LOWER CAPE MAY REGIONAL BOARD OF EDUCATION 687 Route 9 Cape May, NJ (609) REQUEST FOR PROPOSALS FOR VENDING MACHINE SERVICES

Similar documents
HADDON TOWNSHIP BOARD OF EDUCATION 500 RHOADS AVENUE WESTMONT, NJ REQUEST FOR PROPOSAL

BAYONNE BOARD OF EDUCATION. Insurance Brokerage Services: Property and Casualty and Workmen s Compensation

LINDENWOLD BOARD OF EDUCATION 801 EGG HARBOR ROAD LINDENWOLD, NJ REQUEST FOR PROPOSAL

Sample Certificate of Employee Information Report

CAMDEN COUNTY EDUCATIONAL SERVICES COMMISSION 225 White Horse Avenue Clementon, New Jersey 08021

LEAF VACUUM CURBSIDE COLLECTION INCLUDING EQUIPMENT AND OPERATOR

BOROUGH OF HIGHLANDS COUNTY OF MONMOUTH STATE OF NEW JERSEY REQUESTS FOR PROPOSAL & QUALIFICATIONS BOROUGH PLANNER

PLEASANTVILLE HOUSING AUTHORITY

LINCOLN PARK BOARD OF EDUCATION REQUEST FOR PROPOSALS FOR ARCHITECTURAL SERVICES

COUNTY COLLEGE OF MORRIS Business and Finance Division Procedures

PLAINFIELD BOARD OF EDUCATION 1200 Myrtle Avenue Plainfield, New Jersey 07063

TOWNSHIP OF WOOLWICH 120 VILLAGE GREEN DRIVE WOOLWICH TOWNSHIP, NJ SPECIFICATIONS AND RFP FORMS FOR PROFESSIONAL SERVICES CONTRACTS YEAR 2019

BOROUGH OF ELMWOOD PARK REQUEST FOR QUALIFICATIONS AND PROPOSAL FOR MUNICIPAL BOND COUNSEL

Sayreville Housing for Seniors Corporation Gillette Manor

REQUEST FOR PROPOSAL PANEL DEFENSE COUNSEL WORKERS COMPENSATION FUND. Submission Deadline: November 25, 2015

BOROUGH OF HIGHTSTOWN REQUEST FOR PROPOSAL GRANT WRITING & CONSULTING SERVICES

SOMERSET COUNTY INSURANCE COMMISSION

MANTUA TOWNSHIP MUA FEE ACCOUNTING SERVICES

Reference: Request for Proposal Auditor s Services to the West New York Board of Education for the school year.

TOWNSHIP OF RARITAN REQUEST FOR QUALIFICATIONS RISK MANAGEMENT CONSULTANT SUBMISSION DEADLINE AT WHICH TIME PROPOSALS WILL BE OPENED IS

Bid Document Submission Checklist Township of Long Beach Air Conditioning, Heating & Refrigeration Service, Maintenance & Repair

Submission Date: Tuesday, January 5, :00 PM

TOWNSHIP OF HAZLET COUNTY OF MONMOUTH STATE OF NEW JERSEY PROFESSIONAL SERVICES SOLICITATION FAIR & OPEN PUBLIC SOLICITATION PROCESS

REQUEST FOR PROPOSALS FOR SERVICES OF FUND ATTORNEY /REGULATORY COMPLIANCE & LEGISLATIVE SERVICES

REQUEST FOR PROPOSAL FOR RISK MANAGEMENT CONSULTANT

NOTICE TO BIDDERS. Four (4) 2018 Harley Davidson Road King Police Model Motorcycles (FLHP) in solid luxury blue or equal

TOWNSHIP OF HAZLET REQUEST FOR QUALIFICATIONS FOR HEALTH INSURANCE CONSULTANT TOWNSHIP OF HAZLET COUNTY OF MONMOUTH STATE OF NEW JERSEY

