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Ell I El4/2El1 13 12/3~I2E'E'9 12: 113 1 ei: t:5 "09'1~'¡?2Doa 1t::J1 FAX 11 2131-547-52313 2ß1-547-5230 ~ltce: NO. ...~. LAW DEPT LAW DEPT PAGE 10/25 PAGE 08/24 ii OOS/OOS Onaace of the City of Jerey Cit, N.J. Ori. 08.121 Nt ordlnllc: Ilblishini a Buc\ftc5:~ En\It) whii: mak) J)lItl conltlbuiioh' fo miiiiieipal nnidllle iud munieipøl :¡nil ecun\ ~1iticaJ partie in exÇ~6~ o( omn lhe~"ordl ~lIiJl be lilhl~Ø flS _"Ilit) '17 m;ç''YlI public 'Ol1uact ft 'be: C¡, cir Je:cy C" (Coriinctr pflY. to. l'iay Jteilb~ Ordinoct) . I~ ~ IIW' "* lMTIATED BY rETrT.ON C&~T1FIED At/GUST lOt ¡OOI I ~'..Qf . &.EA I COUCn.I'N AT WA ...~ I CltlNCMCM Al .. ,..v. D4OH A.'t IU N,V, Ii.P5Q I NCIIII m¡;-I. ..~"* N.V,.Ni'l.. tAAl ,,'I .. II,¥, JI.Y~lI II" Dl A' ff'l- fl¥. cllSt ~ l/., !lV. ÇO;~ AYI fI R,Y. -111I II ,BPi SllfWl MO PUOD i. ii~ 1~.",EIi ~tl"".1M N.V." *', lAli "UIF~Q 1i-.1" II :t IHB '#- 0 N ~n NM N.V, .U'RSDN ME 14 N.V, llaIDI A~. Il N.v. utO 5lii -- IMNNN tI .""a& ;7 ~ 7 1~1l "" .. CI UF 7 I\lJ .; ~PI'ES. .. .fli YN -, ...v.-wMII Mopl on ,~ct WI tM! raing iier li on ... "..... wn INth f~ 0t~~,. _1i~1l ~ -. It ..nø... ò)"t u 3 ZWl! ø~ ..~ = ..""- Inlt1aio by Pet1ttOh Cert1fled Augu.i 2D. bM SE 0 S 20ae ilPMOVD: --, ~~l#;~ .~ i:i: $I 0 3 BD8 -. ~~ Dl la MlJ' $EPOC_
~1/tlq/2~1~ 12: 113 12/36/2e~9 i~: 45 2131-547-52313 2m -5ti7-523Ø LAW DEPT LAW D~PT c. 271 POLITICAL COmlBUßON DISCLOSURE fORM Contractor Instructions Bul2~ess entities (conmietors) re;"~ing contltl fiom a public agmcy th..t: iie NOT A1arded put,uant to a 'fiund open" pr~ess (defl",ed atN.J.S.A. 19:44A-20.7) ar subject 'to the prisions ofP.t. 2D05. c. 271,.s~ (N.J.S.~ 19A4A-20.26). ThÎ!llil'" prvides that 10 diiys prior to thè ø,wmdofsueli a ~ntrot. tle contnetor shall disclo!: col\trbutCJ9 10: . .. any State. c:oun.ty. or-iiunicip.i committe of.. political pirt .. .'ny leisis)ativc J~lldcrjp cOTmirte:e. . · MY continujhg political committoCi (4.k.a.) potltiQlli acriol' ooniinittee) · any CMdidllfe committee ora cadida.te for. or bolder of, an elective offce: D of tho public entit IiwQ'in¡ the Qontrt o ofchei i:oLUty it¡ which that publ£c en,tity is located o of e.rc.ther public ~ti,iy wit ilat count i o OJ' of a to¡i:;latjve dlBtrct in which thAt public entity is 'ocated or. wlien the pubJie entity Is 8 county. of imy legislative disiiol which includes aU or pan orthe cOQniy . The dISclosure must liS1 reprtable eontribti,ons to any otthe cOlnmittees tbat exetd $300 peT election c)'cle thlt \\re made during the 12 months pror to a'Wrd of the contract. Set 'N :l,SA. i 9:44A-1 and l9:44A.ltí for more de-tails on re¡i1bl" oontrbirioris. '~lJ,S.A. S2:34-:25(b) ;tembes the partic! rrom whom conlnôutons muS' be discJo!i~d wlii:n D. busiliflSS entf~ it 'lgr a mi(ural person, ThIs ineludes the fbllowing: e liidjviduÐJs wIth 8.n "inerest:" OWl.1'hip or contl of more than i Oo of the profits or Ilssets ofa Luaine.s entity Or i Qo/ of thè slOk m the ca~ of' ~ business entity 1hat is ii ~oror.tion for profit · an principÐl~i plirters, afi;i:r:i, or djreplorsofthe buslncu entit or thetr sp!