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Resolutions - Jersey City

Resolutions - Jersey City

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C.!71 PlAl ClRlIN _ FORequi PutTo NJ.S.A. 19:44A-2026)This 'form or itspenned facimile mUst be submitt to the loc unitDO .later than 10 days pñor to the award of the contrct.fu~ .The undergned being authori to cefy, herey cefies that theotl6~~submisson provide herin repestscOmpliance with th provisions ofN.J.S.A. 19:44A-2026 an as reprnted by the Instctions acpaying this~ ~ l.A1 13uriSign Pnted N8:ePart 11- Conbibuton Disclosure_Disclosu requiement: Puuat to N.J.S.A. 19:44A-20.26thisdiloSu mus inludeV I cG (-f'' í) (; TTitleallrepoblepolitical contrbutons (more th $300 per election cycle) over the 12 month prior to submission to thecommittees of the goverDent entities liste on th form prøvideby the localunto Chek her ifdislosu is prvided in elecic fonn..Conbu Nam Recipient Name Dae Dolar AmountSd,.\~(f\ ' \ -//"".r \/ /\"' \ ..".., " \ U .\.,..o Check. here ¡fthe inoonaton is contiued on subsequet page(s)

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