Signature__4___1___002_.pdf
PDF 464 KB Posted
- Attached to
- Competitive Selection OH|DOT111A25-2
- Contract number
- DOT111A25-2
- Issued by
- Ohio
About this file
This document is a Signature Page for Procurement #111-25 from the State of Ohio, Department of Transportation (ODOT), Office of Contract Sales, Purchasing Services. The procurement involves a multiple award contract, with Derg USA Inc. as the bidder/contractor. The signature page serves as a formal acknowledgment of the bidder's understanding and compliance with all procurement terms, conditions, and requirements, and signifies the company's entry into a contract with ODOT.
The contract is for CV2X Connected Vehicle Equipment, with Karl Jeanbart, Chief Operating Officer of Derg USA Inc., executing the signature page on January 22, 2025. The document indicates that Pamela Boratyn, the ODOT Director, has formally accepted the bidder's offer, effectively forming an ODOT Contract between the State of Ohio and Derg USA Inc. The contract was electronically signed, with Nathan Fling signing on behalf of Pamela Boratyn on January 30, 2025. While specific pricing, option periods, and detailed service terms are not included in this signature page, the document represents a formal commitment between ODOT and the contractor for the procurement of connected vehicle equipment.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Derq_USA__Inc_111A-25_-_Affirmation_and_Disclosure.pdf | ||
| Derq_USA__Inc_111A-25_-_Pricing__2025_.xlsx | XLSX spreadsheet | |
| 111Spec__2025___002_.pdf | ||
| ODOT_Terms___Conditions_with_excel_pricing.pdf | ||
| ODOT_Co-Op_Program_Information.pdf |
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Text version
State of Ohio, Department of Transportation (ODOT) Office of Contract Sales, Purchasing Services
SIGNATURE PAGE
Procurement # 111-25
Commodities Commodity/Service:
CV2X Connected Vehicle Equipment
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
| 7FhepkqOmsQY_3ojLpfyDnGwG: 2025-01-22 16:28:18 | |
| 7FhepkqOmsQY_qBzhPqSsB2US: Karl Jeanbart | |
| 7FhepkqOmsQY_P6f7bNSTEZ8I: Chief Operating Officer | |
| 7FhepkqOmsQY_yCvHDKySjSUK: Derq USA Inc. | |
| 2025-01-22T16:28:43+0000 | |
| Client IP: 94.200.146.26, Transaction ID: Gmkn2H6phW5EwSSzx70Im56NjLg= | |
| OneSpan | |
| E-SIGNED by Karl Jeanbart (karl@derq.com), ID: a32f16db-5edf-46a0-af37-5e2a3d2ee070 |
| 2025-01-30T17:46:03+0000 | |
| Client IP: 156.63.133.254, Transaction ID: Gmkn2H6phW5EwSSzx70Im56NjLg= | |
| OneSpan | |
| E-SIGNED by Max Fling (nathan.fling@dot.ohio.gov), ID: f03362fd-4263-46cf-acc0-427a5983dbcd |
File details come from the government source that posted it. Updated .