=uscs · :any ~bsjdiarec diretly or Indirectly controlled by the busi,nea$ entity · IR.S Coda: Section 527 New Jersey bild orgnîZltionli. directly Or ;ndirectly controlled by the business entity and fiillg asi ~il1lljng politicBl eommitteet, (lACs). Whea the bU/l;ne$ entity (II ,-.natra) peon, /la eontrlbutlan by that pe.rson's spouse Or elii1d, residing thereith, snaJJ be deeT to be _ contrbution by ila business entjty.~ (N.J,S,A. t 9: contributor If\ist be liSkd on' the disolo8Uri, 44A-20.26(b)) The Any busméSs entity tl~t (:0.115 to camply witb thr disolo§ure provjsÎon, shaJ be subject to 4 fine imposed by .ELEC ¡nan _mount to 00 detlIined by the Commission which may be ba.ud upon rhe amOUn'1 diac tlt bvsbte$$ entity faiL.ed. to reprt. ' The enclose list ofagenc:íes is proVided to 8.gift the.contractor inJdenlifyjng ibOAê pubJic agencíe, whose eJ~eted offcia\ ancfor eandjdate campaign comittees lle affected by ~he dilc.losurerequiremetl.' It is the- C()ntTllator's re~pon.ibilit: to identifY th~ spccifii:i committes to whiob contributioDs m.y have been made Ilnd need to- be disclosed. The disclosed infoiatiaq may eoeei: the minimum requirement. The enclosed form, B. ooment-c;oqsistnt fac9imji~ or aii elet\tanïc dat fi~ CQl1taining tile: rectuired details (a lang with .. ~isned cover shee) m8i be u.sed f1~ thoQOtrabtor'$ submission Elnd.l discJosable to t~e public under Uie Open Pu'bJiç Recrd Act. Tho Conltaetr must als~ cOMplece the atbed StckhoIder Disclosure Ctrt¡flcltion. This wilt t9air the agency ìD meeting ì~ ob1iga,tions under the law. . 'NJ,S.å. 1S1¡44A.3(5): "1b8 ier ")eKi&i.t¡\'leæen"ipeomI7i~e" mc:IlS a comi\'ei: cstbfi3iied. alid10rJzcd to be ~c8bUshcd, Or di:s¡GnacC4 by lbe l-reident ofdie Son.te, the MinortY Leadr of lhe Sen.ce. t1e Speaker 01' Llie GCleraJ AsCimbIY or tbe Minori Llldcr oftle: G!IC!) A&bly pllt'uantto secton 16 ofP.L,J9'3. e.65 (C.\9:4.iA.iO.l) far tJ. p'Urpos~ Ofnt:¡\lLr.t eonii:i1NioDS ood niia1ciig e)iiir.ditures." PAGE 11/25 PAGE B9/Z4
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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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-~_.._- ._----~_._-~.._----_._----~
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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
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FULL TITLE OF RESOLUTION: RESOLUTIO
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61/64/2636 12: 62 9735860221 JAALE.
