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Hoboken Public Library
Restoration and Rehabilitation of the 1st and 2nd Floor
Hoboken, New Jersey
Prequalification Regulations
September 22, 2025
Department of Community Affairs Division of Local Government Services
Email: lpcl@dca.nj.gov
Telephone: (609)292-6110
TABLE OF CONTENTS
Cover
Table of Contents: TOC
Project Fact Sheet: I-1 to I-3
Statement of General Notice: N-1 to N-2
Questionnaire: QS-1 to QS-5*
Certification: C-1*
Forms: F1 to F-8*
*These pages are to be completed in full and submitted.
PROJECT FACT SHEET
Complete Name of Project: Hoboken Public Library – Restoration and Rehabilitation of the 1st and 2nd Floor
Location: 500 Park Ave, Hoboken, NJ 07030
Owner: City of Hoboken
Owner’s Project Manager: Jennie Pu; Director of Hoboken Public Library
Phone: 201-420-2346
Email Address: pu@hobokenlibrary.org
Architect: Clarke Caton Hintz, P.C.
Architect Project Manager: Evan Wolff
Phone: 609-883-8383
Email Address: ewolff@cchnj.com
Project Funding: Hoboken Public Library’s Board of Trustees Preserve New Jersey Historic Preservation Fund
Background Information:
The original brick, masonry and terra cotta building is three-stories with a full basement that is partially above grade. Rectangular in plan with an extension at the rear, the building was designed with two main entries: One for the Library off of Fifth Street; and the other for the former technical school off of Park Avenue. Capped with a copper cornice and marked by a prominent cupola at the corner, the building is an elaborate and impressive landmark in the City. The exterior of the building was designed in a modified Italian Renaissance Revival style, reflecting one of the styles typical of the late Victorian period. The primary façade facing Fifth Street and the Park is organized with three double bays in an inflected symmetrical manner. The main entrance to the library is at the center, reached by a flight of masonry steps and capped with an elaborate pediment, and is flanked symmetrically by similar bays of paired windows. However, the right bay projects and has additional elaboration to emphasize the corner. This spot is further emphasized by the octagonal dome and flagpole rising above the library building and its neighbors. Similarly, the Park Avenue façade is also symmetrical, with an inflection at the Fifth Street corner, as well at the right hand side accommodating the former entrance to the manual training school. As described in the National Register Nomination, “The building rests on a rusticated base constructed of Wyoming bluestone, a course of Indiana limestone with rock-faced center panels and patent-hammered borders extending from grade level to just below the first floor window sills…The second and third floor are finished with pressed yellow (buff) iron-flecked brick with tight joints…At the second floor, three pairs of … arched windows face Fifth Street…”
The interior of the building is graced with two grand, decorative stairs, one at the main entry, and one at the former entry to the Manual Training School. The main stair has decorative iron railings and balusters, with terrazzo treads, while the second stair is wood, with turned balusters. The entry vestibule and main lobby have decorative terrazzo floors and raised panel wainscoting. The coffered ceilings have painted inset panels. Throughout the building, the more prominent and public spaces are characterized by a high level of decorative finishes, including wood floors and wainscoting; wood shelving; pressed tin or decorative plaster ceilings, etc. Several rooms have impressive fireplaces. The tall ceilings and large windows add to the impressive and airy feel of the building. The more utilitarian spaces have plain plaster walls and ceilings, but all of the doors and windows have large wood moldings. While new dropped ceilings, overpainting, layers of flooring and intrusive HVAC equipment and ductwork mar some of the spaces, much of the original fabric is still present and can be restored.
Project Objective:
Following extensive exterior restoration work in 2016 the Library focused on the interior restoration and repairs. The project is conceived to respond to the recommendations of the report “A Capital Master Plan for the Hoboken Public Library,” prepared by Clarke Caton Hintz Architects, dated October 11, 2017, and revised November 20, 2019. The report identified the key historic elements to be preserved and suggested improvements to be made for the continued use and future expansion of the Hoboken Public Library. Using this information as a guide, construction documents have been prepared that addresses the necessary restoration efforts required to preserve the building, and necessary building systems upgrades permitting continued use.
Interior restoration of the Library has been phased. The first phase, which has already been completed, included the restoration of the third floor finishes and building wide HVAC upgrades. In this phase, work on the first floor and second floor will be done in stages. During stage one, the entirety of the first floor and the mezzanine will be closed and the second floor will remain open. Both floors will be restored to their original finish conditions and new millwork enclosures/bookshelves will be added to conceal the mechanical upgrades of the first phase. The mezzanine will be modified to accept a new accessible lift from the first floor. Additionally, an opening will be re-introduced to the mezzanine between the existing columns. Lastly, the entire Park Avenue Stair will be renovated in this phase. Upon completion of the first stage, the work areas will switch and the majority of the second floor will be closed. The second floor will be restored to its original finish condition and new millwork enclosures/bookshelves will be added to conceal the mechanical upgrades of the first phase.
All work done on this project must conform to the Secretary of the Interior’s Standards for the Treatment of Historic Properties (issued 1995, revised 2017).
Scope of Work:
This project includes rehabilitation of the interior of the first floor, mezzanine, and second floor of the Hoboken Public Library. The interior work shall include restoration of pressed metal ceiling, installation of historically appropriate LED light fixtures, and repair of the interior finishes. New millwork will be installed throughout to enclose the HVAC units installed previously. A new ADA compliant lift will be introduced that serves the first floor and mezzanine. There will be limited modifications to the plumbing and fire alarm systems.
Various upgrades and maintenance will be performed according to the NJ Uniform Construction Code: NJ Rehabilitation Subcode; International Building Code 2021- NJ Edition; International Fire Code 2021; National Electric Code 2020/NFPA 70 – NJ Edition; International Mechanical Code 2021 – NJ Edition; National Standard Plumbing Code 2021 – NJ Edition; NJ Barrier Free Subcode.
The following is a brief description of the key elements included in the scope of work.
- Project Supervision and Administration of Historic Preservation Projects:
- Provide supervision, administration, mockups, protection, and treatment procedures in accordance with the construction documents.
- Selective Demolition:
- Interior: Remove existing electrical and lighting equipment as indicated on the construction documents. Remove flooring and/or provide new openings as required for new mechanical, electrical, and plumbing systems. During demolition of the existing flooring, asbestos containing floor tile is to be removed. Demolish portions of the existing plaster walls and ceilings as required for new mechanical, electrical, and plumbing systems. Perform all demolition as indicated on the construction documents.
- Paint Restoration for a Historic Building:
- All restoration of historic paint must be provided in accordance with the construction documents and historic finishes analysis.
- Gypsum Plaster Restoration:
- All restoration of gypsum plaster must be provided in accordance with the construction documents. Patching and repairing of the existing plaster will be required for the installation of new lighting installation and other instances of demolition.
- Historic Pressed Metal Restoration:
- Existing pressed metal ceiling, cornice, and frieze tiles will be removed and salvaged for the creation of new molds and tiles. New replica tiles will be provided to match existing. The replacement of metal tiles must be provided in accordance with the construction documents. Removal and replacement of the existing tiles will be required for the installation of new electrical systems.
- Door Hardware:
- New hardware shall be provided at new and existing doors in accordance with the contract documents. Modification of the existing doors will be required for the installation of new hardware
- Electrical Installation in a Historic Building:
- New lighting, electrical devices, and lift components will be installed throughout the first floor, mezzanine, and second floor as indicated in the construction documents. The contractor is responsible for trenching and patching all walls and ceilings as required for new electrical equipment.
- Mechanical Upgrades in a Historic Building:
- Mechanical scope was completed during the first phase of the project. New millwork enclosures will be installed to conceal the VRF units. The contractor is responsible for patching all wall finishes as required.
- Plumbing Fixture Installation in a Historic Building:
- Plumbing scope was completed during the first phase of the project. Limited modifications may be required as directed in accordance with the construction documents.
- Fire Alarm Installation in a Historic Building:
- Fire alarm scope was completed during the first phase of the project. Limited modifications may be required as directed in accordance with the construction documents.
