CTR077709_Pre-Contract_Documents.pdf

Sage Brenner <sbrenner@azdot.gov>

Assignment of PRF 4068sbre

Amar Greasham <agreasham@azdot.gov> Wed, Jul 2, 2025 at 4:40 PM To: Sage Brenner <sbrenner@azdot.gov> Cc: Travis Legere <tlegere@azdot.gov>

HiSage, This PRF is being assigned to you. Please see the details below.

Timestamp 7/2/2025 16:18:06 Requester Email sbrenner@azdot.gov Requester Phone Number 6027128860 Project Manager Email tlegere@azdot.gov Project Manager Phone Number 6027125944 Project Name/Description Weigh-in Motion Scales and Systems Maintenance and Support Services Customer Division Enforcement & Compliance (ECD) Is there an existing or previous contract? Yes Contract No. CTR053767 Request Type Ongoing requirement What is the anticipated expenditure? 650000 Annual estimated quantities https://drive.google.com/open?id=14gXnFoX6BoGrQiwTNhPdLfjDAHJP3abX Specifications/Scope of work https://drive.google.com/open?id=12No9epCRz6fobeK9JArMzD5fd2kbSR1b Additional Information https://drive.google.com/open?id=1TnvQfTWFwlxuRA7N1-og_Ee_fxKTZo_I, https://drive.google.com/open?id=1gZHeOy-ultNORJ3nFT8mW8yHueVpUB0j ADOT Project Number

Federal Authorization Documentation (i.e.

Clearances, Joint Project Agreement, Public Interest Finding)

Funding Source State If Project Specific, % of Federal Funds

Select Federal Funding Agency

Manager Approval https://drive.google.com/open?id=1fJKsAf-kXLfB9mcVs3KnWPdf14PmUYQN Division Finance Officer (DiFO): Approval https://drive.google.com/open?id=1GrFq9FDRdVjPgwWBz65jk_ioF0wQS3gi

8/22/25, 9:42 AM State of Arizona Mail - Assignment of PRF 4068sbre https://mail.google.com/mail/u/0/?ik=2059c1cf41&view=pt&search=all&permmsgid=msg-f:1836580464080512265&simpl=msg-f:1836580464080512265 1/2 mailto:sbrenner@azdot.gov mailto:tlegere@azdot.gov https://drive.google.com/open?id=14gXnFoX6BoGrQiwTNhPdLfjDAHJP3abX https://drive.google.com/open?id=14gXnFoX6BoGrQiwTNhPdLfjDAHJP3abX https://drive.google.com/open?id=14gXnFoX6BoGrQiwTNhPdLfjDAHJP3abX https://drive.google.com/open?id=14gXnFoX6BoGrQiwTNhPdLfjDAHJP3abX https://drive.google.com/open?id=12No9epCRz6fobeK9JArMzD5fd2kbSR1b https://drive.google.com/open?id=12No9epCRz6fobeK9JArMzD5fd2kbSR1b https://drive.google.com/open?id=12No9epCRz6fobeK9JArMzD5fd2kbSR1b https://drive.google.com/open?id=12No9epCRz6fobeK9JArMzD5fd2kbSR1b https://drive.google.com/open?id=1TnvQfTWFwlxuRA7N1-og_Ee_fxKTZo_I https://drive.google.com/open?id=1TnvQfTWFwlxuRA7N1-og_Ee_fxKTZo_I https://drive.google.com/open?id=1TnvQfTWFwlxuRA7N1-og_Ee_fxKTZo_I https://drive.google.com/open?id=1gZHeOy-ultNORJ3nFT8mW8yHueVpUB0j https://drive.google.com/open?id=1gZHeOy-ultNORJ3nFT8mW8yHueVpUB0j https://drive.google.com/open?id=1gZHeOy-ultNORJ3nFT8mW8yHueVpUB0j https://drive.google.com/open?id=1fJKsAf-kXLfB9mcVs3KnWPdf14PmUYQN https://drive.google.com/open?id=1fJKsAf-kXLfB9mcVs3KnWPdf14PmUYQN https://drive.google.com/open?id=1fJKsAf-kXLfB9mcVs3KnWPdf14PmUYQN https://drive.google.com/open?id=1GrFq9FDRdVjPgwWBz65jk_ioF0wQS3gi https://drive.google.com/open?id=1GrFq9FDRdVjPgwWBz65jk_ioF0wQS3gi https://drive.google.com/open?id=1GrFq9FDRdVjPgwWBz65jk_ioF0wQS3gi

PRF No. 4068sbre

I've cc'd the customer so they're aware this has been assigned. Let me know if you have any questions.

Best Regards, Amar J. Greasham

PROCUREMENT MANAGER

ARIZONA DEPARTMENT

OF TRANSPORTATION

MD 100P, 1655 W Jackson St Phoenix, AZ 85007

602.712.8259 Cell: 480.404.2166 Website: azdot.gov

8/22/25, 9:42 AM State of Arizona Mail - Assignment of PRF 4068sbre https://mail.google.com/mail/u/0/?ik=2059c1cf41&view=pt&search=all&permmsgid=msg-f:1836580464080512265&simpl=msg-f:1836580464080512265 2/2 https://www.google.com/maps/search/1655+W+Jackson+St+Phoenix,+AZ%C2%A0+85007?entry=gmail&source=g https://www.google.com/maps/search/1655+W+Jackson+St+Phoenix,+AZ%C2%A0+85007?entry=gmail&source=g http://azdot.gov/

Sage Brenner <sbrenner@azdot.gov>

Fwd: Significant Procurement Notification Form 1 message

ProcurementCompliance - ADOT <procurementcompliance@azdot.gov> Wed, Jul 16, 2025 at 9:20 AM To: Sage Brenner <sbrenner@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, Jul 16, 2025 at 9:19 AM Subject: Significant Procurement Notification Form To: <Procurementcompliance@azdot.gov>

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

8/25/25, 2:38 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=2059c1cf41&view=pt&search=all&permthid=thread-f:1837821216694182657&simpl=msg-f:1837821216694182657 1/5 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

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).

