7169 - Assignment of Contract Executed
Procurement
215 E. McKinney St., Denton, TX 76201 (940) 349-7100
OUR CORE VALUES
Inclusion • Collaboration • Quality Service • Strategic Focus • Fiscal Responsibility
Assignment of Contract #7169
FOR VALUE RECEIVED, Rubicon Global, LLC (“Assignor”) hereby assigns and otherwise transfers to
Wastech Corporation (“Assignee”) all rights, title, and interest held by Assignor in and to the “Contract”
described as follows (this “Assignment”):
Contract approved September 22, 2020, by and between the City of Denton, Rubicon Global, LLC for
smart routing services for the City of Denton; said Contract being in the original not to exceed amount of
$500,907.00.
Said Contract has not been modified and remains on the terms and conditions originally contained therein.
Per the Contract Assignment executed on November 25, 2024, between Wastech Corp., Rubicon
Technologies, Inc., and Rubicon Technologies Holdings, LLC, Assignor grants, bargains, sells, conveys,
transfers, assigns, and delivers all of its rights, interests, obligations, and duties under the Contract to
Assignee. Assignee fully assumes and agrees to perform all remaining covenants, duties, and obligations
of Assignor under the Contract in strict accordance with the terms and conditions of the Contract and
agrees to indemnify and hold Assignor harmless from any claim or demand resulting from non-
performance by Assignee. The City of Denton’s obligations to make payment to Assignee shall only be
effective following the date this Assignment becomes effective. In the event that a dispute arises between
Assignor and Assignee as to the allocation or division of any payments payable or paid to Assignor of
Assignee, such dispute shall be resolved strictly between Assignor and Assignee.
This Assignment shall become effective as of the date the Consent to Assignment is executed by the City
of Denton after this Assignment is executed by the Assignee and shall be binding upon and inure to the
benefit of the Assignee, their heirs, administrators, successors, and assigns.
IN WITNESS WHEREOF the Assignee execute and affix their respective approval and signature on
this Assignment on the dates herein set forth.
Dated: 11/25/2024
See attached Contract Assignment
Assignor
Dated: _________________
___________________________
Assignee
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
2/4/2025
Procurement
215 E. McKinney St., Denton, TX 76201 (940) 349-7100
OUR CORE VALUES
Inclusion • Collaboration • Quality Service • Strategic Focus • Fiscal Responsibility
Consent to Assignment of Contract
In accordance with the provisions of the Contract, the City of Denton hereby consents to the Assignment
of Contract affirming that no modification of the Contract is made or intended, except as noted
hereinabove, and that Assignee is now and hereafter substituted for Assignor. The Assignee shall provide
to the City of Denton the following documentation before the Assignment of Contract shall become
effective: (1) a Conflict of Interest Questionnaire.
Attached: Contract #7169
Contract Assignment between Wastech Corp., Rubicon Technologies, Inc., and Rubicon
Technologies Holdings, LLC
Consent to Assignment
Dated: _________________
Approved by:
____________________
Lori Hewell
Purchasing Manager
City of Denton
901B Texas Street
Denton, Texas
940-349-7100
lori.hewell@cityofdenton.com
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
2/4/2025
Docusign City Council Transmittal Coversheet
File Name
Purchasing Contact
City Council Target Date
Piggy Back Option
Contract Expiration
Ordinance
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EXHIBIT E
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Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Exhibit
CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ
For vendor or other person doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as
defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local government entity not later than the 7th business day after
the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a
misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
2
Check this box if you are filing an update to a previously filed questionnaire.
(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business
day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information in this section is being disclosed.
Name of Officer
This section, (item 3 including subparts A, B, C & D), must be completed for each officer with whom the vendor has an employment or other business relationship
as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary.
A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the vendor?
Yes No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer
named in this section AND the taxable income is not received from the local governmental entity?
Yes No
C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an
officer or director, or holds an ownership of one percent or more?
Yes No
D. Describe each employment or business and family relationship with the local government officer named in this section.
4
I have no Conflict of Interest to disclose.