STATEMENT OF GENERAL NOTICE
The Restoration and Rehabilitation of the Hoboken Public Library is located at 500 Park Ave., Hoboken, New Jersey 07030. The property is listed on the New Jersey and National Registers of Historic Places. All work done on this project must conform to the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017) and is subject to review by the State Historic Preservation Office, or the New Jersey Historic Trust, or the historic review body of the municipal authority. The scope of work consists of a single contract for: General conditions; acquisition of all required permits; provision of temporary facilities and controls; selective demolition, and all restoration and renovation activities according to the Project Manual, plans and specifications.
The goals of this project include restoring the first floor, mezzanine, and second floor to their original finish conditions. Interior restoration and renovation work includes new millwork enclosures/bookshelves to conceal the mechanical upgrades of the first phase. The mezzanine will be modified to accept a new accessible lift from the first floor. Additionally, an opening will be re-introduced to the mezzanine between the existing columns. Lastly, the entire Park Avenue Stair will be renovated.
All work done on this project must conform to the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017).
Scope of Work:
The following is a brief description of the key elements included in the scope of work.
- Project Supervision and Administration of Historic Preservation Projects:
- Provide supervision, administration, mockups, protection, and treatment procedures in accordance with the construction documents.
- Selective Demolition:
- Interior: Remove existing electrical and lighting equipment as indicated on the construction documents. Remove flooring and/or provide new openings as required for new mechanical, electrical, and plumbing systems. Demolish portions of the existing plaster walls and ceilings as required for new mechanical, electrical, and plumbing systems. Perform all demolition as indicated on the construction documents.
- Paint Restoration for a Historic Building:
- All restoration of historic paint must be provided in accordance with the construction documents and historic finishes analysis.
- Gypsum Plaster Restoration:
- All restoration of gypsum plaster must be provided in accordance with the construction documents. Patching and repairing of the existing plaster will be required for the installation of new lighting installation and other instances of demolition.
- Historic Pressed Metal Restoration:
- Existing pressed metal ceiling, cornice, and frieze tiles will be removed and salvaged for the creation of new molds and tiles. New replica tiles will be provided to match existing. The replacement of metal tiles must be provided in accordance with the construction documents. Removal and replacement of the existing tiles will be required for the installation of new electrical systems.
- Door Hardware:
- New hardware shall be provided at new and existing doors in accordance with the contract d Modification of the existing doors will be required for the installation of new hardware
- Electrical Installation in a Historic Building:
- New lighting, electrical devices, and lift components will be installed throughout the first floor, mezzanine, and second floor as indicated in the construction documents. The contractor is responsible for trenching and patching all walls and ceilings as required for new electrical equipment.
- Mechanical Upgrades in a Historic Building:
- Mechanical scope was completed during the first phase of the project. New millwork enclosures will be installed to conceal the VRF units. The contractor is responsible for patching all wall finishes as required.
- Plumbing Fixture Installation in a Historic Building:
- Plumbing scope was completed during the first phase of the project.
- Fire Alarm Installation in a Historic Building:
- Fire alarm scope was completed during the first phase of the project.
The architect is Clarke Caton Hintz, P.C; 100 Barrack Street, Trenton, NJ 08608; 609.883.8383; Project manager Evan Wolff; ewolff@cchnj.com.
The owner’s project contact is Jennie Pu; Director of Hoboken Public Library, City of Hoboken, 500 Park Ave, Hoboken, NJ 07030; 201-420-2346; pu@hobokenlibrary.org
Prospective Bidder forms and a Project Fact Sheet describing the project and scope of work are included. Bidder’s prequalification packages are available for download at the following link: https://clarkecatonhintz.sharefile.com/d-sec6bcef8e17849848c4bc7fefb98f9ef. A set of plans and specifications will be available for inspection by appointment beginning on 9/22/25 at the office of Clarke Caton Hintz located at 100 Barrack Street, Trenton, NJ, 08608, please contact Evan Wolff. All prospective bidders are encouraged but not required to visit the project site.
The funding stipulations for the New Jersey Historic Trust require that prospective bidders must submit a completed Qualifications Statement as set forth herein. A complete Qualifications Statement must be submitted in triplicate (3 hardcopies) to the Hoboken Public Library Board of Trustees, 500 Park Ave, Hoboken, NJ, 07030 by 11:00 am prevailing time on Thursday, October 9th, 2025.Failure to complete the bidder’s Qualifications Statement could result in disqualification of the prospective bidder.
The qualifications of prospective bidders will be evaluated by representatives of the Hoboken Public Library Board of Trustees and the project architects in accordance with the Evaluation Criteria set forth herein. Prospective bidders whose bidder’s Qualifications Statements are determined to be acceptable will be identified as Qualified Bidders.
The Hoboken Public Library will notify in writing the Prospective Bidders who have been determined to be Qualified Bidders, as well as those Prospective Bidders who are deemed ineligible to receive plans and specifications. The Hoboken Public Library governing body will issue bid proposal forms, plans and specifications only to Qualified Bidders. Only bids received from Qualified Bidders will be opened.
The successful Prequalified Bidders must submit with the bid the name or names of all subcontractors to whom the bidder will subcontract and evidence of performance surety for themselves as well as all subcontractors.
STATEMENT OF BIDDER’S QUALIFICATIONS/CRITERIA FOR EVALUATING PROSPECTIVE BIDDERS
The following six (6) criteria will be used for evaluating the qualifications of prospective bidders. The evaluation will be based on information in the Statement of Qualifications provided by prospective bidders as well as information supplied by the bidders’ references.
(1) The prospective bidder, acting as general contractor, will be required to demonstrate verifiable, successful experience in Project Supervision and Administration of Historic Preservation Projects. This experience shall include at least two (2) projects involving separate historic buildings or sites of similar activities, project scale and scope of work as the subject project, completed in compliance with the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017) within the past five (5) years preceding the date of the execution of this Qualifications Statement. At least one of the projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
(2)The prospective bidder’s proposed project superintendent/manager will be required to demonstrate verifiable, successful experience in Project Supervision and Administration of Historic Preservation Projects. This experience shall include at least two (2) projects involving separate historic buildings or sites of similar activities, project scale and scope of work as the subject project, completed in compliance with the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017) within the past five (5) years preceding the date of the execution of this Qualifications Statement. At least one of the projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
(3)The prospective bidder must not have wrongfully defaulted on a contract or had work terminated for non-performance within the past (5) years.
(4)The prospective bidder must not have been denied a consent of surety, a bid bond, or a performance bond within the past twelve (12) months, based on the bidder’s inability to meet a surety’s reasonable underwriting standards.
(5) The prospective bidder must provide the name and title of all principal members of prospective bidder’s staff, and indicate the availability of each of those principal members for this particular project.
(6) On all projects currently underway, the prospective bidder must demonstrate the following:
a. Adherence to the project completion schedule mutually agreed upon between the contractor and the client. Deviation from the schedule must be due to factors outside of the contractor’s control.
b. Lack of workmanship defects resulting from a failure to build a structure or component part of a structure pursuant to architectural and engineering plans and specifications.
c. Timely submittal of shop drawings, product literature, samples, mock-ups, requests for information and applications for payment.
Bidder’s Questionnaire
This form shall be completed and submitted by prospective bidders who wish to be considered for this work. Failure to complete the Prospective Bidder’s Qualifications Statement shall result in the disqualification of the prospective Bidder. It is important that ALL information be provided, and ALL items addressed for each submission. Submissions must be on this form or a high-quality photocopy of this form and must be typed. Failure to submit ALL the information required shall result in rejection of the contractor’s qualifications package. Where the length of a response exceeds the space provided in the Qualifications Statement, the response must be completed on an additional sheet of paper. All responses must be clearly labeled to identify the corresponding question.
- Name and Address of Firm:___________________________________________ __________________________________________________________________
- Under what other name(s) has your business operated?______________________ __________________________________________________________________
- Business form (corporation, partnership, LLC, etc.)________________________
o Date of formation:____________________________________________
o Principal location:____________________________________________
o Names and Titles of corporate officers, LLC members, or partners and their number of years with the business:__________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________
- Has your firm or any predecessor firm defaulted on a contract or had work terminated for non-performance within the last five (5) years? If so, on a separate sheet describe the project, owner, date, and circumstances/reasons.
No: Yes (Use separate sheet):
- Has your firm or any predecessor firm been denied a consent of surety, a bid bond, or a performance bond within the past twelve (12) months? If so, on a separate sheet describe the circumstances/reasons.
