3x- I 5 Cole Associates, LLC 3986 Princeton Pike Lawrenceville, NJ 08648 11/27/2018 Borough of Roselle Park 1 10 East Westfield Avenue Roselle Park, NJ 07204 Attn: Andrew J. Casais, RMC, QPA Re: Borough Engineer RFP Dear Mr. Casais, In response to the above stated RFP, our proposal is attached. We are currently performing a similar role for the Borough of Somerville and very interested in serving the Borough of Roselle Park as the Borough Engineer. Please call or email me if you have any questions or if we can be of further assistance. We appreciate the opportunity to serve Roselle Park. if I.) 3.1: . I Michael Cole, P.E., P.P., AICP, CME, CPG mcole@mcoleandassociates.com 609806?2877 609?688?0363 fax Cole Associates, LLC 3986 Princeton Pike Lawrenceville, NJ 08648 A Track Record of Transforming Towns to Communities The principal of Cole and Associates, LLC, Michael Cole, has been the Planning Board Engineer and Planner for large cities, townships and boroughs throughout NJ. Since 2005, he has been the engineer and planner for the Borough of Somerville Planning Board and Zoning Board of Adjustment. He also serves the Borough in other capacities such as the Borough Planner, Sanitary Sewer Engineer and Special Projects Engineer. He also served as municipal engineer for the City of Camden. 13 years of translatable experience: Roselle Park and Somerville Borough are very similar in size, age, style of development. Somerville is approximately 2.2 square miles and has a population of approximately 13,000. The Borough of Roselle Park is 1.2 square miles and has an approximate population of 13,000 too. Both communities were developed prior to WWII and are served by public water and sewer and have a Borough form of government. Over the last thirteen years, Cole and Associates has been a driving force in transforming Somerville to a vibrant town center with focal points like Division Street, the Shoprite development and Somerset development. We believe in realizing your goals with cost efficiency: We understand that Boroughs, especially in this economic climate, need an engineering/planning firm that can provide the needed expertise in a cost effective manner. To that end, we generally discount our municipal bills 1 5% to 20% to give back to the Borough. Cole and Associates is not like a large municipal firms that have multiple professionals review projects. By having the one person perform the planning/engineering for the Borough the fees are minimized. We believe in contributing to the betterment of the Borough: We have a passion for transforming towns to thriving communities. So when we have seen a need that may not be in the budget, we have helped the Borough by performing the work as a pro bono project. For Somerville, a critical factor in increasing foot traffic was to provide parking. Cole and Associates donated the complete redesign of the municipal parking lots: parking and lighting study, new layout, pedestrian walk paths, lighting, curbing for Somerville- mcole@mcoleandassociates.corn 609-306-28 77 609?688-0363 fax Besides Somerville, the Borough of Roselle Park would be our full time municipal client. To us, the Borough of Roselle Park would not be a small client in a large municipal engineeringT firm but a valued client in a small firm. We are proposing that Michael Cole, the principal of the Firm be Borough Engineer. We can provide examples of our work (engineering/planning review reports, road designs, planning documents, etc.). Cole Associates, LLC 3986 Princeton Pike Lawrenceville, NJ 08648 MICHAEL J. COLE, P.E., P.P., A.I.C.P., C.M.E., C.P.G. MUNICIPAL ENGINEER, PLANNER GEOLOGIST EXPERIENCE UMMAR Mr. Cole has nearly 30 years of experience working for New Jersey municipalities; and as the principal of the firm is a licensed planner, engineer and geologist. He is reSponsible for the management of all projects the firm conducts including redevelopment, municipal, and land use planning/engineering; environmental and civil engineering. The breadth of project management responsibilities include the review of land development applications, major and minor site plans/subdivisions, bulk/use variances, performing redevelopment Visioning, preparation of areas in need of redevelopment studies and redevelopment plans. In addition, the firm performs master plan reexaminations and the development of various elements of the master plan including housing element Fair Share Plans. The Housing Element Fair Share Plan is specifically tailored to address COAH round requirements. He has over 28 years of experience working for municipalities and performed projects ranging from traffic engineering/road design, civil engineering (pump station, stormwater, water and sewer main design), environmental engineering (soil/groundwater contamination investigation, landfill closure, UST removal/installation, etc.) and municipal planning. ENGINEERING AND PLANNING EXPERIENCE Planner Engineer, Borough of Somerville, Borough of Somerville Board of Adjustment Planning Board, 2005' to present As the Engineer Planner for the Borough of Somerville (including Flaming and Zoning Boards), he has reviewed hundreds of land development applications including major and minor subdivisions, major and minor site plans and use variance applications (including bulk variances). The applications are reviewed for conformance with the Land Use Ordinance, Flood Hazard regulations, NJDEP environmental COAH regulations and all applicable State standards. In addition, the he has reviewed/ supervised the preparation of the following planning documents: Preliminary Investigation for Determination of an Area in Need of Redevelopment? Borough Landfill Redevelopment Area Extension - Preliminary