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

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

File No. Agenda No. Approved:

Res. 21-234 10.9 Mar 24 2021

RESOLUTION AUTHORIZING THE EXECUTION OF AN AGREEMENT AND CORRESPONDING AMENDMENT WITH HAAMID’S LLC, PERMITTING THE SALE OF SPECIFIED GOODS AT THE

CITY’S PROPERTY KNOWN AS THE LAFAYETTE POOL AND AQUATIC CENTER AT 303 VAN

HORNE STREET.

COUNCIL offered and moved adoption of the following resolution:

WHEREAS, the City of Jersey City (the “City”) is the owner of a property located at located at Block 17401,

Lot 3,, more commonly known as the kiosk at Lafayette Pool And Aquatic Center at 303 Van Horne Street, Jersey City, NJ 07305 (the “Property”) and the City desires to have certain items sold from the kiosk for the

benefit of the community; and WHEREAS, the City may acquire these services pursuant to the competitive contracting provisions of NJSA 40A:11-4.1 et seq.; and WHEREAS, the competitive contracting process is considered to be a fair and open bid process under the New Jersey Local Unit Pay-to-Play Law, N.J.S.A.19:44A-20,4 et seq.; and WHEREAS, pursuant to an authorizing resolution, the City had previously solicited proposals via two prior requests for proposals (“RFPs”) for vendors to operate a concession for sales of goods at various sites in Jersey City on September 22, 2020 and October 22, 2020, respectively, such RFPs including among these sites the subject Property; and WHEREAS, the City did not receive a response these two prior RPFs; and WHEREAS, pursuant to N.J.S.A. 40A:11-5(3)(a), where such circumstances occur, the City may enter into a negotiated agreement for the services contemplated under the RFPs; and WHEREAS, HAAMIDS LLC (d/b/a HUMZ) (the “Contractor”) desires to sell certain goods; and WHEREAS,the City agrees to permit the Contractor to enter onto its Property for the purpose of selling goods as more specifically set forth in an Agreement negotiated between the City and the Contractor; and WHEREAS, the Agreement will require that the Contractor indemnify the City from all risk of loss and/or damage to property or injury to or death of persons arising out of the Contractor’s use of City’s Property; and WHEREAS, the Agreement requires that the Contractor provide the City with Certificate of Insurance that names City insured in accordance with the requirements of the City’s Risk Manager; and WHEREAS, because the kiosks will be operated by HAAMIDS LLC (d/b/a HUMZ) at no cost to the City, a certification of funding pursuant to N.J.S.A. 40A:4-57 is not required for this resolution; and WHEREAS, Contractor has completed and submitted a Business Entity Disclosure Certification which certifies that Contractor has not made any reportable contributions to the political or candidate committees listed in the Business Entity Disclosure Certification in the previous one year, and that the contract will prohibit Contractor from making any reportable contributions during the term of the contract; and WHEREAS, Contractor has submitted its Certification of Compliance with theCity=s Contractor Pay-to-Play Reform Ordinance 08-128 adopted on September 3, 2008; and WHEREAS, Contractor has submitted a Chapter 271 Political Contribution Disclosure Certification at least 10 days prior to the award of this contract; and

Res. 21-234 Approved: March 24 2021 Resolution authorizing the execution of an agreement and corresponding amendment with Haamid’s

LLC, permitting the sale of specified goods at the City’s property known as the Lafayette Pool and

Aquatic Center at 303 Van Horne Street. NOW, THEREFORE, BE IT RESOLVED, by the Municipal Council of the City of Jersey City that:

1. A contract is awarded to the Contractor, at no cost to the City, allowing the Contractor and its employees, agents, guests, invitees or contractors authorization to enter onto City’s Property to perform

the activities described in the Agreement attached hereto, as amended and supplemented by Amendment #1 thereto (also attached hereto), subject to the terms of such Agreement; and

2. Subject to such modifications as may be deemed necessary or appropriate by Corporation Counsel, the Mayor or Business Administrator is authorized to execute the Agreement and Amendment #1 thereto substantially in the forms attached hereto; and

3. The term of the Agreement shall be for one (1) year after the City’s signature thereto unless earlier

terminated by the City;

4. Notice of this action shall be published in a newspaper of general circulation within the municipality within ten (10) days of this award;

5. The resolution authorizing the award of this contract and the contract itself shall be available for public inspection; and

6. The award of this contract shall be subject to the condition that HAAMIDS LLC (DBA HUMZ) provides satisfactory evidence of compliance with the Affirmative Action Amendments to Law against Discrimination, N.J.S.A. 10:5-31 et seq.

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Aquatic Center at 303 Van Horne Street.

APPROVED AS TO LEGAL FORM

Business Administrator

Corporation Counsel

☐ Certification Required

RECORD OF COUNCIL VOTE – Mar 24 9-0

AYE NAY N.V. Absent AYE NAY N.V. Absent AYE NAY N.V. Absent N.V. – RIDLEY ✓ SALEH ✓ LAVARRO ✓ (Abstain) PRINZ-AREY ✓ SOLOMON ✓ RIVERA ✓ BOGGIANO ✓ ROBINSON ✓ WATTERMAN,

PRES ✓

Adopted at a meeting of the Municipal Council of the City of Jersey.

Joyce E. Watterman, President of Council

Sean J. Gallagher, City Clerk

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Aquatic Center at 303 Van Horne Street. RESOLUTION FACT SHEET - This summary sheet is to be attached to the front of any resolution that is submitted for Council consideration. Incomplete or vague fact sheets will be returned with the resolution. Project Manager Melissa Kozakiewicz, Assistant Business Administrator 201-547-5296 [email protected] Division Bureau of Innovation Note: Project Manager must be available by phone during agenda meeting (Wednesday prior to council meeting @ 1:00 p.m.) Purpose Concession for Lafayette Pool ATTACHMENTS: HAAMIDS LLC signed ppw Lafayette Pool License Agreement Kiosk Amend1 3-Feb-2021 20210205102218 Approved by Status: Melissa Kozakiewicz, Assistant Business Administrator Approved - Jan 28 2021 John McKinney, Attorney None Peter Baker, Corporation Counsel None Amy Forman, Attorney None Nick Strasser, Attorney None Norma Garcia, Attorney None Ray Reddington, Attorney None Jeremy Jacobsen, Attorney Approved - Feb 05 2021 Sapana Shah, Attorney None Elizabeth Barna, Assistant Corporation Counsel None John Metro, Director of Finance Approved - Feb 16 2021

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ERTJFI'

OMPLIANNTRACTORPAY-T0-PLAY INANCESEPTEMBER3, 2008 ‘

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C CATION_0Fc_:_ CE W1_T1__1THEC1TY~o1§JERsEYCITYCo REFORMom) 08-128ADOPTED

PARTI -. Ai?rmation

Theundersigned,beingauthorized"andlcno'wledgeable'of the doesherebycertiijrthatof business not made any reportable’contributionsin _**one-yearperiod preceding CityCouncilawards contract) thatwouldbe deemedto beviolationsof of the City of Jersey _City’

isContractorPay—to-PlayReformOrdinance.08-128 and wouldbarthe award_of_this_contract.I further that dining the term of the c "t(nameofbusinessentity)will not make any reportablecontributionsin violationof 08-

PARTII - Signature andAttestation:

The undersignedis fully aware that I‘haye-misrepresentedin whole‘or part thisaf?rmationand-certi?cation’,I and/orthe businessentity, willbe liablefor any‘pena]'typerm1tt'edunder‘law.