No: Yes (Use separate sheet):
- General Contractor:
Provide evidence of successful experience on at least two (2) projects involving separate historic buildings or sites of similar activities and scope of work as the subject project. Each project must demonstrate similar work to the description identified in the general notice. Projects must have been completed in compliance with the Secretary of the Interior’s Standard for the Treatment of Historic Properties (1995/2011) within the past five (5) years preceding the date of the execution of the Bidder’s Questionnaire. At least one of these projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
Project #1
Project Name: ________________________________________________________ Location:______________________________________________________________
Construction Cost:_______________________________________________________ Completion Date:________________________________________________________ Approximate Construction Date of the Historic Building or Site:___________________ Project Superintendent/Manager:____________________________________________ Scope of Work and Nature of Project:________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Mark with an X whether the following was completed or included in the scope of work on the project referenced.
Project Supervision and Administration of Historic Preservation Projects
Selective Demolition
Paint Restoration for a Historic Site
Gypsum Plaster Restoration
Historic Pressed Metal Restoration
Door Hardware
Electrical Installation in a Historic Building
Mechanical Upgrades in a Historic Building
Plumbing Fixture in a Historic Building
Fire Alarm Installation in a Historic Building
Owner:________________________________________________________________ Owner’s Contact Person:__________________________________________________ Phone:__________________________________Fax:___________________________ Email Address: _________________________________________________________ Architect:______________________________________________________________ Architect’s Contact Person:________________________________________________ Phone:__________________________________Fax:___________________________ Email Address: __________________________________________________________ Historical Review Agency:_________________________________________________
Project #2
Project Name:____________________________________________________________ Location:________________________________________________________________ Construction Cost:________________________________________________________ Completion Date:_________________________________________________________ Approximate Construction Date of the Historic Building or Site:____________________ Project Superintendent/Manager:_____________________________________________ Scope of Work and Nature of Project:_________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
Mark with an X whether the following was completed or included in the scope of work on the project referenced.
Project Supervision and Administration of Historic Preservation Projects
Selective Demolition
Paint Restoration for a Historic Site
Gypsum Plaster Restoration
Historic Pressed Metal Restoration
Door Hardware
Electrical Installation in a Historic Building
Mechanical Upgrades in a Historic Building
Plumbing Fixture in a Historic Building
Fire Alarm Installation in a Historic Building
Owner:__________________________________________________________________ Owner’s Contact Person:___________________________________________________ Phone:_________________________________Fax:_____________________________ Email Address: ___________________________________________________________ Architect:________________________________________________________________ Architect’s Contact Person:_________________________________________________ Phone:_________________________________Fax:_____________________________ Email Address: ___________________________________________________________ Historical Review Agency:__________________________________________________
- Proposed Project Superintendent/Manager:
Provide evidence of successful experience on at least two (2) projects involving separate historic buildings or sites of similar activities and scope of work as the subject project, completed in compliance with the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995/2011) within the past five (5) years preceding the date of the execution of the Bidder’s Questionnaire. At least one of these projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
Name and Address of Project Superintendent/Manager:_____________________ __________________________________________________________________
Project #1
Project Name:______________________________________________________ Location:__________________________________________________________ Construction Cost:__________________________________________________ Completion Date:___________________________________________________ Approximate Construction Date of the Historic Building or Site:______________ Scope of Work and Nature of Project:___________________________________ __________________________________________________________________ __________________________________________________________________ Owner:____________________________________________________________ Owner’s Contact Person:_____________________________________________ Phone:______________________________Fax:__________________________ Email Address: ____________________________________________________ Architect:__________________________________________________________ Architect’s Contact Person:___________________________________________ Email Address: _____________________________________________________ Phone:______________________________Fax:__________________________ Historical Review Agency:____________________________________________
Project #2
Project Name:______________________________________________________ Location:__________________________________________________________ Construction Cost:__________________________________________________ Completion Date:___________________________________________________ Approximate Construction Date of the Historic Building or Site:______________ Scope of Work and Nature of Project:___________________________________ __________________________________________________________________ __________________________________________________________________
Owner:____________________________________________________________ Owner’s Contact Person:_____________________________________________ Phone:______________________________Fax:__________________________ Email Address:_____________________________________________________ Architect:_________________________________________________________ Architect’s Contact Person:___________________________________________ Phone:______________________________Fax:__________________________ Email Address: _____________________________________________________ Historical Review Agency:____________________________________________
- Provide a list of the names, titles, and years of experience of all principal members of the prospective bidder’s staff who will be available and assigned to this particular project.
- ____________________________________________________ 2. ____________________________________________________ 3. ____________________________________________________ 4. ____________________________________________________ 5. ____________________________________________________ 6. ____________________________________________________
- General Contractor:
PROVIDE THE FOLLOWING INFORMATION ON ALL CURRENT PROJECTS IN PROGRESS: (If necessary, include additional sheets.)
Project Name:______________________________________________________ Location:__________________________________________________________ Owner:______________________________Phone:________________________ Architect:____________________________Phone:________________________ Contract Amount:___________________________________________________ Scheduled Completion Date:__________________________________________ Architect’s Contact Person:___________________________________________ Phone/Email:_______________________________________________________
Project Name:______________________________________________________ Location:__________________________________________________________ Owner:______________________________Phone:________________________ Architect:____________________________Phone:________________________ Contract Amount:___________________________________________________ Scheduled Completion Date:__________________________________________ Architect’s Contact Person:___________________________________________ Phone/Email:_______________________________________________________
Project Name:______________________________________________________ Location:__________________________________________________________ Owner:______________________________Phone:________________________ Architect:____________________________Phone:________________________ Contract Amount:___________________________________________________ Scheduled Completion Date:__________________________________________ Architect’s Contact Person:___________________________________________ Phone/Email:_______________________________________________________
CERTIFICATION
I (We) the undersigned certify the truth and correctness of all statements and answers contained herein.
DATE:__________________________________________________________________
NAME OF POTENTIAL BIDDER:___________________________________________
ADDRESS OF BIDDER:___________________________________________________
TELEPHONE AND FAX:__________________________________________________
EMAIL ADDRESS:_______________________________________________________
BY (sign name and title):___________________________________________________
(Print/type name and title):__________________________________________________
WITNESSED: (If a Corporation, by the secretary of the corporation)
BY (sign name, no stamps):_________________________________________________
(Print/type name and title):__________________________________________________
Subscribed and sworn to before me
this ______day of __________________, 2025
Notary Public of the State
of______________________
My commission expires
________________________________________ ________________________ (Seal)
Submission of pre-qualifications are due on the date and time as identified in the general notice.
Submissions are to be mailed or delivered in sealed envelopes to the attention of:
The Hoboken Public Library 500 Park Ave Hoboken, NJ 07030
ATTN:
“Hoboken Public Library – Restoration and Rehabilitation of the 1st and 2nd Floor”
(Faxes will NOT be accepted)
STATEMENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.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:_____________________________________________________________
Organization Address:_________________________________________________________________
Part I Check the box that represents the type of business organization:
[ ] Sole Proprietorship (skip Parts II and III, execute certification in Part IV)
[ ] Non-Profit Corporation (skip Parts II and III, execute certification in Part IV)
[ ] For-Profit Corporation (any type)
[ ] Limited Liability Company (LLC)
[ ] Partnership
[ ] Limited Partnership
[ ] Limited Liability Partnership (LLP)
[ ] Other (be specific): ______________________________________________
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 BELOW 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)
(Please attach additional sheets if more space is needed):
Name of Individual or Business Entity Home Address (for Individuals) or Business Address
Part III DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS OR 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 beneficial 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 filing(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 beneficial 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 (URL) containing the last annual SEC (or foreign Page #’s equivalent) filing
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. 52:25-24.2 has been listed. Attach additional sheets if more space is needed.
