HomeMy WebLinkAbout145-26 RESOLUTIONPage 1
113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Resolution: 145-26
File Number: 2026-1787
A RESOLUTION TO APPROVE THE PURCHASE OF PORTABLE TRAFFIC SIGNALS FROM OMJC
SIGNAL INC. IN THE TOTAL AMOUNT OF $65,696.47, PURSUANT TO A BUYBOARD COOPERATIVE
PURCHASING CONTRACT, PLUS ANY APPLICABLE SURCHARGES, FREIGHT CHARGES, TITLE,
LICENSING OR DELIVERY FEES UP TO 10% OF THE ORIGINAL PURCHASE PRICE, AND TO
APPROVE A BUDGET AMENDMENT.
WHEREAS, water and sewer utility construction activity has been increasing through the city, requiring more traffic
control while performing needed work on city infrastructure; and
WHEREAS, the purchase of these portable traffic signals will support ongoing Water and Sewer operations and
reduce the need for continued rental expenses associated with similar equipment on current and future projects and will
provide a more cost-effective long-term solution; and
WHEREAS, the portable traffic signals may also be utilized by other departments as operational needs arise,
improving work zone safety and traffic control on linear projects, reducing reliance on manual flagging operations, and
allowing personnel to be utilized more efficiently while maintaining safety and traffic control compliance.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE,
ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby authorizes the purchase of portable traffic
signals from OMJC Signal Inc. in the total amount of $65,696.47, pursuant to a BuyBoard cooperative purchasing
contract, plus any applicable surcharges, freight charges, title, licensing or delivery fees up to 10% of the original
purchase price.
Section 2: That the City Council of the City of Fayetteville, Arkansas hereby approves a budget amendment, a copy of
which is attached to this Resolution.
PASSED and APPROVED on June 16, 2026
Approved: Attest:
_______________________________
Molly Rawn, Mayor
_______________________________
Kara Paxton, City Clerk Treasurer
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
Mailing address:
113 W. Mountain Street
Fayetteville, AR 72701
www.fayetteville-ar.gov
CITY COUNCIL MEMO
2026-1787
MEETING OF JUNE 16, 2026
TO: Mayor Rawn and City Council
THROUGH: Terry Gulley, Asst Public Works Director - Ops
FROM: Ross Jackson, Fleet Operations Superintendent
SUBJECT: Purchase of two expansion mobile traffic signals for the Water Sewer Department
through OMJC Signal Inc.
RECOMMENDATION:
A RESOLUTION TO AUTHORIZE THE PURCHASE OF ONE SET OF TWO PORTABLE TRAFFIC SIGNALS
IN THE AMOUNT OF $65,696.47 FROM OMJC SIGNAL INC. PLUS ANY ADDITIONAL TAXES,
SURCHARGES, FREIGHT CHARGES, TITLE, LICENSING OR DELIVERY FEES UP TO 10% OF THE
ORIGINAL PURCHASE PRICE IN ACCORDANCE WITH A BUYBOARD COOPERATIVE PURCHASING
CONTRACT (795-26) AND APPROVE A BUDGET AMENDMENT.
BACKGROUND:
Water and Sewer utility construction activity has been increasing throughout the city, requiring more traffic
control while performing needed work on city infrastructure. If approved, it will be asset 9399 (WSEW_F130).
DISCUSSION:
The purchase of these portable traffic signals will support ongoing Water and Sewer operations and reduce the
need for continued rental expenses associated with similar equipment on current and future projects. Based on
operational usage and projected demand, purchasing the equipment is expected to provide a more cost-
effective long-term solution.
In addition to supporting Water and Sewer operations, the portable traffic signals may also be utilized by other
departments as operational needs arise. The equipment will improve work zone safety and traffic control on
linear projects, reduce reliance on manual flagging operations, and allow personnel to be utilized more
efficiently while maintaining safety and traffic control compliance.
BUDGET/STAFF IMPACT:
This is not a FY26 budgeted expansion, a budget amendment is attached for your approval.
ATTACHMENTS: 3. Staff Review Form, 4. Budget Adjustment, 5. OMJC Final Quote , 6. Price Hold Through
June, 7. BuyBoard Contract 795-26 OMJC Tabulation Sheet, 8. OMJC BuyBoard Contract-1
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Page 1
City of Fayetteville, Arkansas
Legislation Text
113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
File #: 2026-1787
A RESOLUTION TO APPROVE THE PURCHASE OF PORTABLE TRAFFIC SIGNALS
FROM OMJC SIGNAL INC. IN THE TOTAL AMOUNT OF $65,696.47, PURSUANT TO A
BUYBOARD COOPERATIVE PURCHASING CONTRACT, PLUS ANY APPLICABLE
SURCHARGES, FREIGHT CHARGES, TITLE, LICENSING OR DELIVERY FEES UP TO
10% OF THE ORIGINAL PURCHASE PRICE, AND TO APPROVE A BUDGET
AMENDMENT.
WHEREAS, water and sewer utility construction activity has been increasing through the city,
requiring more traffic control while performing needed work on city infrastructure; and
WHEREAS, the purchase of these portable traffic signals will support ongoing Water and Sewer
operations and reduce the need for continued rental expenses associated with similar equipment on
current and future projects and will provide a more cost-effective long-term solution; and
WHEREAS, the portable traffic signals may also be utilized by other departments as operational needs
arise, improving work zone safety and traffic control on linear projects, reducing reliance on manual
flagging operations, and allowing personnel to be utilized more efficiently while maintaining safety and
traffic control compliance.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby authorizes the purchase of
portable traffic signals from OMJC Signal Inc. in the total amount of $65,696.47, pursuant to a
BuyBoard cooperative purchasing contract, plus any applicable surcharges, freight charges, title,
licensing or delivery fees up to 10% of the original purchase price.
Section 2: That the City Council of the City of Fayetteville, Arkansas hereby approves a budget
amendment, a copy of which is attached to this Resolution.
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
City of Fayetteville Staff Review Form
2026-1787
Item ID
6/16/2026
City Council Meeting Date - Agenda Item Only
N/A for Non-Agenda Item
Ross Jackson 5/14/2026 FLEET OPERATIONS (770)
Submitted By Submitted Date Division / Department
Action Recommendation:
A RESOLUTION TO AUTHORIZE THE PURCHASE OF ONE SET OF TWO PORTABLE TRAFFIC SIGNALS IN THE AMOUNT
OF $65,696.47 FROM OMJC SIGNAL INC. PLUS ANY ADDITIONAL TAXES, SURCHARGES, FREIGHT CHARGES OR
DELIVERY FEES UP TO 10% OF THE ORIGINAL PURCHASE PRICE IN ACCORDANCE WITH A BUYBOARD COOPERATIVE
PURCHASING CONTRACT (795-26) AND APPROVE A BUDGET AMENDMENT.
Budget Impact:
9700.770.1920-5802.00 FLEET
Account Number Fund
97000.5400.720 FLEET EXPANSION VEHICLES- W&S
Project Number Project Title
Budgeted Item?Yes Total Amended Budget $84,489.00
Expenses (Actual+Encum)$84,308.28
Available Budget $180.72
Does item have a direct cost?Yes Item Cost $65,696.47
Is a Budget Amendment attached?Yes Budget Amendment $66,000.00
Remaining Budget $484.25
Purchase Order Number:Previous Ordinance or Resolution #
Change Order Number:Approval Date:
Original Contract Number:
Comments:
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
City of Fayetteville, Arkansas - Budget Amendment/Adjustment
(Agenda)
Budget Year Division
/Org2 FLEET OPERATIONS (770)
BA Number
2026 Requestor:Ross Jackson
BUDGET AMENDMENT/ADJUSTMENT DESCRIPTION:
This budget adjustment is requested for the purchase of a portable traffic signal to support Water and Sewer operations.
The cost is comparable to a single project rental, making this a cost-effective long-term investment. Owning the equipment
will improve traffic control and job site safety on utility projects while reducing the need for manual flagging and additional
personnel. Traffic signal to be unit 9399 WSEW_F130.
COUNCIL DATE:6/16/2026
ITEM ID#:2026-1787
April Melton
5/20/2026 9:03 AM
Budget Division Date
TYPE:D - (City Council)
JOURNAL #:
GLDATE:
6/16/2026
RESOLUTION/ORDINANCE CHKD/POSTED:/
v.202646TOTAL66,000 66,000
Increase / (Decrease)Project.Sub#
Account Number Expense Revenue Project Sub.Detl AT Account NameGLACCOUNTEXPENSEREVENUEPROJECTSUBATDESCRIPTION X
5400.720.1840-5801.00 (66,000)-15019 1 EX Fixed Assets
5400.720.4000-7602.70 66,000 -59700 5400 EX Transfers To Funds - Shop
9700.770.1920-6602.40 -66,000 97000 5400.720 RE Transfer from Fund - Water & Sewer
9700.770.1920-5802.00 66,000 -97000 5400.720 EX Vehicles & Equipment - base
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Quotation
ATTN:Ross Jackson
PH:479-444-3494
FAX:
Quote Number:
9803
Quote Date:
April 29, 2026
Sales Rep Name
Quoted to:
City of Fayetteville, AR
Good Thru
5/29/26
Customer ID Payment Terms
Page:
CFAYETTEVILLE Net 30 Days Tarah C. Dalziel
1
Quantity Item Description Unit Price Extension
1.00 MISC LDPTS-M: Per Texas BuyBoard 34,051.50 34,051.50
Description
MSRP: $36,225; 6% BuyBoard
Discount
1.00 MISC LDPTS-S: Per Texas BuyBoard 21,620.00 21,620.00
Description
MSRP: $23,000; 6% BuyBoard
Discount
2.00 VPR-26-OMJC Vehicle Motion Detector 1,100.00 2,200.00
BuyBoard Contract #795-26
*Freight as Estimate Only*
Total 65,696.47
Sales Tax 5,642.47
Subtotal 57,871.50
Freight 2,182.50
Freight & handling are in addition to the prices quoted above unless otherwise
specified. All parts, materials and components are new unless otherwise specified.
OMJC has been in business since July of 1985 to serve you.
City of Fayetteville, AR
1525 S Happy Hollow Rd
FAYETTEVILLE, AR 72701
SHIP TO:
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
1
Jackson, Ross
From:Tarah Dalziel <Tarah@omjcsignal.com>
Sent:Wednesday, May 20, 2026 10:30 AM
To:Jackson, Ross
Cc:Sales
Subject:Re: New TX BuyBoard Quote
CAUTION: This email originated from outside of the City of Fayetteville. Do not click links or open attachments unless you recognize
the sender and know the content is safe.
Good Morning Ross,
We will honor the price through the end of June. Do you need me to change the date and send you an
updated quote?
Thanks,
From: Jackson, Ross <rjackson@fayetteville-ar.gov>
Sent: Wednesday, May 20, 2026 10:05 AM
To: Tarah Dalziel <Tarah@omjcsignal.com>
Cc: Sales <sales@omjcsignal.com>
Subject: RE: New TX BuyBoard Quote
Tarah,
Could you let me know if the quoted price will be good through the month of June? The quote currently will expire June
12th, this will go to city council June 16th. I will need to know if you will honor the quote through the month of June.
