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" APPENDIX A AMRICANS WI DISABILITS Acr OF 1990 Equal Opp()rtnl~ for Individua with DlsabDlty The Ç(n~etr and the . of , (her "owner") do hereby agr tht the proisions of Title 11 olthe Ameroan With Disbilties Aot of 1999 (tho CI~ct') (42 ~ 812101 et seq.), whioh prohibits discrimiation on the bais ofdisabilts by public entItles in aD serice progr and actvities prvided or made avaiable by pubUc entities, and tho rules and reglatoi promulgate .pwsuatth~ unto, are made a par of th contrt. In providi any aid, benefit or seii~ on behal of the ownerpUlIt to tls contrct, the contror ag that the peormance shal be in stot compliace wi the Act In the event that the contrtor, its ageits, seits, employee, or subcntretrs violat 01 ar alleged to bave violat tho Actdung the peormance of this contrt, tJecontrotr sh defend tho9woer in anyaoton or adinisve proceding coirence purua to this Act. Thé eontrr shal indem, prote and savo harless the owner, its agents, seants, and employe frm and ågns øny and all suits, cløip\s~ loses, demads. or daages, of whatever kind OJ: ,nat arsing out of or claed tp arse out of1he alleged violaton. The controtor shl. at its oWn expnse, appe. defend, and pay any andall char for . lega serce and any and aU cost and other exes arsing frm such action or admsttive proin or incurr in eonnecon th~ltl In any and al complats brough purua to the owner7s grevance . . procedur, the contracr agrs to abide by an deoision of the owner which is reder puruat to said grevace prure. If an acon or admstve proin relts in an award of dage aga the owner, or itthe owner mews any ex to ew avlolltion of the ADA whioh ha bee brought purst to its grevance proceur the contror shal ~atisf ,and disha the same at its own exense . . . The owner shll. as soon as practcale afr a oJaJ has be made agah it, give wrtt notice therf to the Ç(ntrctor along with fuI and complete pacular 'òf tho. clai If any ac~ or admtive proçein is brought again the ower or an of ifsagents serants, ana employe..the owner shall exitiousy forwar or have forw to the contrctor evci demand. complai notice, sUons," pleading. or other process roceived by1le owner or ir repreentaves. . . It is exprely agr and under th any approvåJ. by the owner of the scrvçe provided by the cotrr purant to th contrt wi not relieve the contrtor of the obligation to coply with'tIe Act and to defend, indemnif, protet; aod sa~c hales the ower puruat to this pagiph. . It is fUer ag and uñderod th.the owner assues no obligaon to indem or save hanes the çOntor_ its. agents serts, emloyees and subCOntrtors for any claim which may ar out ofthcir perormance of thfa Agrent Fuiérore; the contrr expresly underds and ág that the ~. provisions of ths indemcation clause shal in no way Ifm1he contrctor'a obligons assued In th Agrmcnt nor shaD they.be consed to rélieve the con1rtor fr any UabiJty,.nor prelude the ower fim ta any otheraetoDS avøil~leto it under an oth~ provisions ofth~ Agent or otherse ailaw. 0' ~ , IV/~ k.s MbIJWldMa (la/ . . . . '.
MioritylWoman BuSÎJess Enterprise (ME) Questionnair Cor Biaden . lers City Ordice C-829 eslihes agQof awar 20% of the doUar amount of tota 'çj~ procurent to miority and woma owned busess enteries. . To assist US inmoDitonng our achievellent ofths goal pleae indicate below wheter your youi bid propos' . . compy is or is not a miority owned and/or woma owned bliess, and retu ths form with ~ N';: dwil'5 tr0ff iDYl (i!. -cLeO¡i I~ /1' C · Addr . : f OqjAA~ h /y1S-t vi /l e. , TelephoneNo.: q73 -7~9'- (lI'! Contact Nane: . h iii j VI U.s fllhø M MlJ" Plea~ check aplicabi~ caory : . 'A Mînty Owned Business (ME) Woma Owed buses (WB) Neither . DeØtfns Miority BusInes Enterprise -' _ Miorlty& WOIl Ow ~usess(MB) Mi Suses Emo mea a buses ~ch Is a solo pretrsp, paen Qr cooran at leat 51" of which Is owned and contll bypel who ar A1ca Amerca Hisanic, Asan $nerea AJerca .Indian or Ala nave dofied as foRows: . . . ~ Arcan Amerlcao: a peon havig oñgi in aiy~fdiebJa ia~ial8fPs ofA.ca . . . . 'lIuJc: a per off4ex~Jiei Ricaee Sout Amer Of other DO-Eu ~ao 'çu1U or orf regaes of race. AsIID: '. a pen havf origi in any oftJe orin peles ofdic Far Ea soii Ba ABilL IndJ . sucoen Ha or the Jlç Islads. . .. .. ' WØlID Buacss Entèrprie Aåerlcao Iadfa or A1Ja Native: a peon &aviD or fa aD of the or peles o(NOJ .Aerca and who mainta cutu ldenticaOA rhup triba amUltion or COwity regnon . , . . . Woma Buses Boie mea a buines Wh Is.. sole pietp, paer Qr coipoion at lea SIIJ of which is ow 8d coldUed by a woma otwoen . . DIVION OF PURCHAG COpy
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City Clerk File No. Agenda No. Appr
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Continuation of Resolution City Cle
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()- 00;1 EXHIBIT A JAN i 3 2010 BLO
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Block: 00763 Principal: 3,167.01 Ta
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N N N ~ -c N m 0 0 0 0 ;i 0 0 0 0 ;
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Memo to Brian O'Reiley, Business Ad
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Resolution of the City of Jersey Ci
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LEGISLATIVE FACT SHEET This summary
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of the Licensee or anyone employed
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14. Failure to adhere to the terms
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HOST CITY AGREEMENT THIS HOST CITY
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provided in writing by the Red Bull
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on the first business day following
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(1) Severabilty. If any provision o
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SCHEDULE A SERVICES The City shall
