Signature__4___1___002_.pdf
PDF 399 KB Posted
- Attached to
- Competitive Selection OH|DOT101L26-4
- Contract number
- DOT101L26-4
- Issued by
- Ohio
About this file
This document is a Signature Page for a procurement by the State of Ohio, Department of Transportation (ODOT), Office of Contract Sales, Purchasing Services. The procurement is identified as Procurement #101L-26 and involves Cross-Roads Asphalt Recycling Inc as the bidder. The document serves as an acknowledgment of contract terms and a formal acceptance of the bidder's offer, with signatures from Jeremy Ciechanoski (President of Cross-Roads Asphalt Recycling Inc) and Pamela Boratyn (Director of ODOT), executed electronically on 2025-04-29.
The contract is for Liquid Asphalt, designated as a Multiple Award procurement. The signature page indicates that Cross-Roads Asphalt Recycling Inc has been selected for award and will be bound by all terms and conditions of the procurement. While specific pricing details, contract duration, and precise scope are not fully detailed in this signature page, the document represents the formal agreement between ODOT and the contractor for the provision of liquid asphalt commodities or services.
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Other files
| File | Type | Posted |
|---|---|---|
| 1-Signed_Affirmation_and_Disclosure__1_.pdf | ||
| 101L__26__recommend.pdf | ||
| 101L-26.pdf | ||
| 1-101LPricing_26__03_21_25_.xls | XLS spreadsheet | |
| 1-ODOT_Pre_Qualification.pdf |
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Text version
State of Ohio, Department of Transportation (ODOT) Office of Contract Sales, Purchasing Services
SIGNATURE PAGE
Procurement # 101L-26
Commodities Commodity/Service: Liquid Asphalt Multiple Award:
This Signature Page, once fully executed, serves as acknowledgement to the Department that the Bidder understands and will comply with all terms, conditions, and requirements in submitting a response for the above-referenced procurement.
Furthermore, the execution of this Signature Page shall serve as acknowledgment that the Bidder is entering into a Contract with the State of Ohio, Department of Transportation and has been selected for award of the above-referenced procurement and understands it shall be bound by all terms and conditions included in this procurement.
The person signing and executing this Signature Page below acknowledges that he/she is signing on behalf of their Company in a representative capacity and hereby warrants that he/she has been duly authorized by his/her Company to submit this formal response and is authorized to execute Contracts on such Company’s behalf.
(Please execute below)
Company (Bidder) Name: ________________________________________________________
Signature: _____________________________________________________________
Print Name of Officer: ___________________________________________________________
Title of Signing Officer: __________________________________________________________
Date: _________________________________________
FOR USE BY THE OHIO DEPARTMENT OF TRANSPORTATION ONLY:
Pursuant to Section 33 of the Instructions, Terms and Conditions for Bidding, a signature below by the Director of ODOT shall serve as the Department’s formal acceptance of the bidder’s offer and will effectively form ODOT Contract between the State of Ohio, Department of Transportation and the above successful bidder (company):
Pamela Boratyn as signed by Nathan Fling
Pamela Boratyn Director State of Ohio, Department of Transportation
| 193JxyeyUdA9_KS6dZ7eMYksM: Jeremy Ciehanoski | |
| 193JxyeyUdA9_gBsQawsPOXo3: President | |
| 193JxyeyUdA9_t3kGQTVHIowA: Cross-Roads Asphalt Recycling Inc | |
| 193JxyeyUdA9_6knF6K8kZ1MG: 2025-04-29 15:22:07 | |
| 2025-04-29T15:22:13+0000 | |
| Client IP: 24.106.79.246, Transaction ID: on_gr_1aLnuxbbMbfyG5xZMd1NM= | |
| OneSpan | |
| E-SIGNED by Jeremy Ciehanoski (jeremy@crossroadsasphalt.com), ID: bd7bd020-0995-411f-bddb-e944fa124732 |
| 2025-04-29T17:25:26+0000 | |
| Client IP: 156.63.133.8, Transaction ID: on_gr_1aLnuxbbMbfyG5xZMd1NM= | |
| OneSpan | |
| E-SIGNED by Max Fling (nathan.fling@dot.ohio.gov), ID: 332559f9-28a3-4c75-8cb9-89207993fc7a |
File details come from the government source that posted it. Updated .