Investigation for Determination of an Area in Need of Redevelopment? Kirby Avenue Redevelopment Area Redevelopment Plan for the Station Area Landfill Redevelopment zone Reexamination of the Master Plan Housing/Land Use/Economic/Historic elements of the master plan Preparation of the Kirby Avenue Redevelopment Plan Preparation of the Eastern Central Business District Redevelopment Plan Conducting stakeholders meetings and perform subsequent revisions to the Kirby Avenue Redevelopment plan (revisions needed to address the downturn in the economy) . Preliminary Investigation for Determination of an Area in Need of Redevelopment West Main Street Redevelopment Area . Traffic engineering parking study of Municipal Lots #2 #6 to determine utilization during various hours of week/weekend and seasonal variation in parking lot use. Sewer Engineer Special Projects Engineer, Borough of Somerville, 2009 to present As the Borough Sewer and Special Project Engineer, he has designed capitol improvement projects and prepared various engineering reports. These capitol improvement and engineering reports include the following items: . Design of the reconstruction and upgrade to Municipal Parking Lots including design of decorative lighting, storm water inlets/piping, parking lot grades, landscaping, curbing, etc. . Review of the sanitary sewer flow data, sewer grades profiles and preparation of the sanitary sewer analysis surcharge report . Preparation of the 27? sanitary sewer main capacity analysis report Review of the lnsitu lining of the South Street sanitary sewer including the review and supervision of the removal of the debris located within the main Design and construction management of Division Street Project Replacement of sanitary sewer main on South Street. Repair of sanitary sewer manholes along Peters Brook. hispect over 90% of the sanitary sewer manholes to determine their condition Prepare the engineering analysis report that identifies the infiltration and in?ow of the sanitary sewer manholes including of the manhole reinforcement so that sanitary sewer overflow (380 does not occur in Chambres Park. Participate in the creation of ACO with NJDEP and SRVSA Prepare various mapping of the Borough?s sanitary sewer system including identifying locations of the future sanitary sewer flow meters. . Design of the both splash parks Zoning Board Planner, Borough of Middlesex, 2013 to 2016 As the Zoning Board Planner, he reviewed land development applications land development applications including major and minor subdivisions, major and minor site plans and use variance applications (including bulk variances). Planner Engineer, City of Camden Planning Board, 2000 to 2006 As the City of Camden Planning Board Planner Engineer, he has reviewed 100?s of site development plans, including site plans, minor and major subdivision applications. The site development applications are reviewed for conformance with the City?s site development ordinances. . Review of the Cramer Hill Study Area Determination of Needs Study for the Camden Planning Board. . Review of the Cramer Hill Study Area 1.2 Billion dollar Redevelopment Plan. Determination of redevelopment requirements for dozens of Brownfield Sites located in Camden City. - Assisting the City of Camden Fire Department in locating three (3) new fire stations and administration building in the City. Municipal Engineer, City of Camden, 1999 to 2002 Performed and managed numerous projects involving municipal engineering. These projects included the reconstruction of numerous city streets, repair and replacement of water and sewer main, upgrades to water treatment plants, replacement of 100?s of residential water laterals . City of Camden Projects- 2003 to 2006 Construction Management, Well Seal Phase 1 Wells #14 8: #1 5 Design 8: Well Houses Well Redrill Well #1 Well Design Delair #3 and Morris #6 #7 #12 Design of the Parkside water treatment plant 8: potable well Environmental Engineering Projects? 1989 to Present . Removal of 100?s of UST's for municipalities throughout New Jersey . Design of UST fuel dispensing systems for State, County and local governments (AC Expressway authority, Camden County, numerous local municipalities) . Above Ground Storage Tank Fuel System Design . Wetland Delineation and permitting (general and individual permits). . Preparation of Preliminary Assessment/Site Investigation at the following locations: 20 sites in Camden City, Buena Borough Rag Factory, Gloucester City Popcorn and Rug Factory, Sherwin Williams in lindenwold Borough. . Remedial Alternative Analyses (RAA). Supervised and/or performed over 50 RAAs, including the following sites: Westyille Borough Hall, Buena Borough Rag Factory, Serta Mattress - Pennsauken, Gloucester City Popcorn and Rug Factory, Lakehurst Borough DPW, Clementon Borough Hall and DPW, Cherry Hill Township Wastewater Treatment Plant, Berlin Borough DPW, Collingswood Borough MUA. Remington 82 Vernick Engineers, Municipal Engineer, Planner Geologist, 1989 to 2006 Represented municipal clients and performed municipal planning, engineering and hydrogeology. Municipal projects included review of hundreds of land development applications, preparation of master plans including the various elements of. the master plan, reexamination of master plans, redevelopment planning. PROFESSIONAL LICENSES AND CERTIFICATIONS Professional Planner NJ, American Institute of Certified Planner (A-I-C.P.) Professional Engineer NJ, PA, DE Professional Geologist PA, TN NJ Certified Municipal Engineer (CME) Member of the American Planning Association (APA) NJDEP Subsurface Evaluator ED UCA TI ON Attended numerous planning, engineering, geology. environmental science, freshwater