BOROUGH OF TOTOWA NOTICE AND SOLICITATION OF PROPOSALS FOR ANIMAL CONTROL OFFICER FOR THE BOROUGH OF TOTOWA

BOROUGH OF TOTOWA NOTICE AND SOLICITATION OF PROPOSALS FOR RISK MANAGEMENT CONSULTANT SERVICES FOR THE BOROUGH OF TOTOWA

SPECIFICATIONS AND BID MATERIALS FOR BEACH UMBRELLA STAND CONCESSION CITY OF NORTH WILDWOOD CAPE MAY COUNTY NEW JERSEY MAYOR AND COUNCIL

CLASS TRIPS TRANSPORTATION

CITY OF UNION CITY REQUEST FOR PROPOSALS FOR FERAL CAT SPAYING AND NEUTERING SERVICES FOR THE CITY OF UNION CITY

The Housing Authority of the Township of Middletown

REQUEST FOR QUALIFICATIONS TOWNSHIP AUDITOR

Manalapan Township. Request for Proposals for Renewable Energy Power Purchase Agreement (PPA)

BOROUGH OF TOTOWA NOTICE AND SOLICITATION OF PROPOSALS FOR THE POSITION OF TAX APPEAL CONSULTANT FOR THE BOROUGH OF TOTOWA

Stockton Affiliated Services, Inc. Request for Proposals. SNACK FOOD VENDING SERVICES at. The Richard Stockton College of New Jersey.

REQUEST FOR PROPOSAL (RFP)

REQUEST FOR SEALED PROPOSALS

MIDDLETOWN TOWNSHIP PUBLIC SCHOOLS REQUEST FOR PROPOSALS. School District Labor Negotiations Legal Services SPECIFICATIONS

TOWNSHIP OF BLOOMFIELD STANDARDIZED SUBMISSION REQUIREMENTS FOR PROFESSIONAL SERVICES INFORMATION FOR PROFESSIONAL SERVICES ENTITIES

BOROUGH OF TOTOWA NOTICE AND SOLICITATION OF PROPOSALS FOR PROFESSIONAL ENGINEERING SERVICES FOR THE BOROUGH OF TOTOWA

TOWN OF HARRISON PLANNING BOARD PUBLIC NOTICE FOR SOLICITATION PROFESSIONAL SERVICE CONTRACT JANUARY 1, 2019 THROUGH DECEMBER 31, 2019

PUBLIC NOTICE BRICK TOWNSHIP MUNICIPAL UTILITIES AUTHORITY 1551 HIGHWAY 88 WEST, BRICK, NJ NOTICE OF SOLICITATION FOR RFQs

Request for Proposal for Professional Services

Township of Lumberton

MONROE TOWNSHIP SCHOOL DISTRICT REQUEST FOR PROPOSAL FOR: Insurance Brokerage Services Property & Casualty and Workers Compensation

HOUSING AUTHORITY OF THE TOWN OF MORRISTOWN REQUEST FOR PROPOSALS FEE ACCOUNTING SERVICES

FRANKLIN TOWNSHIP BOARD OF EDUCATION

Submission Date: Thursday, August 11, :00 Noon

Middletown Township Public Schools 834 Leonardville Road, 2nd Floor, Leonardo, NJ (732) Fax (732)

Thank you for your interest in the West New York Board of Education, School Year Request for Proposal for (OT PT ST) Services.

TOWNSHIP OF PEQUANNOCK. REQUEST FOR PROPOSALS for PROFESSIONAL SERVICES 2018 FEMA FMA HOME ELEVATION GRANT APPLICATION

TOWN OF GUTTENBERG COUNTY OF HUDSON, STATE OF NEW JERSEY

Request for Proposal For Health Insurance Brokerage Services

Reference: Request for Proposal Attorney - General Counsel Services to the West New York Board of Education for the school year.

