CTR078969_Pre-Contract_Documents.pdf

Sage Brenner <sbrenner@azdot.gov>

Assignment of PRF 3257lfor 1 message

Amar Greasham <agreasham@azdot.gov> Thu, Oct 2, 2025 at 2:58 PM To: Sage Brenner <sbrenner@azdot.gov> Cc: Laura Forst <lforst@azdot.gov>, Craig Skipper <cskipper2@azdot.gov>, Arthur Dykeman <ADykeman@azdot.gov>

Hi Sage

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

Timestamp 10/2/2025 13:42:35 Email Address lforst@azdot.gov Project Manager Email cskipper2@azdot.gov Project Name/Description Wastewater Septic Pumping, Hauling, and Disposal Services Customer Division Administrative Services (ASD) Is there an existing or previous contract? Yes Contract No. CTR051299 Request Type Ongoing requirement What is the anticipated expenditure? 400,000.00 Annual estimated quantities https://drive.google.com/open?id=1uL6ZrRQVqXDCVWoevNcbkyAwSQAAnYbu Specifications/Scope of work https://drive.google.com/open?id=1Fie9lpBF-ZStBKUozSD-7cFLrR0FOmyD Additional Information 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=12FY22cK_jyjWTLknhMXB9f8JUXeyUtzy Division Finance Officer (DiFO): Approval https://drive.google.com/open?id=1G8tlNQxHX7RtqFP5NuknSyTOVRVtiaAM

Requester Phone Number (602) 712-6077 Project Manager Phone Number (602) 397-3326

PRF No. 3257lfor

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

Best Regards, mailto:lforst@azdot.gov mailto:cskipper2@azdot.gov https://drive.google.com/open?id=1uL6ZrRQVqXDCVWoevNcbkyAwSQAAnYbu https://drive.google.com/open?id=1uL6ZrRQVqXDCVWoevNcbkyAwSQAAnYbu https://drive.google.com/open?id=1uL6ZrRQVqXDCVWoevNcbkyAwSQAAnYbu https://drive.google.com/open?id=1uL6ZrRQVqXDCVWoevNcbkyAwSQAAnYbu https://drive.google.com/open?id=1Fie9lpBF-ZStBKUozSD-7cFLrR0FOmyD https://drive.google.com/open?id=1Fie9lpBF-ZStBKUozSD-7cFLrR0FOmyD https://drive.google.com/open?id=1Fie9lpBF-ZStBKUozSD-7cFLrR0FOmyD https://drive.google.com/open?id=12FY22cK_jyjWTLknhMXB9f8JUXeyUtzy https://drive.google.com/open?id=12FY22cK_jyjWTLknhMXB9f8JUXeyUtzy https://drive.google.com/open?id=12FY22cK_jyjWTLknhMXB9f8JUXeyUtzy https://drive.google.com/open?id=1G8tlNQxHX7RtqFP5NuknSyTOVRVtiaAM https://drive.google.com/open?id=1G8tlNQxHX7RtqFP5NuknSyTOVRVtiaAM https://drive.google.com/open?id=1G8tlNQxHX7RtqFP5NuknSyTOVRVtiaAM https://drive.google.com/open?id=1G8tlNQxHX7RtqFP5NuknSyTOVRVtiaAM

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

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

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/ 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: Thanks for filling out this form: Significant Procurement Notification Form 1 message

ProcurementCompliance - ADOT <procurementcompliance@azdot.gov> Tue, Oct 7, 2025 at 1:26 PM 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: Forms response receipts <forms-receipts-noreply@google.com> Date: Tue, Oct 7, 2025 at 1:25 PM Subject: Thanks for filling out this form: Significant Procurement Notification Form To: <Procurementcompliance@azdot.gov>

Thanks for filling out this form: Significant Procurement Notification Form 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?usp=mail_form_link https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?usp=mail_form_link

You’re receiving this email because you filled out the following form using your email address. This form is owned by State of Arizona. Make sure you recognize and trust this form before copying or clicking on any links.

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).