wetlands, courses offered by Rutgers, Cook College, APA, ASCE University of Delaware. Bachelor of Science, Geology, 1989 A WARDS Proposed and designed the award winning Division Street pedestrian plaza which transformed an economically challenged block of Division Street, which is located within the Downtown Central Business District, from a vehicular road into the pedestrian plaza which is the cultural hub of the Borough. All cultural events Christmas tree lighting, Jazz festival, farmers market, etc.) take place on Division Street. The design and construction of the pedestrian plaza received a place award from the Somerset County Planning Board and the Platinum award from Downtown New Jersey 3 Cole Associates, LLC 3986 Princeton Pike Lawrenceville, NJ 08648 UZO AHIARAKWE P.E. P.P., CME, PLS EXPERIENCE SUMMARY Mr. Ahiarakwe is a professional engineer licensed in the states of New Jersey, Maryland and Delaware. He is also a professional planner in the State of New Jersey, and a licensed Professional Land Surveyor in the State of Delaware, Maryland and New Jersey. As Camden City Municipal Engineer, he has an enormous wealth of experience in dealing with the unique needs of municipalities. His experience spans the full depth of permitting, planning, grants/loan applications/administration, budgeting, rehabilitation of old infrastructure and designing new ones, construction management of projects in a congested urban environment, and dealing with utilities and utility companies during planning, designing and construction. He has held various appointed positions as Planner, Municipal Engineer, Traffic Engineer and Municipal Utilities Authority Engineer for numerous Boards and Municipalities. He is very familiar with the Residential site Improvement Standard (R313) and Municipal Land Use Law (MLUL). Mr. Ahiarakwe has undertaken numerous projects (rehabilitation and new construction) with great success. He has also had great success in obtaining funding from various sources totaling more than 200 million dollars for numerous projects over the past SEVENTEEN (17) years, i.e. 1996 to 2013. MUNICIPAL ENGINEERING EXPERIENCE Professional engineer in responsible charge of budgeting, planning, designing, and construction management/inspections for various engineering projects in different municipalities. Duties among other things also include reviewing bids received and making recommendations to Municipal Council, advising the Municipality on technical matters, reviewing of Planning/Zoning board submissions and supervision of water and sewer utilities operations. Funding And Grants Coordination Mr. Ahiarakwe as Camden City Municipal Engineer has liaised with various agencies for Federal and State funding programs. Within the past fourteen (14) years (1996-2010), he has successfully secured over one hundred eighty million dollars for numerous City projects. Some of these include programs sponsored by EDA, NJ EIT, ARRA and NJ DOT. His scope of involvement has included coordination, making the necessary application and providing the required documentation, responding to questions, providing clari?cation on studies and/or design submitted, and administering the loan or grant Tax Map Preparation Revisions Prepared numerous tax map revisions and updates for Township Of Fair?eld (2004? 2009) Water Sewer System Operations And Maintenance Mr. Ahiarakwe as City of Camden Municipal Engineer, is in charge of the oversight of the day? to?day operations, management, and maintenance of the City Sewer and Water System (1 8-MGD Morris Delair Water Treatment Plant Facility Parkside Water Treatment Facility) for a pepulation of 87,000 people. Water Supply Management 2009 Projects Rehabilitation of Pressure Filters (Morris-Delair Water Treatment Plant) Design Engineer for rehabilitation of twelve (12) pressure filters at the Morris?Delair Water Treatment Plant. The proposed scope of work includes, replacement of existing ?lter media and support gravel, cleaning the interior of the ?lter vessel and underdrain, inSpection and repair (if applicable) of ?lter internals, replacement of distribution piping and laterals, and restoration of surface treatments and ?nishes. (Cost: $800,000) Rehabilitation of Aerators/Degasi?ers Design Engineer for rehabilitation of eight (8) aerators at the Morris?Delair Water Treatment Plant. The proposed s00pe of work includes, inSpection of internal/external structure and repair (where applicable), replacement of internal structure and associated media, cleaning the interior of the vessel, replacement of distribution piping and laterals, and restoration of surface treatments and ?nishes. (Cost: $500,000) Upgrade Lime Silo (Lime Storage/Feed System) Design Engineer for rehabilitationlreplacement of existing lime silo at the Morris Delair Water Treatment Plan, Pennsauken, NJ. The project scope involves the rehabilitation of the existing lime silo at the Morris?Delair Water Treatment Plant. The preposed scope of work includes, pump replacement, modi?cation of waste removal system, inspection and repair of electrical system, demolition and removal of old lime feed system. (Cost: $600,000) Painting of Water Storage Tanks Design Engineer for inspection and design of replacement coating system for both the interior and exterior surfaces of the a 5 MG standpipe (North Camden Tank) and two (2) 2MG elevated tanks (Kaighn Avenue Tank and Whitman Park Tank). (Cost: $1.5 million) Rehabilitation of Clari?ers (Morris?Delair Water Treatment Plant) Design Engineer. The scope of work includes, analysis of ?ow balance between clari?ers/?occulators, installation offlow meters, inspection and repair (if applicable) of clari?er piping and associated