Hazard Tree Assessment & Removal Program

Vendor Job Creation Report

  • Each vendorawarded a contract under the Hazard Tree Assessment & Removal Program must submit this report to the NJ Forest Service on the following schedule:
-in the 3rd month of each quarter, by the second to the last Wednesday of the month (i.e., by December 22, March 23, June 22, or September 21, as applicable), until the vendor has submitted its final invoice for payment; and
-at the time the vendor submits its final invoice for payment.
  • It is the responsibility of the vendor to maintain, for a period of at least four years,employment and payroll records sufficient to document the information provided.

Vendor:
(name & address of company headquarters, including zip + 4 digits[1]) / Vendor’s DUNS Number:[2]
(required if for any contract with a total value $25,000)
Vendor’s Authorized Representative:(name, title, phone #, fax #, email)
Product and/or Service Description:
(Include goods purchased (supplies, materials, equipment) and services provided (professional, technical, other), as applicable)
  • Use the form provided on Page 2 to complete and attach a Job Creation Report.
  • These “Page 2” Job Creation Reports must be submitted with each quarter’s report and apply to the work done that quarter. In addition, when a vendor submits its final invoice for payment, in addition to a Job Creation Report for the final quarter, the vendor must provide a SUMMARY Job Creation Report that applies to the entire contract.

Vendor Signature:______

(Signature of Vendor’s Authorized Representative)(Date)

Page 1

11/29/10

[1] The 9-digit zip code may be found for any address on the US Postal Service site at:

[2] DUNS numbers are issued by Dun & Bradstreet (D&B). A DUNS number is a 9 character field. A vendor who does not already have one may obtain a DUNS number at no cost by calling the toll-free DUNS number request line at 1.866.705.5711 or through the D&B website at Before issuing a number, to verify the grant funding this project, D&B may request the Catalog of Federal Domestic Assistance (CFDA) number for the grant. If asked, a contractor should provide this CFDA number: 10.688.