5
Signature of vendor doing business with the governmental entity Date
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Certificate Of Completion
Envelope Id: 533122565F7A4E0A8402E0CF20CEEA80 Status: Completed
Subject: Please DocuSign: City Council Contract 7169-Smart Routing Solutions
Source Envelope:
Document Pages: 29 Signatures: 6 Envelope Originator:
Certificate Pages: 6 Initials: 1 Crystal Westbrook
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
crystal.westbrook@cityofdenton.com
IP Address: 198.49.140.104
Record Tracking
Status: Original
8/12/2020 12:34:15 PM
Holder: Crystal Westbrook
crystal.westbrook@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Crystal Westbrook
crystal.westbrook@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.104
Sent: 8/12/2020 12:41:13 PM
Viewed: 8/12/2020 12:42:20 PM
Signed: 8/12/2020 12:45:16 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Lori Hewell
lori.hewell@cityofdenton.com
Purchasing Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 8/12/2020 12:45:18 PM
Viewed: 8/12/2020 2:09:42 PM
Signed: 8/12/2020 2:10:23 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Mack Reinwand
mack.reinwand@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.104
Sent: 8/12/2020 2:10:25 PM
Viewed: 8/18/2020 3:43:51 PM
Signed: 8/18/2020 3:45:42 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Michael Allegretti
michael.allegretti@rubicon.com
Chief Strategy Officer
Rubicon Global
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 24.152.225.211
Sent: 8/18/2020 3:45:45 PM
Viewed: 8/18/2020 3:47:47 PM
Signed: 8/21/2020 4:10:46 PM
Electronic Record and Signature Disclosure:
Accepted: 8/18/2020 3:47:47 PM
ID: f4a25fee-55b2-41bd-b695-0d51b054c87f
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Signer Events Signature Timestamp
Brian Boerner
brian.boerner@cityofdenton.com
Director of Solid Waste
Security Level: Email, Account Authentication
(None)Signature Adoption: Drawn on Device
Using IP Address: 38.65.73.242
Signed using mobile
Sent: 8/21/2020 4:10:49 PM
Viewed: 8/21/2020 4:11:42 PM
Signed: 8/21/2020 4:50:26 PM
Electronic Record and Signature Disclosure:
Accepted: 8/21/2020 4:11:42 PM
ID: 2334bbcd-6fdd-49ed-a852-4d7bd64efdd8
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.104
Sent: 8/21/2020 4:50:28 PM
Viewed: 9/23/2020 9:26:17 AM
Signed: 9/23/2020 9:26:34 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Todd Hileman
Todd.Hileman@cityofdenton.com
City Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 47.184.93.41
Sent: 9/23/2020 9:26:37 AM
Viewed: 9/23/2020 9:28:26 AM
Signed: 9/23/2020 9:28:31 AM
Electronic Record and Signature Disclosure:
Accepted: 7/25/2017 11:02:14 AM
ID: 57619fbf-2aec-4b1f-805d-6bd7d9966f21
Rosa Rios
rosa.rios@cityofdenton.com
City Secretary
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 9/23/2020 9:28:34 AM
Viewed: 9/23/2020 9:40:55 AM
Signed: 9/23/2020 9:41:12 AM
Electronic Record and Signature Disclosure:
Accepted: 9/23/2020 9:40:55 AM
ID: 9a330d99-b708-4fed-9731-9d394622d08c
In Ierson Signer Events Signature Timestamp
Editor DeliverI Events Status Timestamp
Igent DeliverI Events Status Timestamp
IntermediarI DeliverI Events Status Timestamp
CertiIied DeliverI Events Status Timestamp
CarIon CopI Events Status Timestamp
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 8/12/2020 12:45:18 PM
Electronic Record and Signature Disclosure:
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
CarIon CopI Events Status Timestamp
Not Offered via DocuSign
Sherri Thurman
sherri.thurman@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 8/21/2020 4:50:28 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tolaina Parker
Tolaina.Parker@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 9/23/2020 9:41:15 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tames Tips
Tames.tips@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Sent: 9/23/2020 9:41:16 AM
Viewed: 9/23/2020 9:44:18 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Iitness Events Signature Timestamp
IotarI Events Signature Timestamp
Envelope SummarI Events Status Timestamps
Envelope Sent Hashed/Encrypted 9/23/2020 9:41:16 AM
Certified Delivered Security Checked 9/23/2020 9:41:16 AM
Signing Complete Security Checked 9/23/2020 9:41:16 AM
Completed Security Checked 9/23/2020 9:41:16 AM
IaIment Events Status Timestamps
Electronic Record and Signature Disclosure
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of Denton (we, us or Company) may be required by law to provide to
you certain written notices or disclosures. Described below are the terms and conditions for
providing to you such notices and disclosures electronically through your DocuSign, Inc.
(DocuSign) Express user account. Please read the information below carefully and thoroughly,
and if you can access this information electronically to your satisfaction and agree to these terms
and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of
this document.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
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DocuSign system you will have the ability to download and print any documents we send to you
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any such documents from our office to you, you will be charged a $0.00 per-page fee. You may
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Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
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Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
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DocuSign Express user account to receive required notices and consents electronically from us
or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or
made available to you during the course of our relationship with you. To reduce the chance of
you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
#! ! #$! " "$!!#
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Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
How to contact City of Denton:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: purchasing@cityofdenton.com
To advise City of Denton of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at melissa.kraft@cityofdenton.com
and in the body of such request you must state: your previous e-mail address, your new e-mail
address. We do not require any other information from you to change your email address..