Thank you,
Ross Jackson Jr., CAFM
Fleet Operations Superintendent
Fleet Operations
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v.01.03.2025
Electronic Delivery
Steve Salutric
OMJC Signal Inc
403 Chestnut ST
Waterloo, IA 50703
Welcome to BuyBoard!
Re: Proposal Invitation No. 795-
26, Traffic Signal Systems and Safety Barrier Products
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company
a BuyBoard® contract based on the above-referenced Proposal Invitation. The contract is effective for an
initial one-year term of April 1, 2026, through March 31, 2027, and may be subject to two possible one-
year renewals. Please refer to the Proposal Invitation for the contract documents, including the General
Terms and Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 795-26 at:
www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract
award, and only those awarded items may be sold through the BuyBoard contract. All sales must comply
with the contract terms and must be at or below the awarded pricing as set forth in the General Terms and
Conditions.
A list of Cooperative members is available on the buyboard.com website. In addition, the BuyBoard
Administrators vendor relations staff is available to assist you in locating available BuyBoard informational
resources and answering questions you may have as an awarded BuyBoard vendor.
On behalf of the Cooperative, we appreciate your interest in the Cooperative and we are looking forward
to your participation in the program. If you have any questions, feel free to contact me at
bids@buyboard.com.
Sincerely,
Victoria Lewis, Bid Analyst
Texas Association of School Boards, Inc.,
Administrator for The Local Government Purchasing Cooperative
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
Electronic Delivery
Steve Salutric
OMJC Signal Inc
403 Chestnut ST
Waterloo, IA 50703
Welcome to BuyBoard!
Re: Proposal Invitation No. 795-26, Traffic Signal Systems and
Safety Barrier Products
Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a
BuyBoard® contract based on the above-referenced Proposal Invitation. The contract is effective for an initial one-
year term of April 1, 2026, through March 31, 2027, and may be subject to two possible one-year renewals. Please
refer to the Proposal Invitation for the contract documents, including the National Purchasing Cooperative Vendor
Award Agreement and General Terms and Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 795-26 at
www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract award, and
only those awarded items may be sold through the BuyBoard contract. All sales must comply with the contract terms
and must be at or below the awarded pricing as set forth in the General Terms and Conditions.
A list of National Cooperative members is available on the buyboard.com website. In addition, the BuyBoard
Administrators vendor relations staff is available to assist you in locating available BuyBoard informational resources
and answering questions you may have as an awarded BuyBoard vendor.
On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any
questions, feel free to contact me at bids@buyboard.com.
Sincerely,
Victoria Lewis, Bid Analyst
Texas Association of School Boards, Inc.,
Administrator for the National Purchasing Cooperative
v.01.03.2025
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
PROPOSER’S ACCEPTANCE AND AGREEMENT
Proposal Invitation Name
Traffic Signal Systems and Safety Barrier Products
Proposal Due Date/Opening Date and Time
October 30, 2025, at 4:00 PM
Proposal Invitation Number
795-26
Location of Proposal Opening
Texas Association of School Boards, Inc.
BuyBoard Department
12007 Research Blvd.
Austin, TX 78759
Contract Term
April 1, 2026, through March 31, 2027,
with two possible one-year renewals.
Anticipated Cooperative Board Meeting Date
February 2026
________________________________________________ _______________________________________________
Name of Proposing Company Date
________________________________________________ _______________________________________________
Street Address Signature of Authorized Company Official
________________________________________________ _______________________________________________
City, State, Zip Printed Name of Authorized Company Official
________________________________________________ _______________________________________________
Telephone Number of Authorized Company Official Position or Title of Authorized Company Official
________________________________________________ _______________________________________________
Fax Number of Authorized Company Official Federal ID Number
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OMJC SIGNAL INC 10/29/2025
403 CHESTNUT ST
WATERLOO, IA. 50703
319-236-0200
JENNIFER SHIMP
PRESIDENT
42-1361699
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
PROPOSAL FORMS PART 1: COMPLIANCE FORMS
INSTRUCTIONS:
Proposer must review and complete all forms in this Proposal Forms Part 1:
Proposal Acknowledgements
Felony Conviction Disclosure
Resident/Nonresident Certification
Debarment Certification
Vendor Employment Certification
No Boycott Verification
No Excluded Nation or Foreign Terrorist Organization Certification
Historically Underutilized Business Certification
Acknowledgement of BuyBoard Technical Requirements
Construction-Related Goods and Services Affirmation
Deviation and Compliance
Vendor Consent for Name Brand Use
Confidential/Proprietary Information
EDGAR Vendor Certification
Compliance Forms Signature Page
An authorized representative of Proposer where indicated
and complete and sign the Compliance Forms Signature Page. Proposer’s failure to fully complete, initial,
and sign forms as required may result in your Proposal being rejected as non-responsive.
PROPOSAL ACKNOWLEDGEMENTS
The proposing company (“you” or “your”) hereby acknowledges and agrees as follows:
1. You have carefully examined and understand all information and documentation associated with this Proposal Invitation,
including the Instructions to Proposers, General Information, General Terms and Conditions, attachments/forms,
appendices, item specifications, and line items (collectively “Requirements”);
2. By your response (“Proposal”) to this Proposal Invitation, you propose to supply the products or services submitted at
the pricing quoted in your Proposal and in strict compliance with the Requirements, unless specific deviations or
exceptions are noted in the Proposal;
3. By your Proposal, you acknowledge and certify all items set forth in the General Terms and Conditions, Section B.12
(Certifications), including all non-collusion certifications and certifications regarding legal, ethical, and other matters set
forth therein.
4. Any and all deviations and exceptions to the Requirements have been noted in your Proposal on the required form and
no others will be claimed;
Initial: _____
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
5. If the Cooperative accepts any part of your Proposal and awards you a Contract, you will furnish all awarded products or
services at the pricing quoted and in strict compliance with the Requirements (unless specific deviations or exceptions are
noted on the required form and accepted by the Cooperative), including without limitation the Requirements related
to:
a. conducting business with Cooperative members, including offering pricing to members that is the best you offer
compared to similarly situated customers in similar circumstances;
b. payment of a service fee in the amount specified and as provided for in this Proposal Invitation;
c. the possible award of a piggy-back contract by the National Purchasing Cooperative or nonprofit entity, in which
event you will offer the awarded products and services in accordance with the Requirements; and
d. submitting price sheets or catalogs in the proper format as required by the Cooperative as a prerequisite to
activation of your Contract;
6. You have clearly identified on the included form any information in your Proposal that you believe to be confidential or
proprietary or that you do not consider to be public information subject to public disclosure under the Texas Public
Information Act or similar public information law;
7. The individual submitting this Proposal is duly authorized to enter into the contractual relationship represented by this
Proposal Invitation on your behalf and bind you to the Requirements, and such individual (and any individual signing a
form or Proposal document) is authorized and has the requisite knowledge to provide the information and make the
representations and certifications required in the Requirements;
8. You have carefully reviewed your Proposal, and certify that all information provided is true, complete, and accurate to
the best of your knowledge, and you authorize the Cooperative to take such action as it deems appropriate to verify
such information; and
9. Any misstatement, falsification, or omission in your Proposal, whenever or however discovered, will be grounds for
disqualifying you from consideration for a contract award under this Proposal Invitation, termination of a contract
award, or any other remedy or action provided for in the General Terms and Conditions or by law.
FELONYCONVICTIONDISCLOSURE
Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of Contractor)
states: “A person or business entity that enters into a contract with a school district must give advance notice to the district
if the person or an owner or operator has been convicted of a felony. The notice must include a general description of the
conduct resulting in the conviction of a felony.”
Section 44.034 further states in Subsection (b): “A school district may terminate a contract with a person or business
entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or
misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for
services performed before the termination of the contract.”
My company is a publicly-held corporation. (Advance notice requirement does not apply to publicly-held corporation.)
My company is not owned or operated by anyone who has been convicted of a felony.
My company is owned/operated by the following individual(s) who has/have been convicted of a felony:
Name of Felon(s): ___________________________________________________________________________________
Details of Conviction(s): _______________________________________________________________________________
__________________________________________________________________________________________________
Initial: _____
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
RESIDENT/NONRESIDENT CERTIFICATION
Chapter 2252, Subchapter A, of the Texas Government Code establishes certain requirements applicable to proposers who
are not Texas residents. Under the statute, a “resident” proposer is a person whose principal place of business is in Texas,
including a contractor whose ultimate parent company or majority owner has its principal place of business in Texas. A
“nonresident” proposer is a person who is not a Texas resident. Please indicate the status of your company as a “resident”
proposer or a “nonresident” proposer under these definitions.
I certify that my company is a Resident Proposer.
I certify that my company is a Nonresident Proposer.
If your company is a Nonresident Proposer, you must provide the following information for your resident state (the state in
which your company’s principal place of business is located):
________________________________________________ _______________________________________________
Company Name Address
________________________________________________ ___________ ________________________________
City State Zip Code
A. Does your resident state require a proposer whose principal place of business is in Texas to under-price proposers
whose resident state is the same as yours by a prescribed amount or percentage to receive a comparable contract?
Yes No
B. What is the prescribed amount or percentage? $_______________ or ______________%
DEBARMENT CERTIFICATION
By signature on the Compliance Forms Signature Page, I certify that neither my company nor an owner or principal of my
company has been debarred, suspended or otherwise made ineligible for participation in Federal Assistance programs under
Executive Order 12549, “Debarment and Suspension,” as described in the Federal Register and Rules and Regulations.
Neither my company nor an owner or principal of my company is currently listed on the government-wide exclusions in
SAM, debarred, suspended, or otherwise excluded by agencies or declared ineligible under any statutory or regulatory
authority. My company agrees to immediately notify the Cooperative and all Cooperative members with pending purchases
or seeking to purchase from my company if my company or an owner or principal is later listed on the government-wide
exclusions in SAM, or is debarred, suspended, or otherwise excluded by agencies or declared ineligible under any statutory
or regulatory authority.
VENDOR EMPLOYMENT CERTIFICATION
Section 44.031(b) of the Texas Education Code establishes certain criteria that a school district must consider when
determining to whom to award a contract. Among the criteria for certain contracts is whether the vendor or the vendor’s
ultimate parent or majority owner (i) has its principal place of business in Texas; or (ii) employs at least 500 people in
Texas. If neither your company nor the ultimate parent company or majority owner has its principal place of business in
Texas, does your company, ultimate parent company, or majority owner employ at least 500 people in Texas?
Yes No
Initial: ______
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OMJC SIGNAL INC 403 CHESTNUT ST
Waterloo IA 50703
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
NO BOYCOTT VERIFICATION
A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly or partly
from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees for goods or
services unless the contract contains a written verification from the company that it: (1) does not boycott Israel and will not
boycott Israel during the term of the contract (TEX. GOV’T CODE Ch. 2271), (2) does not boycott energy companies and will not
boycott energy companies during the term of the contract (TEX.GOV’T CODE Ch. 2276), and (3) does not have a practice, policy,
guidance, or directive that discriminates against a firearm entity or firearm trade association and will not discriminate during
the term of the contract against a firearm entity or firearm trade association (TEX. GOV’T CODE Ch. 2274). Accordingly, this
certification form is included to the extent required by law.
“Boycott Israel” means refusing to deal with, terminating business activities with, or otherwise taking any action that is
intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or
entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business
purposes. TEX. GOV’T CODE §808.001(1).
