BPM007067_Pre-Solicitation_Documents.pdf

Kim Matura <kmatura@azdot.gov>

PRF 8045rfis Used Automotive Fluid

Pamela Veal <pveal@azdot.gov> Tue, Aug 12, 2025 at 3:41 PM To: Kim Matura <kmatura@azdot.gov> Cc: Darren Fischer <RFischer@azdot.gov>

Good afternoon Kim, Please see below PRF# 8045rfis for Used Automotive Fluid. Please have your planner to me no later than 8/14. Let me know if you have any questions.

Thank you.

Timestamp 8/11/2025 10:44:33 Requester Email rfischer@azdot.gov Requester Phone Number

Project Manager Email Used Automotive Fluid Collection and Removal Services Project Manager Phone Number Administrative Services (ASD) Project Name/Description Yes Customer Division CTR052632 Is there an existing or previous contract? Ongoing requirement Contract No. 50000 Request Type

What is the anticipated expenditure? https://drive.google.com/open?id=1VS5nIpDPlFirm-vs6_lOWOjUrOCHW-PC Annual estimated quantities

Specifications/Scope of work

Additional Information

ADOT Project Number State Federal Authorization Documentation (i.e.

Clearances, Joint Project Agreement, Public Interest Finding)

Funding Source

If Project Specific, % of Federal Funds https://drive.google.com/open?id=11pDDuhLVdRwFezBTRHMreWk5T9y2oKjs Select Federal Funding Agency https://drive.google.com/open?id=1ws3ggTFy2MbvJla_58aNowNX3JPKj6XW Manager Approval 6027124770 Division Finance Officer (DiFO): Approval

PRF No. 8045rfis

Pamela Veal CPSM Procurement Manager

PROCUREMENT SERVICES

1655 W. Jackson St.

Phoenix, AZ 85007

480.489.9174 | azdot.gov

8/13/25, 7:30 AM State of Arizona Mail - PRF 8045rfis Used Automotive Fluid https://mail.google.com/mail/u/0/?ik=67a562c488&view=pt&search=all&permmsgid=msg-f:1840291250761708389&simpl=msg-f:1840291250761708389 1/1 mailto:rfischer@azdot.gov https://drive.google.com/open?id=1VS5nIpDPlFirm-vs6_lOWOjUrOCHW-PC https://drive.google.com/open?id=1VS5nIpDPlFirm-vs6_lOWOjUrOCHW-PC https://drive.google.com/open?id=1VS5nIpDPlFirm-vs6_lOWOjUrOCHW-PC https://drive.google.com/open?id=11pDDuhLVdRwFezBTRHMreWk5T9y2oKjs https://drive.google.com/open?id=11pDDuhLVdRwFezBTRHMreWk5T9y2oKjs https://drive.google.com/open?id=11pDDuhLVdRwFezBTRHMreWk5T9y2oKjs https://drive.google.com/open?id=11pDDuhLVdRwFezBTRHMreWk5T9y2oKjs https://drive.google.com/open?id=1ws3ggTFy2MbvJla_58aNowNX3JPKj6XW https://drive.google.com/open?id=1ws3ggTFy2MbvJla_58aNowNX3JPKj6XW https://drive.google.com/open?id=1ws3ggTFy2MbvJla_58aNowNX3JPKj6XW https://www.google.com/maps/search/1655+W.+Jackson+St.+Phoenix,+AZ+85007?entry=gmail&source=g https://www.google.com/maps/search/1655+W.+Jackson+St.+Phoenix,+AZ+85007?entry=gmail&source=g http://azdot.gov/

Kim Matura <kmatura@azdot.gov>

Fwd: Significant Procurement Notification Form 1 message

ProcurementCompliance - ADOT <procurementcompliance@azdot.gov> Wed, Aug 13, 2025 at 1:38 PM To: Kim Matura <kmatura@azdot.gov>

Good day, Please utilize this email as your Significant Procurement Disclosure posting on SPO's website. Incorporate this document in your Pre-Solicitation documents.

Best Regards, Gloria Paul

Compliance Team

PROCUREMENT

1655 W. Jackson Street, MD 100P Phoenix AZ 85007

602.712.7466

602.712.8584 | azdot.gov

---------- Forwarded message --------- From: Google Forms <forms-receipts-noreply@google.com> Date: Wed, Aug 13, 2025 at 1:27 PM Subject: Significant Procurement Notification Form To: <Procurementcompliance@azdot.gov>

Thanks for filling out Significant Procurement Notification Form Here's what was received.

Edit response

Significant Procurement Notification Form The following information is required to be provided to the State Procurement Administrator by all state governmental units (SGU; agencies, boards, and commissions) as per Standard Procedure 003 - Significant Procurement Role (SP 003 link).

