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 Completed Submission Quali?cation Statement Statement of Ownership Disclosure Non-Collusion Affidavit Required EEOfAf?rmative Action Evidence Signed Compliance Notice I i a. Acknowledgement of Americans with Disabilities Act Language of 1990 Disclosure of Investment Activities in Iran Insurance Requirement Acknowledgement Form Certi?cation Regarding Political Contributions I New Jersey Business Registration Certi?cate of Vendor W-9 of Vendor 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 of Vendor: TDPOIOEY NI Date: Signature: X. We; Print Name: Philip Abramscn Title: Principal Page 10 of 29 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 perfcirm the services and description of their education and experience with projects similar to the services container! herein: Annie Hindenlang - Project Lead Annie Hindenlang is a licensed planner in the State of New Jersey and certified by the American Institute of Certified Planners. Annie brings more than 10 years? experience, most of which as the Executive Director of the City of Perth Amboy Office of Economic and Community Development. She approaches planning with a focus on quality of life and enjoys complex projects with many moving parts. Over the course of her career, she has overseen numerous redevelopment projects, drafted the City of Perth Amboy's Redevelopment Plan, and completed several municipal Master Plan elements. included within her portfolio of planning documents is the Bay City Transit District Strategy which received the 2017 Outstanding Plan Award from the American Planning Association's NewJersey Chapter. Annie earned her Bachelor of Science in Business Management, Bachelor ofArts in English and and Bachelor of Arts in Urban Planning from Virginia Tech and earned her Master of Urban and Regional Planning at the Rutgers University Bloustein School of Planning and Public Policy with a certificate in historic preservation. The names and qualification descriptions of the other project team members are detailed in the supplementary materials attached. Page 11 of?29 SUBMISSION FORM 1 QUALIFICATION STATEMENT (CONTINUED) ADDITIONAL SHEETS AS NECESSARY. BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS AND 2. References and record of success of same or similar service: The following individuals may be contacted as references on the services provided by Topology: Town of Morristown Jillian Barrick, Business Administrator P: 973.292.6626 Borough of Chatham Steve Williams, Business Administrator E: s-williams@chathamboroughorg p; 973.535.0574 x208 City of Summit Michael Rogers, Business Administrator E: mrogers@cityofsummit.org P: 908.522.3600 City of Perth Amboy Gregory Fehrenbach. Business Administrator E: gma@perthamboynj.org P: 732.826.0290 Township of South Orange Village Adam Loehner, Business Administrator E: aloehner@southorange.org P: 933.378.7715 x2 A summary of Topology?s success record with same or similar projects can be found in the supplementary materials attached. Page 12 of29 SUBMISSION FORM I QUALIFICATION STATEMENT (CONTINUED) (ATTACH ADDITIONAL SHEETS AS NECESSARY. BUT DO SIMPLY ATTACH VENDOR MATERIALS AND TYPEXWRITE: 3. Description of ability to provide the services in a timely fashion (including staf?ng, familiarity and location of key staff): Located in Newark, NJ, Topology is well versed in creating and implementing plans for a wide variety of transportation and land use goals. Complying with the speci?cations of the RFP, Topology will have no issue in completing the Vision Plan for the Borough of Roselle Park within the 12-month period that has been established. Topology understands that the Vision Plan will play an important role for the future of the Borough and believes that the firm's skills and expertise will make a positive contribution. As a planning firm focused on place-making solutions, Topology's mission is to unlock potential in the places you love. Having led several Master Plan creation and Master Plan re-examination processes for Newark, Morristown, Summit and the now in-progress South Orange Master Plan, Topology is well?equipped to handle the complexities to support Roselle Park Borough through the Vision Plan process in a timely fashion. Leading this effort will be Topology's Chief Operating Officer, Annie Hindenlang, a licensed planner in the State of New Jersey who is also certified by the American Institute of Certified Planners. As the Project Director for the Vision Plan, Annie brings more than 10 years? experience to the project. In her former role as the Executive Director ofthe City of Perth Amboy Office of Economic and Community Development, Annie successfully oversaw the the completion of over a dozen comprehensive municipal planning documents, and created numerous sustainability, workforce development and resiliency programs. Moreover, Annie acquired over $20 million in grant funds and oversaw $500 million of new private investment into the City through the redevelopment process. Germaine to this project, Annie has deer: experience in all areas of general planning services, especially in redevelopment, economic and business development and mobility planning. This response is continued in the supplementary materials attached. Page 13 on9 SUBMISSION FORM QUALIFICATION STATEMENT (CONTINUED) (ATTACH ADDITIONAL SHEETS AS NECESSARY. BUT DO NOT SIMPLY ATTACH VENDOR MATERIALS AND 4. Cost details, including the annual fee for primary duties and the hourly rates of each of the individuals who will perfm'm services, and all expenses for any work that is not included in the primary duties: To meet the needs and goals ol?the Transit Village Community Visioning planning process. Topology will utilize a people-oriented approach to foster a more open and inclusive process For key stakeholders and community members. We are excited to work with the Borough of Roselle Park to achieve these ends through a considerately established outreach process. Our process is designed to assist in collaboration between multiaagencies and groups. It is intended to be used when addressing a complex set oleoncerns and signi?cant issues to identify problems and create actionable strategies. Topology will be able to complete this proposed scope of work and schieve the goals of the request for proposals for a ?xed l?ee A detailed breakdown of fees according to tasks is included in the supplementary materials attached. CERTIFICATION OF PROPOSAL (Sign Below) Firm' Topolociq NT Ll .C. Date: limo/2.0m: Authorized thiv, (Hindi/f fwm?? Signature: Title. 