“Boycott energy company” means, without an ordinary business purpose, refusing to deal with, terminating business
activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial
relations with a company because the company: (A) engages in the exploration, production, utilization, transportation, sale,
or manufacturing of fossil fuel-based energy and does not commit or pledge to meet environmental standards beyond
applicable federal and state law; or (B) does business with a company described by Paragraph (A). TEX. GOV’T CODE
§809.001(1).
“Discriminate against a firearm entity or firearm trade association” means, (A) with respect to the entity or association, to:
(i) refuse to engage in the trade of any goods or services with the entity or association based solely on its status as a
firearm entity or firearm trade association; (ii) refrain from continuing an existing business relationship with the entity or
association based solely on its status as a firearm entity or firearm trade association; or (iii) terminate an existing business
relationship with the entity or association based solely on its status as a firearm entity or firearm trade association; and (B)
does not include: (i) the established policies of a merchant, retail seller, or platform that restrict or prohibit the listing or
selling of ammunition, firearms, or firearm accessories; and (ii) a company’s refusal to engage in the trade of any goods or
services, decision to refrain from continuing an existing business relationship, or decision to terminate an existing business
relationship: (aa) to comply with federal, state, or local law, policy, or regulations or a directive by a regulatory agency; or
(bb) for any traditional business reason that is specific to the customer or potential customer and not based solely on an
entity’s or association’s status as a firearm entity or firearm trade association. TEX. GOV’T CODE §2274.001(3).
By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor does not
boycott Israel, boycott energy companies, or discriminate against a firearm entity or firearm trade association and will not
do so during the term of any contract awarded under this Proposal Invitation, that this certification is true, complete and
accurate, and that I am authorized by my company to make this certification.
Initial: _____
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
NOEXCLUDEDNATIONORFOREIGNTERRORISTORGANIZATIONCERTIFICATION
Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a contract with a
company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization – specifically, any company
identified on a list prepared and maintained by the Texas Comptroller under Texas Government Code §§806.051, 807.051, or
2252.153. (A company that the U.S. Government affirmatively declares to be excluded from its federal sanctions regime relating
to Sudan, Iran, or any federal sanctions regime relating to a foreign terrorist organization is not subject to the contract
prohibition.)
By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas Comptroller’s
list identified above; that this certification is true, complete and accurate; and that I am authorized by my company to make
this certification.
HISTORICALLY UNDERUTILIZED BUSINESS CERTIFICATION
A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women Business
Enterprise or “MWBE” and all referred to in this form as a “HUB”) is encouraged to indicate its HUB certification status when
responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications for awarded Vendors that
properly indicate and document their HUB certification on this form
I certify that my company has been certified as a HUB in the following categories:
Minority Owned Business Women Owned Business
Service-Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a
service-connected disability as defined by 38 U.S.C. § 101(16), and who has a disability
rating of 20% or more as determined by the U. S. Department of Veterans Affairs or
Department of Defense)
Certification Number: ___________________________________________________
Name of Certifying Agency: _______________________________________________
My company has NOT been certified as a HUB.
ACKNOWLEDGEMENT OF BUYBOARD TECHNICAL REQUIREMENTS
Vendor shall review the BuyBoard Technical Requirements included in this Proposal Invitation. By signature on the
Compliance Forms Signature Page, the undersigned affirms that Proposer has obtained a copy of the BuyBoard Technical
Requirements, has read and understands the requirements, and certifies that Vendor is able to meet and will comply with
those requirements except as follows:
Note: In accordance with the General Terms and Conditions of the Contract, to the extent Vendor is awarded a Contract
under this Proposal Invitation but is unable or unwilling to meet the applicable BuyBoard Technical Requirements, the
information available on the BuyBoard for Vendor’s awarded products or services may be limited, potentially placing Vendor
at a disadvantage and impacting the ability of Cooperative members to search, find, review, and purchase Vendor’s awarded
products and services on the BuyBoard website. Further, to the extent Vendor has acknowledged ability to meet and comply
with the BuyBoard Technical Requirements, any subsequent failure or refusal by Vendor to promptly provide information
upon request to the Cooperative administrator in accordance with those technical requirements may be deemed an event
of default under the Contract. Initial: _____
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WOSB211809
Women's Business Enterprise National Council
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
CONSTRUCTION-RELATED GOODS AND SERVICES AFFIRMATION
The Cooperative issued the BuyBoard Procurement and Construction-Related Goods and Services Advisory for Texas
Members (“Advisory”), which provides information specifically relevant to the procurement of construction-related goods
and services by Texas Cooperative members. The Advisory, available at buyboard.com/Vendor/Resources.aspx, provides
an overview of certain legal requirements that are potentially relevant to a Cooperative member’s procurement of
construction or construction-related goods and services, including those for projects that may involve or require architecture,
engineering or independent testing services. A copy of the Advisory can also be provided upon request. Because many
BuyBoard contracts include goods or installation services that might be considered construction-related, Proposer must
make this Construction Related-Goods and Services Affirmation regardless of type of goods or services associated with this
Proposal Invitation.
A contract awarded under this Proposal Invitation covers only the specific goods and/or services awarded by the
Cooperative. As explained in the Advisory (“Advisory”), Texas law prohibits the procurement of architecture or
engineering services through a purchasing cooperative. This Proposal Invitation and any Contract awarded
thereunder does not include such services. Architecture or engineering services must be procured by a
Cooperative member separately, in accordance with the Professional Services Procurement Act (Chapter
2254 of the Texas Government Code) and other applicable law and local policy.
By signature on the Compliance Forms Signature Page, Proposer affirms that Proposer has obtained a copy of the Advisory,
has read and understands the Advisory, and is authorized by Proposer to make this affirmation. If Proposer sells
construction-related goods or services to a Cooperative member under a Contract awarded under this Proposal Invitation,
Proposer will comply with the Advisory and applicable legal requirements, make a good faith effort to make its Cooperative
member customers or potential Cooperative member customers aware of such requirements, and provide a Cooperative
member with a copy of the Advisory before accepting the member’s Purchase Order or other agreement for construction-
related goods or services.
Initial: ______
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
DEVIATION AND COMPLIANCE
If your company intends to deviate from the General Terms and Conditions, Proposal Specifications or other requirements
associated with this Proposal Invitation, you MUST list all such deviations on this form, and provide complete and detailed
information regarding the deviations on this form or an attachment to this form. Prior to completing this form, Vendor
shall review the General Terms and Conditions section B.4 (Deviations from Item Specifications and General
Terms and Conditions). Please note that, as provided in section B.4, certain provisions of the General Terms
and Conditions are NOT subject to deviation, and certain deviations will be deemed rejected without further
action by the Cooperative. Any attempted deviation, whether directly or indirectly, to provisions identified
in this Proposal Invitation as not subject to deviation shall be deemed rejected by the Cooperative and,
unless otherwise withdrawn by Vendor, may result in Vendor’s Proposal being rejected in its entirety.
The Cooperative will consider any deviations in its contract award decision and reserves the right to accept or reject a
proposal based upon any submitted deviation.
In the absence of any deviation identified and described in accordance with the above, your company must fully comply
with the General Terms and Conditions, Proposal Specifications and all other requirements associated with this Proposal
Invitation if awarded a Contract under this Proposal Invitation. A deviation will not be effective unless accepted by the
Cooperative. The Cooperative, by and through the Cooperative administrator, may, in its sole discretion, seek clarification
from and/or communicate with Proposer(s) regarding any submitted deviation, consistent with general procurement
principles of fair competition. The Cooperative reserves the right to accept or reject a Proposal based upon any submitted
deviation.
No; Deviations
Yes; Deviations
List and fully explain any deviations you are submitting:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Initial: _____
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
VENDOR CONSENT FOR NAME BRAND USE
BuyBoard members seeking to make purchases using a Contract awarded under this Proposal Invitation may view
information regarding awarded Vendors, including but not limited to product catalogs, pricelists, pricing, and Proposals,
through the BuyBoard website. To improve and enhance the experience of BuyBoard members seeking to procure goods
and services under the Contract utilizing the BuyBoard website, any Vendor logo, product images, and similar brand and
trademark information provided by Vendor for purposes of the Contract (“Vendor Information”) may be posted on the
BuyBoard website.
You acknowledge that, by submitting your Proposal, unless you specifically opt out below, you consent to
use of your company’s Vendor Information on the BuyBoard website if awarded a Contract. You further
acknowledge that whether, where, and when to include the Vendor Information on the BuyBoard website shall be at the
sole discretion of the BuyBoard Administrator. Vendor retains, however, the right of general quality control over the
BuyBoard Administrator’s authorized display of proprietary Vendor Information. Neither the BuyBoard nor its administrator
will be responsible for the use or distribution of Vendor Information by BuyBoard members or any other third party using
the BuyBoard website. This Vendor Consent shall be effective for the full term of the Contract, including renewals, unless
Vendor provides a signed, written notice revoking consent to contractadmin@buyboard.com. BuyBoard shall have up to
thirty days from the date of receipt of a termination or revocation of a Vendor Consent to remove Vendor information from
the BuyBoard website.
This Vendor Consent is subject to the Terms and Conditions of the Contract, including, but not limited to, those terms
pertaining to Disclaimer of Warranty and Limitation of Liability, Indemnification, and Intellectual Property Infringement.
Vendor logo files must be submitted in one of the formats set forth in the BuyBoard Technical Requirements. Proposers
are requested to submit this information with Vendor’s Proposal. (This consent shall not authorize use of your company’s
Vendor Information by BuyBoard if your company is not awarded a Contract.)
OPT OUT:
If your company wishes to opt out of the Vendor Consent for Name Brand Use, you must check the opt out box below.
By checking this box, Vendor hereby declines to provide consent for use of Vendor Information (as defined herein) on
the BuyBoard website. By opting out, Vendor acknowledges and agrees that, if Vendor is awarded a Contract
under this Proposal Invitation, information available on the BuyBoard for Vendor’s awarded products or
services may be limited, potentially placing Vendor at a disadvantage and impacting the ability of
Cooperative members to search, find, review, and purchase Vendor’s awarded products and services on
the BuyBoard website.
Initial: _____
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
CONFIDENTIAL/PROPRIETARY INFORMATION
A. Public Disclosure Laws
All Proposals, forms, documentation, catalogs, pricelists, or other materials submitted by Vendor to the Cooperative in
response to this Proposal Invitation, may be subject to the disclosure requirements of the Texas Public Information Act
(Texas Government Code chapter 552.001, ) or similar disclosure law. Proposer must clearly identify on this form
any information in its Proposal (including forms, documentation, or other materials submitted with the Proposal) that
Proposer considers proprietary or confidential. If Proposer fails to properly identify the information, the Cooperative shall
have no obligation to notify Vendor or seek protection of such information from public disclosure should a member of the
public or other third party request access to the information under the Texas Public Information Act or similar disclosure
law. When required by the Texas Public Information Act or other disclosure law, Proposer may be notified of any third-party
request for information in a Proposal that Proposer has identified in this form as proprietary or confidential.
Does your Proposal (including forms, documentation, catalogs, pricelists, or other materials submitted with the Proposal)
contain information which Vendor considers proprietary or confidential?
NO, I certify that none of the information included with this Proposal is considered confidential or proprietary.
YES, I certify that this Proposal contains information considered confidential or proprietary and all such information is
specifically identified on this form.