Proposal for Garbage and Recycling Collection

REQUEST FOR PROPOSAL (RFP) NON-PUBLIC SCHOOLS SECURITY GUARDS RFP

Bid Specifications for Vended Meals. Request Issued by: Newark Prep Charter School

BLOOMFIELD PARKING AUTHORITY ESSEX COUNTY, NEW JERSEY. Invitation to Bid. Snow Removal & Plowing Services

REQUEST FOR PROPOSALS

Request for Proposals For: HQS Inspection Services From June 1, 2017 May 31, April 2017

TOWNSHIP OF HOWELL COUNTY OF MONMOUTH STATE OF NEW JERSEY

School Year Quotation No: Q-03

HOUSING AUTHORITY OF THE TOWN OF MORRISTOWN REQUEST FOR PROPOSALS ORDINARY LEGAL SERVICES

GUTTENBERG HOUSING AUTHORITY

STAFFORD TOWNSHIP BOARD OF EDUCATION Business Administrator s Office 250 North Main Street Manahawkin, New Jersey REQUEST FOR PROPOSAL (RFP)

BROKER OF RECORD SPECIFICATIONS

REQUEST FOR PROPOSAL BEVERAGE SERVICE FOR ILLINOIS VALLEY COMMUNITY COLLEGE PROPOSAL #RFP2016-P04

FRANKLIN TOWNSHIP BOARD OF EDUCATION

GOODS AND SERVICES BID SPECIFICATIONS: A GUIDE FOR NEW JERSEY LOCAL PUBLIC AGENCIES SECTION A. Instructions to Bidders and Statutory Requirements

Request for Qualifications

Stockton Affiliated Services, Inc. Request for Proposals. SNACK FOOD VENDING SERVICES at. Stockton University. March 28, 2016

TAX APPEAL COUNSEL 2019 RFQ # MC-RFQ

Applied Behavioral Analysis Consultation Services,

REQUEST FOR PROPOSAL FOR VOTING MACHINE TRANSPORTATION SERVICES

July 1, 2017 through June 30, 2018 (Titled: RFQ_PHYS: )

Financial Information for: South Brunswick Board of Education in the County of Middlesex, New Jersey

FRANKLIN BOROUGH REQUEST FOR PROPOSALS FOR BOROUGH ENGINEER

REQUEST FOR QUALIFICATIONS FOR ARBITRAGE REBATE CONSULTING SERVICES

TOWNSHIP OF NUTLEY ESSEX COUNTY NEW JERSEY

REQUEST FOR PROPOSAL (RFP)

OCEANPORT BOARD OF EDUCATION REQUEST FOR PROPOSALS FOR ARCHITECTURAL AND ENGINEERING SERVICES SCHOOL REFERENDUM

BOROUGH OF HIGHLANDS COUNTY OF MONMOUTH STATE OF NEW JERSEY REQUESTS FOR PROPOSAL & QUALIFICATIONS BOROUGH AUDITOR

BOROUGH OF HADDONFIELD CAMDEN COUNTY NEW JERSEY GENERAL BANKING SERVICE

Ocean County Board of Health Request for Qualifications Nurse Practitioner Services for Clinics RFQ# Q110918E

REQUEST FOR COMPETITIVE CONTRACTING PROPOSALS FOR

REQUEST FOR QUALIFICATIONS FOR PAYROLL AUDITOR

GREAT OAKS CHARTER SCHOOL. 24 Maiden Lane Newark, NJ 07102

TRAVERSE CITY HOUSING COMMISSION REQUEST FOR PROPOSALS FOR ARCHITECTURAL/ENGINEERING SERVICES

The CITY OF BAYONNE is soliciting responses/proposals to the City s RFQ/RFP for the provision of the following professional services:

REQUEST FOR PROPOSALS FOR

Proposal No:

Lakewood Board of Education Lakewood, New Jersey. BID Specifications & General Requirements For