13/] Telephone No: 97:) . -3 70- ~13 0 Fax No: {If/4 Page 11 ol'ZlS TOPO LOGY IN YOU Borough of Roselle Park Transit Village Community Visioning Special Planning Services Supglementary Submission Forngzualifigation Statement Materials 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: Phillip Abramson - Founder CEO (Project Advisor) Phillip Abramson is a licensed planner in the State of New Jersey, a licensed attorney in the states of New Jersey and New York and Managing Principal of Topology. Phil brings more than 10 years? experience, most of which was spent as the Project Manager within the Planning and Development Practices in the New York City office of Jonathan Rose Companies. He works to seamlessly blend planning, law and real estate deveIOpment to lead comprehensive planning projects that integrate innovative tools and creative practices. Phillip has extensive experience in the process of drafting municipal Master Plans, having led such efforts in Morristown, Newark and Summit. He has overseen numerous redevelopment projects, mobility studies, and the implementation of sweeping changes to land use ordinances. Phillip is a three?time Rutgers University Alumnus earning a Bachelor of Science in Criminal Justice from Rutgers, Newark College of Arts and Sciences; a Master of City and Regional Planning from the Rutgers Bloustein School of Planning and Public Policy and a Juris Doctorate degree from Rutgers School of Law Newark. Michael Martone Redevelopment Planner (Project Adviser) Michael is a planner and urban designer with a passion for creating vibrant, walkable, human-scaled neighborhoods that are economically, socially and environmentally resilient. He brings hands?on experience from the field, where he worked for a property restoration firm starting as a field technician and working his way to a project management role. Michael approaches his work at Topology with a dedication to the inherent value of communities to ensure that meaningful change and progress are within the community's reach. TOPO LOGY POTENTIAL IN RACES 'rCIu my: Michael earned his Bachelor of Arts in Design Studies from Arizona State University, College of Architecture and Environmental Design and his Master of City and Regional Planning (MCRP) from the Rutgers University Edward J. Bloustein School of Planning and Public Policy. William Kurzenberger Project Planner (Project Support) William Kurzenberger is a Project Manager at Topology with expertise in the management and oversight of large?scale projects and programs. Managing projects and concepts from concept to delivery, William has a wide range of experience in overseeing parks and open space development, city-wide public health initiatives as well as sustainability and resiliency projects. Serving as a former Project Director for the City of Perth Amboy Office of Economic and Community Development, William also has extensive experience in cultivating and maintaining collaborative ventures between for-profit and non?profit entities as well as other stakeholders. William strives to empower the public through transparent information sharing and has experience engaging stakeholders through a variety of engaging ways. William earned his Bachelor of Arts and Sciences in Social Work as well as his Master of Social Work from the Rutgers School of Social Work. 2. References and record of success of same or similar service: Municipgl Planning Experience Topology serves as the general municipal planner for Morristown, South Orange, Summit and Perth Amboy. Through our work with each municipality, Topology has guided development and policy to realize community goals and bring our client communities closer to their individual vision for the future. As municipal planners, we regularly advise on matters of zoning and coordinate with developers to refine projects and ensure that each prOposal honors the intent of the community?s zoning and prior planning efforts. In Topology's municipal planning engagements, we aim to provide for responsible growth that remains true to policy directives from comprehensive planning documents. TOPO IN YOU Municipal Land Use Boards Experience: Topology currently serves as the planning consultant to the Town of Morristown?s and the Township of South Orange Village's Planning and Zoning Boards. In this capacity, Topology reviews applications to the Planning and Zoning Boards, including various development proposals to ensure compliance with the municipal land use regulations and consistency with community values, vision and policies. Our work to support municipal land use boards gives us insight into larger planning initiatives, which we leverage in more comprehensive amendments to the zoning code and planning documents. This work is critical to informing our management planning portfolios in each of the communities we serve. Topology supports these municipal planning and zoning boards in interpretations of zoning language and the intent of policy documents that impact the scale and character of physical development. It is our priority to ensure that Board members understand the intent of technical regulations and guidelines and their implications for the form and function of new development. Our guidance in the Boards' consideration of development applications has shaped physical development of our client communities to fulfill the goals and objectives of the community, as defined in their planning documents. Master Planning Experience Topology has a diverse array of Master Planning experience that includes comprehensive plans, re-examinations, as well as special planning efforts that set the course for smarter land use, transportation and the promotion of the arts. Such planning efforts have made it possible for communities like Perth Amboy to pursue compelling transit-oriented development and Morristown to develop some of the most innovative Form Based Land Use Codes in the State. Within our portfolio, are also ongoing planning efforts such as the South Orange Master Plan, which has set new standards for public participation in municipal planning efforts. We use the diverse skillset of our staff to cover every aspect of life within our client communities to deliver plans that serve as practical guides for them to pursue their goals. TOPO LOGY Ui?llC?C?ll?Ji?z IN Summit re: W'sr'on.? The City of Summit has a unique mix of natural, historic, cultural, and economic assets that set it apart from other suburban communities. Its location in the region, with a midtown direct commuter rail connection, its vibrant downtown and business community, and its remarkable natural setting make Summit a great place to call home for its nearly 22,000 residents. Summit also has a very engaged and active local community. This meant that Topology needed to be organized and comprehensive in its approach to community outreach in order to effectively implement any master planning efforts. Topology led the re-ekamination effort for the City of Summit's 2010 Master Plan in 2017. The Summit document adopted by the City was the culmination of a robust stakeholder and public engagement process. The Topology team evaluated the City?s goals and objectives and created actionable strategies to achieve those community goals and serve as the foundation