NameofBusinessEntity: I

Signed Title:Print Name Date:

& title of a?iant)

**Pursuantto Section2 of Ordinance08-128,no contributionsor solicitationofcontributionsmade prior to the effectivedate Ordinance08-128(September23, 2008)shall be deemed to be aviolationof the Ordinance.

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NON COLLUSION AFFIDAVIT

STATE OF NEW JERSEYCITY OF JERSEY CITY sis:

I certify that I am

of the ?rm of /946.13A156 [-/—/(L

the Respondent making the proposal for the above named project, and that I executed the saidproposal with full authority so to do; that said Respondent has not, directly or indirectly enteredinto any agreement, participated in any collusion,or otherwisetaken any action in restraint of free

,competitive bidding in connection with the above named project; and that all statements containedin said proposal and in this af?davit are true and correct, and made with full knowledge that the

City of Jersey City relies upon the truth of the statements contained in said proposal and in thestatements contained in this affidavit in awarding the contract for the said project.

I further warrant that no person or selling agency has been employed to solicit or secure suchcontract upon an agreement or understanding for a commission, percentage, brokerage orcontingent fee, except bona ?de employees or bona ?de established or selling agenciesmaintained by (N .J.S.A.52: 34-25)

(Signature of Respondent)

SUBSCRIBED AND SWORN TOBEFORE ME THIS DAY OF 20 J I

(TYPE UNDER SIGNATURE)

NOTARY PUBLIC OFMY COMMISSIONEXPIRES: 2093.

KARENBELLAMY

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NOTE:THIS FORM MUST BE COMPLETED, NOTARIZED AND RETURNED WITH THIS

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C POLTICALCONTRIBOIONDICLOOREFORM

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.271 I T S SRequired Pursuant To N.J.S.A. 19:44A-20.26

This form orits permitted facsimile must be submittedto the local unitno later than 10 to the award of the contract.

Part I — Vendor

Vendor Name:Address:

State \

Theundersigned being authorizedto certify, hereby certi?es that the submissionprovided hereinrepresentscompliance with the provisions of N.J .S.A. 19:44A-20.26and as represented by the Instructions accompanying thisform.

Title

Part II — Contribution Disclosure

Disclosure requirement: Pursuant to N.J.S.A. 19 44A 20.26 this disclosuremust includeall reportablepolitical contributions(more than $300 per election cycle) over the 12 months prior to submission to thecommittees of the government entities listed on the form provided by the local unit.

D Checkhere if disclosureisprovided in electronicform.

Contributor Name Recipient ame Date Dollar Amount$

E] Check here if the information is continued on subsequent page(s)

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WNERSHIP DISCLOSURE

Name of Organization: QAA1m55 LLOrganization Address: .?L/ Gig/\| /P /I C N)’ '» D7790 (/5

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tion Part exec certi?cat n in Pion ype) Liab Compan (LLC)

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STATEMENT OF 0N.J.S.A. 52:25-24.2 (P.L. 1977, 0.33, as amended by P.L. 2016, c.43)

This statement shall be completed, certi?ed to, and included with all bid and proposal submissions. Failure tosubmit the required information is cause for automatic rejection of the bid or proposal.

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gig I Check the box that represents the type of business organization:E|Sole Proprietorship (skip Parts IIand Ill, execute certification in Part IV)ElNon-Profit Corpora (skip syndIll, ute io art IV)E|For-Profit Corporat (any t Limited ility yE|Pa_rtnership E|Limited Partnership ElLimitedLiabilityPartnership (LLP)E|Other (be specific)

Part II

V”The list below contains the names and addresses of all stockholders in the corporation who own 10percent or more of its stock, of any class, or of all individualpartners in the partnership who own a 10percent or greater interest therein, or of all members in the limited liabilitycompany who own a 10percent or greater interest therein, as the case may be. (COMPLETE THE LIST BELOW INTHISSECTION)

ORNo one stockholder in the corporation owns 10 percent or more ofits stock, of any class, or noindividual;partner in the partnership owns a 10 percent or greater interest therein, or no member in thelimited liabilitycompany owns a 10 percent or greater interest therein, as the casemay be. (SKIP TOPART IV)

(Please attach additional sheets if more space is needed)

Name of Individual or Business Entity Home Address (for Individuals) or Business Address

Part III DISCLOSUREOF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS OR LLCMEMBERS LISTED IN PART II

If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10 percent orgreater beneficial interest in the publicly traded parent entity as of the last annual federal Security and ExchangeCommission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links to the website(s)containing the last annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent) thatcontain the name and address of each person holding a 10% or greater beneficial interest in the publicly traded parententity, g the re nt page nu s of the filing(s) that contain the information on each such person. Attachadditi s s if m space is n d.

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Website IURLI containing the last annual SEC (or foreign equivalent) filing Page #’s

Please list the names and addresses of each stockholder, partner or member owning a 10 percent or greater interest inany corresponding corporation, partnership and/or limited liabilitycompany (LLC) listed in Part IIother than for anypublicly traded parent entities referenced above. The disclosure shall be continued until names and addresses ofevery noncorporate stockholder, and individual partner, and member exceeding the 10 percent ownership criteriaestablished pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach additional sheets if more space is needed.

Stockholder/PartnerIMember and Home Address (for Individuals) or Business AddressCorresponding Entity Listed in Part II

Part IV Certification

I, being duly sworn upon my oath, hereby represent that the foregoing informationand any attachments thereto to the best ofmy knowledge are true and complete. I acknowledge: that I am authorized to execute this certi?cation on behalf of thebid pro r; th ityof Je City is relyi the rmation ined herein and that I am under a continobl on the this cert ion through mpl n of any acts with City of Jersey City to notify theof Jersey City in writingof any changes to the information containedherein; that I am aware that it is a criminal offense tomake a false statement or misrepresentation in this certification, and if I do so, I am subject to_criminal prosecution under thelawand that it willconstitute a material breach of my agreeme ) with the, permitting the City of Jersey City to declare anycontract(s) resulting from this certification void and unenforcea ’

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Full Name (Print): Title

Signature: Date:

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(NOTE: THIS FORM MUST BE COMPLETED, NOTARIZED AND RETURNED WITH THIS PROPOSAL).