If you responded “YES”, you must clearly identify below the specific information you consider confidential or proprietary.
List each page number, form number, or other information sufficient to make the information readily identifiable. The
Cooperative and Cooperative administrator shall not be responsible for a Proposer’s failure to clearly identify information
considered confidential or proprietary. Further, by submitting a Proposal, Proposer acknowledges that the Cooperative and
Cooperative administrator will disclose information when required by law, even if such information has been identified
herein as information Vendor considers confidential or proprietary.
Confidential / Proprietary Information:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Initial: _____
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B. Copyright Information
Does your Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal)
contain copyright information?
NO, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does
not contain copyright information.
YES, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does
contain copyright information.
If you responded “YES”, clearly identify below the specific documents or pages containing copyright information.
Copyright Information: ________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
C. Consent to Release Confidential/Proprietary/Copyright Information to BuyBoard Members
BuyBoard members (Cooperative and nonprofit members) seeking to make purchases through the BuyBoard may wish to
view information included in the Proposals of awarded Vendors. If you identified information on this form as confidential,
proprietary, or subject to copyright, and you are awarded a BuyBoard contract, your acceptance of the BuyBoard contract
award constitutes your consent to the disclosure of such information to BuyBoard members, including posting of such
information on the secure BuyBoard website for members. Note: Neither the Cooperative nor Cooperative administrator will
be responsible for the use or distribution of information by BuyBoard members or any other party.
D. Consent to Release Proposal Tabulation
Notwithstanding anything in this Confidential/Proprietary Information form to the contrary, by submitting a Proposal, Vendor
consents and agrees that, upon Contract award, the Cooperative may publicly release, including posting on the public
BuyBoard website, a copy of the proposal tabulation and award information for the Contract including Vendor name;
proposed catalog/pricelist name(s); proposed percentage discount(s), hourly labor rate(s), or other specified pricing; and
Vendor award or non-award information.
Initial: ______
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
EDGAR VENDOR CERTIFICATION
(2 CFR Part 200 and Appendix II)
When a Cooperative member seeks to procure goods and services using funds under a federal grant or contract, specific
federal laws, regulations, and requirements may apply in addition to those under state law. This includes, but is not limited
to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requirements for
Federal Awards, 2 CFR 200 (sometimes referred to as the “Uniform Guidance” or new “EDGAR”). All Vendors submitting a
Proposal must complete this EDGAR Certification Form regarding Vendor’s willingness and ability to comply with certain
requirements which be applicable to specific Cooperative member purchases using federal grant funds. Completed
forms will be made available to Cooperative members for their use while considering their purchasing options when using
federal grant funds. Cooperative members may also require Vendors to enter into ancillary agreements, in addition to the
terms and conditions of the BuyBoard contract, to address the member’s specific contractual needs, including contract
requirements for a procurement using federal grants or contracts.
A “NO” response to any of the items may, if applicable, impact the ability of a Cooperative member to purchase
from the Vendor using federal funds.
1. Vendor Violation or Breach of Contract Terms:
Contracts for more than the simplified acquisition threshold, which is the inflation adjusted amount determined by the
Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 USC
1908, must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract
terms, and provide for such sanctions and penalties as appropriate.
Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Section E.18,
Remedies for Default and Termination of Contract. Any Contract award will be subject to such BuyBoard General Terms
and Conditions, as well as any additional terms and conditions in any Purchase Order or Cooperative member ancillary
contract agreed upon by Vendor and the Cooperative member which must be consistent with and protect the Cooperative
member at least to the same extent as the BuyBoard Terms and Conditions. The remedies under the Contract are in addition
to any other remedies that may be available under law or in equity. By submitting a Proposal, you agree to these Vendor
violation and breach of contract terms.
YES, I agree. NO, I do not agree.
2. Termination for Cause or Convenience:
For any Cooperative member purchase or contract in excess of $10,000 made using federal funds, you agree that the
following term and condition shall apply:
If an alternate provision for termination of a Cooperative member purchase for cause and convenience, including the
manner by which it will be effected and the basis for settlement, is included in the Cooperative member’s Purchase Order
or ancillary agreement agreed to by the Vendor, the Cooperative member’s provision shall control.
YES, I agree. NO, I do not agree. Initial: _____
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
3. Equal Employment Opportunity:
Except as otherwise provided under 41 CFR Part 60, all Cooperative member purchases or contracts that meet the definition
of “federally assisted construction contract” in 41 CFR Part 60-1.3 shall be deemed to include the equal opportunity clause
provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal Employment Opportunity” (30 FR
12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, “Amending Executive Order
11246 Relating to Equal Employment Opportunity,” and implementing regulations at 41 CFR Part 60, “Office of Federal
Contract Compliance Programs, Equal Employment Opportunity, Department of Labor.”
The equal opportunity clause provided under 41 CFR 60-1.4(b) is hereby incorporated by reference. Vendor agrees that
such provision applies to any Cooperative member purchase or contract that meets the definition of “federally assisted
construction contract” in 41 CFR Part 60-1.3 and Vendor agrees that it shall comply with such provision.
YES, I agree. NO, I do not agree.
4. Davis-Bacon Act:
When required by Federal program legislation, Vendor agrees that, for all Cooperative member prime construction
contracts/purchases in excess of $2,000, Vendor shall comply with the Davis-Bacon Act (40 USC 3141-3144, and 3146-
3148) as supplemented by Department of Labor regulations (29 CFR Part 5, “Labor Standards Provisions Applicable to
Contracts Covering Federally Financed and Assisted Construction”). In accordance with the statute, Vendor is required to
pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determinate made
by the Secretary of Labor. In addition, Vendor shall pay wages not less than once a week.
Current prevailing wage determinations issued by the Department of Labor are available at www.sam.gov. Vendor agrees
that, for any purchase to which this requirement applies, the award of the purchase to the Vendor is conditioned upon
Vendor’s acceptance of the wage determination.
Vendor further agrees that it shall also comply with the Copeland “Anti-Kickback” Act (40 USC 3145), as supplemented by
Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public Work Financed
in Whole or in Part by Loans or Grants from the United States”). The Act provides that each contractor or subrecipient must
be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work,
to give up any part of the compensation to which he or she is otherwise entitled.
YES, I agree. NO, I do not agree.
5. Contract Work Hours and Safety Standards Act:
Where applicable, for all Cooperative member contracts or purchases in excess of $100,000 that involve the employment
of mechanics or laborers, Vendor agrees to comply with 40 USC 3702 and 3704, as supplemented by Department of Labor
regulations (29 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is required to compute the wages of every mechanic
and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible
provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours
worked in excess of 40 hours in the work week.
The requirements of 40 USC 3704 are applicable to construction work and provide that no laborer or mechanic must be
required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These
requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or
contracts for transportation or transmission of intelligence.
YES, I agree. NO, I do not agree.
Initial: _____
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6. Right to Inventions Made Under a Contract or Agreement:
If the Cooperative member’s Federal award meets the definition of “funding agreement” under 37 CFR 401.2(a) and the
recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the
substitution of parties, assignment or performance or experimental, developmental, or research work under that “funding
agreement,” the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, “Rights to Inventions
Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative
Agreements,” and any implementing regulations issued by the awarding agency.
Vendor agrees to comply with the above requirements when applicable.
YES, I agree. NO, I do not agree.
7. Clean Air Act and Federal Water Pollution Control Act:
Clean Air Act (42 USC 7401-7671q.) and the Federal Water Pollution Control Act (33 USC 1251-1387), as amended –
Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non-Federal award
to agree to comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act (42 USC 7401-
7671q.) and the Federal Water Pollution Control Act, as amended (33 USC 1251-1387). Violations must be reported to the
Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA).
When required, Vendor agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Clean
Air Act and the Federal Water Pollution Control Act.
YES, I agree. NO, I do not agree.
8. Debarment and Suspension:
Debarment and Suspension (Executive Orders 12549 and 12689) – A contract award (see 2 CFR 180.220) must not be
made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with
the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1966 Comp. p. 189) and 12689 (3
CFR Part 1989 Comp. p. 235), “Debarment and Suspension.” SAM Exclusions contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority
other than Executive Order 12549.
Vendor certifies that Vendor is not currently listed on the government-wide exclusions in SAM, is not debarred, suspended, or
otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than Executive Order 12549.
Vendor further agrees to immediately notify the Cooperative and all Cooperative members with pending purchases or seeking
to purchase from Vendor if Vendor is later listed on the government-wide exclusions in SAM, or is debarred, suspended, or
otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than Executive Order 12549.
YES, I agree. NO, I do not agree.
9. Byrd Anti-Lobbying Amendment:
Byrd Anti-Lobbying Amendment (31 USC 1352) - Vendors that apply or bid for an award exceeding $100,000 must file the
required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay
any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of
Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any
Federal contract, grant or any other award covered by 31 USC 1352. Each tier must also disclose any lobbying with non-
Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to
tier up to the non-Federal award. As applicable, Vendor agrees to file all certifications and disclosures required by, and
otherwise comply with, the Byrd Anti-Lobbying Amendment (31 USC 1352).
YES, I agree. NO, I do not agree.
Initial: _____
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10. Procurement of Recovered Materials:
For Cooperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste Disposal
Act, as amended by the Resource Conservation and Recovery Act where applicable and provide such information and certifications
as a Cooperative member may require to confirm estimates and otherwise comply. The requirements of Section 6002 include
procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR Part 247 that contain the
highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the
purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded
$10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery, and
establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines.
YES, I agree. NO, I do not agree.
11. Domestic Preferences for Procurements:
Where appropriate and consistent with law, 2 CFR §200.322 contains certain considerations for domestic preferences for
procurements which may be applicable to Cooperative members using federal funds. When required by a Cooperative
member, Vendor agrees to provide such information or certification as may reasonably be requested by the Cooperative
member regarding Vendor’s products, including whether goods, products, or materials are produced in the United States.
YES, I agree. NO, I do not agree.
12. Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment
2 CFR §200.216 prohibits expending federal loan or grant funds to procure or obtain covered telecommunications equipment
or services. To the extent applicable and when required by a Cooperative member, Vendor agrees to provide such
information or certification as may reasonably be requested by the Cooperative member to confirm whether any
telecommunications equipment or services provided by Vendor is covered telecommunications equipment or services under
2 CFR §200.216.
YES, I agree. NO, I do not agree.
13. General Compliance and Cooperation with Cooperative Members:
In addition to the foregoing specific requirements, Vendor agrees, in accepting any Purchase Order from a Cooperative
member, it shall make a good faith effort to work with Cooperative members to provide such information and to satisfy
such requirements as may apply to a particular Cooperative member purchase or purchases including, but not limited to,
applicable recordkeeping and record retention requirements.
YES, I agree. NO, I do not agree.