structures; and replacement of distribution piping (if required). (Cost: $200,000) Furnish and Delivery of Cold Water Meters Design of replacement and new cold water meter and ERTs for approximately for prOperties in residential (13,000), commercial (95) and industrial accounts in the City ofCamden. (Cost: $600,000) Replacement of City Fire Hydrants Project Engineer for the design of replacement for approximately four?hundred (400) defective ?re hydrants at various locations in the City of Camden. (Cost: $1.6 million) Replacement of Water Main Valves (Various) This task involves the design of replacement for apploximately one-hundred (100) inoperable water main valves. (Cost: $1.7 million) Ventilation System For The VOC Building Design of adequate ventilation system for the VOC building, Morris Delair Water Treatment Plant, NJ. (Cost: $0.05 million) PROFESSIONAL LICENSES AND CERTIFICATIONS New Jersey Licensed Professional Engineer - 1996 Licensed Professional Planner - 1996 Certi?ed Municipal Engineer 1998 Certi?ed Public Works Manager 2007 Certified in Underground Storage Tanks Sewage Collections License 2008 Water Treatment License 2008 Water Distribution License - 2008 Registered Professional Engineer 1996 Registered Professional Land Surveyor-2008 Waterworks Operator 2003 Sewage Treatment Plant Operator Delaware Registered Professional Engineer - 1997 Registered Professional Surveyor -2000 Maryland Registered Professional Engineer - 2011 Registered Professional Surveyor -201 1 ED UCA TI ON Widener University, Chester, PA Master of Engineering in Civil Engineering Georgia Institute of Technology, Atlanta, Georgia Certi?cate in Transportation Engineering Universizjz of Massachusetts, Amherst, Massachusetts Certi?cate in Drinking Water Cole Associates, LLC 3986 Princeton Pike Lawrenceville, NJ 08648 GERALD CONSTRUCTION Gerald O?Brien has been in the construction business for more than 45 years. He started as a tradesman, then became a subcontractor handling concrete, brick, block, carpentry (both rough and finish), excavating, grading and underground improvements before becoming a home builder, general contractor and developer. He has built over 12,000 residential units, of every description, single family homes to New York City High-rise condominiums. Additionally he has built assisted living centers, municipal complexes, school additions, commercial and industrial centers, aircraft hangers and developed and improved over 10,000 acres. Gerald holds a General Contractor License, a General Blasting license and a New Jersey Home Improvement Contractor License. Further, he is an ICC Certified Residential Building, Plumbing and Mechanical Inspector and inspects municipal site-improvements. Gerald provides construction estimates, schedules and support services to contractors, builders, developers and engineers. EVGWREVG EXPERIENCE Cole 8: Associates, LLC, Construction Manager/ Inspector, 2010 to Present Gerald O?Brien performs constructability review of municipal projects and municipal inspection of both private land development projects and municipal capital improvement projects. The projects which he has performed these services are as follows: 0 Inspection of the construction of the parking lot and utilities connections for a 5 story building in downtown Somerville, NJ . inspection of the multimillion dollar JSM mixed use development, project in Downtown Somerville. Site development project involved the construction of a municipal road, 450 space parking lot, construction of the water, sanitary and storm water mains, landscaping and utility hook ups of a 72,000 square foot ShOpRite. . inSpection of the reconstruction of the municipal parking lots #1 #2 in Downtown Somerville. The lots were reconstructed to include pedestrian walkways, curbing, decorative lighting, landscaping, and pay stations. . Inspection of the relocation of the 14' diameter sanitary sewer main associated with the construction of the Mercer Street Bridge. .EDUCA HON Attended numerous engineering, science and engineering courses and has 160 credit hours from Penn State University. High School graduate in 1964. Certification '7 9 4 1 CERTIFICATE OF EMPLOYEE INFORMATION REPORT RENEWAL COLE AND ASSOCIATES 3986 PRINCETON PIKE LAWRENCEVILLE NJ 08 Andrew P. Sidamon- Eristoff State Treasurer a" ?Mm?mm ?3 if 11:: Id. - .3. . f" 0.2m4.9.2.9334e. A . - anuanaa jo umswa Aamar may; 1033mm ?uuov 5% SOIQHSO BOIRISO i tame 22mm i - ?980 PH 1 93mm mud 9868 3HEIEIWHN EIONEIHDEIS SBLVIOOSSV CINV 3103 33WVN EGVHJ. 33 WVN 'W?uh. 1's. 9-3-3519: 1.. 514*. 33?: A I 3930-9179810 1? ?Nomam 5- 293 ms Dd g; ..s anuanau :10 NOISIAICI 30 SSZNISHE I (a Aasuarmau so anus . :9 13.. -wanuaua?sm.?may walk.? .. . Cole Associates, LLC 3986 Princeton Pike Lawrenceville, NJ 08648 2019 Annual Fee Schedule?? Michael Cole, Principal Drafting Technical Assistant Staff Licensed Planner/Engineer Staff Planner/Engineer Development Site Inspection by PE Development Site Inspection by non PE Survey Technician Designer/Draftsman/CADD Technician Survey Crew (3?person) Survey Crew (2?person) Survey Crew (l?person) l80/hour (Private Development) l40/hour (Borough 8: Boards) 55 110/hour 75/hour 1 6 5 /hour (Private Development) 8 140/hour (Borough 8: Boards) llO/hour lBO/hour 1 lO/hour 68.00/hour 68.00/hour $250.00/hour 8 73.00/hour $134.00/hour mcole@rncoleandassociatescom 609?306-2877 609?688?0363 fax Schedule Notes 1. Travel mileage, copying small quantities of reports, plotting of maps, etc. is not charged to the Board/Municipalities. Large quantity copying will be billed the actual cost generated by the copying company Kinkos) with no mark up. Clerical work associated with copying of report/plotting of maps, etc. is