for specific changes to the Master Plan. Summit re.'ston builds upon prior planning to outline a comprehensive strategy for the City to guide growth and reinvestment, while preserving the character and scale of its historic residential neighborhoods. Currently, Topology is involved in several efforts for the implementation of key strategies from this plan. Newark Master P/an: Topology's Managing Principal served as the lead project manager and principal author of the most comprehensive revision to Newark's Master Plan in over 20 years. Formally adopted by Newark?s Planning Board in September 2012, the Master Plan serves as a regulatory document that guides the city's land use, development, preservation, sustainability, and neighborhood revitalization activities through the year 2025. Topology led a team of planners, urban designers, economists, and community organizers to develop a Master Plan which established the groundwork for sustainable development patterns that will allow Newark to be resilient and prosperous in the modern era. TOPO LOGY UHLOCKINC IN YOU The Master Plan takes a systems approach that considers the role of the City?s "physical layers? open space, housing, transportation, infrastructure, etc.) to facilitatejob creation and healthy neighborhoods. The Plan also sets the framework for a new Zoning Ordinance that will ensure future development activities are consistent with Master Plan goals. The Master Plan engagement process included 20 public meetings with local stakeholders over the course of two years. Creative Perth Ambay.? Enhancmg the Qua/i0 of Life and Empowering Economic Development Through Arts and Ctr/rare: The creation of the Arts and Culture Master Plan for the City of Perth Amboy in 2015 earned an award for Outstanding Municipal Plan award from the New Jersey Chapter of the American Planning Association. The plan was designed to make Perth Amboy a better place to live, work, play and visit through arts and culture. A creative team of nearly 20 Perth Amboy residents, worked for a year to build strategies and collaborations to address social and economic issues through arts and culture. The plan analyzed the existing arts infrastructure, the economy for arts as well as other opportunities and issues that needed to be understood in order to ensure the success of the arts and culture initiative. As a direct result of this work, the City of Perth Amboy was provided with a plan that could guide the city for the next 15 years in becoming a regional cultural center and arts destination. wn Mo why Fame/?d A Study :35 Communr'gr Form Fran." Topology led the master planning process in Morristown using a novel approach to address the Town's unique challenges as a regional center. The Mobility and Community Form Plan linked land use planning as inextricable to a transportation plan. This framework was well suited to analyzing and designing smart, feasible strategies to promote responsible development and growth, while at the same time preserving and strengthening the Town?s existing neighborhoods. The Plan was developed as part of a robust public process that reached a broad spectrum of residents, with a priority on ensuring full transparency in all decision-making processes. TOPO LOGY optimum-c, POTENTIAL In: PIACES You Leave During the public input and engagement process, we learned about pressing issues from townspeople and worked collaboratively with them to develop a vision for Morristown as a welcoming, resilient, and sustainable place to live, work, and play. As part of that vision we produced strategies to revitalize places and corridors at the heart of Morristown, including the Train Station District. We devised specific strategies to promote the development of a walkable transit?oriented community around the Morristown rail station, including the redevelopment of surface lots and auto?oriented uses, and planning and implementation of pedestrian, bicycle and roadway enhancements. Perth Amboy Bay City Transit District Strategy Topology's Chief Operating Officer served as the project lead on one of Together North Jersey's "Local Demonstration Projects" that took the form of a plan with redevelopment proposals for the half~mile radius area around the Perth Amboy, NJ Transit train station. The proposed redevelopment hopes to increase ridership at the train station, create economic opportunities, and serve as a source of revitalization for the city?s core. Concentrating development around transit will also address and manage growth in an environmentally sensitive manner that encourages transit use. The plan will be used to support the city in their goal to create a transit overlay district or transit zone and achieve Transit Village designation. It includes several key strategies including the addition of new public civic arrival space, adaptive reuse of upper levels of older commercial buildings and modernizing parking regulations and management. Redevelopment Planning Experience: Topology has extensive experience in redevelopment planning and has focused on redevelopment as a means to promote physical revitalizations and financial reinvestment instead of focusing strictly on economic program development. The firm's approach to redevelopment has been to leverage a community's unique, natural and cultural assets to effect meaningful change that not only produces ancillary economic benefits but also serve as a placemaking strategy. In this work, Topology has managed and created TOPO LOGY PGIENIML Irv PLACES public/private partnerships, conducted entire downtown revitalizations and worked with developers to secure buy-in and additional investment. Topology has worked with communities like Summit, Nutley, Morristown, South Orange, Newark, Perth Amboy, Burlington City, Red Bank, Maplewood, Elmwood Park, Caldwell and Chatham to achieve extraordinaryredevelopment success. Below, please find two samples of this work. Market Bank TopoIOgy led a redevelopment planning effort for a small irregular area, once home to coach makers in the nineteenth century. This prominent tract of land on the edge of Morristown?s central business district saw various uses come and go with limited investment. The Market 81 Bank Redevelopment Plan was designed to capitalize on the site?s prominent location by incorporating distinct urban design elements that reflect the traditional industrial architecture of existing structures on the site. Topology's redevelopment strategy emphasized the redevelopment area's unique position as a gateway into the central business district by incorporating landmark elements and public space. The Market Bank Redevelopment Plan provided for sustainable redevelopment with contextual urban design and architectural standards that embraced the redevelopment area's unique shape and location. Topology facilitated a transparent redevelopment process and maintained an open dialogue with the public and local officials for input on the redevelopment project. The plan drew on LEED-ND neighborhood design standards and includes new public spaces and pedestrian amenities that established safer, more comfortable pedestrian connections. 