Initial: _____
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
COMPLIANCE FORMS SIGNATURE PAGE
By initialing pages and by signature below, I certify that I have reviewed the following forms; that the information provided
therein is true, complete, and accurate; and that I am authorized by my company to make all certifications, consents,
acknowledgements, and agreements contained herein:
Proposal Acknowledgements
Felony Conviction Disclosure
Debarment Certification
Resident/Nonresident Certification
Vendor Employment Certification
No Boycott Verification
No Excluded Nation or Foreign Terrorist Organization Certification
Historically Underutilized Business Certification
Construction-Related Goods and Services Affirmation
Acknowledgement of BuyBoard Technical Requirements
Deviation and Compliance
Vendor Consent for Name Brand Use
Confidential/Proprietary Information
EDGAR Vendor Certification
__________________________________________
Company Name
__________________________________________
Signature of Authorized Company Official
__________________________________________
Printed Name and Title
__________________________________________
Date
25 of 67
Type text here
OMJC SIGNAL INC
JENNIFER SHIMP
10/29/2025
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
VENDOR CONTACT INFORMATION
FEDERAL AND STATE/PURCHASING COOPERATIVE EXPERIENCE
The Cooperative strives to provide Cooperative members with the best services and products at the best prices available from
Vendors with the technical resources and ability to serve Cooperative members. Please respond to the following questions.
1. Provide the dollar value of sales to or through purchasing cooperatives at or based on an established catalog or market
price during the previous 12-month period or the last fiscal year: $______________. (The period of the 12-month
period is _________/_________). In the event that a dollar value is not an appropriate measure of the sales, provide
and describe your own measure of the sales of the item(s).
2. By submitting a proposal, you agree that, based on your written discounting policies, the discounts you offer the
Cooperative are equal to or better than the best price you offer other purchasing cooperatives for the same items under
equivalent circumstances.
3. Provide the information requested below for other purchasing cooperatives for which Proposer currently serves, or in the past
has served, as an awarded vendor. Rows should be added to accommodate as many purchasing cooperatives as required.
PURCHASING
GROUP
CURRENT
VENDOR?
(Y/N)
FORMER VENDOR (Y/N)? –
IF YES, LIST YEARS
AS VENDOR
AWARDED
COMMODITY
CATEGORY(IES)
1. Federal General Services Administration
2. T-PASS (State of Texas)
3. OMNIA Partners
4. Sourcewell (NJPA)
5. E&I Cooperative
6. Houston-Galveston Area Council (HGAC)
7. Choice Partners
8. The Interlocal Purchasing System (TIPS)
9. Other
MY COMPANY DOES NOT CURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYPE CONTRACTS.
CURRENT BUYBOARD VENDORS
If you are a current BuyBoard vendor in the same contract category as proposed in this Proposal Invitation, indicate the
discount for your current BuyBoard contract and the proposed discount in this Proposal. Explain any difference between your
current and proposed discounts.
Current Discount (%): _________________________ Proposed Discount (%):_______________________
________________________________________________________________________________________
27 of 67
$52,210
10/01/2024 09/30/2025
N
N
N
N
N
N
N
N
N
6% 6%
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PROPOSAL FORMS COMM/SVCS V.10.04.2024
GOVERNMENTAL REFERENCES
For your Proposal to be considered, you must supply a minimum of five (5) individual governmental entity references. The
Cooperative may contact any and all references provided as part of the Proposal evaluation. Provide the information requested
below, including the existing pricing/discounts you offer each customer. The Cooperative may determine whether
pricing/discounts are fair and reasonable by comparing pricing/discounts stated in your Proposal with the pricing/discounts
you offer other governmental customers. Attach additional pages if necessary.
Quantity/
Entity Name Contact Phone# Email Address Discount Volume
1._______________________________________________________________________________________________
2._______________________________________________________________________________________________
3._______________________________________________________________________________________________
4._______________________________________________________________________________________________
5._______________________________________________________________________________________________
Do you ever modify your written policies or standard governmental sales practices as identified in the above chart to give
better discounts (lower pricing) than indicated? YES NO If YES, please explain:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
COMPANY PROFILE
Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard website. If your
company is awarded a Contract under this Proposal Invitation, please provide a brief company description that you would
like to have included with your company profile on the BuyBoard website.Submit your company profile in a separate
file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any content provided for inclusion on
the BuyBoard website. The Cooperative reserves the right to exclude or remove any content in its sole discretion, with or
without prior notice, including but not limited to any content deemed by the Cooperative to be inappropriate, irrelevant to
the Contract, inaccurate, or misleading.)
28 of 67
COSA TX Roads Dustin Hohensee 325-277-3063 Dustin.Hohensee@cosatx.us 6% 1ia
Daji Qiao 515-294-2390 Daji@iastate.edu 0% 1
Iowa St University
Jackson County Iowa Jayden Scheckel 563-652-4782 Jceng@jacksoncounty.iowa.gov 5% 1
City of Waterloo Iowa Tina Schellhorn 319-291-4440 Tina.schellhorn@waterloo-ia.org 5% 1
City of Irvine CA Daryl Gee 949-591-6862 Dgee@cityofirvine.org 0% 1
da
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
We provide sustainable, cutting edge roadway and pedestrian traffic solutions. We are
continually at the forefront of developing technologies which lower power consumption and
increase safety, while maximizing your resources.
We manufacture all of our products at our factory in Waterloo, Iowa.
Raw steel is used to build our trailers by our Machinist , and Welders.
our customers money. None of our processes are outsourced.
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
TEXAS REGIONAL SERVICE DESIGNATION
The Cooperative (referred to as “Texas Cooperative” in this form and in the State Service Designation form) offers vendors
the opportunity to service its members throughout the entire State of Texas. In the electronic proposal submission system,
you must indicate if you will service Texas Cooperative members statewide or, if you do not plan to service all Texas
Cooperative members statewide, you indicate the specific regions you will service. If you propose to serve different
regions for different products or services included in your Proposal, you must complete and submit a separate Texas Regional
Service Designation form for each group of products and clearly indicate the products or services to which the designation
applies. (Additional forms can be obtained by contacting bids@buyboard.com
.)
Additionally, if you do not plan to service Texas Cooperative
members (i.e., if you will service only states other than Texas),
Region and Headquarters
1 Edinburg
2 Corpus Christi
3 Victoria
4 Houston
5 Beaumont
6 Huntsville
7 Kilgore
8 Mount Pleasant
9 Wichita Falls
10 Richardson
11 Fort Worth
12 Waco
13 Austin
14 Abilene
15 San Angelo
16 Amarillo
17 Lubbock
18 Midland
19 El Paso
20 San Antonio
29 of 67
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
STATE SERVICE DESIGNATION
As set forth in the Proposal Invitation, it is the Cooperative’s intent that other governmental entities in the United States have
the opportunity to purchase goods or services awarded under the Contract, subject to applicable state law, through a piggy-
back award or similar agreement through the National Purchasing Cooperative BuyBoard. If you plan to service the entire
United States or only specific states,
If you serve different states for different products or services included in your Proposal, you must complete and submit a
separate State Service Designation form for each group of products and clearly indicate the products or services to which the
designation applies. (Additional forms can be obtained by contacting bids@buyboard.com
I will service all states in the United States.
I will not service all states in the United States.
Alabama Montana
Alaska Nebraska
Arizona Nevada
Arkansas New Hampshire
California (Public Contract Code 20118 & 20652) New Jersey
Colorado New Mexico
Connecticut New York
Delaware North Carolina
District of Columbia North Dakota
Florida Ohio
Georgia Oklahoma
Hawaii Oregon
Idaho Pennsylvania
Illinois Rhode Island
Indiana South Carolina
Iowa South Dakota
Kansas Tennessee
Kentucky Texas
Louisiana Utah
Maine Vermont
Maryland Virginia
Massachusetts Washington
Michigan West Virginia
Minnesota Wisconsin
Mississippi Wyoming
Missouri
30 of 67
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT
In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this Proposal
Invitation may be “piggy-backed” by another governmental entity. The National Purchasing Cooperative is an
intergovernmental purchasing cooperative formed by certain school districts outside of Texas to serve its members throughout
the United States. If you agree to be considered for a piggy-back award by the National Purchasing Cooperative, you agree
to the following terms and agree to serve National Purchasing Cooperative members in the states you have indicated on the
State Service Designation form, in your Proposal.
By signing this form, Proposer (referred to in this Agreement as “Vendor”) agrees as follows:
1. Vendor acknowledges that if The Local Government Purchasing Cooperative (“Texas Cooperative”) awards Vendor a
contract under this Proposal Invitation (“Underlying Award”), the National Purchasing Cooperative (“National Cooperative”)
may - but is not required to - “piggy-back” on or re-award all or a portion of that Underlying Award (“Piggy-Back Award”).
By signing this National Cooperative Vendor Award Agreement (“Agreement”), Vendor accepts and agrees to be bound by
any such Piggy-Back Award as provided for herein.
2. In the event National Cooperative awards Vendor a Piggy-Back Award, the National Cooperative Administrator (“BuyBoard
Administrator”) will notify Vendor in writing of such Piggy-Back Award, which award shall commence on the effective date
stated in the Notice and end on the expiration date of the Underlying Award, subject to annual renewals as authorized in
writing by the BuyBoard Administrator. Vendor agrees that no further signature or other action is required of Vendor in order
for the Piggy-Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or
changes to this Agreement by Vendor will be binding on National Cooperative, unless such changes are agreed to by its
BuyBoard Administrator in writing.
3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same pricing and same
general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying Award.
However, nothing in this Agreement prevents Vendor from offering National Cooperative members better (i.e., lower)
competitive pricing and more favorable terms and conditions than those in the Underlying Award.
4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation Form
of this Proposal Invitation. Any changes to the states designated on the State Service Designation Form must be approved
in writing by the BuyBoard Administrator.
5. Vendor agrees to pay National Cooperative the service fee provided for in the Underlying Award based on the amount of
purchases generated from National Cooperative members through the Piggy-Back Award. Vendor shall remit payment to
National Cooperative on such schedule as it specifies (which shall not be more often than monthly). Further, upon request,
Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative members,
vendor invoices, and/or such other documentation regarding those purchase orders as the Cooperative’s administrators may
require in their reasonable discretion for purposes of reviewing and verifying purchase activity. Vendor further agrees that
National Cooperative shall have the right, upon reasonable written notice, to review Vendor’s records pertaining to purchases
made by National Cooperative members in order to verify the accuracy of service fees.
6. Vendor agrees that the Underlying Award, including its General Terms and Conditions, are adopted by reference to the
fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and responsibilities
that would ordinarily inure to the Texas Cooperative pursuant to the Underlying Award shall inure to National Cooperative;
and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying Award shall inure to
Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the only parties to this
Agreement, and that nothing in this Agreement has application to other third parties, including the Texas Cooperative. In the
event of conflict between this Agreement and the terms of the Underlying Award, the terms of this Agreement shall control,
and then only to the extent necessary to reconcile the conflict.
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Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
7. This Agreement shall be governed and construed in accordance with the laws of the State of Texas and venue for any
dispute shall lie in the federal district court of Travis County, Texas.
8. Vendor acknowledges and agrees that the award of a Piggy-Back Award is within the sole discretion of National
Cooperative, and that this Agreement does not take effect unless and until National Cooperative awards Vendor a Piggy-Back
Award and the BuyBoard Administrator notifies Vendor in writing of such Piggy-Back Award as provided for herein.
WHEREFORE, by signing below Vendor agrees to the foregoing and warrants that it has the authority to enter into this
Agreement.
_______________________________________________ _______________________________________________
Name of Vendor Proposal Invitation Number
_______________________________________________ _______________________________________________
Signature of Authorized Company Official Printed Name of Authorized Company Official
__________________________________
Date
32 of 67
OMJC SIGNAL INC 795-26
JENNIFER SHIMP
10/29/2025
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
LOCATION/AUTHORIZED SELLER LISTINGS
If you have more than one location/authorized seller that will service a Contract awarded under this Proposal Invitation,
please list each location/authorized seller below. If additional sheets are required, please duplicate this form as necessary.