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DISCLOSUREOFINVESTMENTACTMTI INIRAN

EA?'L1_:_CER‘l1FicATiONBIDDERS PART 1 BY CHECKING

FAILURETO CHECKONE OF THEBOXES WILLRENDERTHEPROPOSAL NON-RESPONSIVE.

toPubiIcLew2o12.c.25.enypereanorentityihetsubmiteebtdorpropoeelorottienuisep toenterinteorlenewecnntnetmueteoinpietethe enbeiowmatteet.mderpemltydpedury.d1etmnhermepersmoren?ty,norunyotitepemte.

subsiciieriee.or is identi?edon the Department at Treasury's chapter 25 listas a person or entity engagingin invesunent activitiesin inn.1'he chapterzstietietoundonthe Division's et Biddeismust reviewthis listpriorto completingthe belowcerti?cation.Failure to complete the certi?cation will render a bidders proposal

ad.In

to Public Law 2012. c. 25. that neiihet the bidder tisted above nor ny at th bidder‘ patents.OI’affiliates to on the N.J. at the Treeeuty"e listof entitiesdeterminedto be engaged In prohibite

dactivitiesiniranpursuantto P.t.. 2012.:25 (‘Chapter25Uet'). I turiherceitiiythatlamttieperaoniietedaboveorleinanottioeror of the entity listed hove and em authorizedto make thiscerti?cationon its behalf. lwtii elclp Part 2 and Ign andcomplete the certi?cation below.

EABI1:PLEASEPROVIDEFURTHERINFORMATIONRELATEDTO INVESTMENTACTIVITIESJNIRANYou must provide a detailed. accurate and precise description of the activitiesof the bidding person/entity, or one of its parents. subsidiaries or afiliatee.engaging in the investment activities in Iran outlined above by completing thebox below.

Relationship to Bidderlotteror

D on of Activities

Dutattonof En ant' Anticipatedcessation Dam

BidderloffemrContactName Contact PhoneNumber

FullName(Print): 19 sggnamm:

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COMIMNYNAME:

Name

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EQUALEMPLOYMENTOPPORTUNITY (EEO)

AFFIRMATIVEACTION(AA) REQUIREMENTS

FORGOODS, PROFESSIONALSERVICEAND GENERALSERVICECONTRACTS

Questions in reference to EEO/AArequirements for Goods,Professional Serviceand General Service Contracts should be

directed to:

Jeane F. Abuan

PublicAgency Compliance Officer (P.A.C.O.)

Department of AdministrationOfficeof Tax Abatement & Compliance

13-15 Linden Avenue, 2"“FloorJersey City NJ 07305

Tel. # 201-547-4538E—Mai|Address: abuanj@}cnj.org

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EXHIBIT A (Continuation)

The contractor or subcontractor agrees to informin writing its appropriaterecruitmentagencies including,but notlimitedto, employmentagencies,placementbureaus, colleges, universities,and laborunions, that it does notdiscriminateon the basisof age, race, creed,color, national origin,ancestry, maritalstatus, affectionalor sexualorientation,gender identityor expression,disability, nationalityor sex, and that it will discontinuethe use of anyrecruitmentagency which engages in director indirectdiscriminatorypractices.

The contractor or subcontractoragrees to revise any of its testingprocedures,if necessary, to assure that allpersonnel testingconforms with theprinciplesof job-related testing, as establishedby the statutes and court

decisionsof the State of New Jersey and as established by applicableFederallaw andapplicable Federal courtdecisions.

In conformingwith the targeted employment goals, the contractor or subcontractoragrees to review all proceduresrelating to transfer, upgrading,downgradingand layoff to ensure that all such actions are takenwithout regard toage, race, creed,color, national origin,ancestry, marital status, affectionalor sexual orientation,gender identityorexpression,disability,nationalityor sex, consistent with the statutes and court decisionsof the State of New Jersey,and applicableFederal law and applicableFederal court decisions.

The contractor shall submit to the public agency, a?er noti?cation of award but prior to executionof a goodsandservicescontract, one of the following three documents:

Letter of Federal Attinnative ActionPlanApproval

Certi?cateof Employee InformationReport

EmployeeInformation Report Form AA302 (electronicallyprovided by the Divisionand distributedto thepublicagency through the Division’s website at

The contractor andits subcontractorsshall fumishsuch reports or other documents to the Divisionof Purchase &Property, CCAU, EEO MonitoringProgram as may be requestedby the office from time to time in order to carryout the purposes of theseregulations, and public agencies shall furnish such informationas may be requestedby theDivision of Purchase & Property, CCAU, EEO MonitoringProgram for conductinga complianceinvestigationpursuant to Subchapter 10 of the Administrative Code at N.J.A.C. 17:27.

The untlersigned vendor certi?es on their company's receipt, knowledge and commitmentto comply with:

EXHIBITAN.J.S.A. 105-31 and N.J.A.C. 17:27

MANDATORYEQUALEMPLOYMENT OPPORTUNITY LANGUAGEGoods, Professional Services and General ServiceContracts

(Mandatory Affirmative Action Language)

The undersigned vendor further agrees to furnish the required forms of evidence and

understands that their contract/company’s bid shall be rejected as non-responsive if said contractor fails to comply with the requirementsnfi\'..I.S.A. 10:5-31 and N.J.A.C. 17:27.Representative's Name/Title (Pri IA) "J A’

Representative’:

Name of

Tel.N .: Date:-)4‘ 3’

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Signatu ICompa J11)‘/3ibs‘ L/‘f

APPENDIXAAMERICANSWITHDISABILITIESACTOF 1990EqualOpportunityfor Individuals with Disability

The contractor and the of reafter "owner") do hereby agree that theprovisions of Title 11 of the Americans With Disabilities Act of 1990 (the "Act") (42 5'12] 01et seq.), which prohibits discrimination on the basis of disability by public entities in all services,programs, and activities provided or made available by public entities, and the rules and regulationspromulgated pursuant there unto, are made a part of this contract. In providing any aid, bene?t, orservice on behalf of the owner pursuant to this contract, the contractor agrees that the performanceshall be in strict compliance with the Act. In the eventthat the contractor, its agents, servants,employees, or subcontractors violate or are alleged to have violated the Act during the performanceof this contract, the contractor shall defend the owner in any action or administrative proceedingcommenced pursuant to this Act. The contractor shall indemnify, protect, and save harmless theowner, its agents, servants, and employees from and against any and all suits, claims, losses,demands, or damages, of whatever kind or nature arising out of or claimed to arise out of the allegedviolation. The contractor shall, at its own expense, appear, defend, and pay any and all charges forlegal services and any and all costs and other expenses arising from such action or administrativeproceeding or incurred in connection therewith. In any and all complaints brought pursuant to theowner's grievance procedure, the contractor agrees to abide by any decision of the owner which isrendered pursuant to said grievance procedure. Ifany actionor administrative proceeding results inan award of damages against the owner, or if the owner incurs any expense to cure a violation of theADA which has been brought pursuant to its grievance procedure, the contractor shall satisfy anddischarge the same at its own expense.

