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

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DETERMNATION OF VALUE CERTIFICATION Har Melendez, of full age, hereby certifies as follows: 1. I am the Director of the City of Jersey City (City) Deparment of Health and Human Services (DHHS) and have knowledge of the goods and services provided by the DHHS. 2. The New Jersey City University - Peers Educating Peers (PEP) Program promotes drug-free and non-violent values, attitudes and interpersonal skills through their substace abuse prevention and education programs. 3. The City informally solicited quotations for services as professional services pursuant to N.J.S.A. 40A:11-5(l)(a)(i). 4. The New Jersey City University Peers Educating Peers (PEP) Program submitted a proposal to provide ongoing didactic presentations to a wide varety of communty agencies, with an emphasis on connecting with several high schools, to provide mentorig and educational programg that will focus on empowerig teens and helping them to develop coping skills to address a varety of social issues for the sum of $42,000.00. 5. The DHHS recommendation is to award the contract to the New Jersey City University Peers Educating Peers (PEP) Program. 6. The term of the contract is Januar 1,2010 though December 31, 2010. 7. The estimated alount ofthe contract exceeds $17,500.00. 8. This certification is made pursuant to N.J.S.A. 19:44A-20.5. 9. I certify that the foregoing statements are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punshment. Date: /fJ#9 1 Melendez, Director De arent of Health and Human Services
EEO/ AFFIRMATIVE ACTION ----_.- --- ------ .- ... _. .._-.---._- -_._-_._-----~- ---REQUIREMENTS Goods, Professional Services and General Service Contract Questions in reference to EEO/ AA Requirements for Goods, Professional Services and General Service Contracts should be directed to: Jeana F. Abuan Affirmative Action Offcer, Public Agency ComIiance Officer Deparment of Administration Office of Equal Opportty/Affirmative Action 280 Grove Street Room- 1 03 Jersey City, NJ 07302 TeL. #201-547-4533 Fax #201 -547-5088 Email Address: abuanJ~jcnj.org
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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
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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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":.'~" (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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! . ¡', '" 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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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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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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~i/04/2010 12: 10 12/3ß/zÐÐ9 iø
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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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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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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 364 and 365: State Treasurer HORIZON HEALTH CENT
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
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Page 384 and 385: 20. Political Activity Prohibited N
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 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
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Page 414 and 415: 20. Political Activity Prohibited N
Page 416 and 417: DETERMINATION OF V ALUECERTIFICATIO
Page 418 and 419: EXHIBIT A MANDATORY EQUAL EMPLOYMEN
Page 420 and 421: APPENDIX A AMERICANS WITH DISABILIT
Page 424 and 425: P.L. 2004, c. 57 (N.J.S.A. 52:32-44
Page 426 and 427: C.271 POLITICAL CONTRIBUTION DISCLO
Page 430 and 431: List of Agencies with Elected Offic
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Page 434 and 435: 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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C. 271 POLITICAL CONTRIBUTION DISCL
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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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C. 271 POLITICAL CONTRIBUTION DISCL
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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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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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