NOTE: Awarded Vendors shall remain responsible for all aspects of the Contract, including processing of Purchase Orders,
and shall be responsible for the performance of all locations and authorized sellers under and in accordance with the Contract.
Location/Authorized
Seller Name Contact Person
Contact Information
(Mailing Address, Phone, Fax, Email)
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Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
MANUFACTURER DEALER DESIGNATION
If Vendor is a manufacturer that sells products through a dealer network and wishes to designate a dealer or multiple dealers
(“Designated Dealers”) to receive Cooperative member Purchase Orders on Vendor’s behalf, you must complete this form for
each dealer you wish to designate.
Regardless of any Designated Dealers submitted by Vendor, Vendor specifically agrees and acknowledges that any such
designations are for Vendor’s convenience only and shall not, if Vendor is awarded a Contract, relieve Vendor of any
obligations under the Contract, including payment of Cooperative service fees on all Purchase Orders submitted to Vendor or
any Designated Dealer. In accordance with the General Terms and Conditions, an awarded Vendor shall remain responsible
and liable for all of its obligations under the Contract and the performance of both Vendor and any of Vendor’s Designated
Dealers under and in accordance with the Contract and remain subject to all remedies for default thereunder, including, but
not limited to suspension and termination of Vendor’s Contract for nonpayment of service fees.
If awarded, Vendor authorizes the Cooperative, in its sole discretion, to list any Vendor Designated Dealers in the BuyBoard
system and to receive Purchase Orders directly from Cooperative members on behalf of Vendor. To the extent a Vendor with
Designated Dealers receives a Purchase Order directly, it shall be the responsibility of Vendor to appropriately process such
Purchase Order in accordance with the Contract, including but not limited to timely forwarding such Purchase Order to a
Designated Dealer for processing.
The Cooperative reserves the right, in its sole discretion, to refuse addition of, or request removal of, any Designated Dealer,
and Vendor agrees to immediately require such Designated Dealer to cease accepting Purchase Orders or otherwise acting
on Vendor’s behalf under the Contract. Further, the Cooperative administrator shall be authorized to remove or suspend any
or all Designated Dealers from the BuyBoard at any time in its sole discretion.
If you wish to designate a dealer to service a contract awarded under this Proposal Invitation, please list the Designated
Dealer below. If you wish to designate multiple dealers, please duplicate this form as necessary.
_______________________________________________ _______________________________________________
Designated Dealer Name Designated Dealer Contact Person
___________________________________________________________________________________________________
Designated Dealer Address
_______________________________________________ __________ ________________________________
City State Zip Code
_______________________________________________ _______________________________________________
Phone Number Fax Number
_______________________________________________ _______________________________________________
Email address Designated Dealer Tax ID Number* (*attach W-9)
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Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
PROPOSAL INVITATION QUESTIONNAIRE
The Cooperative will use your responses to the questions below in evaluating your Proposal and technical and financial
resources to provide the goods and perform the services (“Work”) under the BuyBoard contract contemplated by this Proposal
Invitation (“Contract”). Proposers must fully answer each question, numbering your responses to correspond to the
questions/numbers below. Proposers must complete below or attach your responses to this questionnaire and submit in one
document with your Proposal. You must submit the questionnaire and responses with your Proposal or the
Proposal will not be considered.
1. List the number of years Proposer has been in business and former business names (if applicable). Note whether your
company is currently for sale or involved in any transaction that would significantly alter its business or result in acquisition
by another entity.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
2. Describe the resources Proposer has to manage staff and successfully perform the Work contemplated under this
Contract. State the number and summarize the experience of company personnel who may be utilized for the Work,
including those who will be available to Cooperative members for assistance with project development, technical issues,
and product selection for Work associated with this Contract.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
3.Marketing Strategy: For your Proposal to be considered, you must submit the Marketing Strategy you will use if the
Cooperative accepts all or part of your Proposal.
Attach additional pages if necessary.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
35 of 67
40 years. We are not for sale nor involved in any transactions that would significantly alter our business.
We have a structure that supports daily operations of our manufacturing facility. A CEO, President, 3 managers
and department leads. We have a high retention rate with 30 employees with years of service from 1 year to 18 years. Our
staff is highly skilled. We offer 24/7 technical support. We offer consultation to assist with project development and reviewing
project specifications. We have an Research and Development team available also.
We have an extensive email subscriber base that we will inform via our campaigns during the year. We will promote
these contracts via targeted, paid and organic listings on search engines and social media.
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
4. Describe Proposer’s financial capability to perform the Contract. State or describe the firm’s financial strength and rating,
bonding capacity, and insurance coverage limits. State whether the firm, or any of the firm’s past or present owners,
principal shareholders or stockholders, or officers, have been a debtor party to a bankruptcy, receivership, or insolvency
proceeding in the last 7 years, and identify any such debtor party by name and relationship to or position with your firm.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
5. Does your company have any outstanding financial judgments and/or is it currently in default on any loan or financing
agreement? If so, provide detailed information on the nature of such items and prospects for resolution.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
6. List all contracts, if any, in the last 10 years on which Proposer has defaulted, failed to complete or deliver the work, or
that have been terminated for any reason. For each such contract, provide the project name, scope, value and date and
the name of the procuring entity. Fully explain the circumstances of the default, failure to complete or deliver the work,
or termination.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
7. List all litigation or other legal proceedings (including arbitration proceedings), if any, in the last 10 years brought against
your firm, or any of the firm’s past or present owners, principal shareholders or stockholders, officers, agents or
employees, that relate to or arise from a contract similar to this Contract or the Work contemplated under this Contract.
Provide the style of the lawsuit or proceeding (name of parties and court or tribunal in which filed), nature of the claim,
and resolution or current status.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
36 of 67
As of September 30, 2025, the Company has stockholders equity of $1,854,594 with a debt to equity ratio of 1.44.
We have never applied for a bond. We have general liability insurance of $1,000,000 with an aggregate of $2,000,000.
No shareholder has been a debtor party to bankruptcy, receivership, or insolvency.
None
None
None
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
PROPOSAL SPECIFICATION SUMMARY
The categories and items specified for this Proposal Invitation are summarized below. For full Proposal
Specifications, you must review and complete the Proposal Specification information in the electronic proposal
submission system in accordance with the Instructions to Proposers (or, if submitting a hard copy Proposal, timely
request and complete the Proposal Specification Form in accordance with the Instructions to Proposers).
__________________________________________________________________________________________________
Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered.
Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or
searchable PDF preferred.
Section I: Equipment, Products, and Supplies
1. Discount (%) off catalog/pricelist for Traffic Light and Signal Systems, Supplies, and Equipment.
2. Discount (%) off catalog/pricelist for Traffic Safety Barrier, Barricade, and Guardrail Products (Cable, Concrete,
Plastic, Steel, Wood, W-Beam, Tri-Beam, End Treatments, Posts, and other related products).
3. Discount (%) off catalog/pricelist for Traffic Intersection Safety (Parking Lot, Pedestrian, Railroad, School Zone)
Equipment and Products.
4. Discount (%) off catalog/pricelist for Traffic Marker and Sign Products.
5. Discount (%) off catalog/pricelist for Computerized Traffic Design Plans, Traffic Flagging, and Special Event
Services.
6. Discount (%) off catalog/pricelist for All Other Traffic Light and Signal System Products.
7. Discount (%) off catalog/pricelist for Traffic Light and Signal Systems Repair Parts.
8. Discount (%) off catalog/pricelist for Traffic Light and Signal Equipment and Products Maintenance/Warranty
Agreements.
Section II: Installation and Repair Service
9.Hourly Labor Rate for Installation/Repair Service of Traffic Signal Systems, Products, and Related Items –
Not to Exceed hourly labor rate for Installation/Repair Service of Traffic Signal Systems, Equipment, and Products.
10.Hourly Labor Rate for Installation/Repair Service of Traffic Safety Barrier, Barricade, and Guardrail
Products, and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Traffic Safety
Barrier, Barricade, and Guardrail Products.
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Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
PROPOSAL FORMS COMM/SVCS V.10.04.2024
REQUIRED FORMS CHECKLIST
Reviewed/Completed:Proposer’s Acceptance and Agreement
PROPOSAL FORMS PART 1: COMPLIANCE FORMS
Reviewed/Completed:Proposal Acknowledgements
Reviewed/Completed: Felony Conviction Disclosure
Reviewed/Completed: Resident/Nonresident Certification
Reviewed/Completed: Debarment Certification
Reviewed/Completed: Vendor Employment Certification
Reviewed/Completed: No Boycott Verification
Reviewed/Completed: No Excluded Nation or Foreign Terrorist Organization Certification
Reviewed/Completed: Historically Underutilized Business Certification
Reviewed/Completed: Acknowledgement of BuyBoard Technical Requirements
Reviewed/Completed: Construction-Related Goods and Services Affirmation
Reviewed/Completed: Deviation and Compliance
Reviewed/Completed: Vendor Consent for Name Brand Use
Reviewed/Completed: Confidential/Proprietary Information
Reviewed/Completed: EDGAR Vendor Certification
Reviewed/Completed: Compliance Forms Signature Page
PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS
Reviewed/Completed: Vendor Business Name
Reviewed/Completed: Vendor Contact Information (
Reviewed/Completed: Federal and State/Purchasing Cooperative Experience
Reviewed/Completed: Governmental References
Reviewed/Completed: Company Profile
Reviewed/Completed: Texas Regional Service Designation (
Reviewed/Completed: State Service Designation (
Reviewed/Completed: National Purchasing Cooperative Vendor Award Agreement
Reviewed/Completed: Local/Authorized Seller Listings
Reviewed/Completed: Manufacturer Dealer Designation
Reviewed/Completed: Proposal Invitation Questionnaire
Reviewed/Completed: Proposal Specifications
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Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
OMJC Signal, INC Information
Address: 403 Chestnut St
Waterloo, IA 50702
Phone: (800) 776-5999 x115
Web Address: omjcsignal.com
By submitting your response, you certify that you are authorized to represent and bind your company.
steve salutric accounting@omjcsignal.com
Signature Email
Submitted at 10/30/2025 05:19:29 AM (CT)
Requested Attachments
BuyBoard Proposal Invitation No. 795-26, Traffic Signal Systems and
Safety Barrier Products
Proposal No. 795-26.pdf
REQUIRED-In PDF format, upload all COMPLETED and FILLED in proposal invitation documents available for
download at www.buyboard.com.vendor. Click on the button to
view and download the forms for this proposal including any additional pages, as necessary. NOTICE: DO NOT
complete proposal forms in internet browser. No data will be stored. Download file to computer and complete proposal
forms prior to submitting. (DO NOT password protect uploaded files.)
Manufacturer Catalog(s) and/or Product Price list(s)Copy of Buy Board Pricing
Calalogue texas 10.29.25.pdf
REQUIRED-In PDF format ONLY, upload manufacturer catalog(s) and/or product price list(s) in accordance with
proposal invitation instructions. Vendors shall submit catalog(s)/price list(s) with their Proposal response or Proposal
will not be considered. No paper catalogs or manufacturer/vendor websites will be accepted. File size must not exceed
250MB. (DO NOT password protect uploaded files.)