not charged to the Boards/Borough. On. a. l.F .1. Cole Associates, LLC 3986 Princeton Pike Lawrenceville, NJ 08648 Municipal Client Reference List 1. Dennis Sullivan, Mayor of Somerville 25 West End Avenue, Somerville, NJ 088 76 Tel. 908?725-2300 Email: mayor-@somervilleniorg 2. Bernie Navatto, Chairman of the Somerville Planning Board 8: Chairman of the Somerset County Planning Board 2 5 West End Avenue, Somerville, NJ 08876 Tel. 9087220056 Email: 3. Arthur Adair, Chairman of the Somerville Board of Adjustment 25 West End Avenue, Somerville, NJ 08876 Tel. 908-672-0249 Email: aadair661@aol.com 4. Frank Vuoso, Borough of Somerville Director of Community Development 2 5 West End Avenue, Somerville, NJ 08876 Tel. 908-704-6962 Email: 5. Jason Kraska, Borough of Somerville Planning Board Member 25 West End Avenue, Somerville, NJ 08876 Tel. 908-256-9402 Email: ikraska106@gmail.com mcole@mcoleandassociates.com 609?3062877 609?688?0363 fax BOROUGH OF ROSELLE PARK SUBMISSION CHECKLIST THE FOLLOWING ITEMS, AS INDICATED BELOW E, SHALL BE PROVIDED Initial WITH THE RECEIPT OF SEALED SUBMISSIONS Here Completed RFP Checklist Non-Collusion Af?davit Required EEO/Af?rmative Action Evidence Signed Compliance Notice Acknowledgement of Americans with Disabilities Act Language of 1990 Disclosure of Investment Activities in Iran Insurance Requirement Acknowledgement Form Certi?cation Regarding Political Contributions (J New Jersey Business Registration Certi?cate of Vendor W-9 of Vendor Completed Submission Form Quali?cation Statement Statement of Ownership Disclosure i This checklist is provided for vendor?s use in assuring compliance with required documentation; however, it does not include all submission requirements and does not relieve the vendor of the need to read and comply with the RFP. Name ofVendor: w??rii7g?fi Date: 172/294 [3 Qk Signature: ngM? :7 Print Name: r/z/l/V( dig?? Title: L- Page 7 of 26 BOROUGH OF ROSELLE PARK SUBMISSION FORM QUALIFICATION STATEMENT (ATTACH ADDITIONAL SHEETS AS NECESSARY, BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS AND 1. Names and roles of the individuals who will perform the services and description of their education and experience with projects similar to the services contained herein: ?(Pei A?I?f?cbi Page 8 of 26 SUBMISSION FORM QUALIFICATION STATEMENT (CONTINUED) (ATTACH ADDITIONAL SHEETS AS NECESSARY, BUT DO NOT SIMPLY ATTACH VENDOR AND 2. References and record of success of same or similar service: 54% med Page 9 of 26 SUBMISSION FORM QUALIFICATION STATEMENT (CONTINUED) (ATTACH ADDITIONAL SHEETS AS NECESSARY, BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS AND WRITE: 3. Description of ability to provide the services in a timely fashion (including staf?ng, familiarity and location of key staff): 5P6 Mf?de (L Page 10 of 26 SUBMISSION FORM STATEMENT (CONTINUED) (ATTACH ADDITIONAL SHEETS AS NECESSARY, BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS AND TYPEJ WRITE: 4. Cost details, including the annual fee for primary duties and the hourly rates of each of the individuals who will perform services, and all expenses for any work that is not included in the primary duties: It? *1 FtheC 119$ CERTIFICATION OF PROPOSAL (Sign Below) Firm: QJC. m5}: 0'71'53/ Date AuthorizedR R/pysentative'n Z: 5/36 C157 (6..- Signature: Title: Prwc, ML Telephone N0.: @5351 3 7 7 Fax N0.: Page 11 0f26 BOROUGH OF ROSELLE PARK OF OWNERSHIP DISCLOSURE N.J.S.A. (PL. 1977, c.33, as amended by PL. 2016, (L43) THIS STATEMENT SHALL BE COWLETED, CERTIFIED TO, AND INCLUDED ALL BID AND PROPOSAL SUBMISSIONS. FAILURE TO SUBMIT THE REQUIRED INFORIWATION IS CAUSE FOR AUTOMATIC REJECTION OF THE BID OR PROPOSAL. Name of Organization: HMCL ?17503? [Pl/l, C, . - A 1 Organization Address: 3 a I NT 096? Part I Check the box that represents the type of business organization: Sole Proprietorship (skip Parts II and execute certi?cation in Part IV) nNon-Pro?t Corporation (skip Parts 11 and execute certi?cation in Part IV) For?Pro ?t Corporation (any type) ?Limited Liability Company (LLC) Partnership El Limited Partnership Limited Liability Partnership (LLP) nOther (be speci?c): Part II The list below contains the names and addresses of all stockholders in the corporation who own 10 percent or more of its stock, of any class, or of all individual partners in the partnership who own a 10 percent or greater interest therein, or of all members in the limited liability company who own a 10 percent or greater interest therein, as the case may be. (COMPLETE THE LIST ON THE NEXT PAGE IN THIS SECTION) OR No one stockholder in the corporation owns 10 percent or more of its stock, of any class, or no individual partner in the partnership owns a 10 percent or greater interest therein, or no member in the limited liability company owns a 10 percent or greater interest therein, as the case may be. (SKIP TO PART IV) Page 12 of 26 STATEMENT OF OWNERSHIP DISCLOSURE (Continued) Please attach additional sheets if more space is needed): Name of Individual or Business Entity Home Address (for Individuals) or Business Address MW a; 3 a; a Prime)? are.) an? swat/?1 Part DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS 0R LLC MEMBERS 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 or greater bene?cial interest in the publicly traded parent entity as of the last annual federal Security and Exchange Commission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links to the website(s) containing the last annual ?ling(s) with the federal Securities and Exchange Commission (or foreign equivalent) that contain the name and address of each person holding a 10% or greater bene?cial interest in the publicly traded parent entity, along with the relevant