
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MAATORY EQUAL EMPLOYMENT OPPORTUNIT
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AMRICANS WITH DISABILITIES ACT OF 1
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MINORITYIWOM. BUSINESS ENTERPRISE (
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INSTRUCTIONS FOR COMPLETING THE EMP
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ITEM 16 .. Print or tye the name of
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, BUSINESS REGISTRATION LANGUAGE AN
Page 115 and 116: Page -' of -- Vendor Name: D Check
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 129 and 130: Resolution of the City of Jersey Ci
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
Page 165: THIS SHALL ONLY INCLUDE EMPLOYMENT
Page 169 and 170: I I I I - - - - - - - - - - l l - l
Page 171 and 172: CERTIFICATION OF COMPLIANCE WITHTHE
Page 173 and 174: Page_of Vendor Name: 'Continuation
Page 175 and 176: LEGISLATIVE FACT SHEET This summary
Page 177 and 178: TITLE: Resolution of the City of Je
Page 185 and 186: t ~ ~ i ¡, . . . i . i J . ; . I .
Page 189 and 190: l" oo .. l"oo ~ Certification 32390
Page 191 and 192: EXHIBIT A (Cont). The contrctor or
Page 193 and 194: Jul 09 2010 5:26PM HP LASERJET FAX
Page 195 and 196: Continuation of Resolution , City C
Page 197 and 198: RESOLUTION FACT SHEET This summary
Page 199 and 200: :"'. ;. ,.ClOfNSiGRÐ:Ç'llUHS"C:ON
Page 201 and 202: Ex;æß'ET .~'.' (ContJ ,. ""'~~~::
Page 203 and 204: ~~I~ll(ClJnt) i~ Îlplementín.g-,t
Page 205 and 206: .-..~ FOï&M-20i STAXJ¡OFN1E,Yf JE
Page 207 and 208: '. ,Form MtVs;.aContractor's;cômii
Page 209 and 210: i :~~, ~ ~"-.. :~ T';~,Yè"t'dem!ti
Page 211 and 212: Stimulus Re.,orting Weare pleased t
Page 213 and 214: PROJECT: MUNICIPALITY: COUNTY: --t\
Page 215 and 216: '"'-':',' 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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~~It V~e' - . 0, , - Jersey City

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