The owner shall, as soon as practicable after a claim has been made against it, give written noticethereof to the contractor along with full and complete particulars of the claim, If any action oradministrative proceeding is brought against the owner or any of its agents, servants, and employees,the owner shall expeditiously forward or have forwarded to the contractor every demand,complaint, notice, summons, pleading,or other process received by the owner or its representatives.

It is expressly agreed and understood that any approval by the owner of the services provided by thecontractor pursuant to this contract will not relieve the contractor of the obligation to comply withthe Actand to defend, indemnify, protect, and save harmless the owner pursuant to this paragraph.

It is further agreed and understood that the owner assumes no obligation to indemnify or saveharmless the contractor, its agents, servants, employees and subcontractors for any claim which mayarise out of their performance of this Agreement. Furthermore,the contractor expressly understandsand agrees that the provisions of this indemnification clause shall in no way limit the contractor'sobligations assumed in this Agreement, nor shall they be construed to relieve the contractor fromany liability, nor preclude the owner from taking any other actions available to it under any otherprovisions of the Agreement or otherwiseat law.

Representative’s Name/Title (Print) I

Representative’s re:Name of ny: /LTel. No.: Date:

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CTYO JE SEYCTYDEPARTMENT OF BUSINESS ADMINISTRATIO

OFFICE OF

,|l<1R

SUPPLIER DIVERSITY BIDDER QUEST ONNAIRE

The City of Jersey City is committed to ensuring that its utilization of vendors reflects the diversity of itscommunity. Please complete this form to assist us with monitoring our supplier diversity performance.

Business Name: I/ItI

Address: /4 [Z I

Phone:

Email: 0 V‘

Contact Name: C [,1 1,

Please indicate if your business gualifies as any of the following: (See definitions for clarification)

E MinorityOwned

_ Woman Owned

Veteran Owned

I DisabilityOwned

_ Lesbian,Gay, Bisexual, Transgender OwnedII-l/@ne

Please indicate if your business is currently certified by an authorized certifying body as any ofthe following:

Zl MinorityBusiness Enterprise

Woman Business Enterprise

II Veteran Business Enterprise

Disability Owned Business Enterprise

Lesbian, Gay, Bisexual, Transgender Business Enterprise

Disadvantaged Business Enterprise

Small Business Enterprise

7/None

THE CITY OF JERSEY CITY IS AN AFFIRMATIVEACTION 8: EQUAL OPPORTUNITY EMPLOYER AND COMPLIES WITH ALLLOCAL,STATE AND FEDERAL LAWS AND REGULATIONS IN EMPLOYMENT

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I FEREICTYO J S YCTYDEPARTMENT OF BUSINESS ADMINISTRATIO

NOFFICE

SUPPLIER DIVERSITYDEFINITIONS

Minority Owned- a business which is a sole proprietorship, partnership or corporation at least 51% ofwhich is owned and controlled by persons who are African American, Hispanic, Asian American,American Indian orA|askan Native, defined as follows:

African American: a person having origins in any of the black racial groups of Africa.

Hispanic: a person of Mexican, Puerto Rican, Central or'South American or other non-European Spanishculture or origin regardless of race.

Asian: a personhaving origins in any of the original peoples of the Far East, South East Asia, Indiansubcontinent, Hawaii or the Pacific Islands.

American Indian or Alaskan Native: a person having origins in any of the original peoples of NorthAmerica and who maintains cultural identification through tribal affiliation or community recognition.

Woman Owned- a business which is a sole proprietorship, partnership or corporation at least 51% ofwhich is owned and controlled by a woman or women.

Veteran Owned- a business which is a sole proprietorship, partnership or corporation at least 51% ofwhich is owned and controlled by a person or persons who are veterans.

"Veteran" means any citizen and resident of this State now or hereafter honorably discharged or releasedunder honorablecircumstances who served in any branchof the Armed Forces of the United States or aReserve component thereof for at least 90 days and shall include disabled veterans.

Disability Owned- a business which is a sole proprietorship, partnership or corporation at least 51% ofwhich is owned and controlled by a person or persons with a disability.

Lesbian, Gay, Bisexual, Transgender Owned- a business which is a sole proprietorship, partnership orcorporation at least 51% of which is owned and controlled by an LGBT person or persons.

THE CITY OF JERSEY CITY IS AN AFFIRMATIVEACTION 8- EQUAL OPPORTUNITYEMPLOYER AND COMPLIESWITHALLLOCAL, STATE AND FEDERAL LAWS AND REGULATIONS IN

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Form AA302 STATE OF NEW JERSEYRe“ 1”” Divisionof Purchase 8: Property

Contract Compliance Audit UnitEE0 Monitoring Program

FMPI OVFF NFORMAT ON REPDRT

IMPORTANT-READINSTRUCIIONSCAREFULLYBEFORECOMPLETINGFORM. FAILURETO PROPERLYCOMPLETETHEENTIREFORMANDTO SUBMITTHEREQUIRED$l50.00 FEEMAYDELAYISSUANCEOF YOURCERTIFICATE.DONOTSUBMITEEO-1REPORTFORSECTIONB.ITEM1!. For Instructions on :ompIeting the Iorm.go to:

PANY

1. F11). NO on socw. SECURITY 2. TYPE or BUSINFSS 3, TOTAL NO. EMPLOYEES [N THE ENTIRED I$9/[:1 2 SERVICE I] 3. WHOLESALE COMPANY 54. RETAIL I] 5. OTHER

,9): /1<:4. COMPANYNAME

5. STREET CITY COUNTY STATE ZIP CODEDI6. NAME OFPARENTOR Al‘FELIATEDCOMPANY (IF NONE, INDICATE) CITY STATE Z?’ CODE

9. TOTALNU.\IBER AT ESTABLISIILEENTWIHCH HAS BEENAWARDED THE CONTRACT

CITY COUNTY

HATP, RFFFIVFT1 MAIN‘. DATE

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1]. Report all permanent, temporary andpart-limeemployeesON YOUROWNPAYROLL.Enterthe appropriate?gures on all lines and in all columns.Where there area panicular category, enter azéro. IncludeALL employees, notjust thosein rninorily/nurrminoritycategories. in columns1.2, & 3 DONOTSUBMITT.

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CATEGORIES TOTAL MALF. FEMALE NONlCoIs2&3) MIN BLACK ASIAN MIN.

OfflclalslManagers

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TOTAL

Total employmentFrom previous I7/ 7,_"

The data below shallNOT be includedin the ?gures for the appropriatecategories above.me

12. H W WASINFORMATIONAS TO RACE OR ETHNIC SECTIONB 14. IS THIS TIE FIRST 15. IF NO,DATE LAST1. Vmul Survey U2.EmploymentR-.-cord U3. fy) EmployeeInfonmtion REPORTSUH.\II']TED

Repon Submitted‘?, MO, YEAR13 DATES0!’ PA

From: To: 1. YES 2. N0]-

SECTION IDENTIFICATION

I6. NAME OF PERSONCOMPLETINGFORM (Print or Type) TITLE DATE

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STATE ZIP CODE PHONE (AREA CODE,N0._EXTENSION)C//JHYIC

17. STREET

of 37

SUBMITTHE REQUIRED§1§0.00 NON-REFUNDABLE FEE MAY DELAYISSUANCE OF YOUR CERTIFICATE

IncludeCity. ly, S and Zip Code. Thicabié ifyou a awin current Certi?cale.

