Resolutions - Jersey City

ITEM 16 _ Print or tye the name ofand date.the person completing the form. Include the signatue: titleITEM 17 _ Enter the physicalZip Code and Phone Number.location where the form is being completed. Include City, State,TYPE OR PRIT IN SHA BALL POINT PENThe vendor is to complete the employee information report form (AA02) and retain copy forthe vendor's own fùes. The vendor is to submit a copy to the public agency awarding thecontract and forward a copy to:NJ Department of the TreasuryDivision of Contract Compliance & Equal Employment OpportunityP.O. Box 209Trenton, New Jersey 08625-0209 Telephone No. (609) 292-5475Form: http://nj .gov/treasu/contract_ compliance/pdfaa02.pdfInstructions: http://nj.gov/treasurcontract compliance/pdf/aa02ins.pdfNote thatthe sample form shown on the following page is for ilustrative puroses onlyshould not be submitted. Use the state website lins above to obta the actual form.and