Exceptions and/or Detailed Information Related to Discount % and/or
Hourly Labor Rate Proposed
No response
In PDF format and if necessary, vendor shall attach detailed information regarding exceptions to pricing and/or
discount percentage and define the services that are proposed to be provided. NOTE: IF DETAILED INFORMATION IS
NOT SUBMITTED, PROPOSAL MAY NOT BE CONSIDERED. (DO NOT password protect uploaded files.)
Company Profile OMJC Company Summary.docx
REQUIRED-Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard
website. If your company is awarded a Contract under this Proposal Invitation, please provide a brief company
description that you would like to have included with your company profile on the BuyBoard website. Submit your
company profile in a separate file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any
content provided for inclusion on the BuyBoard website. The Cooperative reserves the right to exclude or remove any
content in its sole discretion, with or without prior notice, including but not limited to any content deemed by the
Cooperative to be inappropriate, irrelevant to the Contract, inaccurate, or misleading.) (DO NOT password protect
uploaded files.)
IRS Form W-9 Request for Taxpayer Identification Number and
Certification
W-9 2025.pdf
REQUIRED-In PDF format, upload W-9 form. (DO NOT password protect uploaded files.)
Vendor: OMJC Signal, INC 795-26Page 3 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
Bid Attributes
1 Name of Proposing Company (Legal Name)
By submitting a Proposal, Vendor is seeking to enter into a legal contract with the Cooperative. As such, Vendor
must be an individual or legal business entity capable of entering into a binding contract. List the LEGAL NAME of
the company seeking to contract with the Cooperative. Do NOT list an assumed name, dba, aka, etc. here. Such
information may be provided below.
OMJC Signal Inc
2 Vendor Business Name
Name by which Vendor, if awarded, wishes to be identified on the BuyBoard. If different than the Name of Proposing
Company listed above, only valid trade names (dba, aka, etc.) of the Proposing Company may be used.
OMJC Signal Inc
3 Vendor Mailing/Street Address
Vendor Mailing/Street Address
403 Chestnut St
4 Vendor Mailing/Street Address - City
Vendor Mailing/Street Address - City
Waterloo
5 Vendor Mailing/Street Address - State
Vendor Mailing/Street Address - State (Abbreviate State Name)
IA
6 Vendor Mailing/Street Address - Zip Code
Vendor Mailing/Street Address - Zip Code
50703
7 Federal Identification Number
Federal Identification Number
42-1361699
8 No Boycott Verification/No Excluded Nation or Foreign Terrorist Organization Certification/Historically
Underutilized Business Certification
No Boycott Verification/No Excluded Nation or Foreign Terrorist Organization Certification/Historically Underutilized
Business Certification
Vendor: OMJC Signal, INC 795-26Page 4 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
9 No Boycott Certification
A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly
or partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees
for goods or services unless the contract contains a written verification from the company that it: (1) does not
CODE Ch. 2276), and (3) does not have a practice, policy, guidance, or directive that discriminates against a
firearm entity or firearm trade association and will not discriminate during the term of the contract against a firearm
the extent required by law.
is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a
person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for
activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit
commercial relations with a company because the company: (A) engages in the exploration, production, utilization,
transportation, sale, or manufacturing of fossil fuel-based energy and does not commit or pledge to meet
environmental standards beyond applicable federal and state law; or (B) does business with a company described
association, to: (i) refuse to engage in the trade of any goods or services with the entity or association based solely
on its status as a firearm entity or firearm trade association; (ii) refrain from continuing an existing business
relationship with the entity or association based solely on its status as a firearm entity or firearm trade association;
or (iii) terminate an existing business relationship with the entity or association based solely on its status as a
firearm entity or firearm trade association; and (B) does not include: (i) the established policies of a merchant, retail
seller, or platform that restrict or prohibit the listing or selling of ammunition, firearms, or firearm accessories; and (ii)
business relationship, or decision to terminate an existing business relationship: (aa) to comply with federal, state,
or local law, policy, or regulations or a directive by a regulatory agency; or (bb) for any traditional business reason
By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor
does not boycott Israel, boycott energy companies, or discriminate against a firearm entity or firearm trade
association and will not do so during the term of any contract awarded under this Proposal Invitation, that this
certification is true, complete and accurate, and that I am authorized by my company to make this certification.
Yes
10 No Excluded Nation or Foreign Terrorist Organization Certification
Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a
contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization
to be excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to
a foreign terrorist organization is not subject to the contract prohibition.)
By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas
my company to make this certification.
Yes
Vendor: OMJC Signal, INC 795-26Page 5 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
11 Historically Underutilized Business Certification
A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women
certification status when responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications
for awarded Vendors that properly indicate and document their HUB certification on this form.
I certify that my company has been certified as a MWBE/HUB in the following categories:(Please check all that
apply)
12 Minority Owned Business
Minority Owned Business
Minority Owned Business
13 Women Owned Business
Women Owned Business
Women Owned Business
14 Service-Disabled Veteran Owned Business
S. Department of Veterans Affairs or Department of Defense)
Service-Disabled Veteran Owned Business
15 Certification Number
Certification Number
WOSB211809
16 Name of Certifying Agency
Certifying Agency
Women"s Business Enterprise National Council
17 Non-MWBE/HUB
My company has NOT been certified as a MWBE/HUB
Non-HUB
18 Vendor General Contact Information
Proposal/Contract General Contact Information
19 Vendor Proposal/Contract Contact - First Name
Vendor Proposal/Contract Contact - First Name
Steve
20 Vendor Proposal/Contract Contact - Last Name
Vendor Proposal/Contract Contact - Last Name
Salutric
21 Vendor Proposal/Contract Contact E-mail Address
Vendor Proposal/Contract Contact E-mail Address
accounting@omjcsignal.com
Vendor: OMJC Signal, INC 795-26Page 6 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
22 Vendor Proposal/Contract Mailing Address
Vendor Proposal/Contract Mailing Address
403 Chestnut ST
23 Vendor Proposal/Contact Mailing Address - City
Vendor Proposal/Contact Mailing Address - City
Waterloo
24 Vendor Proposal/Contact Mailing Address - State
Vendor Proposal/Contact Mailing Address - State (Abbreviate State Name)
IA
25 Vendor Proposal/Contact Mailing Address - Zip Code
Vendor Proposal/Contact Mailing Address - Zip Code
50703
26 Vendor Proposal/Contact Phone Number
Vendor Proposal/Contact Phone Number (xxx-xxx-xxxx)
319-236-0200
27 Vendor Proposal/Contact Extension Number
Vendor Proposal/Contact Extension Number
112
28 Company Website
Company Website (www.XXXXX.com)
www.omjcsignal.com
29 Purchase Orders Contact Information
All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
I will use the internet to receive Purchase Orders at the following address
Yes
30 Purchase Order E-mail Address
Purchase Order E-mail Address
sales@omjcsignal.com
31 Purchase Order Contact - First Name
Purchase Order Contact - First Name
Jennifer
Vendor: OMJC Signal, INC 795-26Page 7 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
32 Purchase Order Contact - Last Name
Purchase Order Contact - Last Name
Shimp
33 Purchase Order Contact Phone Number
Purchase Order Contact Phone Number (xxx-xxx-xxxx)
319-236-0200
34 Purchase Order Contact Extension Number
Purchase Order Contact Extension Number
119
35 Alternate Purchase Order E-mail Address
Alternate Purchase Order E-mail Address
accounting@omjcsignal.com
36 Alternate Purchase Order Contact - First Name
Alternate Purchase Order Contact - First Name
Steve
37 Alternate Purchase Order Contact - Last Name
Alternate Purchase Order Contact - Last Name
Salutric
38 Alternate Purchase Order Contact Phone Number
Alternate Purchase Order Contact Phone Number (xxx-xxx-xxxx)
319-236-0200
39 Alternate Purchase Order Contact Extension Number
Alternate Purchase Order Contact Extension Number
112
40 Purchase Orders Contact Information
All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
Designation form as provided to the Cooperative administrator. I understand that my company shall remain
responsible for the Contract and the performance of all Designated Dealers under and in accordance with
the Contract.
No
41 Request for Quotes (RFQ)
Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs:
Vendor: OMJC Signal, INC 795-26Page 8 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
42 Request for Quote (RFQ) E-mail Address
Request for Quote (RFQ) E-mail Address
sales@omjcsignal.com
43 Request for Quote (RFQ) Contact - First Name
Request for Quote (RFQ) Contact - First Name
Jennifer
44 Request for Quote (RFQ) Contact - Last Name
Request for Quote (RFQ) Contact - Last Name
Shimp
45 Request for Quote (RFQ) Contact Phone Number
Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx)
319-236-0200
46 Request for Quote (RFQ) Contact Extension Number
Request for Quote (RFQ) Contact Extension Number
119
47 Alternate Request for Quote (RFQ) E-mail Address
Alternate Request for Quote (RFQ) E-mail Address
accounting@omjcsignal.com
48 Alternate Request for Quote (RFQ) Contact - First Name
Alternate Request for Quote (RFQ) Contact - First Name
Steve
49 Alternate Request for Quote (RFQ) Contact - Last Name
Alternate Request for Quote (RFQ) Contact - Last Name
Salutric
50 Alternate Request for Quote (RFQ) Contact Phone Number
Alternate Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx)
319-236-0200
51 Alternate Request for Quote (RFQ) Contact Extension Number
Alternate Request for Quote (RFQ) Contact Extension Number
112
52 Invoices
Your company will be billed monthly for the service fee due under a Contract awarded under this Proposal
Invitation.All invoices are available on the BuyBoard website and e-mail notifications will be sent when
they are ready to be retrieved.
Vendor: OMJC Signal, INC 795-26Page 9 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
53 Invoices
Please choose only one (1) of the following options for receipt of invoices and provide the requested
information:
(a) Service fee invoices and related communications should be provided directly to my company at:
or
(b) In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following
billing agent:
If Vendor authorizes a billing agent to receive and process service fee invoices, in accordance with the General Terms and Conditions of the Contract,
Vendor specifically acknowledges and agrees that nothing in that designation shall relieve Vendor of its responsibilities and obligations under the
Contract including, but not limited to, payment of all service fees under any Contract awarded Vendor.