2nd Street Par/C After being stalled for almost 15 years, this six-acre former brownfield is being remediated into a world-class waterfront park through the coupled efforts of a collaborative, community-led process and a resourceful approach to financing. In 1997, the City of Perth Amboy acquired through eminent domain an TOPO LOGY Brno: rim-4.7 POT EM Mt IN FLAGS YOU IOVE active scrap metal yard for the creation of new parkland along the Raritan River. Shortly after, it became evident that the property was severely contaminated and a long, litigious battled ensued between the former property owner and the City regarding remediation and reuse. Topology brokered a conversation with the Middlesex County Improvement Authority (MCIA) to utilize funding from the US. Environmental Protection Agency (EPA) Brownfields Program to contract a team of community planning specialists and landscape architects from Rutgers University?s Center for Urban at Environmental Sustainability and Bloustein School of Planning a. Public Policy to develop a concept design to convert a contaminated site into a park that meets the needs and interests of the surrounding neighborhood residents. Rutgers conducted an extensive community outreach process receiving feedback from over 500 city residents, students and members of the surrounding neighborhood. In response to sound landscape design practices and a clear community vision, the park concept design included multiple program areas that met the local resident's interests for this space. The areas reflect a diversity of proposed activities and ecological restoration that connect the park to the shoreline, neighborhood, and Perth Amboy?s urban center. In fall of 2016, with assistance from the Department of Environmental Protection, Topology was able to acquire over $7 million in funding for final design, remediation, and construction of the park. FOCUS 2020 In the summer of 2018, Topology completed the first comprehensive overhaul of Perth Amboy?s city-wide redevelopment plan in twenty years. The FOCUS 2020 plan was the result of almost three years of collaboration with City leadership, industry leaders, residents and other stakeholders covering a third of the land within the municipality. Perth Amboy is now equipped with a useable, practical tool that reflects current market conditions, a new vision for the City, and compliance with today's standards for planning and development. TOPO LOGY L'HuiXme HAELES rou low The updates within the plan unlocked outdated zoning restrictions and allowed for new avenues of attracting private partners to revitalize the City's underutilized spaces. The plan has resulted in the on-going remediation of over 300 acres of brownfields, the creation of thousands ofjobs, and brought in a little over $500 million dollars of new investment into the City. Ongoing efforts include residential, retail, and commercial/industrial projects throughout the City with a focus on job creation and more sustainable growth geared to transit riders. Affordable Housing Planning Experience Topology is trusted to provide guidance for the provision of affordable housing for Morristown, South Orange, and Caldwell. Assisting these communities satisfy their legally mandated requirements in a way that provides dignified housing for low-moderate income residents without causing unnecessary congestion or financial hardship requires a complex understanding of the issues involved that Topology has honed throughout the years. That experience helps the firm advise on the location and variety of housing provided that meets the satisfaction of both the law and residents alike. 3. Description of ability to provide the services in a timely fashion (including staffing, familiarity and location of key staff): The Vision Planning process requires strong organizational skills as well as a familiarity of the primary intentions and objectives of the Borough. Moreover, as transparency and community engagement is key to the construction of a successful Vision Plan, an individual that has experience in organizing public outreach processes and marketing these events for increased engagement is crucial. Based on her experience, Annie is the most qualified member of the Topology team to direct these efforts. Her experienced in coordinating multiple projects of both small and large scale will equip her to ensure all deliverables for the Vision Plan are not only timely but efficient. While Annie will lead the project, she will also leverage the skills of the entire project team whose qualifications, credentials, etc. are detailed in the first section of the Submission Formeualifications Statement. Topology works with clients, like the Borough of Roselle Park, who are dedicated to creating a community that improves year after year. Consistently delivering planning and development efforts to maintain the charm of this "wonderful place to call home? is quite TOPO LOGY IH BIAHES 'f'C'iU difficult. However, the Borough of Roselle Park has risen to that challenge. As a firm, Topology is interested in communities such as this that align with our core values of sustainability, empowerment and strategies that harness existing infrastructure, local assets and social innovations. Communities that have worked with the firm have reaped the benefits of our thoughtful approach to planning that identifies realistic opportunities and crafted bold and thoughtful solutions to complex problems. The Borough of Roselle Park?s desire for a Vision Plan that sets the stage for a thriving transit village and is driven by active public participation, fits perfectly into our core model for strategic planning. Communities constantly evolve and in an ever~changing world, the Borough of Roselle Park needs a partner that will be steadfast and equally invested in the future success of the Borough. Tepology is that partner. 