WITH A CHECK IN THE AMOUNT QQF§l§0.Q? PAYABLE T0NON-REIST.-\'I‘E OF NEW JE E ‘ICEI

INSTRUCTIONSFOR COMPLETINGTHEEMPLOYEE INFORMATION REPORT (FORM AA302)

IMPORTANT: READ THE FOLLOWINGINSTRUCTIONSCAREFULLYBEFORE COMPLETINGTHE FORM.PRINT OR TYPE ALLINFORMATION.FAILURETO PROPERLY COMPLETETHE ENTIREFORM ANDTO

IFYOU HAVE A CURRENTCERTIFICATE OF EMPLOYEE INFORMATION REPORT, DO NOT COMPLETETHIS

I

FORM UNLESS YOURARE RENEWING A CERTIFICATE THAT IS DUE FOR EXPIRATION.DO NOT COMPLETETHIS FORM FOR CONSTRUCTIONCONTRACTAWARDS,

ITEM1 — Enter the Federal Identification Numberassigned bythe Internal Revenue Service, or ifa Federal EmployerIdenti?cationNumberhas been applied for.or if yourbusiness is such that you have not or willnot receive aFederal Employer Identi?cationNumber, enter the SocialSecurity Number of the owner or of one partner, in the caseof a partnership.

ITEM2 - Check the box appropriate to your TYPEOFBUSINESS.Ifyou are engaged in more than one type ofbusiness check the predominate one. Ifyou are amanufacturer deriving more than 50% of your receipts fromyour own retailoutlets.check “Retail”.

ITEM3 - Enter the total ‘number’ of employees in the entirecompany,including part—timeemployees. This number shallincludeallfacilitiesin the entire ?rm or corporation.

ITEM4 — Enterthe name by which the company is identi?ed.If-there is more thanone company name.enter thepredominate one.

ITEM5 — Enter the physical location of the company. IncludeCity. County, State and Zip Code.

ITEM6 - Enter the name of any parent or af?liatedcompanyincluding the City. County. State and Zip Code. If there isnone.so indicate by entering “None”or NIA.

ITEM7 - Check the box appropriate to your type of companyestablishment.“Single-establishment Employer’ shall includean employer whose business is conductedat only onephysical location. ‘Multi-establishmentEmployer“shallincludean employer whose business is conducted at morethanone location.

ITEM8 — If “Multi—establishment’was entered in item8, enterthe numberof establishments within the State of NewJersey.

ITEM9 - Enter the total number of employees at theestablishment being awarded the contract.

ITEM10 — Enter the name of the Public Agency awarding thecontract. Coun tate s isnot appii re ren g a

ITEM11 - Enter the appropriate ?gures on all lines and inallcolumns. THIS SHALLONLYINCLUDE EMPLOYMENTDATA FROMTHEFACILITYTHAT IS BEINGAWARDEDTHECONTRACT.DONOT list the same employeein morethan one job category. DO NOTattach an EEO-1 Report.

RaciaIIEthnic Groups will be defined:Black: Notof Hispanic origin. Persons having origin in any ofthe Blackracialgroups ofAfrica.Hispanic: Persons of Mexican.Puerto Rican, Cuban, orCentral or South Americanor other Spanish culture or origin.regardless of race.American Indian orAIaska_n Native: Persons having originsin any of the original peoples of NorthAmerica.and whomaintain cultural identi?cationthrough tribal at?liationorcommunity recognition.Asian or Pacific Islander: Persons having origin in any ofthe original peoples of the Far East.Southeast Asia, theIndian Sub-continent or the Paci?c Islands. This areaincludes forexample, China.Japan, Korea.the PhillippineIslandsand Samoa.Non-Minority: Any Persons not identi?edin any of theaforementionedRacial/EthnicGroups.

ITEM12 — Check the appropriate box. if the race or ethnicgroup Informationwas not obtained by 1 or 2. specify by whatother means thiswas done in 3.

ITEM13 - Enter the dates of the payroll period used toprepare the employment data presented in Item12.

ITEM14 - Ifthis is the ?rst time an EmployeeInformationReport has been submitted for this company, check block"Yes".

ITEM15 — lfthe answer to Item 14 is “No”.enter the datewhen the last Employee InformationReport was submittedbythis company.

ITEM16 - Printor type the name of the person completingthe fonn. include the signature. titleand date.

ITEM17 - Enter the physical location where the form is beingcompleted. IncludeCity, State.Zip Code and Phone Number.

TYPE OR PRINTINSHARP BALLPOINT PENTHE VENDOR IS TO COMPLETETHE EMPLOYEE INFORMATIONREPORT FORM (AA302) AND RETAIN A COPY FOR THEVENDOR’SOWN FILES.THE VENDOR SHOULD ALSO SUBIVIITA COPY TO THE PUBLIC AGENCY AWARDING THE CONTRACTIF THIS IS YOUR FIRSTREPORT; AND FORWARD ONE COPY

TO’NJ Department of the TreasuryDivision of Purchase & PropertyContract Compliance Audit Unit

EEO Monitoring ProgramP.O. Box 206

Trenton.New Jersey 08625-0206 Telephone No. (609) 292-5473

of 37

SUBMIT THE REQUIRED§150.00 NON-REFUNDABLE FEE MAYDELAYISSUANCE OF YOUR CERTIFICATE

WITH A H.EC]( IN THE AMOUNT 917§l§Q,Q0 PAYABLE TOTI-IE‘

INSTRUCTIONS FOR COMPLETINGTHEEMPLOYEE INFORMATIONREPORT (FORM AA302)

IMPORTANT: READTHE FOLLOWING INSTRUCTIONSCAREFULLYBEFORECOMPLETINGTHE FORM.PRINTOR TYPE ALLINFORMATION.FAILURETO PROPERLY COMPLETETHE ENTIREFORM AND TO

IFYOU HAVE A CURRENTCERTIFICATE OF EMPLOYEE INFORMATION REPORT, DO NOT COMPLETE THIS

I

FORM UNLESS YOURARE RENEWINGA CERTIFICATE THAT IS DUE FOR EXPIRATION.DO NOT COMPLETETHIS FORM FOR CONSTRUCTIONCONTRACT AWARDS.

ITEM1 — Enter the Federal Identi?cationNumberassigned bythe InternalRevenue Service, or ifa Federal Employeridenti?cationNumber has been applied for.or if yourbusiness is such that you have not or willnot receive aFederal Employer Identi?cation Number, enter the SocialSecurity Number of the owner or of one partner, in the caseof a partnership.