8/13/25, 2:17 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=67a562c488&view=pt&search=all&permthid=thread-f:1840374141066660671&simpl=msg-f:1840374141066660671 1/4 https://www.google.com/maps/search/1655+W.+Jackson+Street?entry=gmail&source=g http://azdot.gov/ mailto:forms-receipts-noreply@google.com mailto:forms-receipts-noreply@google.com mailto:Procurementcompliance@azdot.gov mailto:Procurementcompliance@azdot.gov https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?usp=mail_form_link https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?edit2=2_ABaOnueDGYW-fdDyscXwWFNC4mTetI4MgMWQpo878-_yMRIg8M7RujUShkw_1r0ioVKxR8Y https://spointra.az.gov/resources/standard-procedures

Notes about this Google Form to provide notification of a SPR:

• You will receive a copy of your response via email

• You may edit your response after it is submitted in two ways. To ensure there's no duplication of efforts, please do one of the following:

1) Once you submit the form, you may click on "Edit you response" in the same browser; or

2) If some time has passed and it's necessary to make edits, please check your email for the original submission as it will have an "Edit response" link. If you don’t remember when you originally submitted your SPR notification, you may check the date and time on the spreadsheet via https://spo.az.gov/contracts/significant-procurement-roles and match it to the email.

• If your entry needs to be deleted, email SPOCompliance@azdoa.gov to provide an explanation for the deletion. If accepted, SPO Compliance will delete the entry.

Please contact the State Procurement Office (SPO) at SPOCompliance@azdoa.gov for any questions.

Email *

Procurementcompliance@azdot.gov

What is the name of the person leading the procurement? *

Kim Matura

Which agency is the procurement for? If it is a mandatory statewide contract, select your agency. *

Transportation, Dept. of

What is the title of the procurement? *

BPM007067 Used Automotive Fluid Collection and Removal Services

What is the procurement type? *

8/13/25, 2:17 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=67a562c488&view=pt&search=all&permthid=thread-f:1840374141066660671&simpl=msg-f:1840374141066660671 2/4 https://spo.az.gov/contracts/significant-procurement-roles https://spo.az.gov/contracts/significant-procurement-roles mailto:SPOCompliance@azdoa.gov mailto:SPOCompliance@azdoa.gov mailto:Procurementcompliance@azdot.gov mailto:Procurementcompliance@azdot.gov

RFQ - Request for Quotation

✓ IFB - Invitation for Bid

RFP - Request for Proposal

CI - Competition Impracticable (SPO Form 101)

Emergency Procurement (SPO Form 102)

SS - Sole Source (SPO Form 103)

NPTQ - Not Practicable to Quote (Determination Template D301(4))

Other:

What is the date when the first procurement disclosure statement (PDS) was signed (i.e. SPO Form 120 or SPO Form 130)? *

MM

07 /

DD

18 /

YYYY

What is the actual date or estimated date that the purchased materials will be delivered or the purchase of services or construction will begin, per A.R.S. § 41- 753(D)? *

MM

11 /

DD

13 /

YYYY

What is your name (if different from above)?

Gloria Paul

What is your e-mail address (if different from above)?

gpaul@azdot.gov

8/13/25, 2:17 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=67a562c488&view=pt&search=all&permthid=thread-f:1840374141066660671&simpl=msg-f:1840374141066660671 3/4 mailto:gpaul@azdot.gov

Create your own Google Form Does this form look suspicious? Report

8/13/25, 2:17 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=67a562c488&view=pt&search=all&permthid=thread-f:1840374141066660671&simpl=msg-f:1840374141066660671 4/4 https://docs.google.com/forms?usp=mail_form_link http://reportabuse/

ARIZONA DEPARTMENT OF

ADMINISTRATION STATE PROCUREMENT

OFFICE

PROCUREMENT DISCLOSURE STATEMENT

Dear Employee:

You have been selected to participate in the particular procurement activity as referenced above. Your selection was based on your technical knowledge and expertise in this area. Your regular job duties may not include procurement activities but for the purpose of this process you may play a significant procurement role in one or more of the following: participating in the development of a procurement as defined in A.R.S. § 41-2503;

participating in the development of an evaluation tool; approving a procurement as defined in A.R.S. § 41-2503 or an evaluation tool; serving as a technical advisor or an evaluator who evaluates a procurement as defined in A.R.S. § 41-2503; or recommending or selecting a vendor that will provide materials, services or construction to this state.

It is essential that the integrity of the procurement process be maintained to ensure that each Offeror is given fair and equal consideration. Your familiarity with particular brands, types of equipment, material, services, individuals or firms may tend to influence your evaluation; however, you are required in this specific instance to be particularly objective and guard against any tendency that might slant your evaluation in favor of a personal preference.