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: Phase 1 Organize: 2 Months; $1,500 Under the guidance of the Borough, Annie Hindenlang will oversee project logistics and guide collaborating agencies as Project Director in undertaking the activities in the Organize phase. She will then manage the facilitation process through the completion of the Transit Village Community Visioning process. Within two weeks of receiving a notice to proceed, the Project Director will develop a working schedule. This schedule will be updated quarterly by Topology to reflect any necessary changes. Topology will coordinate a kickoff meeting with all partners to conduct a site visit and formalize project parameters, a detailed schedule, roles and responsibilities, communication protocols, and project goals and objectives. The decisions made at this initial meeting will be formalized into a Project Brief that will serve as a project management tool to guide decisions, provide structure, and lay out the planning process. The goal of the Project Brief is to ensure that all stakeholders involved in the planning process understand how they will be working together, what they can expect from the process and what is expected of them. TOPO LOGY MIENIIM IN roll 10% Additionally, Topology will work with the Borough to develop a format for progress reports that will meet the Project Team's requirements within two weeks of the kickoff meeting. The Project Team will receive a draft agenda no less than seven days prior to the kick?off meeting (and all subsequent meetings) to review and comment. Creating a safe, informative, interesting and fun process can break down barriers of regulated or formal public forums and allow for more personal engagement. To support a successful engagement strategy, Topology will work with the Project Team and the Coordination Committee members to develop parameters for a Neighborhood Snapshot that presents an overall perspective of the neighborhood and an introduction to the pressures, challenges, and opportunities facing the community. Topology will set the agenda for and facilitate an internal scoping meeting with the Project Team and Transit Village Coordination Committee to initiate the outreach process, establish parameters for alternatives vetting and create a public engagement and communications plan. Topology will also set the agenda and run the meeting for both of the committee meetings to help the project team further identify objectives, a range of possible alternatives, and constraints for the project. Each group of constituents will require tailored engagement. Developing an upfront, deep understanding of the stakeholders? network provides an opportunity to address potential risks, challenges and opportunities, and sensitive topic areas and concerns. TOpology will work with the Project Team and Coordination Committee to help develop a Public Engagement and Communication Plan (Engagement Strategy) based off a collaboratively developed Neighborhood Snapshot to ensure that the process will include as many residents as possible. This plan will identify outreach methods and develop scoping, comment periods, required meetings and public information materials strategies. During public workshops, engagement activities are designed so that planners and participants take deep dives into issues that are central to the planning work. Workshops are most productive when individual discussions occur around specific topics. The Engagement Strategy will be designed to be as inclusive as possible by entailing varying meeting times to accommodate all work schedules, centrally located event spaces with ease of access, usage of multiple media opportunities to enhance awareness and the creation of inviting workshop environments. These meetings will engage people directly, encourage one-on-one conversation and, when possible, organize outreach into a small group setting. For each meeting, attendees will be provided with documentation of how their participation will be used and an opportunity to stay connected throughout the entire TOPO LOGY castrate-C 1M TDIJ Love process. As needed, Topology will provide visuals for all engagements that are compelling and relatable to participants. Most residents do not have the time or willingness to participate in public workshops, however obtaining input from a diverse cross section of the community is critical to the success of the planning process. To engage a broader range of community members, field engagement activities such as surveys, social media, street fair participation, and other individualized engagement strategies should be considered. It is expected that the Borough and Coordination Committee will handle and support public outreach. This includes utilizing all available outlets, providing contact information, and utilizing available platforms. Additionally, any public notices will be handled by the Borough. The Borough and Coordination Committee will largely be needed for their insider knowledge and background of the community to inform deliverables. Deliverables: - Draft Project Schedule . Kickoff Meeting and Site Visit . Template for Progress Report - Project Brief . Meetings (2) with Project Team and Coordination Committee to Develop Parameters for Neighborhood Snapshot - Final Neighborhood Snapshot . Working Meeting with Project Team and Coordination Committee to Draft Public Engagement and Communications Plan . Final Engagement Strategy and Communication Plan Step 2 - Learn: 5 months; $19,250 The goal of the Learn phase is to provide the Project Team and community members with the opportunity to enliven and enrich preliminary data and field study with a deeper understanding of how changes are affecting the everyday life, concerns. and future of the community. The Project Team and Coordination Committee will provide data to Topology's Project Director to support three workshops during the Learn phase. The goal of these workshops is to communicate the scope and schedule of the process, present preliminary research to the public and get feedback on the extent to which the preliminary research resonates with community members based on their lived experience. The TOPO LOGY IN YOU UCWE workshops should take place in an open house format so that participants can choose their own path and experience. Activities will be established in the Engagement Strategy, but can include interactive games, asset mapping and survey stations. These workshops will be coupled with the field engagement plan from the Engagement Strategy to reach a broader range of community members and may include tactics like online surveys, site walks, canvassing, focus groups, and block parties. Additionally, Topology will support the Public Meeting Plan from the Public Engagement and Communications Plan to solicit public input on objectives, range of possible alternatives, and constraints for the project. Once the Project Team and Coordination Committee have a better understanding of the community from both a qualitative and quantitative perspective, a Coordination Committee Workshop can be held to narrow down alternatives for implementation based off stakeholder and community comments. Topology will coordinate this meeting and establish an agenda to organize this consensus building process. A final public workshop, Workshop will be held to create and confirm a consensus- built vision, goals and guiding principles for the community as it relates to this process. While the final engagement strategy will dictate the model for this workshop, ideally the workshop will begin with a brief presentation to re-contextualize and share strategies with the public. The larger group will then be broken into small groups lead by a facilitator to dive