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 https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?edit2=2_ABaOnudmyG2-TMiclRz5hvfkANn2Fy2BXu6LPcHYfoWYEryzxpf71A0ak0JmtsX-8mNgppc 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 mailto:Procurementcompliance@azdot.gov mailto:Procurementcompliance@azdot.gov

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

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? *

CTR078969 Wastwater Septic Pumping, Hauling, and Disposal 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))

Other:

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

MM

06 /

DD

30 /

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

10 /

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 mailto:gpaul@azdot.gov https://docs.google.com/forms?usp=mail_form_link

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: BE2C9BA7-158F-402A-AA8C-4B2F3E27D6B2

BPM007041 - Wastewater Septic Pumping, Hauling, and Disposal Services Statewide 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.

n/a n/a

D. Thompson 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

DThompson@azdot.govD. Thompson

602.7127744Risk Management Analyst

7/7/2025

X

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: 189D1291-05EC-4568-A867-A7DCC32172AB

BPM007041 - Wastewater Septic Pumping, Hauling and Disposal Services 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

Arthur Dykeman

VLS

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

Facilities Planning Manager

X

Arthur Dykeman

6/30/2025

ADOT Facilities Planning

Adykeman@azdot.gov adykeman@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: FE2522DC-BE18-48A6-8DDA-9E3A2BE1C09C 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

Laura Forst 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

6/30/2025

ADOT

Laura Forst

ASD Contracts Compliance Officer

LForst@azdot.gov

X

6027126077

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: 78E0D0B3-C583-45E2-9D2C-5503DAEC9BC9 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

Craig Skipper 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

ADOT6/30/2025

Craig Skipper cskipper2@azdot.gov

Water/Wastewater Manager 6023973326

Entity Details

Statutory Agent Information

Principal Information

Entity Known Place of Business

Entity Name:

VLS ENVIRONMENTAL

SOLUTIONS LLC

Entity ID: 23264992

Entity Type: Foreign LLC Entity Status: Active

Formation Date: 8/26/2021 Reason for Status:

Approval Date: 8/31/2021 Status Date:

Original Incorporation Date: 12/11/2007 Life Period: Perpetual

Business Type:

Management of Companies and Enterprises

Last Annual Report Filed:

Domicile State: Delaware Annual Report Due Date:

Years Due:

Name:

CORPORATION SERVICE

COMPANY

Appointed Status: Active 9/28/2021

Attention:

Address:

7955 S Priest Dr., Suite 102, Tempe, AZ 85284, USA

Agent Last Updated: 4/29/2022

Attention: Mailing Address:

7955 S Priest Dr., Suite 102, Tempe, AZ 85284, USA

E-mail: County: Maricopa

Title Name Address Date of Taking Office

Last Updated

Manager John C Magee 19500 SH 249, Suite 440, HOUSTON, TX, 77070, Harris County, USA

8/31/2021

Manager David M Fleming

19500 SH 249, Suite 440, HOUSTON, TX, 77070, Harris County, USA

8/31/2021

In Good Standing

Arizona Corporation Commission Corporations Division Website Entity Detail. http://ecorp.azcc.gov/

Arizona Corporation Commission Page 1 of 2Page 1 of 2

10/24/2025 11:53:43 AM10/24/2025 11:53:43 AM

Entity Principal Office Address

Address: AZ, USA County: Last Updated: 8/31/2021

Address:

David Agnew

19500 SH 249,

Suite 440, HOUSTON, TX, 77070, USA

County: Harris Last Updated: 4/29/2022

Arizona Corporation Commission Corporations Division Website Entity Detail. http://ecorp.azcc.gov/

Arizona Corporation Commission Page 2 of 2Page 2 of 2

10/24/2025 11:53:44 AM10/24/2025 11:53:44 AM

Entity Details

Statutory Agent Information

Principal Information

Entity Name:

STORMWATER PROS

LLC

Entity ID: L16090818

Entity Type: Domestic LLC Entity Status: Active

Formation Date: 6/16/2010 Reason for Status:

Approval Date: 6/21/2010 Status Date:

Original Incorporation Date: 6/16/2010 Life Period: Perpetual

Business Type: Any legal purpose Last Annual Report Filed:

Domicile State: Arizona Annual Report Due Date:

Years Due:

Origninal Publish Date: 7/14/2010

Name:

CT CORPORATION

SYSTEMS

Appointed Status: Active 2/9/2022

Attention:

Address:

3800 NORTH CENTRAL

AVENUE SUITE 460,

PHOENIX, AZ 85012, USA

Agent Last Updated: 2/9/2022

Attention: Mailing Address:

3800 NORTH CENTRAL

AVENUE SUITE 460,

PHOENIX, AZ 85012, USA

E-mail:

ct-statecommunications@wolterskluwer.com

County: Maricopa

Title Name Address Date of Taking Office

Last Updated

Manager

BRIG

CHRISTENSEN

4077 E CULLUMBER ST, GILBERT, AZ, 85234,

Maricopa County, USA

4/14/2017 2/9/2022

Member

BRIG

CHRISTENSEN

4077 E CULLUMBER ST, GILBERT, AZ, 85234,

Maricopa County, USA

6/16/2010 2/9/2022

In Good Standing

Arizona Corporation Commission Corporations Division Website Entity Detail. http://ecorp.azcc.gov/

Arizona Corporation Commission Page 1 of 2Page 1 of 2

10/24/2025 11:54:43 AM10/24/2025 11:54:43 AM

Entity Known Place of Business

Entity Principal Office Address

Member

SWP HOLDINGS,

LLC

621 17TH STREET SUITE 1710, DENVER, CO,

80202, Denver County, USA

2/4/2022 2/9/2022

Manager GLEN MILLETT

502 E HOUSTON AVE, GILBERT, AZ, 85234,

Maricopa County, USA

2/4/2022 2/9/2022

Address:

1640 S. Stapley Drive, Ste. 235, MESA, AZ, 85204, USA

County: Maricopa Last Updated: 2/9/2022

Address: County: Last Updated:

Arizona Corporation Commission Corporations Division Website Entity Detail. http://ecorp.azcc.gov/

Arizona Corporation Commission Page 2 of 2Page 2 of 2

10/24/2025 11:54:44 AM10/24/2025 11:54:44 AM

VLS ENVIRONMENTAL SOLUTIONS LLC

Unique Entity ID

NDXYKF5ZP1N9

CAGE / NCAGE

9FDK1

Purpose of Registration

All Awards

Registration Status

Active Registration

Expiration Date

Oct 22, 2026

Physical Address

19500 State Highway 249 STE 440

Houston, Texas 77070-3022

United States

Mailing Address

19500 State Highway 249 STE 440

Houston, Texas 77070-3022

United States

Business Information

Doing Business as

(blank)

Division Name

(blank)

Division Number

(blank)

Congressional District

Texas 38

State / Country of Incorporation

Delaware / United States

URL

(blank)

Registration Dates

Activation Date

Oct 24, 2025

Submission Date

Oct 22, 2025

Initial Registration Date

Dec 6, 2022

Entity Dates

Entity Start Date

Dec 27, 2007

Fiscal Year End Close Date

Dec 31

Immediate Owner

CAGE

(blank)

Legal Business Name

(blank)

Highest Level Owner

CAGE

(blank)

Legal Business Name

(blank)

Executive Compensation

Registrants in the System for Award Management (SAM) respond to the Executive Compensation questions in accordance with Section 6202 of

P.L. 110-252, amending the Federal Funding Accountability and Transparency Act (P.L. 109-282). This information is not displayed in SAM. It is sent to USAspending.gov for display in association with an eligible award. Maintaining an active registration in SAM demonstrates the registrant responded to the questions.

Proceedings Questions

Registrants in the System for Award Management (SAM.gov) respond to proceedings questions in accordance with FAR 52.209-7, FAR 52.209-9, or 2. C.F.R. 200 Appendix XII. Their responses are displayed in the responsibility/qualification section of SAM.gov. Maintaining an active registration in SAM.gov demonstrates the registrant responded to the proceedings questions.

Exclusion Summary

Active Exclusions Records?

No

SAM Search Authorization

I authorize my entity's non-sensitive information to be displayed in SAM public search results:

Yes

Entity Types

Business Types

Entity Structure

Corporate Entity…