You are required to report to the Procurement Officer, or person facilitating the above referenced procurement process, any actual or potential conflict of interest as defined in A.R.S. §§ 38-503, 41-2616(C), 41-753, and 41-2517. You are also subject to the Code of Ethics set forth in Section A.A.C. R2-5A-501 of the Arizona Department of Administration, Personnel Division, Administrative Rules, and Regulations.

An additional consideration is the legal mandate to maintain strict security and confidentiality regarding the content of any proposal, as well as the proceedings of the Evaluation Committee meetings during the evaluation process.

Once the evaluation process has started, it is essential that any contact with Offerors, other than that disclosed, be through, and by, the Procurement Officer or person facilitating the above referenced procurement.

In addition, the Employee shall not have any communication related in any way to the particular procurement, except during formal Committee meetings, with any Offeror or potential subcontractor to that Offeror prior to award, nor shall that Member discuss the proposal or their evaluation with anyone other than the Procurement Officer, or person facilitating the above referenced procurement and Evaluation Committee Members. This is mandatory.

A person who holds a Significant Procurement Role as defined by A.R.S. §§ 41-741 and 41-2503 for a particular procurement shall sign a statement before starting any participation that the person has no financial interest in the procurement other than that disclosed and will have no contact with any representative of a competing Offeror related to the particular procurement during the course of evaluation of proposals, except those contacts specifically authorized perA.R.S. §§ 41-2534, 41-2537, 41-2538, and 41-2578. The person shall disclose on this statement any contact unrelated to the pending procurement that the person may need to have with a representative of a competing offeror and any contact with a representative of a competing offeror during evaluation of proposals except those contacts specifically authorized per A.R.S. §§ 41-2534, 41-2537, 41-2538, and 41-2578. A person who has been identified as having a significant procurement role for this procurement and fails to disclose contact with a representative of a competing Offeror or who fails to provide accurate information on this statement is subject to civil penalty of at least one thousand dollars but not more than ten thousand dollars per A.R.S. § 41-2616(C).

cc: Agency File Page 1 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23)

BPM007067 Used Automotive Fluid Collection and Removal Service

Docusign Envelope ID: 41561947-4D09-4895-91E1-A7F4E0110400

As mandated by A.R.S. § 38-503, I, , have listed on this form all ownerships, employments, public and private affiliations, and relationships held by me and/or a relative1 which may have a substantial (pecuniary2 and proprietary3) interest as defined in A.R.S. § 38-502(11) in any contract, sale, purchase or service involving the agency. I understand that as my interests or those of my relatives change, I may need to modify this statement.

The substantial interests, both pecuniary and proprietary, held by me and/or a relative which may involve the State include (attach additional sheets as necessary):

During the course of my regular business, I may have contact, unrelated to this procurement, with the Offerors or potential Offerors/Bidders listed below, who have submitted proposals in response to this solicitation (attach additional sheets as necessary):

1 “Relative” means my spouse, child, child’s child, parent, grandparent, brother or sister (of the whole or half-blood) and their spouses and the parent, brother, sister or child of my spouse.

2 “Pecuniary” means money or economic or other benefits that can be valued in monetary terms 3 “Proprietary” means ownership or rights by virtue of ownership, whether public or private.

Citations listed above are available on the SPO website, https://spointra.az.gov/resources/standard-forms-and-documents.

Statements

The Undersigned attests to and agrees to abide by the following statements:

I have read and understand the above and agree to be bound by the rules and principles represented. If applicable, I have also received, read and understand the Evaluation Committee Instructions for this procurement.

I know of no conflict of interest on my part nor have I committed any indiscretion or accepted any gratuities or favors that would compromise my impartiality. Further, I will not accept an offer of employment from or have employment discussions with any person or entity lobbying for or potentially responding to a solicitation during the defined time frame stated in A.R.S. § 41-753. I will maintain all deliberations of the Evaluation Committee in strict confidence during the evaluation process. My recommendations shall be based upon an objective/ subjective review of the Offeror’s response and the appropriate award criteria from the solicitation in accordance with the Arizona Procurement Code. I have read and understand A.R.S. §§ 41-753, 41-2517, and 41-2616(C) and will fully comply with the requirements.

I have not and will not communicate with any potential Offeror or vendor in preparation of specifications/scopes of work, evaluation tool or other confidential information related to the above referenced Solicitation which would provide an unfair advantage or to prepare specifications/scopes of work which favor particular vendor(s).