page numbers of the ?ling(s) that contain the information on each such person. Attach additional sheets if more space is needed. Website con the last annual SEC or fore uivalent Please list the names and addresses of each stockholder, partner or member owning a 10 percent or greater interest in any correSponding corporation, partnership and! or limited liability company (LLC) listed in Part II other than for any publicly traded parent entities referenced above. The disclosure shall be continued until names and addresses of every noncorporate stockholder, and individual partner, and member exceeding the 10 percent ownership criteria established pursuant to N.J.S.A. 5225?242 has been listed. Attach additional sheets if more space is needed. .._mra StockholderfPartner/Member and Home Address (for Individuals) or Business Address Corresponding Entity Listed in Part II NA Page 13 0f26 STATEMENT OF OWNERSHIP DISCLOSURE (Continued) Part IV Certi?cation I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this certi?cation on behalf of the bidder/proposer; that the Borough of Roselle Park is relying on the information contained herein and that I am under a continuing obligation from the date of this certi?cation through the completion of any contracts with the Borough of Roselle Park to notify the Borough of Roselle Park in writing of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certi?cationsubject to criminal prosecution under the law and that it Will constitute a material breach of my agreement(s) with the, permitting the Borough of Roselle Park to declare any contract(s) resulting from this certi?cation void and unenforceable. Full Name (Print): Wmhac Ln Ca 142,, Title: Rem/2m: Signature: a a Date: I 1?7 e' Page 14 of 26 BOROUGH OF ROSELLE PARK NON-COLLUSION AFFIDAVIT State of County of I, I/l?ifalmzb Caj?la/ oftheCityof AW Mare in the Countyof 9D. 09,11, full age, being duly and State of sworn according to law on my oath depose and say that: Pr as 1: (ML-- 1 am ofthe?rtmof A06. (Title or Position) (Name of Firm) I the bidder making this Proposal for the above named project, and that I executed the said proposal with full authority so to do; that said bidder has not collusion, or otherwise taken any action i named project; and that all statements c0] made with full knowledge that the Boron; said proposal and in the statements contai I further warrant that no persor such contract upon an agreement or under except bona ?de employees or bona ?de maintained by 65 Ill"! ?irt? Subscribed and sworn to before me this ?day of Akudn?g, Z0 "27. directly or indirectly entered into any agreement, participated in any restraint of free, competitive bidding in connection with the above itained in said proposal and in this a?idavit are true and correct, and gh of Roselle Park relies upon the truth of the Statements contained in ned in this af?davit in awarding the contract for the said project. or selling agency has been employed or retained to solicit or secure standing for a commission, percentage, brokerage, or contingent fee, employees or bona ?de established commercial or selling agencies Cfn?llfl; Ll Eiame of contractor). {743' A Signature axe, (Type or print name of af?ant under signature) Notary public o? .M 0 tag?? 9356;5st Notary?EUDngmelonExpiree 1 March 28 2202 . i Page 15 of26 BOROUGH OF ROSELLE PARK AF IRMATIVE ACTION COMPLIANCE NOTICE N.J.S.A. 10:5-31 and .J.A.C. 17:27 GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS This form is a summary of the successful bidder?s requirement to comply with the requirements of NJ .S.A. 10:5?31 and N.J.A.C. 17:27-1 et seq. The successful bidder shall submit to the public agency, after noti?cation of award but prior to execution of this contract, one of the following three documents as forms of evidence: a) A photocopy of a valid letter that the contractor is operating under an existing Federally approved or sanctioned af?rmative action program (good for one year from the date of the letter); OR b) A photocopy of a Certi?cate of Employee Information Report approval, issued in accordance with N.J.A.C. 17:27-4; OR 0) A photocopy of 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. The successful vendor may obtain the Af?rmative Action Employee Information Report (AA302) from the contracting unit during normal business hours. The successful vend0r(s) must submit the copies of the AA302 Report to the Division of Contract Compliance and Equal Employment Opportunity in Public Contracts (Division). The Public Agency copy is submitted to the public agency, and the vendor copy is retained by the vendor. The undersigned vendor certi?es that hefshe is aware of the commitment to comply with the requirements of NJ .S.A. 10:5-31 and N.J.A.C. 17:27.1 et seq. and agrees to furnish the required forms of evidence. The undersigned vendor further understands that his/ her bid shall be rejected as non-responsive if said contractor fails to comply with the requirements of NJ .S.A. 10:5-31 and N.J.A.C. 17227?1 et seq. COMPANY: 443M SIGNATURE: - PRINTNAME: Wiz/Ier Qia TITLE: DATE: 1 i /1q/ 8/ Page 16 of 26 BOROUGH OF ROSELLE PARK AMERICANS WITH DISABILITIES ACT OF 1990 Equal Opportunity for Individuals with Disability The Contractor and the Owner, do hereby agree that the provisions of Title 11 of the Americans with Disabilities Act of 1990 (the "Act") (42 U3. C. 3121 01 et 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 regulations promulgated pursuant there unto, are made a part of this contract. In providing any aid, bene?t, or service on behalf of the owner pursuant to this contract, the contractor agrees that the performance shall be in strict compliance with the Act. In the event that the contractor, its