Stockholder/Partner/Member and Corresponding Entity Listed in Part II
Home Address (for Individuals) or Business Address
Part IV Certification
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 certification on behalf of the bidder/proposer; that the City of Hoboken is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the completion of any contracts with the City of Hoboken to notify the City of Hoboken 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the, permitting the City of Hoboken to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
NON-COLLUSION AFFIDAVIT
State of New Jersey
City of Hoboken ss:
I, _____________________ residing in ________________________ in the County of ____________________ and State of ____________________ of full age, being duly sworn according to law on my oath depose and say that:
I am ________________ of the firm of __________________, the Respondent making this proposal for the request for qualifications of professional services entitled Request for Proposals – Prequalification of General Contractors for the Restoration and Rehabilitation of the Hoboken Public Library, and that I executed the said proposal with full authority to do so, that said Respondent has not, directly or indirectly, entered into an agreement, participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named qualification, and that all statements contained in the Respondent’s proposal and in this affidavit are true and correct, and made with full knowledge that the Owner relied upon the truth of the statements contained in said request for qualifications and in this affidavit in qualifying the Respondent to provide services to the Owner.
Name of Respondent (Please Print):
Signature of Authorized Representative:
Name (Please Print):
Title (Please Print): Date:
Subscribed and sworn to before me on this _____ day of ______________, _____.
___________________________________ Signature of Notary Public
CERTIFICATION OF NON-DEBARMENT FOR FEDERAL GOVERNMENT CONTRACTS N.J.S.A. 52:32-44.1 (P.L. 2019, c.406)
This certification shall be completed, certified to, and submitted to the contracting unit prior to contract award, except for emergency contracts where submission is required prior to payment.
PART I: VENDOR INFORMATION Individual or Organization
Name
Address of Individual or Organization
DUNS Code (if applicable)
CAGE Code (if applicable)
Check the box that represents the type of business organization:
[ ] Sole Proprietorship (skip Parts III and IV)
[ ] Non-Profit Corporation (skip Parts III and IV)
[ ] For-Profit Corporation (any type)
[ ] Limited Liability Company (LLC)
[ ] Partnership
[ ] Limited Partnership
[ ] Limited Liability Partnership (LLP)
[ ] Other (be specific): ______________________________________________
PART II – CERTIFICATION OF NON-DEBARMENT: Individual or Organization
I hereby certify that the individual or organization listed above in Part I is not debarred by the federal government from contracting with a federal agency. I further acknowledge: that I am authorized to execute this certification on behalf of the above-named organization; that the Owner is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the date of contract award by the Owner to notify the Owner 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Owner, permitting the Owner to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
PART III – CERTIFICATION OF NON-DEBARMENT: Individual or Entity Owning Greater than 50 Percent of Organization
Section A (Check the Box that applies)
[ ] Below is the name and address of the stockholder in the corporation who owns more than 50 percent of its voting stock, or of the partner in the partnership who owns more than 50 percent interest therein, or of the member of the limited liability company owning more than 50 percent interest therein, as the case may be.
Name of Individual or Organization
Home Address (for Individual) or Business Address
OR
[ ] No one stockholder in the corporation owns more than 50 percent of its voting stock, or no partner in the partnership owns more than 50 percent interest therein, or no member in the limited liability company owns more than 50 percent interest therein, as the case may be.
Section B (Skip if no Business entity is listed in Section A above)
[ ] Stockholder/Partner/Member Owning Greater Than 50 Percent of Parent Entity
Home Address (for Individual) or Business Address
[ ] Below is the name and address of the stockholder in the corporation who owns more than 50 percent of the voting stock of the organization’s parent entity, or of the partner in the partnership who owns more than 50 percent interest in the organization’s parent entity, or of the member of the limited liability company owning more than 50 percent interest in organization’s parent entity, as the case may be.
OR
No one stockholder in the parent entity corporation owns more than 50 percent of its voting stock, no partner in the parent entity partnership owns more than 50 percent interest therein, or no member in the parent entity limited liability company owns more than 50 percent interest therein, as the case may be.
Section C – Part III Certification
I hereby certify that no individual or organization that is debarred by the federal government from contracting with a federal agency owns greater than 50 percent of the Organization listed above in Part I or, if applicable, owns greater than 50 percent of a parent entity of <name of organization>. I further acknowledge: that I am authorized to execute this certification on behalf of the above-named organization; that the Owner is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the date of contract award by the Owner to notify the Owner 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Owner, permitting the Owner to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
Part IV – CERTIFICATION OF NON-DEBARMENT: Contractor – Controlled Entities
Section A
Below is the name and address of the corporation(s) in which the Organization listed
in Part I owns more than 50 percent of voting stock, or of the partnership(s) in which
[ ] the Organization listed in Part I owns more than 50 percent interest therein, or of the limited liability company or companies in which the Organization listed above in Part I owns more than 50 percent interest therein, as the case may be.
Name of Business Entity Business Address
**Add additional sheets if necessary**
OR
[ ] The Organization listed above in Part I does not own greater than 50 percent of the p voting stock in any corporation and does not own greater than 50 percent interest in any partnership or any limited liability company.
Section B (skip if no business entities are listed in Section A of Part IV)
[ ] Below are the names and addresses of any entities in which an entity listed in Part III A owns greater than 50 percent of the voting stock (corporation) or owns greater than 50 percent interest (partnership or limited liability company).
Name of Business Entity Controlled by Entity Business Address Listed in Section A of Part IV
**Add additional Sheets if necessary**
OR
[ ] No entity listed in Part III A owns greater than 50 percent of the voting stock in any p corporation or owns greater than 50 percent interest in any partnership or limited liability company.
Section C – Part IV Certification
I hereby certify that the Organization listed above in Part I does not own greater than 50 percent of any entity that that is debarred by the federal government from contracting with a federal agency and, if applicable, does not own greater than 50 percent of any entity that in turns owns greater than 50 percent of any entity debarred by the federal government from contracting with a federal agency. I further acknowledge: that I am authorized to execute this certification on behalf of the above-named organization; that the Owner is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the date of contract award by the Owner to notify the Owner 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Owner, permitting the Owner to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN FORM
BID SOLICITATION # AND TITLE:
VENDOR/BIDDER NAME:
Pursuant to N.J.S.A. 52:32-57, et seq. (P.L. 2012, c.25 and P.L. 2021, c.4) any person or entity that submits a bid or proposal or otherwise proposes to enter into or renew a contract must certify that neither the person nor entity, nor any of its parents, subsidiaries, or affiliates, is identified on the New Jersey Department of the Treasury’s Chapter 25 List as a person or entity engaged in investment activities in Iran. The Chapter 25 list is found on the Division’s website at https://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf Vendors/Bidders must review this list prior to completing the below certification. If the Director of the Division of Purchase and Property finds a person or entity to be in violation of the law, s/he shall take action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.
CHECK THE APPROPRIATE BOX
[ ] I certify, pursuant to N.J.S.A. 52:32-57, et seq. (P.L. 2012, c.25 and P.L. 2021, c.4), that neither the Vendor/Bidder listed above nor any of its parents, subsidiaries, or affiliates is listed on the New Jersey Department of the Treasury’s Chapter 25 List of entities determined to be engaged in prohibited activities in Iran.
OR
[ ] I am unable to certify as above because the Vendor/Bidder and/or one or more of its parents, subsidiaries, or affiliates is listed on the New Jersey Department of the Treasury’s Chapter 25 List. I will provide a detailed, accurate and precise description of the activities of the Vendor/Bidder, or one of its parents, subsidiaries or affiliates, has engaged in regarding investment activities in Iran by completing the information requested below.
Entity Engaged in Investment Activities Relationship to Vendor/Bidder Description of Activities
Duration of Engagement Anticipated Cessation Date
Attach Additional Sheets if Necessary
____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________
CERTIFICATION
I, the undersigned, certify that I am authorized to execute this certification on behalf of the Vendor, that the foregoing information and any attachments hereto, to the best of my knowledge are true and complete. I acknowledge that the State of New Jersey is relying on the information contained herein, and that the Vendor is under a continuing obligation from the date of this certification through the completion of any contract(s) with the State to notify the State 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 certification. If I do so, I may be subject to criminal prosecution under the law, and it will constitute a material breach of my contract(s) with the State, permitting the State to declare any contract(s) resulting from this certification void and unenforceable.