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.. November 16, 2009 Paragraph D -
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Aricle 26 November 16, 2009 Paragra
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Aricle 30 Insert New Paragraph H as
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Aricle 36 November 16,2009 Add new
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wil be $50 per 30-day supply, meani
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CERTIFICATION OF BRIAN O'REILLY IN
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. AFTI ACTION COMPLIACE NOTICE N.J.
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EXITA N.J.s.A. 10:5-31 aDd N.J.AC.
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APPENIX A AMRICANS WI DISABIL ACT O
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" Taxpayer Identifcation# 221~896.1
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0148637 CITY OF JERSEY CITY Requisi
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A summary of Aetna's proposal rates
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City of Jersey City Dental Program
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UL-\, .L C- C-UiiO .L-i- Jc: veL I
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CERTIFICATION OF BRIAN O'REILLY IN
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-,-~._'~_.,----_._.~.._--_.- -'-~--
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EXIT A N.J.s.A. 10:5-31 and N.J.AC.
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APPENDIX A AMRICANS WI DISABIL ACT
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Reqúisition # 0148636 Vendor DELTA
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. A sumary of Aetna's proposal rate
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Total Annual: Total Monthly: $158,0
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VcL-l¿-¿~~~ IJ;J¿ DEL TA DENTAL
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EXTRAORDINARY UNSPECIFIABLE SERVICE
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Requisition # 0148639 Vendor RELIAS
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EXIT A N.J.s.A.IG:5-3la.d N.J.A.C.
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APPENIX A AMRICANS WI DISABIL ACT O
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./ Resolution of the City of Jersey
Page 101 and 102: Resolution of the City of Jersey Ci
Page 103 and 104: FULL TITLE OF RESOLUTION: RESOLUTIO
Page 105 and 106: 61/64/2636 12: 62 9735860221 JAALE.
Page 107 and 108: 01/04/2030 12: 02 9736800221 JAALEX
Page 109 and 110: Continuation of Resolution City Cle
Page 111 and 112: . ..... ~_.... .., CITY OF JERSEY C
Page 113 and 114: 12/16/2009 18: ~1 9732435549 PAG 02
Page 115 and 116: : 12/1&/2009 17: 56 , ILl 19"'1111"
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Page 125 and 126: : ::. _._'.- ::-: - - CERTiF1CA l"E
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Page 129 and 130: 12i'6/2E1E19 17: 56 9732435549 IL/1
Page 131 and 132: 12/16/2009 18: 41 9732435549 PAGE 0
Page 133 and 134: 12/1&/2009 18: 41 9732435549 PAGE 6
Page 135 and 136: i.~rl.~(~ElElê l!3: ~1. '" ~H~~4~S
Page 137 and 138: ":.'~" (l-~.. DEPAATUE1' OF 1'REASY
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Page 145 and 146: --- I~I'~/LYV~ ~~.yy Iftft 'V'~~~IV
Page 147 and 148: i",~"yy~ 1~.YI rftn ~UI~~UIUbl IdAV
Page 149 and 150: EXHIT A 'MAATORY.EQUAL EMPLOYM OPPO
Page 151: C6r~ôn CERTIFICATE OF EMPLOYEE INF
Page 155 and 156: .: i ..; ..' . TAXPAYER NAME: CHUKS
Page 159 and 160: AGREEMENT AGREEMENT made this _ day
Page 161 and 162: ARTICLE iv Compensation and Payment
Page 163 and 164: loss of life or property or in any
Page 165 and 166: executed by their duly authorized o
Page 167 and 168: EXBmIT A (Cant.) The contractor or
Page 169 and 170: Questionnaire for Bidders Jersey Ci
Page 171 and 172: City Clerk File No. Agenda No. Appr
Page 173 and 174: " Treasurer ~: State Certification
Page 177 and 178: ,"" -' CERTIFICATION IN SUPPORT OF
Page 179 and 180: Consulting Services Agreement For t
Page 181 and 182: A. The selected consultant shall pu
Page 183 and 184: The parties hereto reserve the righ
Page 185 and 186: A business organization that fails
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Page 193 and 194: t '. " l ~. ~ON CO~LrlMON ~A~ STATE
Page 195 and 196: ! . ¡', '" I.: " l~ . CERnFCATION
Page 197 and 198: City Clerk File No. Agenda No. Appr
Page 201 and 202: This Agreei:ent dated the AGREEMENT
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approved in advance for any specifi
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et seq. 2. An Affirmative Action Em
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iLliiIL~~~ lL:LL Lin -~4 1-~23Ø LA
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...... oJ, r ...£~U LAW DEPT PAGE
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Page') of2 00491S4 II ,....... 8QVA
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12/11/2009 12:22 201-547-5230 LAW D
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LL(iiIL~~~ l¿:¿¿ :¿1:1-54 7 -52
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1¿/li/2ElEl9 12:22 201-547-52313 L
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City Clerk File No. Pg. #-- Agenda
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~i/~ii~~i~ 'l~:~~ ~~1-541-523Ø . .
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. ; ii/12/20El9 10: ld 2131-547-523
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U~'ur(~u¿u ¿~~~~ L~i-~q(-~~~~ 11/
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JRN-07-211111 15:34 trDm:2016536979
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month an affidavit of services spec
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The City does not agree to pay for
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administration of this contract. Al
