BID CHECKLIST

Owner’s CHECKMARKS
Items Submitted with Bid
Bidder’s INITIALS
A. FAILURE TO SUBMIT ANY OF THESE ITEMS WITH THE BID IS MANDATORY CAUSE FOR REJECTION
Letter of Qualification –Bid Form 1 TS.
Bid Bond or certified/cashier’s check - Proposal Form 2 TS.
Purchase Price –Bid Form 3 TS.
Letter of Intent –Bid Form 4 TS.
Disclosure Statement – Bid Form 5 TS.
Acknowledgment of Receipt of Addenda (if any) –Bid Form 6 TS.
Statement of Ownership –Bid Form 7 TS.
Non-Collusion Affidavit –Bid Form 8 TS.
C.271 Political Contribution Disclosure Form – Bid Form 9 TS.
B. ITEMS PREFERRED AT TIME OF BID, BUT MANDATORY AT THE TIME INDICATED
Disclosure of Investment Activities in Iran Form - Bid Form 10 TS.
Certification of Non-Involvement in Prohibited Activities in Russia or Belarus
Pursuant to P.L. 2002, c.3 (Prior to Contract Award)
TS.
New Jersey Business Registration Certificate (Prior to Contract Award) TS.
PRINT NAME OF BIDDER:
New Jersey-American Water Company, Inc.
SIGNED BY:
Signature of Thomas Shroba
PRINT NAME AND TITLE:
Thomas Shroba, Vice President, Operations
DATE:
June 22, 2022
#3176895
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