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
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To request paper copies from City of Denton
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an e-mail to purchasing@cityofdenton.com and in
the body of such request you must state your e-mail address, full name, US Postal address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with City of Denton
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
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must state your e-mail, full name, IS Postal Address, telephone number, and account
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consequences of your withdrawing consent for online documents will be that transactions
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NetScape 7.2 (or above)
Email: Access to a valid email account
Screen Resolution: 800 x 600 minimum
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Server must enable HTTP 1.1 settings via
proxy connection
** These minimum requirements are subject to change. If these requirements change, we will
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have the right to withdraw your consent.
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Acknowledging your access and consent to receive materials electronically
To confirm to us that you can access this information electronically, which will be similar to
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were able to read this electronic disclosure and that you also were able to print on paper or
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please let us know by clicking the 'I agree' button below.
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ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
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• Until or unless I notify City of Denton as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to me by City of Denton during the course of my relationship with you.
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
CONTRACT ASSIGNMENT
This CONTRACT ASSIGNMENT (this “Assignment”), dated November 25, 2024, is
made by and among Wastech Corp., a Delaware corporation (“Assignee”), and the entities listed
as “Assignors” on the signature pages hereto (collectively, the “Assignors”).
WHEREAS, pursuant to the terms of that certain Asset Purchase Agreement, dated as of
May 7, 2024, by and among Rubicon Technologies, Inc., a Delaware corporation, Rubicon
Technologies Holdings, LLC, a Delaware limited liability company, and Assignee (the “Purchase
Agreement”), the Assignors have agreed to sell, convey, transfer and deliver to Assignee, and
Assignee has agreed to acquire from Assignors, subject to the terms and conditions set forth in the
Purchase Agreement (including Section 8.2 thereof), the Unassignable Contracts.
WHEREAS, capitalized terms used but not defined herein have the respective meanings
ascribed to them in the Purchase Agreement.
WHEREAS, the Assignee has requested consents to this Assignment, pursuant to and as
required by the terms of each respective Contract (defined below) (the “Consents”).
NOW, THEREFORE, in consideration of the foregoing and of other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto
agree as follows:
1.Subject to and conditional upon attainment of each respective Consent, the
Assignors transfer, convey, assign and deliver to Assignee, and Assignee hereby acquires from the
Assignors, all of the rights, title, interests and obligations of the Assignors in and to each contract
listed on Schedule A hereto (collectively, the “Contracts”). Upon attainment of each respective
Consent, Assignee hereby accepts such assignment of the respective Contract and hereby assumes
all of the Assignors’ duties and obligations under such Contract and agrees to pay, perform and
discharge, as and when due, all of the obligations of the Assignors under such Contract accruing
on and after the date of such Consent, subject to the terms and conditions set forth in the Purchase
Agreement (including in respect of Excluded Liabilities relating to the Contracts). For the
avoidance of doubt, Assignee agrees to be bound by the terms and conditions of each Contract
upon attainment of the respective Consent.
THIS ASSIGNMENT IS IN ALL RESPECTS SUBJECT TO THE PROVISIONS OF THE
PURCHASE AGREEMENT AND IS NOT INTENDED IN ANY WAY TO SUPERSEDE,
LIMIT OR QUALIFY ANY PROVISION OF THE PURCHASE AGREEMENT.
2.The parties hereto agree to execute and deliver such further documentation,
instruments, and the like, and to take such further action as is commercially reasonable to carry
out the intentions or to facilitate the performance of the terms of this Assignment.
3.This Assignment may be executed in one or more counterparts, or by the different
parties hereto in separate counterparts, each of which when executed shall be deemed to be an
original but all of which, taken together, shall constitute one and the same instrument. Delivery
of an executed counterpart of a signature page to this Assignment by facsimile or electronic copy
shall be effective as delivery of a manually executed counterpart to this Assignment.
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
2
4.This Assignment shall be construed by and governed in accordance with the laws
of the State of Delaware, without giving effect to any choice of law or conflict of law provision.
5.This Assignment shall be binding upon and inure to the benefit of Assignor and
Assignee and each of their respective successors and permitted assigns.
[Signature page follows]
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Signature Page to Contract Assignment
IN WITNESS WHEREOF, the undersigned have duly executed this Contract Assignment
as of the date first written above.
