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Resolutions - Jersey City

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c. 27 1 POLITICAL CONTRIUTION DISCLOSURE FORM<br />

Requied pursuant To N.J.S.:A 19:44A-20.26<br />

Th ronn òr its permitted facsimIle miist be s~blDttted to the local unt<br />

iio.later thn 10 day~ rior to the awu,ra of the contract.<br />

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ThF undergned being authorized to 'cer, hertb)' ocrifi.cs tht. the submssion provided htre1 repesen1E<br />

çomplimce with the provisions erN.! .S.A, 19:44A-20.26 and as represented by the Incti0J& acompanyingihis .<br />

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Part n-<br />

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Disclosure requirement: pursuant to'N.J.S.A. 19:44A~20.26'th disclosure must include aU repartble<br />

politic:a1 con1nõutoDS (more than $3O' per election cycle) over the 12 months prior to submssion w the<br />

com,ttees of the gover~t entities listed on the form provided öy the iocal unt. .<br />

o check hc~ if disclQstnc t~ provided in elec~i:nic f~. .<br />

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Contribulcr N.anie,<br />

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the inforn.ation Iscon.rlnuéd on s'lbseq't~t pa.ge(~),<br />

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