ITEM2 - Check the box appropriate to your TYPE OFBUSINESS.Ifyou are engaged in more than one type ofbusiness check the predominate one. Ifyou are amanufacturer deriving more than 50% of your receipts fromyour own retail outlets.check ‘Retail’.

ITEM3 - Enter the total “number‘of employees in the entirecompany, including part-time employees. This number shallIncludeall facilities in the entire ?rm or corporation.

ITEM4 — Enterthe name by which the company is identi?edlfthere is more thanone company name.enter thepredominate one.

ITEM5 — Enter the physical locationof the company IncludeCity. County. State and Zip Code.

ITEM6 — Enter the name of any parent or af?liatedcompanyincluding the City. County. State and Zip Code. If there isnone.so indicate by entering “None”or N/A.

ITEM7 — Check the box appropriate to your type of companyestablishment."Single—estabIishmentEmployer"shall includean employer whose business is conducted at only onephysical location. “Muiti-establishmentEmployer‘ shallincludean employer whose business is conducted at morethan one location.

ITEM8 — If “Multi-establishment‘was entered in item 8, enterthe number of establishments within the State of NewJersey.

ITEM9 - Enter the total number of employees at theestablishmentbeing awarded the contract.

ITEM10 — Enter the name of the Public Agency awarding thecontract. IncludeCity, County, State and Zip Code. This isnot applicable ifyou are renewing a current Certi?cate.

ITEM11 — Enter the appropriate ?gures on all lines and inallcolumns. THIS SHALLONLYINCLUDEEMPLOYMENTDATA FROMTHEFACILITYTHAT IS BEINGAWARDEDTHECONTRACT.DO NOT list the same employee in morethan one job category. DO NOTattach an EEO-1 Report.

RaciaIlEthnic Groups will be defined:Black: Notof Hispanic origin. Persons having origin in any ofthe Black racial groups of Africa.Hispanic: Persons of Mexican.Puerto Rlcan.Cuban, orCentral or South American or other Spanish culture or origin.regardless of race.American Indian or Alaskan Native: Persons having originsin any of the original peoples of NorthAmerica, and whomaintain cultural identi?cationthrough tribal af?liationorcommunity recognition.Asian or Pacific Islander: Persons having origin in any ofthe originai peoples of the Far East.SoutheastAsia, theIndian Sub—continentor the Paci?c Islands. This areaIncludes forexample. China.Japan, Korea,the PhillippineIslandsand Samoa.Non-Minority: Any Persons not identi?edin any of theaforementionedRacia!IEthnicGroups.

ITEM12 — Check the appropriate box. If the race or ethnicgroup Informationwas not obtainedby 1 or 2, specify by whatother meansthis was done in 3.

ITEM13 - Enter the dates of the payroll period used toprepare the employment data presented in Item 12.

ITEM14 — If this is the ?rst time an Employee informationReport has been submitted for this company. check block“Yes”.

ITEM15 — Ifthe answer to Item 14 is “No‘.enter the datewhen the last Employee InformationReport was submittedbythis company.

ITEM16 - Printor type the name of the person completingthe fonn. Include the signature. titleand date.

ITEM17 - Enter the physical location where the form is beingcompleted. IncludeCity, State.Zip Code and Phone Number.

TYPE OR PRINT IN SHARP BALLPOINT PENTHE VENDOR IS TO COMPLETETHE EMPLOYEE INFORMATION REPORT FORM (AA302) AND RETAIN A COPY FOR THEVENDOR’SOWN FILES. TI-IEVENDOR SHOULD ALSO SUBMIT A COPY TO THE PUBLIC AGENCY A\VARDING THE CONTRACTIF THIS IS YOUR FIRST REPORT; AND FORWARD ONE COPY

TO"NJ Department of the TreasuryDivision of Purchase & PropertyContract Compliance Audit Unit

EEO Monitoring ProgramP.O. Box 206

Trenton, New Jersey 08625-0208 Telephone No. (609) 292-5473

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I-{ISAGREEMEN madethi Z7 dayof J/pzwabetweenCity, a municipal orporatio of the State of New Je ey ts addres

AGREEMENT

T T s , 2021 the Cityof Jersey c n with i s at 280Grove Street, Jersey City, New Jersey (hereinafter referred to as "City" or “City”) andHAAMIDS LLC (DBA HUMZ) (hereinafter collectively referred to as “Contractor”), withand address at 24 Canal Circle, #402, Jersey City, NJ 07304.

WHEREAS, the City had previously solicited two prior requests for proposals(“RFPS”) for vendors to operate a concession at various sites in Jersey City, includingamong such sites a property owned by the City located at Block 17401, Lot 3, morecommonly known as the Lafayette Pool And Aquatic Center at 303 Van Horne Street,Jersey City, NJ 07305 (hereinafter referred to as the “Premises”) on September 22, 2020and October 22, 2020, respectively.

WHEREAS, the City did not receive a response these two prior RPFS; and

WHEREAS, pursuant to N.J.S.A. 40A: 1l-5(3)(a), where such circumstances occur,the City may enter into a negotiated agreement for the services contemplated under theRFPS; and

WHEREAS, the City thereafter negotiated an agreement whereby with theContractor whereby the Contractor would use the property to operate a concession; and

WHEREAS, Contractor intends to use the premises for the purposes of selling foodand drink;

NOW, THEREFORE, by this Agreement the City grants permission to theContractor to enter onto the Premises. Contractor is permitted to enter the premises solelyfor the purposes describedin this Agreement and subject to the terms and conditions of thisAgreement which are set forth below.

1. The term of this Agreement shall be deemed effective as of the date ?rst above writtenupon execution of this Agreement by City of?cials duly authorized pursuant to law. Itshall remain effect for a period of up to one (1) year or until the City’s revocation of itspermission to use the Premises, whichever is period is shorter.

2. The Contractor shall be permitted to use the premises solely the activities permittedunder section 2(a) below, and is strictly prohibited from using the Premises for anypurposes expressly prohibited under section 2(b) below:

(a) Permitted. Sale of Contractor’s inventory of prepared foods, drinks;

(b) Explicitly Prohibited. Sale of cigarettes, tobacco, vapes, alcohol or any othercontrolled substances,and performance of any on—premisesservices.

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Contractor from its responsibility to procure and maintain in effect all other requisitepermissions and approvals.

8. The entire agreement between the City and Contractor is contained herein and nomodi?cations hereof shall be effective unless in writing, signed by the party to be chargedherewith. This Agreement cancels and supersedes any and all prior agreements betweenthe parties with respect to the subject matter hereto.

9. City officials, of?cers, directors, employees or agents shall not be chargedpersonally with any liability under any term or provision of this agreement or because ofits execution or attempted execution or because of any breach or alleged breach thereof.

