Contractor Responsibility Certification  Firm Name: CIENERAL AphaTynG Co Ic  Firm Address: 9301 Kreuastoww R.  PcA PA 19H5 Ausnw Apoehan m  Contact Name: Fax No.: Email Address:  Telephone No.: 215 677 2626  25 627 9433  Project Name: 2048 MILEw64w OuerkayPgeer  Project Number: 18-01 Milly PAvif  Iattest thatIhave rea.ardy willoguply yith thel Borough of. Jenkintown's) Model Responsible Contractor 70-m. as amended by Ordinance #13-100f2013).  Signature:  MDater 531-18  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 ofJ Jenkintown, submitting firms must answer "Yes"to Questions 1,2 and 9, 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, licenses, registrations or certificates required to: (a) do business in the designated locale; and (b) perform the contract work it seeks to perform. These shallinclude, but not be limited to, licenses, registrations or certificates forany type oftrade work or specialty work which the firm proposes to self-perform?  Yes No X  D-3    (2) Does the firm meet the 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   (3) Has the firm been debarred by any federal, state or local government agency or  authorityi in the past three (3): years?  Yes No C  (4) Has the firm defaulted on any project in thej past three (3) years?  Yes No Cxi  (5) Has the firm had any type ofb business, contracting or trade license, registration, or other certification suspended or revoked in the past three (3) years?  Yes No X  (6) Has the firm been cited for a willful violation of federal or state safety laws as determined by ai final decision ofac court or government agency in the past three (3)  years?  Yes No N  (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  D-4    (8) Has the firm, in the past three (3) years, been found by a final decision ofa court or govemment agency in violation ofanyl law applicable to its contracting business, including, but notl limited to, licensing laws, tax laws, prompt payment laws, wage and hourlaws, prevailing wage laws, environmental laws or others, where ther result of such violation was thej payment ofai fine, back pay damages or any other type of  penalty in the amount of$1,000.00 or more?  Yes No i  (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 &  (10) Does the firm participate in a Class A Apprenticeship Program for each separate trade or classification in whichi it employs craft employees and agree to continue to participate in such program or programs for the duration of the referenced project? (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 ofLabor or as state apprenticeship agency and has graduated apprentices toj journeyperson status for at least three (3) oft the past five (5) (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 oft this section for each trade or classification of craft workers it will employ on the project. This verifiçation 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.  years.  Yes No a  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 A  (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   (13) Does the firm understand and agree that, ifit 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 as Subcontractor List thati identifies any subcontractors it will usei inc connection with the project and furnish Contractor Responsibility Certifications for all identified  subcontractors with all required supporting documentation.  Yes No X  (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 8 D  D-6    Ine executing this Responsibility Certification, the submitting firm understands and agrees thati 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 a period oft three (3) years. Such circumstances shall also subject the firm to any other penalties and sanctions, including contract termination, available tot the Borough of Jenkintown under law. A contract terminated under these circumstances shall further entitle the Borough of Jenkintown to withhold Icertify that the foregoing representations regarding the past performance andj present  payment ofany monies due to the firm as damages. qualifications oft the undersigned firm are true and correct.  Name, L AUStIPA Meehan II President  Title Name of Firm Date  Generat Asphalt Paving Cc 9301 Krewstown Road Phia.,PA_19115 3-3/-18  Subscribed and sworno beforeme,his 3/ay 326  MGMAMOTCMTVAA FRANCIS) X. NOTARIAL DEVLIN, SEAL Cityo of Philadelphia, Notaryp Phila. County Public My Commission Expires March 28, 2021  of_ Notàry  2018  My Commission Epinsbbopaoal  D-7