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01/04/2030 12: 02 9736800221 JAALEX
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. ..... ~_.... .., CITY OF JERSEY C
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12/16/2009 18: ~1 9732435549 PAG 02
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: 12/1&/2009 17: 56 , ILl 19"'1111"
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: ::. _._'.- ::-: - - CERTiF1CA l"E
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12i'6/2E1E19 17: 56 9732435549 IL/1
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12/16/2009 18: 41 9732435549 PAGE 0
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12/1&/2009 18: 41 9732435549 PAGE 6
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i.~rl.~(~ElElê l!3: ~1. '" ~H~~4~S
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":.'~" (l-~.. DEPAATUE1' OF 1'REASY
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i",~"yy~ 1~.YI rftn ~UI~~UIUbl IdAV
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EXHIT A 'MAATORY.EQUAL EMPLOYM OPPO
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C6r~ôn CERTIFICATE OF EMPLOYEE INF
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MioritylWoman BuSÎJess Enterprise
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.: i ..; ..' . TAXPAYER NAME: CHUKS
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AGREEMENT AGREEMENT made this _ day
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ARTICLE iv Compensation and Payment
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loss of life or property or in any
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executed by their duly authorized o
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EXBmIT A (Cant.) The contractor or
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Questionnaire for Bidders Jersey Ci
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" Treasurer ~: State Certification
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,"" -' CERTIFICATION IN SUPPORT OF
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Consulting Services Agreement For t
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A. The selected consultant shall pu
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The parties hereto reserve the righ
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A business organization that fails
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, " .I~""IUI lt'~ IA I: (r¡1"~ 53t
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t '. " l ~. ~ON CO~LrlMON ~A~ STATE
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! . ¡', '" I.: " l~ . CERnFCATION
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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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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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Page 231 and 232: month an affidavit of services spec
Page 233 and 234: The City does not agree to pay for
Page 235 and 236: administration of this contract. Al
Page 237 and 238: Continuation of Resolution City Cle
Page 239 and 240: such as court reporters, investigat
Page 241 and 242: The City does not agree to pay for
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Page 261 and 262: City Clerk File No. Agenda No. Appr
Page 263 and 264: AGREEMENT . Ths Agreement dated the
Page 265 and 266: Should the services of one or more
Page 267 and 268: affixed the day, month and year abo
Page 269 and 270: Continuation of Resolution Pg. # 2
Page 271 and 272: cents ($1.50) per page; and (ii) ch
Page 273 and 274: pursuant to section 1 ofP.L.2001, c
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Page 277 and 278: ~i/04/2010 12: 10 12/3ß/zÐÐ9 iø
Page 279 and 280: 01/64/2610 J.:O ,jt;l :'I:ll:l': 12
Page 281: ." ~l/~q/~~lØ l2~10 1~/3e/2009 18:
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Page 287 and 288: ~1/Ø4/2~1~ 12: 1~ 201-547-5230 i~i
Page 289 and 290: 4""'& "".. r - .j'~U LHW Ui=r-, PAG
Page 291 and 292: .&¿.. .LV Lui -J"l t -;"L.::U:I -~
Page 293 and 294: ~~, u~, ¿u¿u ¿¿~iD iLI ~~I ~~~~
Page 297 and 298: the preceding month. All statements
Page 299 and 300: complete or substantially complete
Page 301 and 302: Robert Byrne City Clerk Brian O'Rei
Page 303 and 304: Continuation of Resolution Pg. # Ci
Page 305 and 306: Requisition # 0148621 Vendor SOLOMO
Page 307 and 308: City of Jersey City Department of H
Page 309 and 310: VII. RECORDS AND FILES' All patient
Page 311 and 312: EXHIBIT A (Cont.) The contractor or
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Page 315 and 316: MINORITY/wOMAN BUSINESS ENTERPRISE
Page 317 and 318: -d!.~tlN~Ni~y "i"" State' Of New Je
Page 319 and 320: Princeton Insurance Company COMMON
Page 321 and 322: . BUSINESS ENTITY DISCLOSUR CERTIFI
Page 331 and 332: Requisition # 0148192 . Vendor EDUC
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EEO/ AFFIRMATIVE ACTION REQUIREMENT
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EXHIBIT A (Cont.) The contractor or
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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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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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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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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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I ___...____._-----....--..~---_---
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....__..--_.._--------_..-_..-.._-_
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____..____._...._.._.._.__.~__'____
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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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