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such as court reporters, investigat
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The City does not agree to pay for
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12(lS!20B9 11:52. 281-547-5230 lA D
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i~/l~/2BB~ 11: 52 08nll7t'''9 11:90
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12/1B/20e9 11: 52 OI/~.I;OOB t1'~1
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12/18/2e09 11: 52 ~l/~4/~OØ9 '1;31
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12/18/2e~9 11~52 291-547-5238 LAW D
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12/19/2Ð09 11: 52 2ßl-547-5230 I.
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12/1ß/ze09 11 :52 201-547-5230 LA
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- ... '.'.. . . + 12/iB/28Ðti 11:5
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12/iS/2ee9 11: 52 281-547-5230 LAW
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AGREEMENT . Ths Agreement dated the
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Should the services of one or more
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affixed the day, month and year abo
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Continuation of Resolution Pg. # 2
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cents ($1.50) per page; and (ii) ch
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pursuant to section 1 ofP.L.2001, c
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l:1/l:4/2E:l: 12: 10 201-547-5230 L
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~i/04/2010 12: 10 12/3ß/zÐÐ9 iø
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01/64/2610 J.:O ,jt;l :'I:ll:l': 12
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." ~l/~q/~~lØ l2~10 1~/3e/2009 18:
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~1/tlq/2~1~ 12: 113 12/36/2e~9 i~:
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~i,~q,~~i~ l~:l~ 2~1-547-5230 12/30
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~1/Ø4/2~1~ 12: 1~ 201-547-5230 i~i
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4""'& "".. r - .j'~U LHW Ui=r-, PAG
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.&¿.. .LV Lui -J"l t -;"L.::U:I -~
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~~, u~, ¿u¿u ¿¿~iD iLI ~~I ~~~~
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the preceding month. All statements
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complete or substantially complete
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Robert Byrne City Clerk Brian O'Rei
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Continuation of Resolution Pg. # Ci
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Requisition # 0148621 Vendor SOLOMO
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City of Jersey City Department of H
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VII. RECORDS AND FILES' All patient
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EXHIBIT A (Cont.) The contractor or
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.. ". \ .~ . ..' '::' . . . .~ . ,~
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MINORITY/wOMAN BUSINESS ENTERPRISE
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-d!.~tlN~Ni~y "i"" State' Of New Je
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Princeton Insurance Company COMMON
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. BUSINESS ENTITY DISCLOSUR CERTIFI
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Requisition # 0148192 . Vendor EDUC
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EEO/ AFFIRMATIVE ACTION REQUIREMENT
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MINORITYIWOMAN BUSINESS ENTERPRISE
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P.L. 2004, c. 57 (N.J.S.A. 52:32-44
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, .' C. 271 POLITICAL CONTRIBUTION
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C. 271 POUTICAL CONTRIBUTION DISCLO
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List of Agencies with Elected Offic
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BUSINESS ENTITY DISCLOSURE CERTIFIC
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AGREEMENT THIS AGREEMENT entered in
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6. Purchases C) The City may send a
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12. Retention of Records Financial
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17. Labor Standards All laborers an
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Requisition # 0148794 Vendor HORIZO
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EEOIAFFIRMATIVE ACTION --REQUIREMEN
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State Treasurer HORIZON HEALTH CENT
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l'l.J. LlCIJWLllCHl VI llCè1:Sury
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C. 271 POLITICAL CONTRIBUTION DISCL
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Page_of Vendor Name: Continuation P
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CERTIFICATION OF COMPLIANCE WITH TH
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3. Compliance with Approved Program
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B) Subgrantees that receive at leas
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comply with such additional conditi
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20. Political Activity Prohibited N
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DETERMNATION OF VALUE CERTIFICATION
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EXHIBIT A MANDATORY EQUAL EMPLOYMEN
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APPENDIX A AMERICANS WITH DISABILIT
