Contractor Responsibility Certification  Firm Name: National Water Main Cleaning Company Firm Address: 1806 Newark Turnpike Contact Name: Salvatore F. Perri Telephone No.: 973-483-3200 Fax No.: 973-483-5065 Email Address: bidreg@nwmec.com  Kearny, NJ 07032  Project Name: 2019Sanitary Sewer Lining and Spot Repair  Project Number: Contract 19-02  Iattest thatIhave read, and will comply with thel Borough of. Jenkintown's Model Responsible Contractor Ordinance (Ordinance #08301 of2008 as amended by Ordinance #13-10 of2 2013).  Signature: Chut  Date: 07/15/2019  Fh  Salvatore F. Perri President  The submitting firm is required to certify compliance with the contractor responsibility standards set forth below by checking appropriate boxes. Specifically, to perform work for the Borough of. Jenkintown, submitting firms must answer "Yes" to Questions 1,2 and 9,1 10, 11,12,  13 and 14 and answer "No" to Questions 3 through 8.  (1) Does the firm have or will it obtain all valid, effective licenses, registrations or certificates required by federal, state, county, or local law, including, but not limited to, liçenses, registrations or certificates required to: (a) do business in the designated locale; and (b) perform the contract work it seeks to perform. These shall include, but not be limited to, licenses, registrations or certificates for any type oftrade work or specialty work which the firm proposes to self-perform?  Yes No XI  D-3    (2) Does the firm meet thel bonding requirements for the contract, as required by applicable law or contract specifications and any insurance requirements, as required by applicable law or contract specifications, including general liability insurance, workers compensation insurance and unemployment insurance  requirements?  Yes No XI  (3) Has the firm been debarred by any federal, state or local government agency or  authority in the past three (3) years?  Yes No XJ  (4) Has the firm defaulted on any project ini the past three (3)years?  Yes No  (5) Has the firm had any type ofbusiness, contracting or trade license, registration, or other certification suspended or revoked in the past three (3) years?  Yes No XJ  (6) Has the firm been cited for a willful violation of federal or state safety laws as determined by a final decision of a court or government agency in the past three  (3)years?  Yes No X]  (7) Has the firm or its owners been convicted of any crime relating to the contracting business as determined by a final decision ofa court or government agency in the  past ten (10)years?  Yes No [X]  D-4    (8) Has the firm, in the past three (3) years, been found by a final decision of a court or government agency in violation of any law applicable to its contracting business, including, but not limited to, licensing laws, tax laws, prompt payment laws, wage and hour laws, prevailing wage laws, environmental laws or others, where the result ofs such violation was the payment ofa fine, back pay damages or  any other type of penalty in the amount of $1,000.00 or more?  Yes No XJ  (9) Does the firm agree to pay all craft employees that it employs on the project the current wage rates and benefits as required under applicable federal or state wage  laws for the duration oft the referenced project?  Yes No XJ  (10) Does the firm participate in a Class A Apprenticeship Program for each separate trade or classification in which it employs craft employees and agree to continue to participate in such program or programs for the duration of the referençed (A) For purposes of this section, a "Class A Apprenticeship Program" is an apprenticeship program that is currently registered with and approved by the U.S. Department of Labor or a state apprenticeship agency and has graduated apprentices to journeyperson status for at least three (3) of the (B) Ifa firm is identified as the lowest responsible bidder or otherwise selected as the prospective awardee or as a subcontractor of an awardee, it shall provide appropriate documentation, as determined by the Central Purchasing Department, to verify it meets the requirements of this section for each trade or classification of craft workers it will employ on the project. This verification shall be provided prior to performance of work by the firm and the documentation shall clearly indicate which crafts the firm employs and which crafts are covered by the identified apprenticeship programs.  project?  past five (5): years.  Yes No X]  D-5    (11) Does the firm have all other technical qualifications and resources, including equipment, personnel and financial resources, to perform the referenced contract, or agree that it will obtain same through the use of qualified, responsible  subcontractors?  Yes No X]  (12) Does the firm agree to notify the Central Purchasing Department of any material changes to any matters attested to in this certification within seven (7) days?  Yes No XI  (13) Does the firm understand and agree that, ifiti is a general contractor, construction manager or other prime contract and it receives a Notice of Intent to Award Contract, it shall provide the Central Purchasing Department within seven (7) days a Subcontractor List that identifies any subcontractors it: will use in connection with the project and furnish Contractor Responsibility Certifications forall identified subcontractors with all required supporting documentation.  Yes No XI  (14) Does the firm understand and agree that this certification must be completed by an authorized representative of the firm that that sufficient knowledge and  information to address all matter addressed herein.  Yes No XI  D-6    Ine executing this Responsibility Certification, the submitting firm understands and agrees that ift the Central Purchasing Department determines that this certification contains false or misleading material information that was provided knowingly or with reckless disregard for the truth or omits material information knowingly or with reckless disregard oft the truth, the firm may be prohibited from performing work for thel Borough of Jenkintown for aj period ofthree (3) years. Such circumstances shall also subject the firm to any other penalties and sanctions, including contract termination, available to the Borough of Jenkintown under law. A contract terminated under these circumstances shall further entitle the Borough ofJenkintown to withhold  payment of any monies due to the firm as damages. qualifications of the undersigned firm are true and correct.  Icertify that the foregoing representations regarding the past performance and present  Cashe Print and Sign Name Salvatore F. Perri President Title Name of Firm 07/15/2019 Date  National Water Main Cleaning Company  Subscribed and sworn to before me this 15th day of_ July  Notary Public  IRNESA OKANOVIC NOTARY PUBLIC OF NEW JERSEY Comm. # 50043132 My Commission Expires 8/3/2021  2019  My Commission Expires: 08/03/2021  D-7