TOWN OF FARMINGTON REQUEST FOR PROPOSALS INSURANCE / RISK MANAGEMENT SERVICES

Union City Board Of Education County of Hudson, New Jersey Lease Purchase Financing Bid, Bid Opening: 11: A.M., July 29, 2015

Request for Proposal # Citrus Community College District VENDING SERVICES PROPOSAL

BROKEN ARROW PUBLIC SCHOOLS 701 SOUTH MAIN BROKEN ARROW, OK PHONE (918) FAX (918)

FINANCIAL ADVISORY SERVICES

REQUEST FOR PROPOSALS FOR RISK MANAGEMENT INSURANCE CONSULTANT/BROKER SERVICES

Transcription:

LOWER CAPE MAY REGIONAL BOARD OF EDUCATION 687 Route 9 Cape May, NJ 08204 (609) 884-3475 REQUEST FOR PROPOSALS FOR VENDING MACHINE SERVICES Submission Date: Tuesday, November 25, 2014 Time: 11:00 am

Purpose: REQUEST FOR PROPOSALS FOR VENDING MACHINE SERVICES The Lower Cape May Regional School District (District) is seeking proposals from experienced vendors to provide beverage and/or snack vending services that are reasonably priced and customer service oriented. The service must offer energy efficient equipment with a reasonable financial return to the Lower Cape May Regional School District. The requests are being made to ensure the District receives the highest quality service at a fair and competitive price. The District intends to award a service contract that will cover all Lower Cape May Regional Schools and properties at 687 Route 9, Cape May, NJ 08204, which include the following: Lower Cape May Regional High School - 687 Route 9, Cape May, NJ 08204 M-Wing Faculty Lounge two beverage vending machines and one snack vending machine E-Wing Faculty Lounge one beverage vending machine and one snack vending machine Hallway outside of new gym one water/flavored water vending machines and one snack vending machine (not operable until 2:30pm) Richard M. Teitelman Middle School - 687 Route 9, Cape May, NJ 08204 1 st Floor Faculty Lounge - two beverage vending machines and one snack vending machine The Bagel Shop on the High School serves canned soda/beverages, which are purchased by the case. The District reserves the right to add additional machines if necessary. Questions or inquiries should be directed to Mark G. Mallett, Business Administrator/Board Secretary, 687 Route 9, Cape May, NJ 08204 or via email at mallettm@lcmrschools.com Submission of Proposal: One (1) original and one (1) copy of the Vending Services proposal is to be received no later than November 25, 2014 at 11:00 am prevailing time at the Board of Education Office located at 687 Route 9, Cape May, NJ 08204. No facsimile or e-mail proposals will be accepted. 1. Submissions must be sealed and clearly labeled with the title Request for Proposals for Vending Services. 2. The vendor acknowledges that he/she has read this Request for Proposal, understands it, and agrees to be bound by its terms and conditions. 2

3. The Board of Education reserves the right to reject any or all proposals in whole. 4. Any departures from the specification must be noted. Any conditions or terms must be written and included with the RFP. 5. It is the responsibility of the vendor to ensure that their proposals reach the appropriate office prior to the close time on the proposal. Those proposals received after the date and time of closing will be considered non-responsive. Scope of Services: The awarded vendor shall install and manage beverage and/or snack vending machines at optimum professional and food safety standards and provide high quality, name brand products at all times. The vendor shall ensure that all machines are in good operating condition at all times, which includes maintenance, servicing, temperature monitoring (as needed) and the replenishment of items dispensed by the machine. This service shall be provided at no cost to the District and the vendor would manage all monies associated with the operation of the machine. The vendor shall perform the contract in such a manner as not to interrupt or interfere with the operation of any existing activity on school grounds. A. Vending Machines a. Vendors must hold title to all machines and other auxiliary equipment installed. b. All vending machines must be energy efficient ENERGY STAR equivalent or equipped with an energy miser. c. All vendor equipment shall have the capability of returning change in amounts of 5, 10 or 25 cents as required, and have adequate change inventory for required returns. d. Machines will be required to have dollar bill acceptors. e. Vendors must describe the machines being used, including their energy consumption and energy efficiency features. f. All machines shall be maintained by the vendor throughout the contract period in a condition satisfactory to the District. g. The vendor will be responsible for the delivery, installation and positioning of all vending machines at the vendor s expense. h. The District will not be responsible for loss or damage to the vending machines or their contents resulting from any cause while on District premises whether such damage should be caused by any agent or employee of the District or by any other person. B. Product Mix a. Provide menu lists of vending offerings being proposed, including brand names, product size, and vending price. The snack vending machine in the High School hallway must meet the USDA Smart Snack guidelines. 3

