Signature__4___1___002_.pdf

State of Ohio, Department of Transportation (ODOT) Office of Contract Sales, Purchasing Services

SIGNATURE PAGE

Procurement # 801G-26

Commodities Commodity/Service: Asphalt Concrete, Bituminous Mixes, Equipment Rental, and Material Hauling

Multiple Award: For all Plants submitted on this contract, and supplying the Asphalt Concrete Pricing (Bid Items 1-19 and 25-31), at any time during the contract period (through 2/28/2026) the AWP code is not on the approved/active list, the Plant will be subject to suspension of the contract, for these items, until they have provided documentation of the AWP code or have been re-established on the approved/active list.

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