ASSIGNORS:
RUBICON GLOBAL, LLC
By: Rubicon Technologies Holdings, LLC, its Sole
Member
By: Rubicon Technologies, Inc., its Managing
Member
By: ______________________________________
Name: Osman Ahmed
Title: Interim Chief Executive Officer
Docusign Envelope ID: 74BCEF7D-328F-4283-8115-DD9BA1FB312ADocusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Signature Page to Contract Assignment
IN WITNESS WHEREOF, the undersigned have duly executed this Contract Assignment
as of the date first written above.
ASSIGNEE:
WASTECH CORP.
By: ______________________________________
Name: Tim Dahltorp
Title: Chief Financial Officer
Docusign Envelope ID: A1D4A5FA-9FE1-4208-A580-27B6C71B77ADDocusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Schedule A
Contracts Assignment
Schedule A
Assigned Contracts
1. [redacted]
2. Contract, by and between Rubicon Global LLC and the City of Denton, Texas, dated
September 22, 2020.
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
October 4, 2024
Via certified/registered mail
The City of Denton, Texas
901B Texas Street
Denton, TX 7629
Marked Attn: Purchasing Manager
RE: Consent to Assignment
To whom it may concern:
Pursuant to the terms of that certain Asset Purchase Agreement, dated as of May 7, 2024 (the
“Purchase Agreement”), by and among Rubicon Technologies, Inc., a Delaware corporation
(“Parent”), Rubicon Technologies Holdings, LLC, a Delaware limited liability company (together with
Parent, “Sellers”) and Wastech Corp., a Delaware corporation (“Buyer”), Sellers caused Rubicon
Global, LLC, a Delaware limited liability company (the “Rubicon Entity”) to sell and assign to Buyer,
and Buyer agreed to purchase and assume from the Rubicon Entity, certain contracts of the Rubicon
Entity.
In connection with the Purchase Agreement, please sign below acknowledging your consent for
the Rubicon Entity to assign to Buyer all right, title and interest in and to the Contract by and between
the Rubicon Entity and the City of Denton, Texas, dated September 22, 2020 (the “Contract”). Effective
with the assignment, Buyer hereby agrees to assume all obligations in and to, and agrees to pay, perform
and discharge, in a timely manner in accordance with the terms hereof, the Contract, and by signing this
letter agreement, you hereby agree to and acknowledge such assignment and assumption.
Additionally, please note that the address for any written notices to Buyer will be:
c/o Routeware, Inc.
16525 SW 72nd Ave
Portland, OR 97224
Attention: Chief Financial Officer
Phone: 503-906-8500
Email: tdahltorp@routeware.com
In addition, subsequent to the completion of the transactions contemplated by the Purchase
Agreement, all of the equity interests of Buyer were acquired by Routeware Parent, LLC (“Routeware
Parent”), an indirect subsidiary of Routeware, Inc. (“Routeware”), pursuant to that certain Agreement
and Plan of Merger, dated as of August 23, 2024, by and among Routeware Parent, Routeware, Wastech
LP and Routeware Merger Sub, Inc. (the “Control Acquisition”), which constituted a change of control
under the Contract. For the avoidance of doubt, the Control Acquisition is not a further assignment of
the Contract and does not affect the assignment of the Contract to Buyer detailed above. By execution
of this letter, you also hereby consent, to the extent such consent is required, to the Control Acquisition,
including any transfers or assignments (or deemed transfers or assignments) in connection therewith of
the Contract as a result of the Control Acquisition.
[rest of page intentionally left blank]
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
[Signature Page to Consent to Assignment (Wastech Corp.)]
Agreed and Acknowledged:
THE CITY OF DENTON, TEXAS
By: __________________________
Name:
Title:
Date:
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Lori Hewell
Purchasing Manager
2/4/2025
CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ
For vendor or other person doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined
by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local government entity not later than the 7th business day after the
date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a
misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
2
Check this box if you are filing an update to a previously filed questionnaire.
(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day
after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information in this section is being disclosed.
Name of Officer
Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section
176.003(a)(2)(A). Also describe any family relations hip with the local government officer. This section, (item 3 including subparts A, B, C & D), must be
completed for each officer with whom the vendor has an employment or other business relationship as defined by Section 176.00 1(1-a), Local Government Code.
Attach additional pages to this Form CIQ as necessary.
A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the vendor?
Yes No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in
this section AND the taxable income is not received from the local governmental entity?
Yes No
C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer
or director, or holds an ownership of one percent or more?
Yes No
D. Describe each employment or business and family relationship with the local government officer named in this section.
4
I have no Conflict of Interest to disclose.