deeper into the core findings and receive additional public comment. Topology will support the Public Meeting Plan from the Public Engagement and Communications Plan to solicit public input on the strategies. Topology will ensure adequate and comprehensive public notice and outreach for all meeting. During this phase, the Project Team and Coordination Committee will be key partners in reviewing, testing and finalizing recommendations. Topology will also need their continued assistance with public outreach and coordination including securing meeting space. Prior to Topology purchasing or producing any materials for these meetings, they will run the costs by the Project Team. TOPO LOGY IH PIACES ?rOlJ LOVE Deliverables: . Meeting with Coordination Committee - Public Workshop #1 - Public Workshop #2 - Public Workshop #3 . Field Engagement (four stakeholder meetings) . Final Neighborhood Snapshot - Coordination Committee Meeting . Draft Strategy Grid . Public Workshop #4 Step 3 - Create: 3 months; $8,000 Having developed a clearer understanding of the key concerns, aspirations and goals of the community during the Learn phase, the process transitions to brainstorming about potential solutions. During this phase, the Project Team and Coordination Committee will need to sort and organize data and feedback, define objectives and brainstorm final alternatives. The Project Director will vet policies, strategies, and projects against community feedback to create and implement a process for the Project Team and Coordination Committee to choose the preferred strategies. Topology will then lead a meeting to choose the preferred alternatives. A coordinated review of these alternatives among the Project Team and Coordination Committee should take place before they are tested with key stakeholders or presented to the larger community at the final workshop. Topology will lead the Project Team and Coordination Committee in creating and vetting strategies and facilitate the meeting including an agenda, handouts, and a sign~in sheet. These discussions will be worked into a draft plan. When the draft Transit Village Community Vision is complete, Topology will facilitate a meeting of the Project Team and Coordination Committee to review the draft. Before the Transit Village Community Vision is finalized, it is critical to obtain feedback from residents?and to ask for ways to refine initial proposals and/or develop alternatives?to ensure that they fundamentally address the goals and concerns from the community's perspective. Part of this vetting will take place with stakeholders to refine and confirm strategies to meet community objectives. To accomplish this final outreach state, Topology will ensure that all participants in stakeholder, committee and public meetings are notified of and have opportunity to comment on the plan in compliance with TOPO LOGY IH FUN-55 YOU LOVE the Public Engagement Plan. Topology will support agenda development and public meeting implementation to present the selected concept alternatives and plan at a final workshop. Topology will ensure the Project Team has all necessary meeting materials. Topology will rely on the Project Team and Coordination Committee to provide support in the form of outreach, local expertise and priority setting for the alternative process. Deliverables: Preferred Alternative Selection Process Preferred Alternative Development Meeting Draft Transit Village Community Vision Meeting Communications with Stakeholders and Participants Regarding Draft Master Plan Pie-examination Final Public Workshop Final Plan Review Meeting Step 4 Finalize: 1 Month; $2,000 Topology will coordinate and run the regulatory process for the adoption of the Transit Village Community Vision as part of the Borough's Master Plan. Topology will just need the Borough?s assistance with scheduling, noticing and set up for these meetings. Deliverables: Borough Council Presentation Public Notice Planning Board Public Hearing Planning Board Adoption Hearing BOROUGH OF ROSELLE PARK STATEMENT OF OWNERSHIP DISCLOSURE N.J.S.A. (PL. 1977, (2.33, as amended by P.L. 2016, c.43) THIS STATEMENT SHALL BE COMPLETED, CERTIFIED TO, AND INCLUDED WITH ALL BID AND PROPOSAL SUBMISSIONS. FAILURE TO SUBMIT THE REQUIRED INFORMATION IS CAUSE FOR AUTOMATIC REJECTION OF THE BID OR PROPOSAL. Name of Organization: NJ 110 Organization Address: 60 Union Street Newark NI 07105 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?Pt?ofit Corporation (skip Parts II and execute certi?cation in Part IV) For-Pro?t Corporation (any type) Limited Liability Company (LLC) Partnership a Limited Partnership Limited Liability Partnership (LLP) Other (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 even 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 er greater interest therein, as the case may be. (SKIP TO PART IV) Page 15 of29 STATEMENT OF OWNERSHIP DISCLOSURE (Continued) jPlease attach additional sheets if more space is needed}: Name of individual or Business Entity Home Address (for Individuals) or Business Address Philip Abramson 296 Meeting House Lane, Mountainside 07902 Part DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS 0R LLC MEMBERS LISTED IN PART II If a bidder has a direct er 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 fereign equivalent ?ling, 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 (er 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 filing(s) that contain the information on each such person. Attach additional sheets if more space is needed. Website can the last annual SEC orf alent ?lin Pa 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. Stockholder/PartnerMember and Home Address (for Individuals) or Business Address Corresponding Entity Listed in Part II Page 16 of 29 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 biddeerroposer; 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 Bomugh of Roselle Park to declare any Contraot(s) resulting from this certi?cation void and unenforceable. Full Name (Print). Phi .B Abramson Title: Principal Signature: Date: 11f29/18 Page 17 of 29 BOROUGH OF ROSELLE PARK NON-COLLUSION AFFIDAVIT State arm Caunty of Essex 35: I, Ebilip of the City of Newark in the County of Essex and State of New Jersey full age, being duly sworn according to law on my oath depose and say that: I am Prinicpal of the ?rm of NI 11c (Title or Position) (Name of Finn) 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, directly or indirectly entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named project; and that all statements contained in said proposal and in this affidavit are true and correct, and made with full knowledge that the Borough of Roselle Park relies upon the truth of the statements contained in said preposal and in the statements contained in this affidavit in awarding the contract for the said project. 