b. Price adjustments will be considered once a year in June. Consideration for price increases must be supported by appropriate manufacturer s documentation and the District must approve any price adjustments. C. Service & Maintenance a. The vendor shall provide machine maintenance & repair service between 8:00 a.m. and 6:00 p.m. Monday through Friday. b. Service technician shall arrive within twenty-four (24) hours of notification of malfunction. c. All machines shall be labeled or have sign(s) prominently displayed that contain instruction as to procedures for obtaining cash refunds. D. Reporting a. At a minimum, vendor must provide on a monthly basis: i. Monthly sales: By building, By machine ii. Replenishment schedule b. Snack vending equipment should be equipped by the vendor with non-reset item sale counters, which are maintained in continual operative conditions. Compensation: 1. The vendor shall specify the percentage of commission the Lower Cape May Regional School District will receive for merchandise dispensed by the vendor s vending machines. 2. The commission structure must be clearly stated as a specific percentage for commission applied solely to total gross sales. 3. Commission payments are due to the District on or before the 15 th of the following month. 4. The District would like additional funding of $1,500 to be used for its scholarship programs Evaluation and Award Criteria: These criteria are to be utilized in the evaluation and selection of a vendor. Vendors are required to address each evaluation criterion in the order listed and be specific in presenting their qualifications. 1. Suitability of product offerings to meet the needs of individual vending areas 2. Pricing of product offered in machine 3. Schedule for refill of machines 4. Plan for maintenance/upkeep of machines 5. Commission returned to District 6. Any Additional Funding or Incentives* *Additional funding or incentives could include promotions or scholarships. 4

Insurance Coverage: The bidder agrees to carry the insurance policies described herein and submit to the District at the execution of this Agreement and annually, evidence thereof in the form of a current certificate of insurance. The District requires being named on any policy or certificate of insurance as an additional insured during the contract period. The bidder agrees to obtain, pay for and maintain the following: 1. Worker s Compensation Coverage and Employer s Liability insurance covering all employees with a minimum limit of five hundred thousand ($500,000). 2. Comprehensive General Liability insurance coverage with a minimum of one million dollars ($1,000,000) combined single limit occurrence. 3. Automobile Liability Insurance coverage for all owned, non-owned or hired vehicles with a minimum of one million ($1,000,000) combined single limit per occurrence. If a situation so exists where the bidder is unable to secure the required insurance coverage then please attach a letter of explanation to this document, duly signed by the president of the firm or company. General Terms and Conditions: 1. By responding to this RFP, vendors acknowledge and consent to the conditions set forth herein relative to the submission, review and consideration of their responses. Any changes, alterations or modifications to the contract will be valid and binding only if mutually agreed upon and documented in writing and signed by both parties. 2. Criminal Background Checks are mandatory for all vendor employees gaining access to the schools. Failure to comply with this requirement will result in immediate termination of the contract. 3. The vendor shall provide proper identification badges for all vendor employees. While on school premises, all vendor employees must wear a badge that identifies them as the vendor s employee and they must sign-in at the main office of each school during school hours. 4. The vendor shall provide a complete list of names (including supervisors) that may be working on school property. 5. The District may, if deemed in its best interest, pick multiple vendors to fulfill the contract. This decision will be based on how appropriately the needs of each vending area are met. 6. All machines must be delivered and operating in all building by January 1, 2015 7. The term of contract for vending services shall be from January 1, 2015 through December 31, 2015 and shall be renewed for two one year periods unless written notice is provided by either party sixty (60) days in advance of the termination date. 8. The awarded vendor may not assign, sell or sub-contract its obligations under the contract to any third party without prior written approval by the District. 9. The vendor must supply a New Jersey Business Registration Certificate. 5

