CTR054377_Contract_Amendment_Summary_Four__4_.pdf

ARIZONA DEPARTMENT OF TRANSPORTATION

1739 W. Jackson Street, MD 100P

Phoenix, AZ 85007 602.712.7211

Contract Amendment Summary CONTRACTOR: Phoenix Pumps Inc. AMENDMENT NO.: Four (4) DESCRIPTION: On-Call Storm Pump Repair Services

Rev. 04/2020

Procurement

Pursuant to the Uniform Terms and Conditions, Section 5, Contract Changes, the above referenced contract is amended. Summary of changes is as follows:

1. In accordance with Arizona Revised Statues Section § 35-394, the Forced Labor of Ethnic Uyghurs Ban certification (attached) is hereby added to the contract.

2. All other terms, conditions and provisions of this contract remain unchanged.

Procurement

FORCED LABOR OF ETHNIC UYGHURS BAN

CTR054377 Available online at https://app.az.gov

SPO Form 205 (rev 09-2022)

Forced Labor of Ethnic Uyghurs Ban Please note that if any of the following apply to the Contractor, then the Offeror shall select the “Exempt Contractor” option below:

• Contractor is a sole proprietorship;

• Contractor has fewer than ten (10) employees; OR

• Contractor is a non-profit organization.

Pursuant to A.R.S. § 35-394, the State of Arizona prohibits a public entity from entering into or renewing a contract with a company unless the contract includes written certification that the company does not use the forced labor, or any goods or services produced by the forced labor, of ethnic Uyghurs in the People's Republic of China.

Under A.R.S. §35-394:

1. "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company or other entity or business association, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate, that engages in for-profit activity and that has ten or more full-time employees.

2. "Public entity" means this State, a political subdivision of this State or an agency, board, commission or department of this State or a political subdivision of this State.

In compliance with A.R.S. §§ 35-394 et seq., all offerors must select one of the following:

The Company submitting this Offer does not use, and agrees not to use during the term of the contract, any of the following:

• Forced labor of ethnic Uyghurs in the People’s Republic of China;

• Any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China; or

• Any Contractors, Subcontractors, or suppliers that use the forced labor or any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China.

☐ The Company submitting this Offer does participate in use of Forced Uyghurs Labor as described in A.R.S. § 35-394.

Exempt Contractor.

Indicate which of the following statements applies to this Contractor (may be more than one):

☐ Contractor is a sole proprietorship;

☐ Contractor has fewer than ten (10) employees; and/or ☐ Contractor is a non-profit organization.

Phoenix Pumps Inc.

Company Name Signature of Person Authorized to Sign

5100 S. 36th Street

Scott Shepherd Address Printed Name

Phoenix AZ 85040

Service Production Manager City State Zip Title

9/18/2023 Date https://app.az.gov/