Signature Date
Print Name and Title
Hoboken Public Library Restoration and Rehabilitation of the 1st and 2nd Floor
Hoboken, New Jersey
Prequalification Regulations
September 22, 2025
Department of Community Affairs Division of Local Government Services
Email: lpcl@dca.nj.gov
Telephone: (609)292-6110
TABLE OF CONTENTS
Cover
Table of Contents: TOC
Project Fact Sheet: I-1 to I-3
Statement of General Notice: N-1 to N-2
Questionnaire: QS-1 to QS-5*
Certification: C-1*
Forms: F1 to F-8*
*These pages are to be completed in full and submitted.
PROJECT FACT SHEET
Complete Name of Project: Hoboken Public Library – Restoration and Rehabilitation of the 1st and 2nd Floor
Location: 500 Park Ave, Hoboken, NJ 07030
Owner: City of Hoboken
Owner’s Project Manager: Jennie Pu; Director of Hoboken Public Library
Phone: 201-420-2346
Email Address: pu@hobokenlibrary.org
Architect: Clarke Caton Hintz, P.C.
Architect Project Manager: Evan Wolff
Phone: 609-883-8383
Email Address: ewolff@cchnj.com
Project Funding: Hoboken Public Library’s Board of Trustees Preserve New Jersey Historic Preservation Fund
Background Information:
The original brick, masonry and terra cotta building is three-stories with a full basement that is partially above grade. Rectangular in plan with an extension at the rear, the building was designed with two main entries: One for the Library off of Fifth Street; and the other for the former technical school off of Park Avenue. Capped with a copper cornice and marked by a prominent cupola at the corner, the building is an elaborate and impressive landmark in the City. The exterior of the building was designed in a modified Italian Renaissance Revival style, reflecting one of the styles typical of the late Victorian period. The primary façade facing Fifth Street and the Park is organized with three double bays in an inflected symmetrical manner. The main entrance to the library is at the center, reached by a flight of masonry steps and capped with an elaborate pediment, and is flanked symmetrically by similar bays of paired windows. However, the right bay projects and has additional elaboration to emphasize the corner. This spot is further emphasized by the octagonal dome and flagpole rising above the library building and its neighbors. Similarly, the Park Avenue façade is also symmetrical, with an inflection at the Fifth Street corner, as well at the right hand side accommodating the former entrance to the manual training school. As described in the National Register Nomination, “The building rests on a rusticated base constructed of Wyoming bluestone, a course of Indiana limestone with rock-faced center panels and patent-hammered borders extending from grade level to just below the first floor window sills…The second and third floor are finished with pressed yellow (buff) iron-flecked brick with tight joints…At the second floor, three pairs of … arched windows face Fifth Street…”
The interior of the building is graced with two grand, decorative stairs, one at the main entry, and one at the former entry to the Manual Training School. The main stair has decorative iron railings and balusters, with terrazzo treads, while the second stair is wood, with turned balusters. The entry vestibule and main lobby have decorative terrazzo floors and raised panel wainscoting. The coffered ceilings have painted inset panels. Throughout the building, the more prominent and public spaces are characterized by a high level of decorative finishes, including wood floors and wainscoting; wood shelving; pressed tin or decorative plaster ceilings, etc. Several rooms have impressive fireplaces. The tall ceilings and large windows add to the impressive and airy feel of the building. The more utilitarian spaces have plain plaster walls and ceilings, but all of the doors and windows have large wood moldings. While new dropped ceilings, overpainting, layers of flooring and intrusive HVAC equipment and ductwork mar some of the spaces, much of the original fabric is still present and can be restored.
Project Objective:
Following extensive exterior restoration work in 2016 the Library focused on the interior restoration and repairs. The project is conceived to respond to the recommendations of the report “A Capital Master Plan for the Hoboken Public Library,” prepared by Clarke Caton Hintz Architects, dated October 11, 2017, and revised November 20, 2019. The report identified the key historic elements to be preserved and suggested improvements to be made for the continued use and future expansion of the Hoboken Public Library. Using this information as a guide, construction documents have been prepared that addresses the necessary restoration efforts required to preserve the building, and necessary building systems upgrades permitting continued use.
Interior restoration of the Library has been phased. The first phase, which has already been completed, included the restoration of the third floor finishes and building wide HVAC upgrades. In this phase, work on the first floor and second floor will be done in stages. During stage one, the entirety of the first floor and the mezzanine will be closed and the second floor will remain open. Both floors will be restored to their original finish conditions and new millwork enclosures/bookshelves will be added to conceal the mechanical upgrades of the first phase. The mezzanine will be modified to accept a new accessible lift from the first floor. Additionally, an opening will be re-introduced to the mezzanine between the existing columns. Lastly, the entire Park Avenue Stair will be renovated in this phase. Upon completion of the first stage, the work areas will switch and the majority of the second floor will be closed. The second floor will be restored to its original finish condition and new millwork enclosures/bookshelves will be added to conceal the mechanical upgrades of the first phase.
All work done on this project must conform to the Secretary of the Interior’s Standards for the Treatment of Historic Properties (issued 1995, revised 2017).
Scope of Work:
This project includes rehabilitation of the interior of the first floor, mezzanine, and second floor of the Hoboken Public Library. The interior work shall include restoration of pressed metal ceiling, installation of historically appropriate LED light fixtures, and repair of the interior finishes. New millwork will be installed throughout to enclose the HVAC units installed previously. A new ADA compliant lift will be introduced that serves the first floor and mezzanine. There will be limited modifications to the plumbing and fire alarm systems.
Various upgrades and maintenance will be performed according to the NJ Uniform Construction Code: NJ Rehabilitation Subcode; International Building Code 2021- NJ Edition; International Fire Code 2021; National Electric Code 2020/NFPA 70 – NJ Edition; International Mechanical Code 2021 – NJ Edition; National Standard Plumbing Code 2021 – NJ Edition; NJ Barrier Free Subcode.
The following is a brief description of the key elements included in the scope of work.
- Project Supervision and Administration of Historic Preservation Projects:
- Provide supervision, administration, mockups, protection, and treatment procedures in accordance with the construction documents.
- Selective Demolition:
- Interior: Remove existing electrical and lighting equipment as indicated on the construction documents. Remove flooring and/or provide new openings as required for new mechanical, electrical, and plumbing systems. During demolition of the existing flooring, asbestos containing floor tile is to be removed. Demolish portions of the existing plaster walls and ceilings as required for new mechanical, electrical, and plumbing systems. Perform all demolition as indicated on the construction documents.
- Paint Restoration for a Historic Building:
- All restoration of historic paint must be provided in accordance with the construction documents and historic finishes analysis.
- Gypsum Plaster Restoration:
- All restoration of gypsum plaster must be provided in accordance with the construction documents. Patching and repairing of the existing plaster will be required for the installation of new lighting installation and other instances of demolition.
- Historic Pressed Metal Restoration:
- Existing pressed metal ceiling, cornice, and frieze tiles will be removed and salvaged for the creation of new molds and tiles. New replica tiles will be provided to match existing. The replacement of metal tiles must be provided in accordance with the construction documents. Removal and replacement of the existing tiles will be required for the installation of new electrical systems.
- Door Hardware:
- New hardware shall be provided at new and existing doors in accordance with the contract documents. Modification of the existing doors will be required for the installation of new hardware
- Electrical Installation in a Historic Building:
- New lighting, electrical devices, and lift components will be installed throughout the first floor, mezzanine, and second floor as indicated in the construction documents. The contractor is responsible for trenching and patching all walls and ceilings as required for new electrical equipment.
- Mechanical Upgrades in a Historic Building:
- Mechanical scope was completed during the first phase of the project. New millwork enclosures will be installed to conceal the VRF units. The contractor is responsible for patching all wall finishes as required.
- Plumbing Fixture Installation in a Historic Building:
- Plumbing scope was completed during the first phase of the project. Limited modifications may be required as directed in accordance with the construction documents.
- Fire Alarm Installation in a Historic Building:
- Fire alarm scope was completed during the first phase of the project. Limited modifications may be required as directed in accordance with the construction documents.
STATEMENT OF GENERAL NOTICE
The Restoration and Rehabilitation of the Hoboken Public Library is located at 500 Park Ave., Hoboken, New Jersey 07030. The property is listed on the New Jersey and National Registers of Historic Places. All work done on this project must conform to the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017) and is subject to review by the State Historic Preservation Office, or the New Jersey Historic Trust, or the historic review body of the municipal authority. The scope of work consists of a single contract for: General conditions; acquisition of all required permits; provision of temporary facilities and controls; selective demolition, and all restoration and renovation activities according to the Project Manual, plans and specifications.