agents, servants, employees, or subcontractors violate or are alleged to have violated the Act during the performance of this contract, the contractor shall defend the owner in any action or administrative proceeding commenced pursuant to this Act. The contractor shall indemnify, protect, and save harmless the owner, 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 alleged violation. The contractor shall, at its own expense, appear, defend, and pay any and all charges for legal services and any and all costs and other expenses arising from such action or administrative proceeding or incurred in connection therewith. In any and all complaints brought pursuant to the owner?s grievance procedure, the contractor agrees to abide by any decision of the owner which is rendered pursuant to said grievance procedure. If any action or administrative proceeding results in an award of damages against the owner, or if the owner incurs any expense to cure a violation of the ADA which has been brought pursuant to its grievance procedure, the contractor shall satisfy and discharge the same at its own expense. The owner shall, as soon as practicable after a claim has been made against it, give written notice thereof to the contractor along with full and complete particulars of the claim, If any action or administrative 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 the contractor pursuant to this contract will not relieve the contractor of the obligation to comply with the Act and 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 save harmless the contractor, its agents, servants, employees and subcontractors for any claim which may arise out of their performance of this Agreement. Furthermore, the contractor expressly understands and agrees that the provisions of this indemni?cation clause shall in no way limit the contractor?s obligations assumed in this Agreement, nor shall they be construed to relieve the contractor from any liability, nor preclude the owner from taking any other actions available to it under any other provisions of the Agreement or otherwise at law. The undersigned vendor consents to the full understanding of the forgoing Americans with Disabilities Act Language of 1990: BidderNend - CHE. ?yc? King/?c, ?fa/47,9 (CC Signature: Full Name (Print): ?[60/th 6;)th Title: Pfiiaf?ipa? Date i Page 19 of26 BOROUGH OF ROSELLE PARK DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN PART 1: CERTIFICATION BIDDERS MUST COMPLETE PART 1 BY CHECKING EITHER BOX. Pursuant to Public Law 2012, c. 25, any person or entity that submits a bid or proposal or otherwise proposes to enter into or renew a contract must complete the certi?cation below to attest, under penalty of perjury, that neither the person or entity, nor any of its parents, subsidiaries, or af?liates, is identi?ed on the Department of Treasury?s Chapter 25 list as a person or entity engaging in investment activities in Iran. The Chapter 25 list is found on the Division?s website at Bidders must review this list prior to completing the below certi?cation. Failure to complete the certi?cation will render a bidder?s proposal non-responsive. PLEASE CHECK EITHER BOX: m1 certify, pursuant to Public Law 2012, c. 25, that neither the person/entity listed above nor any of the entity?s parents, subsidiaries, or af?liates is listed on the Department of the Treasury?s list of entities determined to be engaged in prohibited activities in Iran pursuant to FL. 2012, c. 25 (?Chapter 25 List?). I further certify that I am the person listed above, or I am an of?cer or representative of the entity listed above and am authorized to make this certi?cation on its behalf. I will skip Part 2 and sign and complete the Certi?cation below. OR El I am unable to certify as above because I or the bidding entity and/or one or more of its parents, subsidiaries, or af?liates is listed on the Department?s Chapter 25 list. I will provide a detailed, accurate and precise description of the activities in Part 2 below and sign and complete the Certification below. Failure to provide such will result in the proposal being rendered as non?responsive and appropriate penalties, ?nes and/or sanctions will be assessed as provided by law. PART 2 PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN You must provide a detailed, accurate and precise description of the activities of the bidding person/ entity, or one of its parents, subsidiaries or af?liates, engaging in the investment activities in Iran outlined above by completing the form below. (PROVIDE INFORMATION RELATIVE TO THE ABOVE QUESTIONS. PLEASE PROVIDE THOROUGH ANSWERS TO EACH QUESTION. IF YOU NEED TO MAKE ADDITIONAL ENTRIES, USE ADDITIONAL PAGES). Name: Relationship to Bidder/Vendor: Description of Activities: Duration of Engagement: Anticipated Cessation Date: Bidder/Vendor: Contact Name: Contact Phone Number: Page 20 of 26 DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN (Continued) CERTIFICATION I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. I attest that I am authorized to execute this certification on behalf of the below-referenced person or entity. I acknowledge that the Borough of Roselle Park is relying on the information contained herein and thereby acknowledge that I am under a continuing obligation from the date of this certi?cation through the completion of contracts with the Borough of Roselle Park to notify the Borough of Roselle Park in writing of any changes to the answers or information contained herein. I acknowledge that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certi?cationrecognize that I am subject to criminal prosecution under the law and that it will also constitute a material breach of my agreements(s) with the Borough of Roselle Park and that the Borough of Roselle Park at its option may declare any contract(s) resulting from this certi?cation void and unenforceable. Full Namc?iit): 62/5,. Title: (Pf He?d} Date i ?6"!th Bidder/Vendor: Carla -. CC C, Si gnature?? Page 21 of26 BOROUGH OF ROSELLE PARK INSURANCE REQUIREMENTS AND ACKNOWLEDGEMENT FORM Ccrtifioatc(s) of Insurancc shall be ?led with the Borough Of?ce upon award of contract by the governing body The minimum amount of insurance to be carried by the Professional Service Entity shall be as follows: PROFESSIONAL LIABILITY INSURANCE Limits shall be a minimum of $1,000,000.00 for each claim and $1,000,000.00 aggregate each policy period. Acknowledgement of Insman?iinent: SIGNATURE: 99 DATE: [/39 Midi/99L PfizfiC/ya?