I have not and will not provide insight, confidential information or assistance to any potential Offeror or vendor that might give an unfair advantage or inhibit fair competition for the above referenced Solicitation. My input regarding the development of the Solicitation documents, if any, has been and will be based solely on the State’s requirements. I have not and will not communicate those requirements or confidential information to any potential Offeror or vendor.

cc: Agency File Page 2 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23)

Darren Fischer

N/A

N/A

Docusign Envelope ID: 41561947-4D09-4895-91E1-A7F4E0110400 https://spointra.az.gov/resources/standard-forms-and-documents

I know of no conflict of interest on my part nor shall I take any action (e.g., commit an indiscretion or accept any gratuities or favors) that would compromise my impartiality or my responsibilities. Should a conflict of interest become known to me relevant to my role, I shall immediately disclose such conflict of interest.

I shall not receive any direct benefit from the utilization of confidential information, specifications, plans, scopes of work, or evaluation tools I prepared or assisted in the preparation of.

I shall maintain strict security and confidentiality regarding the content of any proposal, as well as the proceedings of the Evaluation Committee meetings during the evaluation process that I may be a participant or attend as a committee member or a technical advisor.

I shall maintain strict security and confidentiality regarding the process or decisions regarding any protest or appeal that I am a participant, advisor or decision maker.

Whether recommending or selecting a vendor that will provide materials, services or construction to the State, approving a procurement or an evaluation tool or soliciting quotes greater than ten thousand dollars for the provision of materials, services or construction, I shall maintain strict security and confidentiality regarding the process and decisions to ensure fair competition.

Upon termination of my employment with the State, for any reason, these provisions and statements remain in effect until such time as the solicitation has been successfully awarded by the State, or the State provides me a written release. These provisions and statements apply if I accept employment with any entity, its affiliates, subcontractors, or business partners that may submit an offer or are included in an offer to this solicitation. I shall not accept an offer of employment from or have employment discussions with any person or entity lobbying for or potentially responding to a solicitation for one year following the delivery of purchased materials or the purchase of services or construction begins.

I understand that if I knowingly violate the terms of this Agreement, I will be subject to suspension for not less than ninety days or dismissal from State service.

The Undersigned has read and understands the above and agrees to be bound by the statements, rules, and principles represented herein and in accordance with the provisions of the State Statutes and Rules regarding personnel, conflict of interest, confidentiality, and procurement.

Please check the applicable box below:

Yes No I am an architect or an engineer registered pursuant to section A.R.S. § 32-121

Yes No I am a State employee who was employed within the past year by a person or firm responding to a solicitation, pursuant to A.R.S. § 41-2517(F)

Signature Date Agency

Name Email address

Title Telephone cc: Agency File Page 3 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23)

Docusign Envelope ID: 41561947-4D09-4895-91E1-A7F4E0110400

Darren Fischer RFischer@azdot.gov

ADOT

Parts Manager 602-712-4770

7/18/2025

Pre-Offer Conference BPM007067 Used Automotive Fluid Removal and Collection Services September 23, 2025 • 9:00 am – 11:00 am Virtual

Rev. 03/2025

Completion of this sign-in sheet is completely voluntary and helps the project team keep an accurate record of meeting attendees. Under state law, any identifying information provided below will become part of the public record and, as such, must be released to any individual upon request. Please print clearly.

NAME ORGANIZATION PHONE EMAIL SIGNATURE

For virtual (present/not present)

Kim Matura ADOT kmatura@azdot.gov Here

Tom Kornell ADOT tkornell@azdot.gov Here

Darren Fischer ADOT rfischer@azdot.gov Here

Jeremy Mason Reladyne Jeremy.mason@reladyne.com Here

Pamela Veal ADOT pveal@azdot.gov Not Here

Leonard Lapham Safety Kleen Lapham.leonard@safety-kleen.com

Here

Jeff Carpenter Crystal Clean Jeff.carpenter@crystal-clean.com

Not here

Michael Wilson Crystal Clean Michael.wilson2@crystal-clean.com

Not Here

Ricky Packingham Crystal Clean Ricky.packingham@crystal-clean.com

Here

Chris Radcliff BR Associates Chris.brassociates@gmail.com Here

Sierra Occo For Love Here

Oliver H 4 Elements Distribution Group sales@4elementsdg.com Not Here

Pre-Offer Conference BPM007067 Used Automotive Fluid Removal and Collection Services September 23, 2025 • 9:00 am – 11:00 am Virtual

Rev. 03/2025

Completion of this sign-in sheet is completely voluntary and helps the project team keep an accurate record of meeting attendees. Under state law, any identifying information provided below will become part of the public record and, as such, must be released to any individual upon request. Please print clearly.

NAME ORGANIZATION PHONE EMAIL SIGNATURE

For virtual (present/not present)

Bridget 4 Elements Distribution Group info@4elementsdg.com Here

Patrick Church Crystal Clean Here

Ryan Grainger ryan@fuels360.con Here