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 or bona ?de employees or bona fide established or selling agencies maintained by Tapology NI 11C (name of contractor). Subscribed and sworn to before me this '29 day 2 of November 2018 . X. 1mg smeared JENNIFER KAPP ID 50056639 Philip Abrammn EY (Type or print name of a?iant under signature) My Commission expires 2) E. Page 13 of 29 BOROUGH OF ROSELLE PARK AFFIRMATIVE ACTION COMPLIANCE NOTICE N.J.S.A. 10:15-31 and N.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 N.J.S.A. 10:5-3! 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 affirmative 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. c) 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?nnative Action Employee Information Report (AA302) from the contracting unit during normal business hours. The successful vendor(s) must submit the copies of the M302 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 helshe is aware of the commitment to comply with the requirements ofNJ .S.A. 1015-31 and N.J.A.C. 17:27.1 ct seq. and agrees to furnish the required forms of evidence- The undersigned vendor further understands that hisfher bid shall be rejected as non-responsive if' said contractor fails to comply with the requirements 1025-31 and N.J.A.C. 17211 et seq. COMPANY: NT SIGNATURE: PRINT NAME: Philip Abramson TITLE: Principal 111291?18 Page 19 of 29 BOROUGH OF ROSELLE PARK MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE N.J.S.A. 10:5-31 et seq. (P.L. 1975, c. 127) N.J.A.C. 17:27 Goons, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS During the performance of this contract, the contractor agrees as follows: The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for employment because of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality Or sex. Except with reSpect to affections] or sexual Orientation and gender identity or expression, the contractor will ensure that equal employment opportunity is afforded to such applicants in recruitment and employment, and that employees are treated during employment, without regard to their age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex. Such equal employment opportunity shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship- The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency Compliance Of?cer setting forth provisions of this nondiscrimination clause. The contractor or subcontractor, where applicable will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all quali?ed applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex. The contractor or subcontractor will send to each labor min, with which it has a collective bargaining agreement, a notice, to be provided by the agency contracting officer, advising the labor union of the contractor?s commitments under this chapter and shall post copies of the notice in conspicuous places available to employees and applicants for employment. The contractOr or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer pursuant to N.J.S.A. 10:5-31 et seq., as amended and supplemented from time to time and the Americans with Disabilities Act. The contractor or subcontractor agrees to make good faith efferts to meet targeted Borough employment goals established in accordance with N.J.A.C. 17:27-52. The contractor or subcontractor agrees to inform in writing its appropriate recruitment agencies including, but not limited to, employment agencies, placement bureaus, colleges, universities, and labor unions, that it does not discriminate on the basis of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity er expression, disability, nationality or sex, and that it will discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices. The Contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to assure that all personnel testing conforms with the principles of job-related testing, as established by the statutes and court decisions of the State of New Jersey and as established by applicable Federal law and applicable Federal court decisions. in conforming with the targeted employment goals, the contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and layoff to ensure that all such actions are taken Page 20 of29 EXHIBIT A MANDATORY EOUAL EMPLOYMENT OPPORTUNITY LANGUAGE N.J.S.A. 10:5-31 et seq. (PL. 1975, C. 127) N.J.A.C. 17:27 GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS (Continued) without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex, consistent with the statutes and court decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions. The contractor shall submit to the public agency, after noti?cation of award but prior to execution of a goods and services contract, one of the following three documents: Letter of Federal Affirmative Action Plan Approval Certi?cate of Employee Information Report Employee Information Report Form AASOZ (electronically provided by the Division and distributed to the public agency through the Division?s website at The contractor and its subcontractors shall furnish such reports or other doournents to the Division of Purchase do Preperty, CCAU, EEO Monitoring Program as may be requested by the of?ce from time to time in order to carry out the purposes of these regulations, and public agencies shall furnish such information as may be requested by the Division of Purchase 35 Property, CCAU, EEO Monitoring Program for conducting a compliance investigation pursuant to Subchapter 10 of the Administrative Code at N.J.A.C. 17:27. Page 21 of 29 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 U.S.C. 5?12} 0! 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 contracton its agents, servants, employees, or subcontractors violate or are alleged to have violated the Act during the perfomtanCe 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 capeditiously 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 indenmitication 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, not 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: Bidder/Vendor: Ni 11': ,1 Signature: 4 ?t 2am, Full Name (Print): Philip Abramson Title: Principal Date 11/29/18 Page 22 of 29 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 pigder?s proposal non-responsive. PLEASE CHECK EITHER BOX: El I certify, pursuant to Public Law 2012, c. 25, that neither the personfentity 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 officer or representative of the entity listed above and am authorized to make this certification on its behalf. I will skip Part 2 and sign and complete the Certi?catiOn below. OR El Iam unable to certify as above because I or the bidding entity andfor 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 Certi?cation below. Failure to provide such will result in the proposal being rendered as non-responsive and 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 personfentity, 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: BidderNendor: Contact Name: Contact Phone Number: Page 23 of 29 DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN (Continued) CERTIFICATION I, being duly sworn upon my oath, hereby represent and state that the foregoing infannation and any attachments thereto to the best of my knowledge are true and complete. I attest that I am authorized to execute this certi?cation 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 Name (Print?lL Philip Abram? Signature: Title: Principal Date 11/29/18 BidderNendOr: Topology NI 11c Page 24 of 29 BOROUGH OF ROSELLE PARK INSURANCE RE UIREMENTS AND ACKNOWLEDGEMENT FORM Certi?catc(s) of Insurance shall be ?led with the Borcugh Clerk?s Of?ce upnn 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 Insurance Requirement: SIGNATURE: DATE: 11/29/13 u? Philip Abramson, Principal (Printed Name 8: Title) Page 25 of 29 BOROUGH OF ROSELLE PARK CERTIFICATION REGARDING POLITICAL CONTRIBUTIONS STATE OF NEW JERSEY SS- COUNTY OF Essex 1, Philip Abramson . Principal of the Topology NI lie of Newark in the County of Essex and the State of New Jersey, of full age, being duly sworn according to law on my oath depose and say that: I am the Principal of the firm of Topoloev NT 11c 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 office 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 sewiee 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 Bor0ugh 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. Subscribed and sworn to before me this 29th day of November 20_13 - jg? - (Signature oflli'rofessional) Name: Philip Abramson Title: Principal ID 50056031; NOTARY STATE OF NEW -. My Explrea March as. Page 26 of 29 Form (Rev. November 2017) Department or the Treasury Internal Fievenue Service Topology NJ He Request for Taxpayer Identification Number and Certi?cation Go to for instructions and the latest information. 1 Name {as shown on your Income tax retumi. Name is required on this line: do not leave this line blank. Give Form to the requester. Do not send to the IRS. 2 Business entity name. it dl?erent from above following seven boxes, lndivlduallsoie proprietoror El CUorporalIon single-member LLG other (see Instructions) S- Corporation Lll'hlterd liability company. Enter the tart classi?cation iC-c corporation. 3:5 carporetlcn. PaParinershIp) Note: Check the appropriate box In the line above for the tart classification or the single-member owner. to not check Exemption ircm FATDA reporting LLC if the LLG Is classi?ed as a single-member LLC that Is disregarded from the owner unless the owner or the LLG Ia another do that Is not disregarded trern the ovmer tar as. federal tax purposes. Otherwise. a single-member that i? ll l5 disregarded from the owner should check the appropriate box for the tart classification of its owner. 3 Check appropriate box for federal tax classi?cation of the person whose name Is entered on line 1. Check only one urine 4 Exemptions (codes apply only to certain entities. not Individuals: see installations on page Li}: Partnership l:l Trtistiestate Exempt payee code any} may; in semen-armed metre. me us; 5 Address (number. street. and apt. crsuIta no.) See 60 Union Street #1 Print or type See Specific instructions on page 3. Resonators name and address (optional) City. state. and ZIP code Newark NJ 071 I35 7 List account numberts) here (optic rial] Taxpayer Identi?cation Number (TIN) Enter your In the appropriate boat. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals. this is generally your social security number (SEN). However. for a resident alien. sole proprietor. or disregarded entity. see the instrUctions for Part I, later. For other - - entities. it is your employer identi?cation number If you do not have a number. see How to get a later. Note: If the account is in more than one name, see the for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Social security number I Certi?cation Under penalties of perjury, I certify that: The number shown on this form is my correct taxpayer identi?cation number (or I am waiting for a number to be issued to me]; and 2. i am not subject to backup withholding because: i are exempt from backup withholding. or have not been noti?ed by the Intemal Revenue Service (IRS) that I are subject to backup withholding as a result of a failure to report all interest or dividends. or the IRS has noti?ed me that i am no longer subject to backup withholding: and 3. I am a US. citizen or other LLS. person (de?ned below]; and 4. The FATCA caddie) 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 noti?ed 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 and generally, payments other than Interest and dividendajoufre not required to sign the certi?cation. but you must provide your correct TIN. See the inert-actions for Part II. later. Sign Signature of ha Here U?mersonlr - . NM General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Fom'i W-Q and its instructions. such as legislation enacted after they were published. go to wwarsgoviFon-nwe. Purpose of Form An individual or entity (Form We?! requester) who Is required to ?le an lnforn'iation retum with the must obtain your correct taxpayer identi?cation number (TIN) which may be your social security number (SEN). Individual taxpayer identi?cation number (lTiNi, adoption taxpayer identi?cation number or employer identi?cation number (EIN). to report on an infon'nation return the regiment paid to you. or other amount reportable on an Information realm. Examples of information retume include, but are not limited to. the following. Form (interest oamed or paid) - Form 1DQQ-Eiindividends. including those from stocks or mutual funds] - Form WES-MISC (various types of income. prizes, awards. or gross proceeds] - Form 1099-3 (stock or mutual fund sales and certain other transactions by brokers} Form 1099-5 (proceeds from real estate transactions] - Form mas-K (merchant card and third party network transactions) 0 Form 1093 (home mortgage interest}. 1 use-E (student loan interest). (tuition) I Form 1099?0 (canceled debt) I Form 1099-A (acquisition or abandonment of secured property] Use Form W-9 only if you are a U.S. person (moluding a resident alien), to provide your con'ect TIN. if you do not return Foch W-Q to the requester with a TIN. you might be subject to backup wimholdi'ng. See What Is backup withholding. later. IL. ?La rum. 1 anuanau 10 umswu sinner man 1033mm zawa ?5:3ng souo -, mam; m- 133319 Homn 09 33Nan033 1383mm . . 31'! raww 309.31%; rava-aawaxw It?ll'g?lqt?ago-mac f' ma Od' JG munsva?i :10 ma?lawaa SLVOHILHHO MEN ELVLS . Ftntifat?mm .1 Hid" n' i Certification 5 4 4 2 7 CERTIFICATE OF EMPLOYEE INFORMATION REPORT INITIAL This is to oertify that the contractor Hole: 4 N.J.A.C. et. seq. and the effect for the period of ?tig?i??x au mt?? :99 a . rioyee Information Report pursuant to iz'eil?eaoprgr hmapprove? . =port. This approval will remain in - - 1w 5-. - TOPOLOGY no 59 LINCOLH nan: 44: . NEW Andra P. Sidamon-Erielo? State Treasurer