/L (Printed Name Title) Page 22 of 26 BOROUGH OF ROSELLE PARK CERTIFICATION REGARDING POLITICAL CONTRIBUTIONS STATE OF NEW JERSEY SS. COUNTY OF 1, 16-0661 414?- 0f the of in the County of ?5511 and the State of New Jersey, of Amt? r1193? i full age, being duly sworn according to law on my oath depose and say that(1270:? Add ?6 If} the Professional Service Entity making the submissions for the above named Service, and that I executed the said submission with full authority to do so, that said Professional Service Entity acknowledges that it is aware that the Borough of Roselle Park pursuant to Section 2-4 of the Borough Code prohibits the awarding of any public contract to any Professional Service Entity that has contributed in excess of two hundred ($200.00) dollars to a campaign committee of any Borough of Roselle Park candidate or holder of the public of?ce having ultimate responsibility for the award of the contract, or to any Borough of Roselle Park or Union County Party Committee, or to any political action committee (PAC) that is organized for the primary purpose of promoting or supporting Borough of Roselle Park municipal candidates or municipal of?ceholders, within one (1) calendar year immediately preceding the date of the contract or agreement. I further warrant that pursuant to Roselle Park Borough Section 2?4, a ?professional service provider? seeking a public contract means: an individual, including the individual?s spouse, if any, and any child living at home; person; firm; corporation; professional corporation; partnership; organization; or association. The de?nition of a service provider includes all principals who own one percent or more of the equity in the corporation or business trust, partners, and of?cers in the aggregate employed by the provider as well as any subsidiaries directly controlled by the service provider. I further warrant that I have reviewed Borough Code Section 2?4. I hereby certify that the foregoing statements made by me are true I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment for contempt of Court. Subscrib and sworn to before me this 19 dayofttoucmam .2033 ?dO? (Signature o?Professional) Name: A Title: Cl; ubl'lc 3131901109 EXQI 5:15:10 631 28' 24022;. Page 23 of 26 - Form 9 (Rev. October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Go to for instructions and the latest information. Give Form to the requester. Do not send to the IRS. Cole and Associates, LLC 2 Business name/disregarded entity name, if different from above 1 Name (as shewn on your income tax return). Name is required on this line; do not leave this line blank. following seven boxes. Individual/sole proprietor or I: Corporation single-member LLC I: Other (see instructions) Corporation El Limited liability company. Enter the tax classification (0:0 corporation, corporation, PzPartnership} Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting LLC if the LLC is classified as a single?member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single?member LLC that is disregarded from the owner should check the appropriate box for the tax ciassification of its owner. 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): El Partnership '3 Trust/estate Exempt payee code (if any) code (if any) to accounts maintained outsrole the U. S.) 5 Address (number, street, and apt. or suite no.) See instructions. 3986 Princeton Pike Print or type See Specific Instructions on page 3. Requester?s name and address (optional) 6 City, state, and ZIP code Lawrenceville, NJ 08648 7 List account number(s) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other - entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line Also see What Name and Number To Give the Requester for guidelines 0n whose number to enter. I Social security number or Employer identification number I 20?4871301 Part II Certification Under penalties of perjury, i certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subiect to backup withholding because: I am exempt from backup withholding, or I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends. you are not retype? to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later. Sign Signature of Here U.S. person Date? General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to Purpose of Form An individual or entity (Form requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. . Form 1099-INT (interest earned or paid) - Form 1099- DIV (dividends, including those from stocks or mutual funds) - Form (various types of income, prizes, awards, or gross proceeds) - Form (stock or mutual fund sales and certain other transactions by brokers} 0 Form 1099?8 (proceeds from real estate transactions) in Form 1099-K (merchant card and third party network transactions) 0 Form 1098 (home mortgage interest), 1098-E (student loan interest), (tuition) 0 Form 1099-0 (canceled debt) Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018)