10. The Contractor's use of the Premises shall keep all improved and open public streetsfree and clear of obstructions and shall not interfere with their use. '

A

11. The City shall not be responsible for any loss or theft sustained by the Contractorduring its use of the Premises.

12. The Contractor shall provide insurance coverage to the City indemnifying the Cityfrom any liability in connection with the Contractor’s use of the Premises. Contractor willsupply the City with a copy of its insurance liability policy. The amount of the insuranceshall be determined by the City’s Risk Manager. The City shall be named as an insuredparty. All accidents or injuries to person, or any damages to property, occurring as a resultof or in connection with the Contractor’s use of the property shall be reported immediatelyto the City of Jersey City, Division of Risk Management and the Of?ce of Real Estate asauthorizedrepresentatives of the City together with all information required by the City onprescribed forms to be provided by the City.

13. The Contractor's use of the Premises shall be in accordance with all applicablefederal,’state, county, and City laws and:regulations including but not limited to healthordinancesand regulations of the City of Jersey City which are applicable to the intendeduse of the Premises by the Contractor.

14. All equipment installedor used by the Contractor in connection with its use of thePremises that may be removed withoutdamage to the City’s Premises shall be deemed tobe the property of the Contractor and shall be removed by it at the termination of the useof the Premises under this Agreement. In the event that the same is not removed, the sameshall be deemed abandoned and the City shall have the right to dispose of the same andcharge the Contractor for any cost of disposing thereof.

15. The Contractor shall provide in writing to the City the name of one (1) authorizedrepresentativeof the Contractor who shall be responsible for adherence to the terms andconditions of the Agreement before, during and after the effective date of this Agreement.No other persons are to speak or act for the Contractor.

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prior written approval from the City after submission of proposed signage, provided suchsignage is placed to allow free ingress and egress and otherwise complies with allapplicable laws, rules and regulations.

StaffingContractor’s staff may not exceed three (3) staff members on site at any one time.Contractor must provide the names and contact information for each member of its on-site staff in writing to the City prior to such member staf?ng the Premises. All staff mustbe of legal age to work in the State of New Jersey. The Contractor is expected to havethe kiosk open and staffed during business hours. Failure to do so may result intermination of the Agreement.

StorageThe Contractor may store its own inventory on the Premises after business hours withinthe area allotted for storage by the City, provided that it only stores inventory being soldin accordance with the scope of this Agreement. It may not store inventory of any otherparty without the written consent of the Site Management. If food is approved for sale,any stored food should be secured in sealed plastic containers.

Food Quality and Safety.Contractor shall endeavor to offer foods/snacks of a more varied selection than thestandard snack bar fare of hot dogs, hamburgers, and pizzas, and shall submit to SiteManagement a list of the food/snack products that it intends to sell. Contractor shallprovide nutrition facts/ nutrition labels to the City regarding its products and prior tostockingnew products, and shall not stock such products until it has the City’s writtenapproval.

Contractor shall ensure that no out of date food/snack products are sold. Expiration datesshould be on any and all food products offered for sale and should clearly show themonth and the year of expiration. All food and beverage products must be delivered intheir original packaging. Contractor must immediately correct any situation in whichproduct integrity is violated and notify the City in writing the event of any material issueinvolving compromised or expired food. 1

Sustainability.The use of polystyrene packaging or food containers is prohibited. Contractor shallcomply with 0rd. 18-065, which prohibits retailers from providing single-use plasticcarry—out bags and non-recyclable paper bags to customers at the checkout counter ofretail stores.

Prior to commencing sales, Contractormust submit to Site Management a list of the typeof packaging, utensils and food containers that will be provided, cleaning/sanitaryproducts that will be used, as well as any other sustainability measures that Contractorwould like to employ for the City’s consideration. They City may disallow the use of

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http://www.g;eenseal.org/?ndaproduct/index.c?n

any packaging, containers, utensils and/or cleaning/sanitary products that it deemsunsuited for sustainability reasons, including but not limited to its expectations listedbelow.

The City encourages the Contractor to:use chlorine-free, biodegradable products if the Contractor intends to provide anydisposable products such plates, napkins, etc.use “Green Seal” eco-friendly products such as, but not limited to, soaps andcleaners for operational and cleaning purposes. A list of “Green Seal” certi?edproducts canbe found atsell environmentally sustainable food productstrain its staff on environmentally-friendlyfood practices and enforce the use ofthe same. 1

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AMENDMENT #1

This Amendment (“Amendment #1”) made this ______ day of __________, 2021 between the City of Jersey City, a municipal corporation of the State of New Jersey with its address at 280 Grove Street, Jersey City, New Jersey (hereinafter referred to as "City" or “City”) and HAAMIDS LLC (d/b/a Haamids) (hereinafter referred to as “Contractor”), with and address at 24 Canal Circle #402, Jersey City, New Jersey (collectively, the “Parties”) shall hereby amend and supplement the Agreement made between the aforementioned Parties and dated 29th day of January, 2021 (“Agreement” or “Contract”) but with the Agreement effective upon authorization of the Council by appropriate resolution.

WHEREAS, the Parties wish to further memorialize terms indicating what is necessary for mutual compliance with federal, state and local laws and have concluded that doing so will be of mutual benefit;

NOW, THEREFORE, the Agreement is hereby amended and supplemented by adding the following terms:

22. COMPLIANCE WITH AFFIRMATIVE ACTION PLANIf the Agreement exceeds $40,000.00, it shall be subject to the Affirmative Action

Amendments to the Law Against Discrimination, N.J.S.A. 10:5-31 et seq.This Agreement shall not become effective and Contractor shall provide no services

under this Agreement until it has executed the following documents:(i) A supplemental Affirmative Action Agreement pursuant to N.J.S.A.

10:5-31 et seq. (for contracts which exceed $40,000.00). The Affirmative Action Agreement is attached hereto as Exhibit ?B@ and is incorporated herein by reference.

(ii) An Affirmative Action Employee Information Report (form AA-302) (for contracts which exceed $40,000.00.

23. CITY OF JERSEY CITY LOBBYIST DISCLOSURE ORDINANCEThis contract was awarded in accordance with the provisions of the City’s Disclosure of

Lobbyist Representative Status Ordinance §3-9.1 et seq. adopted on June 12, 2002. As such the undersigned does hereby attest that Contractor either did not retain the services of a lobbyist to lobby on behalf of the Contractor for the award of this contract, or if a lobbyist was retained by the Contractor for such purposes, the Contractor’s lobbyist, prior to commencing his/her lobbying activities, filed a notice of lobbyist representative status form with the City Clerk. Any Contractor whose lobbyist failed to comply with the provisions of Ordinance §3-9.1 et seq., following notice and an opportunity to be heard, shall be disqualified from entering into contracts with the City for a period of two (2) years for each violation.

24. NEW JERSEY BUSINESS REGISTRATION REQUIREMENTS

The Contractor shall provide written notice to its subcontractors of the responsibility to submit proof of business registration to the Contractor.

Before final payment on the contract is made by the contracting agency, the contractor shall submit an accurate list and the proof of business registration of each subcontractor or supplier used in the fulfillment of the contract, or shall attest that no subcontractors were used.