RFP for Vending Service Submission Checklist Acknowledgement Page Bid Proposal Sheet Affirmative Action Questionnaire Business Registration Certificate Taxpayer Identification Request (W-9 Form) Vendor Questionnaire/Certification Non-collusion affidavit Stockholder/Partnership Disclosure and Statement of Ownership Indemnity and Hold Harmless Agreement Certificate of Insurance 6

ACKNOWLEDGEMENT PAGE The undersigned proposer certifies that the proposal as submitted complies with all Terms and Conditions as set forth in this Request for Proposal. The undersigned further certifies that this proposal is made without prior understanding, agreement or connection with any corporation, firm or person submitting a proposal for the same material, supplies or equipment and is in all respects fair and without collusion or fraud. To receive consideration for award, this signature sheet must be returned to the Business Office as it shall be a part of your response. Signature: Name (Print): Official Title: Date: Address: Telephone No.: 7

RFP for Vending Services BID PROPOSAL SHEET 1. Description of general background, experience, and qualifications of the vendor including relevant school experience: 2. Description of vending machine being used: 3. Proposed listing of all product offerings including brand name, product size and vending price: 4. Proposed schedule for refilling machines: 5. Percentage of gross receipts payable to the Lower Cape May Regional School District for the following: a. SODA b. WATER c. JUICE d. SNACKS 6. Cost per case for the following to be sold in the Bagel Shop: a. SODA b. WATER c. JUICE 7. Additional funding or incentives: 8

AFFIRMATIVE ACTION REQUIREMENTS Each respondent shall submit to the public agency, after notification of award but prior to execution of a goods and services contract, one of the following three documents: i. Appropriate evidence that the respondent is operating under an existing federally approved or sanctioned affirmative action program; or ii. A certificate of employee information report approval issued in accordance with N.J.A.C. 17:27-4; or iii. An employee information report (Form AA302) provided by the Division and distributed to the public agency to be completed by the contractor, in accordance with N.J.A.C.17:27-4. Please note: A completed and signed Affirmative Action Questionnaire is required with submission of proposal. However, the Board will accept in lieu of the Questionnaire, Affirmative Action Evidence stapled to the Affirmative Action Questionnaire form. If awarded a contract your company/firm will be required to comply with the requirements of N.J.S.A. 10:5-31 et. seq. and N.J.A.C. 17:27 et. seq. 9

AFFIRMATIVE ACTION QUESTIONNAIRE This form is to be completed and returned with the RFP. The Board will accept in lieu of this Questionnaire, Affirmative Action Evidence Employee Information Report stapled to this page. 1. Our company has a federal Affirmative Action Plan approval. Yes No If yes, please attach a copy of the plan to this questionnaire. 2. Our company has a N.J. State Certificate of Employee Information Report Yes No If yes, please attach a copy of the certificate to this questionnaire. 3. If you answered NO to both questions No. 1 and 2, you must apply for an Affirmative Action Employee Information Report Form AA302. Please visit the New Jersey Department of Treasury website for the Division of Public Contracts Equal Employment Opportunity Compliance: www.state.nj.us/treasury/contract compliance/ Click on Employee Information Report Complete and submit the form with the appropriate payment to: Department of Treasury Division of Public Contracts/EEO Compliance P.O. Box 209 Trenton, NJ 08625-0002 All fees for this application are to be paid directly to the State of New Jersey. A copy shall be submitted to the Board of Education within seven (7) days of the notice of the intent to award the contract or the signing of the contract. I certify that the above information is correct to the best of my knowledge. Name: Signature: Title: Date: Name of Company: Address: City, State, Zip: To be completed, signed and submitted with the quotation proposal form. 10

