Resolutions - Jersey City

c. 271 POLITICAL CONTRIBUTION DISCLOSUREFORM
Requied Pursuant To N.J.S.A. i9:4~A-20.26
Thi form or its permed facsime must be s.ubmitted to the local unt
no. later than 10 days prior to the award of the contract.
Par I - Vendor Information
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Vendor Nam: I i-awil lìlt\ r)øv iJ 0't.)
Addess:' I 5"0 ~öi.l)~ tr
cit: I tJ (,/î V i IH- I State: \'.\. I Zip: O-: '83~
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The 'Udersigned being authoried to cer, hereby certes tht the sumission provid~d htrIn represents
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form
Signatue .
. çompliance with the provisiåns ofN.I.S.A 19:44A-20.26
Part U - Còntribl,ticm Disclosure.
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and as repesented by the Inctions accompanyig ths
1?b' t\~~~.ì.iiò h .~teS.
Prted Name
Title'. .
Disèlosurerequiement: PusÜatto'N.J.S.A. 19:44A-20.26.th disclosue mus include al repørtable
.politiqal contrbutions (more th $300 per election cycle) over the 12.months prior to sumision to the
commttees of the governent entities listed on the form provided by the local u:t
L.
o Check here if disclosire I! provided in electronic f~.
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Contributor N,ame Recioient Name Date. Dollar Amount
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Q 'Ch~ck here if
the inormation is contiuédon suse'q1lenlpage(s)
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