Quote Name: Purchase of Twin Disk MG5050SC Transmission
or equivalent
Description: SEE BELOW FOR FURTHER INFORMATION
Township Contact: Dustin Martin
Contact Phone Number: (609) 361-2097
Contact E-mail: stindall@longbeachtownship.com
Quote Number: 26-29
Posted Date: August 7, 2026
Dates Quotes are Due by: August 18, 2026 at 10am
Bid Specifications
Twin Disk MG5050SC Transmission
Ratio 2.04:1
SAE 3 Standard
Vulkan VKE-3211 Drive Plate
Mechanical selector valve
Total for 2: _______________
Freight:_______________
Total:___________________
Company Name
Agent Name
Agent Signature
___________________________________________________________________________________
Contact Telephone #______________________________________________________________
Company Address: ______________________________________________________
Email: _________________________________________________________________
Date Quote Submitted: ______________ Date of Quote Expiration: _______________
INDEMNIFICATION AGREEMENT
THIS AGREEMENT (“Agreement”), by and between Township of Long Beach (“Township”), whose address
is 6805 Long Beach Boulevard, Brant Beach, New Jersey 08008, and
_________________________________________________
(“Bidder”),
whose
address
is
___________________________________________________, shall be binding and legally effective upon the execution
of the Bidder.
WITNESSETH:
1.
Bidder expressly, knowingly, and, to the fullest extent permitted by law, agrees to and shall release,
indemnify, defend, and hold harmless Township, its elected and appointed officials, officers, employees,
agents, volunteers, and others working on behalf of the Township, from and against any loss, damages,
claims, causes of action, liabilities, obligations, penalties, demands, municipal mechanic’s liens filed
pursuant to N.J.S.A. 2A:44-125, et seq., and any and all other costs and expenses, including attorneys’
fees and costs, threatened against, suffered, and/or incurred by Township, its elected and appointed
officials, officers, employees, agents, volunteers, and others working on behalf of the Township arising
out of and/or in any manner relating to the contracted and/or licensed activity engaged in and/or the
work or services provided by Bidder, its officers, owners, agents, employees, independent contractors,
guests, volunteers, others working on behalf of Bidder, and the acts, omissions, and/or negligence of the
Bidder, its officers, owners, agents, employees, independent contractors, guests, volunteers, and others
working on behalf of or which the Bidder is responsible for arising out of and/or relating to the Bidder’s
contract with the Township. Bidder shall be responsible and liable for the payment of any and all of the
foregoing attorney’s fees and costs to attorneys of Township’s selection for any investigation and review,
pre-litigation, litigation, post-judgment litigation, bankruptcy proceedings, and any and all appeals
arising out of and/or relating to this Agreement.
2.
The terms of this indemnification agreement shall be in addition and cumulative to the indemnification
provisions set forth in the general conditions of the contract documents.
3.
The existence of any available and/or applicable insurance shall not waive or release Bidder from the
Bidder’s obligations set forth in this Agreement.
Dated: ____________
____________________________________
BIDDER
STATE OF ________________ )
)
SS
COUNTY OF _____________ )
On _______, 20__ before me, _________________________, Notary Public in and for said county, personally
appeared (signer) who has satisfactorily identified him/her as the signer on behalf of the Bidder to the above-
referenced document.
Seal
____________________________________
Notary’s Name
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
FORM
STATE OF NEW JERSEY
DEPARTMENT OF THE TREASURY - DIVISION OF PURCHASE AND
PROPERTY 33 WEST STATE STREET, P.O. BOX 230 TRENTON, NEW
JERSEY 08625-0230
BID SOLICITATION # AND TITLE:
________________________________________________________________________________
VENDOR 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 requestedbelow.
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
CERTIFICATION OF NON-INVOLVEMENT IN PROHIBITED ACTIVITIES IN RUSSIA OR
BELARUS
(Check the Appropriate Box)
A.
That the Vendor is not identified on the OFAC Specially Designated Nationals and Blocked Persons list on
account of activity related to Russia and/or Belarus.
OR
B.
That I am unable to certify as to “A” above, because the Vendor is identified on the OFAC Specially
Designated Nationals and Blocked Persons list on account of activity related to Russia and/or Belarus.
OR
That I am unable to certify as to “A” above, because the Vendor is identified on the OFAC Specially
Designated Nationals and Blocked Persons list. However, the Vendor is engaged in activity related to Russia
C. and/or Belarus consistent with federal law, regulation, license or exemption. A detailed description of how
the Vendor’s activity related to Russia and/or Belarus is consistent with federal law is set forth below.
(Attach Additional Sheets If Necessary.)
Signature of Vendor’s Authorized Representative
Date
Print Name and Title of Vendor’s Authorized Representative
Vendor’s FEIN
Vendor’s Name
Vendor’s Phone Number
Vendor’s Address (Street Address)
Vendor’s Fax Number
Vendor’s Address (City/State/Zip Code)
Vendor’s Email Address
i Vendor means: (1) A natural person, corporation, company, limited partnership, limited liability partnership, limited liability company, business association, sole
proprietorship, joint venture, partnership, society, trust, or any other nongovernmental entity, organization, or group; (2) Any governmental entity or instrumentality of
a government, including a multilateral development institution, as defined in Section 1701(c)(3) of the International Financial Institutions Act, 22 U.S.C. 262r(c)(3); or
(3) Any parent, successor, subunit, direct or indirect subsidiary, or any entity under common ownership or control with, any entity described in paragraph (1) or (2).
This is the opportunity summary page. It provides an overview of this opportunity and a preview of the attached documentation.