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Page L ot3 Public Contracts Equal E
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P.L. 2004, c. 57 (N.J.S.A. 52:32~44
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N.J. uepartent of Treasury - Uivisi
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Page_of Vendor Name: o Check here i
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DETERMINATION OF V ALUECERTIFICATIO
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EXHIBIT A MANDATORY EQUAL EMPLOYMEN
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APPENDIX A AMERICANS WITH DISABILIT
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P.L. 2004, c. 57 (N.J.S.A. 52:32-44
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C.271 POLITICAL CONTRIBUTION DISCLO
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. ~ , BUSINESS ENTITY DISCLOSURE CE
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AGREEMENT TIDS AGREEMENT entered in
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6. Purchses C) The City may send a
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ATTACHEMENT A PROGRAM DESCRIPTION:
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AGREEMENT . THIS AGREEMENT entered
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6. Purchses C) The City may send a
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ATTACHEMENT A PROGRAM DESCRIPTION:
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~. Requisition # 0148802 Vendor PHI
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EEO/ AFFIRMATIVE _.._----_._."---.
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Certification 778 CERTIFICATE OF EM
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MINORITYIWOMAN.BUSINESS ENTERPRISE
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l'l.J. UCPi:UIlCUl UL HCa:sury - Ui
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AGREEMENT THIS AGREEMENT entered in
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C) The City may send a representati
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Requisition # 0148804 Vendor . . PR
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EEO/ AFFIRMATIVE - --- - ----~- ---
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- --"- - - - -- - ----- - - - - - -
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n.J. Ui;paiulll;llt vi ill;~UlY - u
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Page ::of 2- Vendor Name: Continuat
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City Clerk File No. Pg.#~ Agenda No
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Date Submitted ORDINANCEIRSOLUTION
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'~""- " JON S. CORZINE Governor Dec
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WILLIAMR. GOBLE, P.E., CITY ENGINEE
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Grant Application for State Aid to
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Grant Application for State Aid to
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Scope of Work cant' d Grant Applica
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CITY OF JERSEY CITY o E PA R TM E N
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_/ ,....\ --' ./'~''' /./,/ '\ ':'.
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---_. _._i:-~- i IZ~.. \., ." I . &
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,..~J i. \. \.....,.. ...........-
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Engineer's Estimate (12.03-2009) IT
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Project Classification (J Pedestria
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Name of Grantee: Jersey City Organi
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;:t:dn udlldynt:.. - Un:in¡; "'t:~
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LEGISLATIVE FACT SHEET This summary
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10. Any equipment installed or used
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Cit Clerk File No. Agenda No. 10.Z.
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and fully cooperate with the Direct
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7. Plan for collection ofuutstandin
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Resolution of the City of Jersey Ci
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Dated: ~ SHEET 1 Dated: Director of
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Sheet 2 RECORDED VOTE- Ayes: SO-rOL
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SHEET3A ,. SEE BUDGET APPROPRIATION
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SHEET3B_1 PRIORYEAR.'S LOCAL MUNICI
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SHEET3C Totals days 265,942 $73,979
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09-206 34,736,189 ________-:_____._
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SHEET 9 ----_....__...._------_.._-
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Click It or Ticket _.._.._-_.._---_
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01/12/10 SHEET 15A _________.._____
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01/12/10 SHEET 18A I I I 13,711 I T
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I 01/12/10 SHEET 240 I I I I , ----
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TÖTALCAPITAL IMPROVEMENTS FROM "CA
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(Tis appendix must be Included in a
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Sheet 40b C-3 TOT ALS- ALL PROJECTS
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TOTALS. ALL PROJECTS 33-399 210,155
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Sheet 44 JAN 1 3 2010 Date If you h
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Year 2010 temporary budget to make available the ... - Jersey City

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