The goals of this project include restoring the first floor, mezzanine, and second floor to their original finish conditions. Interior restoration and renovation work includes new millwork enclosures/bookshelves to conceal the mechanical upgrades of the first phase. The mezzanine will be modified to accept a new accessible lift from the first floor. Additionally, an opening will be re-introduced to the mezzanine between the existing columns. Lastly, the entire Park Avenue Stair will be renovated.
All work done on this project must conform to the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017).
Scope of Work:
The following is a brief description of the key elements included in the scope of work.
- Project Supervision and Administration of Historic Preservation Projects:
- Provide supervision, administration, mockups, protection, and treatment procedures in accordance with the construction documents.
- Selective Demolition:
- Interior: Remove existing electrical and lighting equipment as indicated on the construction documents. Remove flooring and/or provide new openings as required for new mechanical, electrical, and plumbing systems. Demolish portions of the existing plaster walls and ceilings as required for new mechanical, electrical, and plumbing systems. Perform all demolition as indicated on the construction documents.
- Paint Restoration for a Historic Building:
- All restoration of historic paint must be provided in accordance with the construction documents and historic finishes analysis.
- Gypsum Plaster Restoration:
- All restoration of gypsum plaster must be provided in accordance with the construction documents. Patching and repairing of the existing plaster will be required for the installation of new lighting installation and other instances of demolition.
- Historic Pressed Metal Restoration:
- Existing pressed metal ceiling, cornice, and frieze tiles will be removed and salvaged for the creation of new molds and tiles. New replica tiles will be provided to match existing. The replacement of metal tiles must be provided in accordance with the construction documents. Removal and replacement of the existing tiles will be required for the installation of new electrical systems.
- Door Hardware:
- New hardware shall be provided at new and existing doors in accordance with the contract d Modification of the existing doors will be required for the installation of new hardware
- Electrical Installation in a Historic Building:
- New lighting, electrical devices, and lift components will be installed throughout the first floor, mezzanine, and second floor as indicated in the construction documents. The contractor is responsible for trenching and patching all walls and ceilings as required for new electrical equipment.
- Mechanical Upgrades in a Historic Building:
- Mechanical scope was completed during the first phase of the project. New millwork enclosures will be installed to conceal the VRF units. The contractor is responsible for patching all wall finishes as required.
- Plumbing Fixture Installation in a Historic Building:
- Plumbing scope was completed during the first phase of the project.
- Fire Alarm Installation in a Historic Building:
- Fire alarm scope was completed during the first phase of the project.
The architect is Clarke Caton Hintz, P.C; 100 Barrack Street, Trenton, NJ 08608; 609.883.8383; Project manager Evan Wolff; ewolff@cchnj.com.
The owner’s project contact is Jennie Pu; Director of Hoboken Public Library, City of Hoboken, 500 Park Ave, Hoboken, NJ 07030; 201-420-2346; pu@hobokenlibrary.org
Prospective Bidder forms and a Project Fact Sheet describing the project and scope of work are included. Bidder’s prequalification packages are available for download at the following link: https://clarkecatonhintz.sharefile.com/d-sec6bcef8e17849848c4bc7fefb98f9ef. A set of plans and specifications will be available for inspection by appointment beginning on 9/22/25 at the office of Clarke Caton Hintz located at 100 Barrack Street, Trenton, NJ, 08608, please contact Evan Wolff. All prospective bidders are encouraged but not required to visit the project site.
The funding stipulations for the New Jersey Historic Trust require that prospective bidders must submit a completed Qualifications Statement as set forth herein. A complete Qualifications Statement must be submitted in triplicate (3 hardcopies) to the Hoboken Public Library Board of Trustees, 500 Park Ave, Hoboken, NJ, 07030 by 11:00 am prevailing time on Thursday, October 9th, 2025.Failure to complete the bidder’s Qualifications Statement could result in disqualification of the prospective bidder.
The qualifications of prospective bidders will be evaluated by representatives of the Hoboken Public Library Board of Trustees and the project architects in accordance with the Evaluation Criteria set forth herein. Prospective bidders whose bidder’s Qualifications Statements are determined to be acceptable will be identified as Qualified Bidders.
The Hoboken Public Library will notify in writing the Prospective Bidders who have been determined to be Qualified Bidders, as well as those Prospective Bidders who are deemed ineligible to receive plans and specifications. The Hoboken Public Library governing body will issue bid proposal forms, plans and specifications only to Qualified Bidders. Only bids received from Qualified Bidders will be opened.
The successful Prequalified Bidders must submit with the bid the name or names of all subcontractors to whom the bidder will subcontract and evidence of performance surety for themselves as well as all subcontractors.
STATEMENT OF BIDDER’S QUALIFICATIONS/CRITERIA FOR EVALUATING PROSPECTIVE BIDDERS
The following six (6) criteria will be used for evaluating the qualifications of prospective bidders. The evaluation will be based on information in the Statement of Qualifications provided by prospective bidders as well as information supplied by the bidders’ references.
(1) The prospective bidder, acting as general contractor, will be required to demonstrate verifiable, successful experience in Project Supervision and Administration of Historic Preservation Projects. This experience shall include at least two (2) projects involving separate historic buildings or sites of similar activities, project scale and scope of work as the subject project, completed in compliance with the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017) within the past five (5) years preceding the date of the execution of this Qualifications Statement. At least one of the projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
(2) The prospective bidder’s proposed project superintendent/manager will be required to demonstrate verifiable, successful experience in Project Supervision and Administration of Historic Preservation Projects. This experience shall include at least two (2) projects involving separate historic buildings or sites of similar activities, project scale and scope of work as the subject project, completed in compliance with the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995 or 2017) within the past five (5) years preceding the date of the execution of this Qualifications Statement. At least one of the projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
(3) The prospective bidder must not have wrongfully defaulted on a contract or had work terminated for non-performance within the past (5) years.
(4) The prospective bidder must not have been denied a consent of surety, a bid bond, or a performance bond within the past twelve (12) months, based on the bidder’s inability to meet a surety’s reasonable underwriting standards.
(5) The prospective bidder must provide the name and title of all principal members of prospective bidder’s staff, and indicate the availability of each of those principal members for this particular project.
(6) On all projects currently underway, the prospective bidder must demonstrate the following:
- Adherence to the project completion schedule mutually agreed upon between the contractor and the client. Deviation from the schedule must be due to factors outside of the contractor’s control.
- Lack of workmanship defects resulting from a failure to build a structure or component part of a structure pursuant to architectural and engineering plans and specifications.
- Timely submittal of shop drawings, product literature, samples, mock-ups, requests for information and applications for payment.
Bidder’s Questionnaire
This form shall be completed and submitted by prospective bidders who wish to be considered for this work. Failure to complete the Prospective Bidder’s Qualifications Statement shall result in the disqualification of the prospective Bidder. It is important that ALL information be provided, and ALL items addressed for each submission. Submissions must be on this form or a high-quality photocopy of this form and must be typed. Failure to submit ALL the information required shall result in rejection of the contractor’s qualifications package. Where the length of a response exceeds the space provided in the Qualifications Statement, the response must be completed on an additional sheet of paper. All responses must be clearly labeled to identify the corresponding question.
- Name and Address of Firm:___________________________________________ __________________________________________________________________
- Under what other name(s) has your business operated?______________________ __________________________________________________________________
- Business form (corporation, partnership, LLC, etc.)________________________ o Date of formation:____________________________________________ o Principal location:____________________________________________
Names and Titles of corporate officers, LLC members, or partners and their number of years with the business:__________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________
- Has your firm or any predecessor firm defaulted on a contract or had work terminated for non-performance within the last five (5) years? If so, on a separate sheet describe the project, owner, date, and circumstances/reasons.
No: Yes (Use separate sheet):
- Has your firm or any predecessor firm been denied a consent of surety, a bid bond, or a performance bond within the past twelve (12) months? If so, on a separate sheet describe the circumstances/reasons.
