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

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AFTI ACTION COMPLIACE NOTICE
N.J.S.Al0:5-31 and N.J.AC.17:27
GOODS AN SERVICES CONTCTS
(ICLUDING PROFESSIONAL SERVICES)
Th form is a su of the sucsfu bidde's requient to comply with the requiements
ofN.J.S.A. 10:5-31 and N.J.A.C.17:27.
The successfu bidd shall submt to th public agen, af noticaon of award but prior to
exection of ths contIt, one of the followi th doents as form of evidee:
(a) A photopy of a vald lett th th
contrr is ope un an existg
Federay approved or sactioned afve acon progr (goo for one yea frm the
da of the lettr);
OR
(b) A photopy of a Cercate of Employee Inomition Rep apprva, issued in
acordae with N.J.A.C. 17:27-4;
OR
(c) A photopy of an Employee
Informon Reprt (Form AA02) provided by the
Division an distbute to the public agency to be colete by the contrtor in
acrdåce with N.J.A.C. 17:27-4.
. The sucesfu vendor may obta th Afve Acton Emloyee Inormon Reprt
(AA02) from the contrg unt dung norm busies hour.
The succssfu vendoi(s) must sumit the copies of the AA02 Reprt to the Diviion of
Contrt Compli an Equa Employment Oppoty in Pulic Cont (Division). The
Pulic Agency coy is submitt to the public agency, and the vendr copy is retd by the
vendor. .
The underigned vendor cefies th he/she is awar of the cotmt to comply with th
reuient ofN.J.S.A. 10:5-31 and N.l.A.C. 17:27 and ag to fuh the re form of
evdence.
The unign vendr fuer undeds th bisler bid sh be rejecte as non-respnsive
if sad contrctor fals to comply with th reuiements ofN .J.S.A. 10:5-31 and NJ.A.C. 17:27.
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SIGNATU: sømJ!~
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DATE:
Ir/r/61
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AFIRTI ACTION COMPLICE (SAMLE DOUM