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? *

8/25/25, 2:38 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=2059c1cf41&view=pt&search=all&permthid=thread-f:1837821216694182657&simpl=msg-f:1837821216694182657 2/5 https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?edit2=2_ABaOnufEKazG5pxKCebwWy1x9vZj2-VQzk-q_rWRslwTcTiYZm7nikqakwmJa7cKqgWE5tA https://spointra.az.gov/resources/standard-procedures https://spo.az.gov/contracts/significant-procurement-roles https://spo.az.gov/contracts/significant-procurement-roles mailto:SPOCompliance@azdoa.gov mailto:SPOCompliance@azdoa.gov

Sage Brenner

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? *

CTR077709 Weigh-in Motion Scales and Systems Maintenance and Support Services

What is the procurement type? *

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))

8/25/25, 2:38 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=2059c1cf41&view=pt&search=all&permthid=thread-f:1837821216694182657&simpl=msg-f:1837821216694182657 3/5

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

15 /

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

07 /

DD

23 /

YYYY

What is your name (if different from above)?

Gloria Paul

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

gpaul@azdot.gov

Create your own Google Form

8/25/25, 2:38 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=2059c1cf41&view=pt&search=all&permthid=thread-f:1837821216694182657&simpl=msg-f:1837821216694182657 4/5 mailto:gpaul@azdot.gov https://docs.google.com/forms?usp=mail_form_link

Does this form look suspicious? Report 8/25/25, 2:38 PM State of Arizona Mail - Fwd: Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=2059c1cf41&view=pt&search=all&permthid=thread-f:1837821216694182657&simpl=msg-f:1837821216694182657 5/5 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)

Docusign Envelope ID: 96755D5C-65A6-4B66-8A4F-8A2EF5CC5DAB

CTR077709 Weigh-in Motion Scales and Systems Maintenance and Support Services cc: Agency File Page 2 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23)

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.

D. Thompson n/a n/a https://spointra.az.gov/resources/standard-forms-and-documents cc: Agency File Page 3 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23)

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

X

DThompson@azdot.gov

Risk Management Analyst

X

D. Thompson

7/15/2025

602.712.7744

ADOT Risk Management

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

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

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

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

Docusign Envelope ID: E238FBBA-20B7-4A2E-8BE0-3EBBF2284FEF cc: Agency File Page 2 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23) 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, The substantial interests, both pecuniary and proprietary, held by me and/or a relative which may involve the

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

1 “Relative” means my spouse, child, child’s child, parent, grandparent, brother or sister (of the whole or half-

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

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

John Morales

We have truck screening equipment at various locations and we meet regular to ensure that the system is functioning properly.

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

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

I shall not receive any direct benefit from the utilization of confidential information, specifications, plans, scopes 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

I shall maintain strict security and confidentiality regarding the process or decisions regarding any protest or

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

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

I understand that if I knowingly violate the terms of this Agreement, I will be subject to suspension for not less than

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

X jmorales@azdot.gov

ADOT

X

Program Administrator

John Morales

602-712-4136

7/17/2025

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

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

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

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

Docusign Envelope ID: B15D13BA-87C6-410A-9C45-59A6FB104531 cc: Agency File Page 2 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23) 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, The substantial interests, both pecuniary and proprietary, held by me and/or a relative which may involve the

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

1 “Relative” means my spouse, child, child’s child, parent, grandparent, brother or sister (of the whole or half-

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

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

Kelly Lightfoot

N/A

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

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

I shall not receive any direct benefit from the utilization of confidential information, specifications, plans, scopes 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

I shall maintain strict security and confidentiality regarding the process or decisions regarding any protest or

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

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

I understand that if I knowingly violate the terms of this Agreement, I will be subject to suspension for not less than

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

Kelly Lightfoot

ADOT/ ECD

Program Administrator 2

928-587-2192

7/16/2025 klightfoot@azdot.gov

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

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

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

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

Docusign Envelope ID: 51243483-729E-49E8-A278-9F5F1F92A293 cc: Agency File Page 2 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23) 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, The substantial interests, both pecuniary and proprietary, held by me and/or a relative which may involve the

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

1 “Relative” means my spouse, child, child’s child, parent, grandparent, brother or sister (of the whole or half-

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

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

NA

Thomas Branham

NA

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

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

I shall not receive any direct benefit from the utilization of confidential information, specifications, plans, scopes 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

I shall maintain strict security and confidentiality regarding the process or decisions regarding any protest or

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

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

I understand that if I knowingly violate the terms of this Agreement, I will be subject to suspension for not less than

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

Cyber Security & Privacy Officer tbranham@azdot.gov

6027636089

ADOT

Thomas Branham

X

7/15/2025

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

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

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

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

Docusign Envelope ID: 020043D9-2C97-414A-97FB-6E02F6A5929F cc: Agency File Page 2 of 3 SPO Form 120 - State Employee Procurement Disclosure Statement (rev 04-04-23) 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.