No: Yes (Use separate sheet):
- General Contractor:
Provide evidence of successful experience on at least two (2) projects involving separate historic buildings or sites of similar activities and scope of work as the subject project. Each project must demonstrate similar work to the description identified in the general notice. Projects must have been completed in compliance with the Secretary of the Interior’s Standard for the Treatment of Historic Properties (1995/2011) within the past five (5) years preceding the date of the execution of the Bidder’s Questionnaire. At least one of these projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
Project #1
Project Name: ________________________________________________________ Location:______________________________________________________________
Construction Cost:_______________________________________________________ Completion Date:________________________________________________________ Approximate Construction Date of the Historic Building or Site:___________________ Project Superintendent/Manager:____________________________________________ Scope of Work and Nature of Project:________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Mark with an X whether the following was completed or included in the scope of work on the project referenced.
[ ] Project Supervision and Administration of Historic Preservation Projects
[ ] Selective Demolition
[ ] Paint Restoration for a Historic Site
[ ] Gypsum Plaster Restoration
[ ] Historic Pressed Metal Restoration
[ ] Door Hardware
[ ] Electrical Installation in a Historic Building
[ ] Mechanical Upgrades in a Historic Building
[ ] Plumbing Fixture in a Historic Building
[ ] Fire Alarm Installation in a Historic Building
Owner:________________________________________________________________ Owner’s Contact Person:__________________________________________________ Phone:__________________________________Fax:___________________________ Email Address: _________________________________________________________ Architect:______________________________________________________________ Architect’s Contact Person:________________________________________________ Phone:__________________________________Fax:___________________________ Email Address: __________________________________________________________ Historical Review Agency:_________________________________________________
Project #2
Project Name:____________________________________________________________ Location:________________________________________________________________ Construction Cost:________________________________________________________ Completion Date:_________________________________________________________ Approximate Construction Date of the Historic Building or Site:____________________ Project Superintendent/Manager:_____________________________________________ Scope of Work and Nature of Project:_________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
Mark with an X whether the following was completed or included in the scope of work on the project referenced.
[ ] Project Supervision and Administration of Historic Preservation Projects
[ ] Selective Demolition
[ ] Paint Restoration for a Historic Site
[ ] Gypsum Plaster Restoration
[ ] Historic Pressed Metal Restoration
[ ] Door Hardware
[ ] Electrical Installation in a Historic Building
[ ] Mechanical Upgrades in a Historic Building
[ ] Plumbing Fixture in a Historic Building
[ ] Fire Alarm Installation in a Historic Building
Owner:__________________________________________________________________ Owner’s Contact Person:___________________________________________________ Phone:_________________________________Fax:_____________________________ Email Address: ___________________________________________________________ Architect:________________________________________________________________ Architect’s Contact Person:_________________________________________________ Phone:_________________________________Fax:_____________________________ Email Address: ___________________________________________________________ Historical Review Agency:__________________________________________________
- Proposed Project Superintendent/Manager:
Provide evidence of successful experience on at least two (2) projects involving separate historic buildings or sites of similar activities and scope of work as the subject project, completed in compliance with the Secretary of the Interior’s Standards for the Treatment of Historic Properties (1995/2011) within the past five (5) years preceding the date of the execution of the Bidder’s Questionnaire. At least one of these projects must have been reviewed by a State Historic Preservation Office, or New Jersey Historic Trust, or the historic review body of the municipal authority. Each project must be at least $2,100,000.
Name and Address of Project Superintendent/Manager:_____________________ __________________________________________________________________
Project #1
Project Name:______________________________________________________ Location:__________________________________________________________ Construction Cost:__________________________________________________ Completion Date:___________________________________________________ Approximate Construction Date of the Historic Building or Site:______________ Scope of Work and Nature of Project:___________________________________ __________________________________________________________________ __________________________________________________________________ Owner:____________________________________________________________ Owner’s Contact Person:_____________________________________________ Phone:______________________________Fax:__________________________ Email Address: ____________________________________________________ Architect:__________________________________________________________ Architect’s Contact Person:___________________________________________ Email Address: _____________________________________________________ Phone:______________________________Fax:__________________________ Historical Review Agency:____________________________________________
Project #2
Project Name:______________________________________________________ Location:__________________________________________________________ Construction Cost:__________________________________________________ Completion Date:___________________________________________________ Approximate Construction Date of the Historic Building or Site:______________ Scope of Work and Nature of Project:___________________________________ __________________________________________________________________ __________________________________________________________________
Owner:____________________________________________________________ Owner’s Contact Person:_____________________________________________ Phone:______________________________Fax:__________________________ Email Address:_____________________________________________________ Architect:_________________________________________________________ Architect’s Contact Person:___________________________________________ Phone:______________________________Fax:__________________________ Email Address: _____________________________________________________ Historical Review Agency:____________________________________________
- Provide a list of the names, titles, and years of experience of all principal members of the prospective bidder’s staff who will be available and assigned to this particular project.
- ____________________________________________________ 2. ____________________________________________________ 3. ____________________________________________________ 4. ____________________________________________________ 5. ____________________________________________________ 6. ____________________________________________________
- General Contractor:
PROVIDE THE FOLLOWING INFORMATION ON ALL CURRENT PROJECTS IN PROGRESS: (If necessary, include additional sheets.)
Project Name:______________________________________________________ Location:__________________________________________________________ Owner:______________________________Phone:________________________ Architect:____________________________Phone:________________________ Contract Amount:___________________________________________________ Scheduled Completion Date:__________________________________________ Architect’s Contact Person:___________________________________________ Phone/Email:_______________________________________________________
Project Name:______________________________________________________ Location:__________________________________________________________ Owner:______________________________Phone:________________________ Architect:____________________________Phone:________________________ Contract Amount:___________________________________________________ Scheduled Completion Date:__________________________________________ Architect’s Contact Person:___________________________________________ Phone/Email:_______________________________________________________
Project Name:______________________________________________________ Location:__________________________________________________________ Owner:______________________________Phone:________________________ Architect:____________________________Phone:________________________ Contract Amount:___________________________________________________ Scheduled Completion Date:__________________________________________ Architect’s Contact Person:___________________________________________ Phone/Email:_______________________________________________________
CERTIFICATION
I (We) the undersigned certify the truth and correctness of all statements and answers contained herein.
DATE:__________________________________________________________________
NAME OF POTENTIAL BIDDER:___________________________________________
ADDRESS OF BIDDER:___________________________________________________
TELEPHONE AND FAX:__________________________________________________
EMAIL ADDRESS:_______________________________________________________
BY (sign name and title):___________________________________________________
(Print/type name and title):__________________________________________________
WITNESSED: (If a Corporation, by the secretary of the corporation)
BY (sign name, no stamps):_________________________________________________
(Print/type name and title):__________________________________________________
Subscribed and sworn to before me
this ______day of __________________, 2025
Notary Public of the State
of______________________
My commission expires
________________________________________ ________________________ (Seal)
Submission of pre-qualifications are due on the date and time as identified in the general notice.
Submissions are to be mailed or delivered in sealed envelopes to the attention of:
The Hoboken Public Library 500 Park Ave Hoboken, NJ 07030
ATTN:
“Hoboken Public Library – Restoration and Rehabilitation of the 1st and 2nd Floor”
(Faxes will NOT be accepted)
STATEMENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.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:_____________________________________________________________
Organization Address:_________________________________________________________________
Part I Check the box that represents the type of business organization:
[ ] Sole Proprietorship (skip Parts II and III, execute certification in Part IV)
[ ] Non-Profit Corporation (skip Parts II and III, execute certification in Part IV)
[ ] For-Profit Corporation (any type)
[ ] Limited Liability Company (LLC)
[ ] Partnership
[ ] Limited Partnership
[ ] Limited Liability Partnership (LLP)
[ ] Other (be specific): ______________________________________________
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 BELOW 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)
(Please attach additional sheets if more space is needed):
Name of Individual or Business Entity Home Address (for Individuals) or Business Address
Part III DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS, PARTNERS OR 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 beneficial 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 filing(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 beneficial 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 (URL) containing the last annual SEC (or foreign Page #’s equivalent) filing
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. 52:25-24.2 has been listed. Attach additional sheets if more space is needed.