For the term of the contract, the contractor and each of its affiliates and a subcontractor and each of its affiliates [N.J.S.A. 52:32-44(g)(3)] shall collect and remit to the Director, New Jersey Division of Taxation, the use tax due pursuant to the Sales and Use Tax Act on all sales of

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tangible personal property delivered into this State, regardless of whether the tangible personal property is intended for a contract with a contracting agency.

A business organization that fails to provide a copy of a business registration as required pursuant to section 1 of P.L.2001, c.134 (C.52:32-44 et al.) or subsection e. or f. of section 92 of P.L.1977, c.110 (C.5:12-92), or that provides false business registration information under the requirements of either of those sections, shall be liable for a penalty of $25 for each day of violation, not to exceed $50,000 for each business registration copy not properly provided under a contract with a contracting agency.

25. CITY OF JERSEY CITY CONTRACTOR PAY-TO-PLAY REFORM ORDINANCE

The contract is awarded in accordance with the City of Jersey City=s Contractor Pay-to-Play Reform Ordinance 08-128 adopted on September 23, 2008. The Contractor, its subsidiaries, assigns or principals have certified that they have neither made a reportable contribution in the one year period preceding the date that the City Council awarded the contract that would be deemed to be a violation of Ordinance 08-128, nor will Contractor, its subsidiaries, assigns or principals make a reportable contribution during the term of the contract that would be in violation of Ordinance 08-128.

All other terms and conditions of the Agreement shall remain in full force and effect. The Parties hereby agree to of the foregoing by signing and dating the duplicate originals hereof.

AGREED to this ______ day of _____________, 2021

HAAMIDS, LLC CITY OF JERSEY CITY(Contractor)

By: _________________________ By: ____________________Reginald White John MetroOwner/Proprietor Acting Business Administrator

Attest: _____________________ Attest: _________________ Sean Gallagher

City Clerk

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at — n tAI?rm ‘on

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BUSINESS ENTITY DISCLOSURE CERTIFICATIONFOR N ON—FAIRAND OPEN CONTRACTS

RequiredPursuant To N .].S.A.19:44A—20.8CITY OF JERSEY CITY

The undersigned, being authorized and knowledgeableof the circumstances,does hereby certify that the <aa7ae afbayzamentzy/>has not made and will not make any reportable contributions pursuant to N.].S.A. 19:44A—1et seq. that, pursuant toP.L. 2004, c. 19 would bar the award of this contract in the one yearperiodpreceding (dateofaa/am’xcbeda/ea’forapprovalofth

econtract bythegoaemzagboa’)/)to any of the followingnamed candidate committee, joint candidates committee; or politicalparty committee representing the elected officials of the <aameofeafzyofelected > as defined pursuant to N.].S.A.19:44A and

I certify that the list below contains the names and home addresses of all owners holding 10% or more of the issuedand outstanding stock of the undersigned.

Check the box that represents the type of business entity:

DPartnership DSoleProprietorship D ter S C ation

DLimitedPartnership ilityCorporation DLimited Partne

The undersigned is fullyaware that if I have misrepresentedin whole or part this affirmation and certification, Iand/or the business entity, be liable for any penaltypermitted under lawName of BusinessSignature‘ofPrinted Name of Affiant

before me this da ofKARE

Publicof NewJersev155

My expires:

(Seal)

_Ste\_renFulop 2021Lavarro for CouncilmanFriends of Joyce WattermanFriends of Daniel RiveraRidley for Council

Name of Stock or Shareholder

Regina4 l/ULQL,

and

Mira Prinz-Arey for CouncilFriends of Richard BoggianoSaleh for Jersey City CouncilSolomon for Council 2021Friends of JermaineRobinson

Home Addresslb, C,6v\«¢\ C/iLcL¢« ‘H’LID?’ ?‘.e.I‘(_

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(Witnessed or attested

of 37

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BUSINESS ENTITY DISCLOSURE CERTIFICATIONFOR NON—FAIR AND OPEN CONTRACTS

RequiredPursuant To N.].S.A. 19:44A-20.8<NAME OF CONTRACTING AGENCY>

“Local Unit Pay-To-Play Law” (P.L. 2004, c.19, as amended by P.L. 2005, c.51

The followingis statutory text related to the terms and citations used in the Business Entity DisclosureCerti?cation form.

19:44A-20.6 Certain contributions deemed as contributions by business entity.5. When a business entityis a natural person, a contribution by that person's spouse or child,residing therewith,shall be deemed to be a contribution by the business entity. \Whena business entity is other than a natural person, acontribution by any person or other business entity having an interest therein shall be deemed to be a contributionby the business entity.

19:44A-20.7 De?nitions relativeto certain campaign contributions.6. As used in sections 2 through 12 of this act:

“business entity"means any natural or legalperson, business corporation, professional services corporation, limitedliabilitycompany, partnership, limited partnership, business trust, association or any other legalcommercial entityorganized underthe laws of this State or of any other state or foreign jurisdiction;“interest" means the ownership or control of more than 10% of the pro?ts or assets of a business entity or 10% ofthe stockin the case of a business entity that is a corporation for pro?t, as appropriate;

Temporary and Executing1

12. Nothing contained in this act shall be construed as affecting the eligibilityof any business entity to perform apublic contract because that entity made a contribution to any committee during the one—year period immediatel

ypreceding the effective date of this act.

The New Jersey Campaign Contributions and Expenditures Reporting Act (N .J.S.A.19:44A-1et seq.)

19:44A-3 Definitions. In pertinent part. ..

p. The term "politicalparty committee" means the State committee of a politicalparty, as organized pursuant toR.S.19:5—4,any county committee of a politicalparty, as organized pursuant to R.S.19:5—3,or any municipalcommitteeof a political party, as organized pursuant to R.S.19:5—2.

q. The term "candidatecommittee" means a committee established pursuant to subsection a. of section 9 ofP.L.l973, c.83 (C.19:44A—9)for the purpose of receiving contributions and making expenditures.

r. the term "joint candidates committee" means a committee established pursuant to subsection a. of section 9 ofP.L.1973, c.83 (C.19:44A—9)by at least two candidates for the same elective public offices in the same election in alegislativedistrict, county, municipalityor school district, but not more candidates than the total number of the sameelective public offices to be ?lled in that election, for the purpose of receiving contributions and makingexpenditures. For the purpose of this subsection: ; the of?ces of member of the board of chosen freeholdersand county executive shall be deemed to be the same elective public of?ces in a county; and the offices of mayorand member of the municipalgoverningbody shall be deemed to be the same elective public offices in amunicipality.

19:44A-8 and 16 Contributions, expenditures, reports, requirements.IV/92'/e2‘/9epmw'Jz'omoflbzlrreetionare too extemzl/eto reprim‘/yere,tbefo 2'5deemedto bet/yeperfinentlbarteg?eetingamount; ofe0m‘r2'l7m‘z'0m.'“The $300 limit established in this subsection shall remain as stated in this subsection without further adjustment bythe commission in the manner prescribed by section 22 of P.L.1993, c.65 (C.19:44A—7.2)

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

Documents

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