Attachment_1_-_Offer_and_Acceptance_Form.pdf

Attachment 1: Offer and Acceptance Form Solicitation No. BPM005375

Electronic Payment Transaction Processing Services

State of Arizona Department of Corrections, Rehabilitation & Reentry Procurement Services 701 E. Jefferson Street

Phoenix, AZ 85034

Attachment 1: Offer and Acceptance Form Rev. 4.2.2023

OFFER

TO THE STATE OF ARIZONA:

The Undersigned hereby offers and agrees to provide Electronic Payment Transaction Processing Services in compliance with all terms, conditions, specifications, and amendments in the Solicitation and any written exceptions in the Offer.

Offeror company name Signature of person authorized to sign Offer

Address Printed name and title

City, State, ZIP Contact name and title

CERTIFICATION: By signature in the above, Offeror certifies that it: Contact email address Contact phone number

1. Will not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, [Arizona] State Executive Order 2009-9 or A.R.S. §§ 41-1461 through 1465;

2. Has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause will result in rejection of the Offer. Signing the Offer with a false statement will void the Offer, any resulting contract, and may be subject to legal penalties under law;

3. Complies with A.R.S. § 18-132 when offering electronics or information technology products, services, or maintenance;

4. Has submitted this Offer as a firm offer for 180 days following the Solicitation due date and time. After 180 days, the Offer will remain open unless revoked by Offeror via written withdrawal of Offeror’s proposal in accordance with the Arizona Procurement Code;

5. Did not and will not involve collusion or other anti-competitive practices; and

6. Is not debarred from, or otherwise prohibited, from participating in any contract awarded by federal, state, or local government.

ACCEPTANCE OF OFFER

The Offer is hereby accepted.

The Contractor is now bound to sell the Materials or Services listed by the attached contract and based upon the Solicitation, including all terms, conditions, specifications, amendments, etc., and the Contractor’s Offer as accepted by the State.

The Contract shall henceforth be referred to as Contract No.

The effective date of the Contract is The Contractor is cautioned not to commence any billable work or to provide any Material or Service under this contract until Contractor receives purchase order, contract release document, or written notice to proceed.

State of Arizona Awarded this Day of 20

Chief Procurement Officer signature

JPay LLC

3450 Lakeside Drive, Suite 100 Alex Yeo, Chief Revenue and Product Officer

Miramar, FL 33027 alex.yeo@aventiv.com (734) 709-4013

Alex Yeo, Chief Revenue and Product Officer