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12/3e(2aø3 1ø; q5 2IH-547-5230 LAW Vl:l-I : LAW DEPT EXllI1.IT A (Cont) PAGE 18(26 PAGE 16/24 The contracto or subcontractor agri;es to inform in writing its appr.oprillte recruitment agonc:les includiogt but not JiI7Itcd to, employm~nt agencies, placement bUrea\is. coUegçs, universities. labor union~. that it does not discriminate on the basis ofage, cr~ed. COIOf, national origin, ancestry, marital status. affcctional or sexual orientation, gender jden,tity ()T expression, disability, nationality or sex. aod that, it wil di$oontinue' the usc of any recn.Îtment agtincy which engages in direct or indiret discriminatory practices. decision,. The contractor etr subcontractor àgres to revise any of it!! testing procedures, ¡tnecessar, , to assure that ø,ll personal testing confoims with the principles of job-related tostÙ\. as established by the iitatutes and court decisions of the State of New .Jersey and as estbJi~hed by appJicable Poderal law and applicable Federal cou~t In conforming with the tageted employment goals, the Contrctor or subcoiitretor agroo9 to review all procedures relating to'transfer, u.pgrading, downgrading and layoff to ensure that all such actions ara taen without regard to age, eteed~ color, national origin, anceshYt marital status, affcetiooal Qr sex.ual Orientation, gender identity or . c'aression, dlslibiJty. natiQnal ity or sex, consistent with the st8tutes and court decisions of the State of NÐW Jersey, ilnd applicablt Fedc~,J law and s.ppl-joable Federal court deeisiòns. The contrctor shall submit. to the public agencYt a.fter notification of awar~ but pfi.or Ix e"ecut¡on of a goods and ser\fjces contract, one of.tha following thtec d.~úmorits: Letr ofFederiil Affrmative ActiDn Plan ApprovaJ Certficate of Employee Infonnation Report Employee Informa.tion Report Fonn AA302 TIlli contraètor a.nd its suboontrctor shall fum ish such reports Or oter documents to the Division of Public Contnits Equal.Employment Opportunity Compliance /lS may be reqi.ested by the Division from time t(t time in order to can O.ut thb purposes ofthésc regulations, and publie agencies shall fumish such ¡l1fó~ation as may be with:' , , EXHIBIT A N.J.S.A.l0:S...31 and N.J.A.C. 17:27' MANDATORY EQUAL E~LOYMENT OPPORtUNIY LANGUAGE Goods, Professional SeriCtli and Ge..eral Service C()ntraets requ,ested by the Division of Pub He Contracts Equal Employment 0ppol1unity Com'pliance for conducting 8 compliance investigation pursuant to Subchapier 10 of the Administrative Code at N.J.A,C.IZ:27 . The uødcnigDed \ll'ndqr certifi on theircømpBny's recejptt knowlooge and conimitm,e.nt tQ comply (Mandatory Affrmllh1e Action Language) The undersigned vendor further agrees to furnish the required forms of evidence And uD.derstl'nds that their contract/company's bid shall be rejected .5 non-responsive if said contractor r.Uøto coUtp'Y1fjth tbe req~irelncmb of N.J.S.A. 10:5-31 aDd N..J.A.Ç. i7:~7. Rcpresentatfv. '8 N m "- , Represeotativ ~s Sf,gi.(ure: Name of Company: John, iL' Cul ey t.c 201-217-0700 Dece~ 30 i009 Tei. No.: ___._Date: '
.&¿.. .LV Lui -J"l t -;"L.::U:I -~ j",- ~ëJ/¡:fÎl')': L ti: 4~ ~I ..~.. .: ....... ¿l:1-!547-523Et .....-.... ... . ..... ......'....... .. .,..._...~..'" LAW Ul:1-1 LAW DEPT . . .......,...........-....1 . .A.... " .e.,,~ I ~,"."...~ ,1',.. '....1 ~. , , Miorlt.IWOb*J BIU_ £n..e (MBE). . QustloJlaI." toJ" Bidder- ' 1~ City Orla C..S29 eaishes agg of city prur to minority and wo own bune enterises . awaring 20% ofthe doJlør amou o.to To USiBt 1J in mCJtoii Otl açhlevt ofths 'oa plea iAçae below whether your ()Oly Is or 1$ not a m.ori oWn aadlr WOman owed bU9inCSS~ an ie tllÌs fonn wi your bid prposa. ' PAGE 23/25 PAGE 21/24 ,I .. l.. ",. . ..".. rA, 'i ".... ....~.....I...( Buses Nai~ : Joh J. Culey Ltc .. Adds HaborSide Finanial Ceter, 1202 Plaza Ten, Jersey City, N1 07311 TelephoDe No. : Cotact Nøio : P1ees~ check aplicable ea : 201-217-0700 ' John J. Culey -- Miority Ow Bueø (ME) . _ Mûoia& WOt Ow Buseas - Wom' Owned busùk (WB) x Nei - DcßøWo Milari Baiaes. EnW'rl MInOf.l1l,¡... ~ Ði. lnl.. whch fa a sole pm~lf, P8rtlilp or ieOt li lea 51" ofwfla It GYm end~lltd by para ~ .. A8oa A~.If.panlc. As Aml!08, Anerc: lDJii Of Alas.l*tI, defød &I f'JIOM Al'ib. Ammic:a: II p~ bi"i orgi hi lI Orb blac raial cr of Atica H,,,'dm · per ofM'libi, Pno Rloa Ce or Soadi Amedln or ot non-Buropei Spaish eulru or Mløln rtcn ofnu AI".: Jl pt ha orgl ht Ir ofu. orig.1 pGes ofiæ F., But Soci E8 Asia lru /ltlboomr, HaU or th. P-aci6c Isfa. . . . A"Brae lid". or ..I-.n N.dr: i pnon baYl ora lD 8J ofthl' oriiB1 pecl otNQI Ala_faa lad wbo lUe.ntu c:ll identltfon Ihiii tr&ø aSUdlQf or COb) rwiitoa. Wotn BlIaen EnteJ11e WomlD Biill1KS Rnlle ÌD . babien whlc Îl a 9010 P"ri pardf OS ool'on at lea 51% otWbiDh fa 0M 8b eutrirfl by..WO or WGCQ OJ'CE OF EQUAL OPORTI CO,Py
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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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~ ~ '~ 10 * D . It ~ . D ~ I, j .,'
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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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...... 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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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 and 282: ." ~l/~q/~~lØ l2~10 1~/3e/2009 18:
Page 283 and 284: ~1/tlq/2~1~ 12: 113 12/36/2e~9 i~:
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Page 289: 4""'& "".. r - .j'~U LHW Ui=r-, PAG
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Page 295 and 296: Continuation of Resolution City Cle
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 329 and 330: Continuation of Resolution City Cle
Page 331 and 332: Requisition # 0148192 . Vendor EDUC
Page 333 and 334: EEO/ AFFIRMATIVE ACTION REQUIREMENT
Page 335 and 336: EXHIBIT A (Cont.) The contractor or
Page 338 and 339: 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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EXHIBIT A (Cont.) The contractor or
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State Treasurer HORIZON HEALTH CENT
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MINORITYIWOMAN BUSINESS ENTERPRISE
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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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,..~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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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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___________.....___.______._.__----
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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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. 1 ___....__......_..__.._...__~..
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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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.___~___.__..~._..____.__________._
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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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