BUSINESS REGISTRATION CERTIFICATE (N.J.S.A. 52:32-44) Pursuant to N.J.S.A. 52:32-44 as amended by P.L. 2004 Chapter 57, all respondents shall submit with their proposal package a copy of their New Jersey Business Registration Certificate as issued by the Department of Treasury of the State of New Jersey. Failure to provide the New Jersey Business Registration Certification with the proposal package, or prior to the award of contract, will be cause for the rejection of the entire proposal. Goods and Services Contracts N.J.S.A. 52:32-44 imposes the following requirements on contractors and all subcontractors that knowingly provide goods or perform services for a contractor fulfilling this contract: 1) The contractor shall provide written notice to its subcontractors to submit proof of business registration to the contractor; 2) prior to receipt of final payment from a contracting agency, a contractor must submit to the contracting agency an accurate list of all subcontractors or attest that none was used; 3) during the term of this contract, the contractor and its affiliates shall collect, remit, and notify all subcontractors and their affiliates that they must collect and remit to the Director of the New Jersey Division of Taxation, the use tax due pursuant to the Sales and Use Tax Act, (N.J.S.A. 54:32B-1 et seq.) on all sales of tangible personal property delivered into this State. A contractor, subcontractor or supplier who fails to provide proof of business registration or provides false business registration information shall be liable to a penalty of $25 for each day of violation, not to exceed $50,000 for each business registration not properly provided or maintained under a contract with a contracting agency. Information on the law and its requirements is available by calling (609) 292-9292. 11

VENDOR QUESTIONNAIRE/CERTIFICATION Name of Company Street Address PO Box City, State, Zip Business Phone Number ( ) Ext. Emergency Phone Number ( ) FAX No. ( ) E-Mail FEIN No. Years in Business Number of Employees References Work previously done for School Systems in New Jersey 1. 2. 3. Name of District Address Contact Person/Title Phone Direct/Indirect Interests Vendor Certification I declare and certify that no member of the Lower Cape May Regional Board of Education, nor any officer or employee or person whose salary is payable in whole or in part by said Board of Education or their immediate family members are directly or indirectly interested in this bid or in the supplies, materials, equipment, work or services to which it relates, or in any portion of profits thereof. If a situation so exists where a Board member, employee, officer of the board has an interest in the bid, etc., then please attach a letter of explanation to this document, duly signed by the president of the firm or company. Gifts; Gratuities; Compensation I declare and certify that no person from my firm, business, corporation, association or partnership offered or paid any fee, commission or compensation, or offered any gift, gratuity or other thing of value to any school official, board member or employee of the Lower Cape May Regional Board of Education. Vendor Contributions I declare and certify that I fully understand N.J.A.C. 6A:23A-6.3(a1-4) concerning vendor contributions to school board members. I certify that I am not an official or employee of the Lower Cape May Regional Board of Education. I further certify that I understand that it is a crime in the second degree in New Jersey to knowingly make a material representation that is false in connection with the negotiation, award or performance of a government contract. President or Authorized Agent Signature 12

