Year 2010 temporary budget to make available the ... - Jersey City

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State Treasurer HORIZON HEALTH CENTER ~~ 714 BERGEN AVE. JERSEY CITY NJ '.. - ,". " . tt This is to certify that the contractor listed N.J.A.C. 17:27-1.1 et. seq. and t'ì~ effect for the period of ~'2 TPsdipproval wil remain in yee Information Report pursuant to Certification 9649 CERTI~MåkiLOF EMPLOYEE INFORMATION REPORT
Jersey City Ordinance C-829 establishes a goal of MINORITYIWOMAN BUSINESS ENTERPRISE (MWBE) Questionnaire for Bidders. city procurement to minority and woman owned business enterprises. awarding 20% of the dollar amount of total . To assist us in monitoring our achievement of this goal, please indicate below whether your company is or is not a minority owned and/or woman owned business, and retur this form with your bid proposal. Business Name: J-ö r(wvi flea 1M (JM1& Î It 6.Hjen Avenfk , k ~ Ci!J Address: N:5 O?~~ Telephone No.: de 1-- .;9-,22ù I Contact Name: lAo. 'Ci \\. If C,iY\'-O~ Please c eck applicable category : \ Minority Owned Business (MBE) Minority & Woman Owned Businesss (MWBE) Woman Owned Business (WBE) Neither Definition of Minority Business Enterprise Minority Business Enterprise means a business which is a sole proprietorship, parnership or corporation at least 51% of which is owned and controlled by persons who are Afrcan American, Hispanic, Asian American, American Indian or Alaskan native, defined as follows: African American: a person having origins in any of the black racial groups of Afca Hispanic: a person of Mexican, Puerto Rican, Central or South American or other noo- European Spansh culture or origin regardless of race. Asian: a person having origins in any of Asia, Indian subcontinent, Hawaii or the Pacific Islands. . American Indian or Alaskan Native: a person having origins in any of the original peoples of the Far East, South East the original peoples of North America and who maintains cultual identification though trbal affliation or community recognition. Woman Business Enterprise Woman Business Enterprise means a business which is a sole proprietorship, parership or corporation at .least 51 % of which is owned and controlled by a woman or women. DIVISION OF PURCHASING 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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-~_.._- ._----~_._-~.._----_._----~
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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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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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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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1¿/li/2ElEl9 12:22 201-547-52313 L
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City Clerk File No. Pg. #-- Agenda
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. ; ii/12/20El9 10: ld 2131-547-523
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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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12/19/2Ð09 11: 52 2ßl-547-5230 I.
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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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~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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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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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 323 and 324: City Clerk File No. Agenda No. Appr
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
Page 340 and 341: P.L. 2004, c. 57 (N.J.S.A. 52:32-44
Page 342 and 343: , .' C. 271 POLITICAL CONTRIBUTION
Page 344 and 345: C. 271 POUTICAL CONTRIBUTION DISCLO
Page 346 and 347: List of Agencies with Elected Offic
Page 348 and 349: BUSINESS ENTITY DISCLOSURE CERTIFIC
Page 350 and 351: AGREEMENT THIS AGREEMENT entered in
Page 352 and 353: 6. Purchases C) The City may send a
Page 354 and 355: 12. Retention of Records Financial
Page 356 and 357: 17. Labor Standards All laborers an
Page 358 and 359: Requisition # 0148794 Vendor HORIZO
Page 360 and 361: EEOIAFFIRMATIVE ACTION --REQUIREMEN
Page 362 and 363: EXHIBIT A (Cont.) The contractor or
Page 368 and 369: l'l.J. LlCIJWLllCHl VI llCè1:Sury
Page 370 and 371: C. 271 POLITICAL CONTRIBUTION DISCL
Page 372 and 373: Page_of Vendor Name: Continuation P
Page 376 and 377: CERTIFICATION OF COMPLIANCE WITH TH
Page 378 and 379: 3. Compliance with Approved Program
Page 380 and 381: B) Subgrantees that receive at leas
Page 382 and 383: comply with such additional conditi
Page 384 and 385: 20. Political Activity Prohibited N
Page 386 and 387: DETERMNATION OF VALUE CERTIFICATION
Page 388 and 389: EXHIBIT A MANDATORY EQUAL EMPLOYMEN
Page 390 and 391: APPENDIX A AMERICANS WITH DISABILIT
Page 392 and 393: Page L ot3 Public Contracts Equal E
Page 396 and 397: P.L. 2004, c. 57 (N.J.S.A. 52:32~44
Page 398 and 399: N.J. uepartent of Treasury - Uivisi
Page 400 and 401: C. 271 POLITICAL CONTRIBUTION DISCL
Page 402 and 403: Page_of Vendor Name: o Check here i
Page 406 and 407: CERTIFICATION OF COMPLIANCE WITH TH
Page 408 and 409: 3. Compliance with Approved Program
Page 410 and 411: B) Subgrantees that receive at leas
Page 412 and 413: comply with such additional conditi
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20. Political Activity Prohibited N
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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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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 DISCLO
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C. 271 POLITICAL CONTRIBUTION DISCL
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List of Agencies with Elected Offic
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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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12. Retention of Records Financial
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17. Labor Standards All laborers an
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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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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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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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MINORITYIWOMAN BUSINESS ENTERPRISE
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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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BUSINESS ENTITY DISCLOSURE CERTIFIC
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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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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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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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.___~___.__..~._..____.__________._
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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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