Stockholder/Partner/Member and Corresponding Entity Listed in Part II
Home Address (for Individuals) or Business Address
Part IV Certification
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 certification on behalf of the bidder/proposer; that the City of Hoboken is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the completion of any contracts with the City of Hoboken to notify the City of Hoboken 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the, permitting the City of Hoboken to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
NON-COLLUSION AFFIDAVIT
State of New Jersey
City of Hoboken ss:
I, _____________________ residing in ________________________ in the County of ____________________ and State of ____________________ of full age, being duly sworn according to law on my oath depose and say that:
I am ________________ of the firm of __________________, the Respondent making this proposal for the request for qualifications of professional services entitled Request for Proposals – Prequalification of General Contractors for the Restoration and Rehabilitation of the Hoboken Public Library, and that I executed the said proposal with full authority to do so, that said Respondent has not, directly or indirectly, entered into an agreement, participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named qualification, and that all statements contained in the Respondent’s proposal and in this affidavit are true and correct, and made with full knowledge that the Owner relied upon the truth of the statements contained in said request for qualifications and in this affidavit in qualifying the Respondent to provide services to the Owner.
Name of Respondent (Please Print):
Signature of Authorized Representative:
Name (Please Print):
Title (Please Print): Date:
Subscribed and sworn to before me on this _____ day of ______________, _____.
___________________________________ Signature of Notary Public
CERTIFICATION OF NON-DEBARMENT FOR FEDERAL GOVERNMENT CONTRACTS N.J.S.A. 52:32-44.1 (P.L. 2019, c.406)
This certification shall be completed, certified to, and submitted to the contracting unit prior to contract award, except for emergency contracts where submission is required prior to payment.
PART I: VENDOR INFORMATION Individual or Organization
Name
Address of Individual or Organization DUNS Code (if applicable) CAGE Code (if applicable)
Check the box that represents the type of business organization:
[ ] Sole Proprietorship (skip Parts III and IV)
[ ] Non-Profit Corporation (skip Parts III and IV)
[ ] For-Profit Corporation (any type)
[ ] Limited Liability Company (LLC)
[ ] Partnership
[ ] Limited Partnership
[ ] Limited Liability Partnership (LLP)
[ ] Other (be specific): ______________________________________________
PART II – CERTIFICATION OF NON-DEBARMENT: Individual or Organization
I hereby certify that the individual or organization listed above in Part I is not debarred by the federal government from contracting with a federal agency. I further acknowledge: that I am authorized to execute this certification on behalf of the above-named organization; that the Owner is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the date of contract award by the Owner to notify the Owner 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Owner, permitting the Owner to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
PART III – CERTIFICATION OF NON-DEBARMENT: Individual or Entity Owning Greater than 50 Percent of Organization
Section A (Check the Box that applies)
[ ] Below is the name and address of the stockholder in the corporation who owns more than 50 percent of its voting stock, or of the partner in the partnership who owns more than 50 percent interest therein, or of the member of the limited liability company owning more than 50 percent interest therein, as the case may be.
Name of Individual or Organization
Home Address (for Individual) or Business Address
OR
[ ] No one stockholder in the corporation owns more than 50 percent of its voting stock, or no partner in the partnership owns more than 50 percent interest therein, or no member in the limited liability company owns more than 50 percent interest therein, as the case may be.
Section B (Skip if no Business entity is listed in Section A above)
Stockholder/Partner/Member Owning Greater Than 50 Percent of Parent Entity
Home Address (for Individual) or Business Address
[ ] Below is the name and address of the stockholder in the corporation who owns more than 50 percent of the voting stock of the organization’s parent entity, or of the partner in the partnership who owns more than 50 percent interest in the organization’s parent entity, or of the member of the limited liability company owning more than 50 percent interest in organization’s parent entity, as the case may be.
OR
[ ] No one stockholder in the parent entity corporation owns more than 50 percent of its voting stock, no partner in the parent entity partnership owns more than 50 percent interest therein, or no member in the parent entity limited liability company owns more than 50 percent interest therein, as the case may be.
Section C – Part III Certification
I hereby certify that no individual or organization that is debarred by the federal government from contracting with a federal agency owns greater than 50 percent of the Organization listed above in Part I or, if applicable, owns greater than 50 percent of a parent entity of <name of organization>. I further acknowledge: that I am authorized to execute this certification on behalf of the above-named organization; that the Owner is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the date of contract award by the Owner to notify the Owner 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Owner, permitting the Owner to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
Part IV – CERTIFICATION OF NON-DEBARMENT: Contractor – Controlled Entities
Section A
[ ] Below is the name and address of the corporation(s) in which the Organization listed in Part I owns more than 50 percent of voting stock, or of the partnership(s) in which the Organization listed in Part I owns more than 50 percent interest therein, or of the limited liability company or companies in which the Organization listed above in Part I owns more than 50 percent interest therein, as the case may be.
Name of Business Entity Business Address
**Add additional sheets if necessary**
OR
[ ] The Organization listed above in Part I does not own greater than 50 percent of the p voting stock in any corporation and does not own greater than 50 percent interest in any partnership or any limited liability company.
Section B (skip if no business entities are listed in Section A of Part IV)
[ ] Below are the names and addresses of any entities in which an entity listed in Part III A owns greater than 50 percent of the voting stock (corporation) or owns greater than 50 percent interest (partnership or limited liability company).
Name of Business Entity Controlled by Entity Business Address Listed in Section A of Part IV
**Add additional Sheets if necessary**
OR
[ ] No entity listed in Part III A owns greater than 50 percent of the voting stock in any p corporation or owns greater than 50 percent interest in any partnership or limited liability company.
Section C – Part IV Certification
I hereby certify that the Organization listed above in Part I does not own greater than 50 percent of any entity that that is debarred by the federal government from contracting with a federal agency and, if applicable, does not own greater than 50 percent of any entity that in turns owns greater than 50 percent of any entity debarred by the federal government from contracting with a federal agency. I further acknowledge: that I am authorized to execute this certification on behalf of the above-named organization; that the Owner is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the date of contract award by the Owner to notify the Owner 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 certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the Owner, permitting the Owner to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN FORM
BID SOLICITATION # AND TITLE:
VENDOR/BIDDER NAME:
Pursuant to N.J.S.A. 52:32-57, et seq. (P.L. 2012, c.25 and P.L. 2021, c.4) any person or entity that submits a bid or proposal or otherwise proposes to enter into or renew a contract must certify that neither the person nor entity, nor any of its parents, subsidiaries, or affiliates, is identified on the New Jersey Department of the Treasury’s Chapter 25 List as a person or entity engaged in investment activities in Iran. The Chapter 25 list is found on the Division’s website at https://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf Vendors/Bidders must review this list prior to completing the below certification. If the Director of the Division of Purchase and Property finds a person or entity to be in violation of the law, s/he shall take action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.
CHECK THE APPROPRIATE BOX
[ ] I certify, pursuant to N.J.S.A. 52:32-57, et seq. (P.L. 2012, c.25 and P.L. 2021, c.4), that neither the Vendor/Bidder listed above nor any of its parents, subsidiaries, or affiliates is listed on the New Jersey Department of the Treasury’s Chapter 25 List of entities determined to be engaged in prohibited activities in Iran.
OR
[ ] I am unable to certify as above because the Vendor/Bidder and/or one or more of its parents, subsidiaries, or affiliates is listed on the New Jersey Department of the Treasury’s Chapter 25 List. I will provide a detailed, accurate and precise description of the activities of the Vendor/Bidder, or one of its parents, subsidiaries or affiliates, has engaged in regarding investment activities in Iran by completing the information requested below.
Entity Engaged in Investment Activities Relationship to Vendor/Bidder Description of Activities
Duration of Engagement Anticipated Cessation Date
Attach Additional Sheets if Necessary
____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________
CERTIFICATION
I, the undersigned, certify that I am authorized to execute this certification on behalf of the Vendor, that the foregoing information and any attachments hereto, to the best of my knowledge are true and complete. I acknowledge that the State of New Jersey is relying on the information contained herein, and that the Vendor is under a continuing obligation from the date of this certification through the completion of any contract(s) with the State to notify the State 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 certification. If I do so, I may be subject to criminal prosecution under the law, and it will constitute a material breach of my contract(s) with the State, permitting the State to declare any contract(s) resulting from this certification void and unenforceable.
Signature Date
Print Name and Title