Resolution of the City of Jersey City, N.J.

State of New.JerseyDivision of Purchase and PropertCertifcation andContributionsTwo-Year Chapter51I Executive Order 117 VendorDisclosure of political, Gerierallnformation, Solicitation: RFP or Contract No., Description of ServicesFor AGENCY USE ONLY- Award Amount". 'õ'.~Agency Contact InformationAgencyPhone NumberContact PersonAgency EmailPart 1: Vendor InformationFull Legal Business Name RMD Instruments Corptrade name If aPBllcable)(Including, Bus!ness Type o Corporation 0 Limited Partnership 0 Professional Corporation 0 Gener~1 PartnershipAddress 1 44 Hunt StreetCityWatertownVendor Email ...saies~ridinc.como Limited liabilty Company 0 Sole Propnetorship .0 Limited Liabilty Pai:ershlpStale MassachusettsAddress 2VsndorFEINZip 02472Part 2: Public Law 2005, Chapter 511 Executive Order 117 (2008) CertifcationI hereby certify as follows:1. On or after October 15, 2004; neither the below-named entity nor any individualPLEASE262897356Phone (617) 668~900whose contibutions are attributable tothe entity pursuant to Executive Order 117 (2006) has solicited or made any contribution of money, pledge of contribution,including in-kind contribi.tions, company or organization contributions, 117 (2008). as set forth below that wouldbalthe award of a"-:;.~. . '. - . -. . .co,ntract to the vendor, pursuant to the terms of Executive Ordera) Within the preceding 18 months, the below-named person or organization has not made a contribution to:(i) Any candidate committeeand/ör election fund of any candidate for or 'holder of the public offce of Governor- or Lieutenant Governor, , , ,(ii) Any State, county, municipal political part committee; OR(ii) Any legislatie leadership commitee. 'b) During-the term of offce of the current Governor(s), the below-nanied person or organization has not niadea, contribution to(i) Any Candidate, committee 'and/or election fund of the Governor or Lieutenant Governor, ORState; county or municipal political part committee nominating such Govemor in the election preceding,(ii) Anythe commencement of said Governotsterr.'c) Within the 18 months immediately prior to the first day' of thelerm ofoffce of the Governor(s), theperson or organization has not made a contribution to. "below-named '(i) ,Any candidate, committee and/òr election fund of the Govemorpr the political Lieutenant part nominating Governor; the OR successful ' gubernatorialAny State, county,municipal politica(part committee ofcandidate(s)in the last gubernatorial eíection. - 'NOTE: Prior to Novembe"r 15,2008, the only disqualifyingcontributibns include those made by thevendoror a prtneipal owningentity ,,or controllng more tha,n10 percent of the profits or assets of abusinessentiiy (orio percent Df the stcickin the case of a businessterm ofany candidateOffcecommittee and/or electionoffundGovernor.of the or to any state or county poliical'part .that is a corporation for profi) towithin the 18 months immediately priorof thè current Governor orwithin the preceding1B months, during the term of offce,the, CHSLl Rl/21/2009 'Page 1 of 3to the first day of