Resolutions - Jersey City

. BUSINESS ENTITY DISCLOSURE CERTIFICATION
FOR NON-FAIR AND opm CONTC.TS
. . Requid Pusuant 1'0 NJS.A. 19:44A-20.8
CIOF jERSEYClT
Pan I - Vendor Afation
The undersiged, bei authoried and knowledgle of the cicus~ces. does hereby certify that the":name oj
buJÍM.u mtitJ-; ha. not made'nd wi not màke any reporble coninbutions puruat to N J.S.A. 19:44A-l. et seq. tht,
pursuant to P.L 2004, Cc 19 would wthe award of ths eontrèt in the one ye peiod precedi (ddl4 if l/drd sehedJled
fOr apal of thl rontrt '? the g¡vmzing bor!) to any of the followig named cadidate commttee, jo.ítcandidates
commttee; or politica paity commttee representig the elected offci of the ":name oj entity oJ eleitJ ofciaI~.as
defied puruano . . NJ SA -
, 19'44A ._--- 3(P) (q) and (rt . .. .
- --P'--"
.Friends of PeterlJreo'nanElectio~FuDd
Gauehan Election Fund
.
Friends ofKaimah H. Ahac
TheEIection Fund of Steven Fiiop
Election Fund óf Radames VelazquezJr. . Friends of Viola Richardson forWar.F
Fritomds of Michael SQttlano
EFO David P. Don."lely J .C. Counci12010 . Healy for Mayor 2013.
. :prietds of Nidi a R.Lope2: .
~I - Ownership DisçiQsiie Certfication . ... . .. .
~cet that the 1st below. contais the ~esand home addres~~ of ~ owner holdi 1 0% .~r riore of the .
issued and outst:di stock of the Underigned. .
Check the box that repreents the tye ofbusitess entity
Dpattne.hip 0 Corporation 0 Sole Proprietorship DSubchapter S Corpo.rátion .
. DIited Partnership Ilmited Libilty C~~oration . o Lited Libilty.P~tnership.
Name of Stock or siiàrëiiolder . Home Address
. Pll3':Sigiatue aidAitstatioii:. .
The undeiiged is fuy awae . that if I have mirepresented in whole or part th affiation and cerii~tion, 1 and/or.
tle business entity, . be lible fo! any penalty ~ttedunder . w. .
Name ófB s tity -I, (,
Sig;ed: Title:
Frit Name: Date:.
Subscribed and swom before me ths, y 9f
.:Ne .2i2i
MyComm:;ion ~xpi.c:; j'/'t. 1'1 ,;è?(3
"
. NOTARY PU8L1G
STATEOFNÉW JERSEY
MYCOf.io EASAPR14,2013
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