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

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DETERMINATION OF V ALUECERTIFICATION 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 National Council on Alcoholism and Drug Dependency of Hudson County - Parners in Prevention Program (PIP), promotes drg-free and non-violent values, attitudes and interpersonal skills through their substance abuse prevention and education programs. 3. The City informally solicited quotations for services as professional services pursuant to N.J.S.A. 40A:II-5(l)(a)(i). 4. The National Council on Alcoholism and Drug Dependency of Hudson County - Parners in Prevention Program (PIP) submitted a proposal to present (3) scientific-based substance abuse prevention and education curcula to a minium of (900) children ages 6-9 at selected private and public school located in Jersey City for the sum of $40,000.00. 5. The DHHS recommendation is to award the contract to the National Council on Alcoholism and Drug Dependency of Hudson County - Parners in Prevention Program (PIP). 6. The term ofthe contract is Janua 1,2010 through December 31,2010. 7. The estimated amount ofthe contract exceeds $17,500.00. 8. Ths certification is made pursuat 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 wilfully false, I am subject to punshment. Dare: ~~e Melendez~ Director D parent 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: J eana F. Abuan Affative Action Officer, Public Agency Comliance Offcer Deparment of Administration Office of Equal Opportty/ Affinative Action 280 Grove Street Room-1 03 Jersey City, NJ 07302 TeL. #201-547-4533 Fax #201-547-5088 Email Address: abuan~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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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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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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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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01/64/2610 J.:O ,jt;l :'I:ll:l': 12
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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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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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Page 374 and 375: BUSINESS ENTITY DISCLOSURE CERTIFIC
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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
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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 404 and 405: BUSINESS ENTITY DISCLOSURE CERTIFIC
Page 406 and 407: CERTIFICATION OF COMPLIANCE WITH TH
Page 408 and 409: 3. Compliance with Approved Program
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Page 418 and 419: EXHIBIT A MANDATORY EQUAL EMPLOYMEN
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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
Page 436 and 437: 6. Purchses C) The City may send a
Page 438 and 439: 12. Retention of Records Financial
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Page 442 and 443: ATTACHEMENT A PROGRAM DESCRIPTION:
Page 444 and 445: AGREEMENT . THIS AGREEMENT entered
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Page 452 and 453: ATTACHEMENT A PROGRAM DESCRIPTION:
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Page 458 and 459: EXHIBIT A (Cont.) The contractor or
Page 460 and 461: Certification 778 CERTIFICATE OF EM
Page 462 and 463: MINORITYIWOMAN.BUSINESS ENTERPRISE
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C. 271 POLITICAL CONTRIBUTION DISCL
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List of Agencies with Elected Offic
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AGREEMENT THIS AGREEMENT entered in
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C) The City may send a representati
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12. Retention of Records Financial
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17. Labor Standards All laborers an
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Requisition # 0148804 Vendor . . PR
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EEO/ AFFIRMATIVE - --- - ----~- ---
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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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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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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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