NON-COLLUSION AFFIDAVIT Re: Proposal for the Lower Cape May Regional Board of Education. STATE OF ) :ss: COUNTY OF ) Date: I, of the City of in the County of and the State of of full age, being duly sworn according to law on my oath depose and say that: I am of Position in Company the firm of and the bidder making the Proposal for the above names contract, and that I executed the said Proposal with full authority so to do; that I have not, directly or indirectly, entered into any agreement, participated in any collusion, discussed any or all parts of this proposal with any potential bidders, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named bid, and that all statements contained in said Proposal and in this affidavit are true and correct, and made with full knowledge that the Board of Education of the Township of Upper relies upon the truth of the statements contained in said Proposal and in the statements contained in this affidavit in awarding the contract for the said bid. I further warrant that no person or selling agency has been employed or retained to solicit or secure such contract upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, except bona fide employees of bona fide established commercial or selling agencies maintained by (Print Name of Contractor/Vendor) Subscribed and sworn to: (SIGNATURE OF CONTRACTOR/VENDOR) before me this day of,. Month Year NOTARY PUBLIC SIGNATURE Print Name of Notary Public My commission expires,. Seal Month Day Year 13

STOCKHOLDER/PARTNERSHIP DISCLOSURE AND STATEMENT OF OWNERSHIP Please check one type of Ownership, complete the form, and execute where provided. Corporation-- Limited Partnership-- Partnership-- Limited Liability Corp.-- Sole Proprietorship-- Limited Liability Partnership-- Sub Chapter S Corp.-- Other- No corporation or partnership shall be awarded any contract nor shall any agreement be entered into for the performance of any work or the furnishing of any material or supplies, the cost of which is to be paid with or out of any public funds, by the State or any county, municipality or school district, or any subsidiary or agency of the State, or by an authority, board or commission which exercises governmental functions, unless prior to the receipt of the bid or accompanying the bid of said corporation or said partnership, there is submitted a statement setting forth the names and all individual partners in the partnership who own a 10% or greater interest therein, as the case may be. If one or more such stockholder or partner is itself a corporation or partnership, the stockholder holding 10% or more of that corporation or partnership the individual partners owning 10% or greater interest in that partnership, as the case may be, shall also be listed. The disclosure shall be, continued until names and addresses of every non-corporate stockholder, and individual partner, exceeding the 10% ownership criteria established in this act, has been listed. IT IS MANDATORY THAT THIS FORM BE COMPLETED AND SUBMITTED WITH BID. In the event that there are no persons who own ten percent or more of the stock or ownership of the bidder, then such fact should be certified below as part of this disclosure. Name of Company Address City, State, Zip List of Owners with Ten Percent (10%) or More Interest Owner s Name Home Address Title/Office Held Percent (%) of Partnership Shares Owned NOTE: If you need more space than that provided above, please use an extra sheet for furnishing the above required information for any remaining persons or entities. Signature Date (form continued on next page) 14

To be completed and signed below. STOCKHOLDER/PARTNERSHIP DISCLOSURE AND STATEMENT OF OWNERSHIP (con t) If your firm is not a corporation and/or partnership, please explain below how your firm is organized and include a list of the various principals. Our firm,, is organized Names of Principals Title Use additional paper if needed. Check here if additional sheets are attached. Name of Company Address City, State, Zip Authorized Agent Title SIGNATURE OF AUTHORIZED AGENT 15

INDEMNITY AND HOLD HARMLESS AGREEMENT agrees to indemnify and hold harmless Lower Cape May (Contractor, Individual, Group, etc.) Regional School District, and their agents and employees, from and against all claims, damages, losses, and expenses, including reasonable attorney s fees in case it shall be necessary to file an action, arising out of performance of the work herein, which is 1) for personal or bodily injury, illness or death, or for property damage, including loss of use, and 2) caused in whole or in part by negligent act or (Contractor, Individual, Group, etc.) omission or that of a subcontractor, or that of anyone employed by them or for whose acts contractor or subcontractor may be liable. This indemnification and agreement shall apply in all instanced whether Lower Cape May Regional School District is made a party to the action or claim or is subsequently made a party to the action by third-party inpleading or is made a party to a collateral action arising, in whole or in part, from any of the issues emanating from the original cause of action or claim. Contractor, Individual, Group, etc. Date 16