Resolutions - Jersey City

ITEM 16 - Print or type the name ofand date.the person completing the form. Include the signature, titleITEM 17- Enter the physicalZip Code and Phone Number.location where the fomi is being completed. Include City, State,TYPE OR PRINT IN SHAR BALL POINT PENThe vendor is to complete the employee information report form (AA302) and retain copy forthe vendor's own fies. 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) 292-5475F onn: http://nj.gov/treasury/contract_compliance/pdf/aa302.pdfInstructions: http://nj .gov/treasurycontract compliance/pdf/aa302ins.pdfNote that thc sample form shown on the following page is for illustrative purposes only andshould not be submitted. Use the state website links above to obtain the actual form,