Service fee invoices and notices direct to company
54 Invoice Company Name
Invoice Company Name
OMJC Signal Inc
55 Invoice Company Department Name
Invoice Company Department Name
Accounting
56 Invoice Contact - First Name
Invoice Contact - First Name
Steve
57 Invoice Contact - Last Name
Invoice Contact - Last Name
Salutric
58 Invoice Mailing Address
Invoice Mailing Address (P.O. Box or Street Address)
PO Box 1594
59 Invoice Mailing Address - City
Invoice Mailing Address - City
Waterloo
60 Invoice Mailing Address - State
Invoice Mailing Address - State (Abbreviate State Name)
IA
61 Invoice Mailing Address - Zip Code
Invoice Mailing Address (Zip Code)
50704
Vendor: OMJC Signal, INC 795-26Page 10 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
62 Invoice Contact Phone Number
Invoice Contact Phone Number (xxx-xxx-xxxx)
319-236-0200
63 Invoice Contact Extension Number
Invoice Contact Extension Number
112
64 Invoice Contact Fax Number
Invoice Contact Fax Number (xxx-xxx-xxxx)
No response
65 Invoice Contact E-mail Address
Invoice Contact E-mail
accounting@omjcsignal.com
66 Invoice Contact Alternate E-mail Address
Invoice Contact Alternate E-mail Address
sales@omjcsignal.com
67 Billing Agent Company Name
Billing Agent Company Name
No response
68 Billing Agent Department Name
Billing Agent Department Name
No response
69 Billing Agent Contact - First Name
Billing Agent Contact - First Name
No response
70 Billing Agent Contact - Last Name
Billing Agent Contact - Last Name
No response
71 Billing Agent Mailing Address
Billing Agent Mailing Address (P.O. Box or Street Address)
No response
72 Billing Agent Mailing Address - City
Billing Agent Mailing Address - City
No response
73 Billing Agent Mailing Address - State
Billing Agent Mailing Address - State (Abbreviate State Name)
No response
Vendor: OMJC Signal, INC 795-26Page 11 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
74 Billing Agent Mailing Address - Zip Code
Billing Agent Mailing Address - Zip Code
No response
75 Billing Agent Contact Phone Number
Billing Agent Contact Phone Number (xxx-xxx-xxxx)
No response
76 Billing Agent Contact Extension Number
Billing Agent Contact Extension Number
No response
77 Billing Agent Fax Number
Billing Agent Fax Number
No response
78 Billing Agent Contact E-mail Address
Billing Agent Contact E-mail Address
No response
79 Billing Agent Alternative E-mail Address
Billing Agent Alternative E-mail Address
No response
80 Shipping Via
Common Carrier, Company Truck, Prepaid and Add to Invoice, or Other
Common Carrier
81 Payment Terms
Note: Vendor payment terms must comply with the BuyBoard General Terms and Conditions and the Texas Prompt
Payment Act (Texas Government Code Ch. 2251).
Net 30 Days
82 Vendor's Internal/Assigned Reference/Quote Number
Vendor's Internal/Assigned Reference/Quote Number
No response
83 State or Attach Return Policy
terms, terms of sale, or other information not specifically related to return requirements and processes included in
Deviation and Compliance Form and accepted by the Cooperative.
No response
84 Electronic Payments
Are electronic payments acceptable to your company?
Yes
Vendor: OMJC Signal, INC 795-26Page 12 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
85 Credit Card Payments
Are credit card payments acceptable to your company?
No
86 Texas Regional Service Designation
Texas Regional Service Designation - Refer to Form in Proposal Invitation
The
vendors the opportunity to service its members throughout the entire State of Texas. If you do not plan to service all
Texas Cooperative members statewide, you must indicate the specific regions you will service on this form. If you
propose to serve different regions for different products or services included in your Proposal, you must complete
and submit a separate Texas Regional Service Designation form for each group of products and clearly indicate the
products or services to which the designation applies. By designating a region or regions, you are certifying that
you are authorized and willing to provide the proposed products and services in those regions. Designating
regions in which you are either unable or unwilling to provide the specified products and services shall be
grounds for either rejection of your Proposal or, if awarded, termination of your Contract.Additionally, if you
do not plan to service Texas Cooperative members (i.e., if you will service only states other than Texas), you must
so indicate on this form.
87 Company Name
Company Name
OMJC Signal Inc
88 Texas Regional Service Designation
Select only one of the following options.If you select "I will NOT serve all Regions of Texas", you must then
check the individual Regions you wish to serve.
I will serve all Regions of Texas
89 Region 1
Region 1 - Edinburg
Region 1
90 Region 2
Region 2 - Corpus Christi
Region 2
91 Region 3
Region 3 - Victoria
Region 3
92 Region 4
Region 4 - Houston
Region 4
93 Region 5
Region 5 - Beaumont
Region 5
94 Region 6
Region 6 - Huntsville
Region 6
Vendor: OMJC Signal, INC 795-26Page 13 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
95 Region 7
Region 7 - Kilgore
Region 7
96 Region 8
Region 8 - Mount Pleasant
Region 8
97 Region 9
Region 9 - Wichita Falls
Region 9
98 Region 10
Region 10 - Richardson
Region 10
99 Region 11
Region 11 - Fort Worth
Region 11
100
Region 12
Region 12 - Waco
Region 12
101
Region 13
Region 13 - Austin
Region 13
102
Region 14
Region 14 - Abilene
Region 14
103
Region 15
Region 15 - San Angelo
Region 15
104
Region 16
Region 16 - Amarillo
Region 16
105
Region 17
Region 17 - Lubbock
Region 17
106
Region 18
Region 18 - Midland
Region 18
Vendor: OMJC Signal, INC 795-26Page 14 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
107
Region 19
Region 19 - El Paso
Region 19
108
Region 20
Region 20 - San Antonio
Region 20
109
State Service Designation
State Service Designation - Refer to Form in Proposal Invitation.
As set
States have the opportunity to purchase goods or services awarded under the Contract, subject to applicable state
law, through a piggy-back award or similar agreement through the National Purchasing Cooperative BuyBoard. If
you plan to service the entire United States or only specific states, you must complete this form accordingly. (Note:
If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional Service
Designation form.)In addition to this form, to be considered for a piggy-back award by the National
Purchasing Cooperative, you must have an authorized representative sign the National Purchasing
Cooperative Vendor Award Agreement that follows this form.
If you serve different states for different products or services included in your Proposal, you must complete and
submit a separate State Service Designation form for each group of products and clearly indicate the products or
services to which the designation applies. By designating a state or states, you are certifying that you are
authorized and willing to provide the proposed products and services in those states. Designating states in which
you are either unable or unwilling to provide the specified products and services shall be grounds for either
rejection of your Proposal or, if awarded, termination of your Contract.
110
Company Name
Company Name
OMJC Signal Inc
111
State Service Designation
Select only one of the following options. If you select "I will NOT serve all States", you must then check
the individual States you wish to serve.
I will serve all states in the United States
112
Alabama
Alabama
Alabama
113
Alaska
Alaska
Alaska
114
Arizona
Arizona
Arizona
115
Arkansas
Arkansas
Arkansas
Vendor: OMJC Signal, INC 795-26Page 15 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
116
California
California (Public Contract Code 20118 & 20652)
California
117
Colorado
Colorado
Colorado
118
Connecticut
Connecticut
Connecticut
119
Delaware
Delaware
Delaware
120
District of Columbia
District of Columbia
District of Columbia
121
Florida
Florida
Florida
122
Georgia
Georgia
Georgia
123
Hawaii
Hawaii
Hawaii
124
Idaho
Idaho
Idaho
125
Illinois
Illinois
Illinois
126
Indiana
Indiana
Indiana
127
Iowa
Iowa
Iowa
Vendor: OMJC Signal, INC 795-26Page 16 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
128
Kansas
Kansas
Kansas
129
Kentucky
Kentucky
Kentucky
130
Louisiana
Louisiana
Louisiana
131
Maine
Maine
Maine
132
Maryland
Maryland
Maryland
133
Massachusetts
Massachusetts
Massachusetts
134
Michigan
Michigan
Michigan
135
Minnesota
Minnesota
Minnesota
136
Mississippi
Mississippi
Mississippi
137
Missouri
Missouri
Missouri
138
Montana
Montana
Montana
139
Nebraska
Nebraska
Nebraska
Vendor: OMJC Signal, INC 795-26Page 17 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
140
Nevada
Nevada
Nevada
141
New Hampshire
New Hampshire
New Hampshire
142
New Jersey
New Jersey
New Jersey
143
New Mexico
New Mexico
New Mexico
144
New York
New York
New York
145
North Carolina
North Carolina
North Carolina
146
North Dakota
North Dakota
North Dakota
147
Ohio
Ohio
Ohio
148
Oklahoma
Oklahoma
Oklahoma
149
Oregon
Oregon
Oregon
150
Pennsylvania
Pennsylvania
Pennsylvania
151
Rhode Island
Rhode Island
Rhode Island
Vendor: OMJC Signal, INC 795-26Page 18 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
152
South Carolina
South Carolina
South Carolina
153
South Dakota
South Dakota
South Dakota
154
Tennessee
Tennessee
Tennessee
155
Texas
Texas
Texas
156
Utah
Utah
Utah
157
Vermont
Vermont
Vermont
158
Virginia
Virginia
Virginia
159
Washington
Washington
Washington
160
West Virginia
West Virginia
West Virginia
161
Wisconsin
Wisconsin
Wisconsin
162
Wyoming
Wyoming
Wyoming
Bid Lines
Vendor: OMJC Signal, INC 795-26Page 19 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
1 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for Traffic Light and Signal Systems, Supplies, and Equipment.
Catalog/Price list MUST be included or proposal will not be considered.
Total:6%
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
OMJC Signal Inc
2 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for Traffic Safety Barrier, Barricade, and Guardrail Products (Cable,
Concrete, Plastic, Steel, Wood, W-Beam, Thri-Beam, End Treatments, Posts, and other related products).
Catalog/Price list MUST be included or proposal will not be considered.
No Bid
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Vendor: OMJC Signal, INC 795-26Page 20 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
3 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for Traffic Intersection Safety (Parking Lot, Pedestrian, Railroad, School
Zone)Equipment and Products. Catalog/Price list MUST be included or proposal will not be considered.
No Bid
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
4 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for Traffic Marker and Sign Products. Catalog/Price list MUST be included
or proposal will not be considered.
No Bid
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Vendor: OMJC Signal, INC 795-26Page 21 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
5 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for Computerized Traffic Design Plans, Traffic Flagging, and Special
Event Services. Catalog/Price list MUST be included or proposal will not be considered.
No Bid
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
6 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for All Other Traffic Light and Signal System Products. Catalog/Price list
MUST be included or proposal will not be considered.
No Bid
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Vendor: OMJC Signal, INC 795-26Page 22 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
7 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for Traffic Light and Signal Systems Repair Parts. Catalog/Price list MUST
be included or proposal will not be considered.
No Bid
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
8 Section I: Equipment, Products, and Supplies
Discount (%) off catalog/price list for Traffic Light and Signal Equipment and Products
Maintenance/Warranty Agreements. Catalog/Price list MUST be included or proposal will not be considered.
No Bid
Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/ vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/price list per line item must
submit the information as follows or proposal may not be considered:
Select "Add Alternate" for each additional manufacturer product line and/or catalog/price list
proposed
list listed
Item Attributes
1. State Name of Manufacturer Catalog or Product Price list Proposed with Discount Percentage
NOTE: Do not reference SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
9 Section II: Installation and Repair Service
Hourly Labor Rate for Installation/Repair Service of Traffic Signal Systems, Products, and Related Items
Not to Exceed hourly labor rate for Installation/Repair Service of Traffic Signal Systems, Equipment, and
Products.
Quantity:1 UOM:Hourly Labor Rate Price:$150.00 Total:$150.00
Vendor: OMJC Signal, INC 795-26Page 23 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816
10 Section II: Installation and Repair Service
Hourly Labor Rate for Installation/Repair Service of Traffic Safety Barrier, Barricade, and Guardrail
Products, and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Traffic Safety
Barrier, Barricade, and Guardrail Products.
Quantity:1 UOM:Hourly Labor Rate No Bid
Response Total: $150.00
Vendor: OMJC Signal, INC 795-26Page 24 of 24 pages
Docusign Envelope ID: 37324E2B-84DA-8EF6-838D-EC29D8403816