5
Signature of vendor doing business with the governmental entity Date
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
2/4/2025
None
Tim Dahltorp
Wastech Corp.
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local Government Code may be found at http://www.statutes.legis.state.tx.us/ Docs/LG/htm/LG.176.htm. For easy
reference, below are some of the sections cited on this form.
Local Government Code § 176.001(1-a): "Business relationship" means a connection between two or more parties based on commercial activity of one of the
parties. The term does not include a connection based on:
(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an agency of a federal, state, or local
governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by,
and reporting to, that agency.
Local Government Code § 176.003(a)(2)(A) and (B):
(A) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:
(2) the vendor:
(A) has an employment or other business relationship with the local government officer or a family member of the officer that
results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during
the 12-month period preceding the date that the officer becomes aware that
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor;
(B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of
more than $100 in the 12-month period preceding the date the officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor.
Local Government Code § 176.006(a) and (a-1)
(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family
member of the officer, described by Section 176.003(a)(2)(A);
(2) has given a local government officer of that local governmental entity, or a family member of the officer, one or more gifts with the
aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003(a-1); or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day
after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental entity; or
(B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another
writing related to a potential contract with the local governmental entity; or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a family member of the officer,
described by Subsection (a);
(B) that the vendor has given one or more gifts described by Subsection (a); or
(C) of a family relationship with a local government officer.
City of Denton Ethics Code Ordinance Number 18-757
Definitions:
Relative: a family member related to a City Official within the third 3rd degree of affinity (marriage) or consanguinity (blood or adoption)
City Official: for purpose of this article, the term consists of the Council Members, Department Heads, or member of the Board of Ethics, Planning
and zoning Commission Members, Board of Adjustment, Historic Landmark Commission, or Public Utilities Board
Vendor: a person who provides or seeks to provide goods, services, and/or real property to the City in exchange for compensation. This definition
does not include those property owners from whom the City acquires public right-of-way or other real property interests for public use.
Per the City of Denton Ethics Code, Section 2-273. – Prohibitions
(3) It shall be a violation of this Article for a Vendor to offer or give a Gift to City Official exceeding fifty dollars ($50.00) per gift, or multiple gifts
cumulatively valued at more than two hundred dollars ($200.00) per a single fiscal year.
Per the City of Denton Ethics Code, Section 2-282. – Disposition (b), (5) Ineligibility
If the Board of Ethics finds that a Vendor has violated this Article, the Board may recommend to the City Manager that the Vendor be deemed
ineligible to enter into a City contract or other arrangement for goods, services, or real property, for a period of one (1) year.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015
Docusign Envelope ID: 11882D87-9D45-4C95-8599-1FD75A3F1FAE
Certificate Of Completion
Envelope Id: 11882D87-9D45-4C95-8599-1FD75A3F1FAE Status: Completed
Subject: Please DocuSign: Assignment of Contract
Source Envelope:
Document Pages: 47 Signatures: 4 Envelope Originator:
Certificate Pages: 5 Initials: 0 Cheyenne Defee
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
cheyenne.defee@cityofdenton.com
IP Address: 198.49.140.104
Record Tracking
Status: Original
2/3/2025 10:34:40 AM
Holder: Cheyenne Defee
cheyenne.defee@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Tim Dahltorp
tdahltorp@routeware.com
CFO
Wastech Corp.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 73.14.177.118
Sent: 2/3/2025 10:42:33 AM
Viewed: 2/4/2025 8:06:07 AM
Signed: 2/4/2025 8:07:40 AM
Electronic Record and Signature Disclosure:
Accepted: 2/4/2025 8:06:07 AM
ID: 96785364-9cbe-4814-ae22-a8e661ef6283
Lori Hewell
Lori.Hewell@cityofdenton.com
Purchasing Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 2/4/2025 8:07:43 AM
Viewed: 2/4/2025 8:31:53 AM
Signed: 2/4/2025 8:32:06 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Procurement Administration Supervisor
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 2/4/2025 8:32:09 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Carbon Copy Events Status Timestamp
Tim Dahltorp
tdahltorp@routeware.com
CFO
Wastech Corp.
Security Level: Email, Account Authentication
(None)
Sent: 2/4/2025 8:32:10 AM
Electronic Record and Signature Disclosure:
Accepted: 2/4/2025 8:06:07 AM
ID: 96785364-9cbe-4814-ae22-a8e661ef6283
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 2/3/2025 10:42:33 AM
Certified Delivered Security Checked 2/4/2025 8:31:53 AM
Signing Complete Security Checked 2/4/2025 8:32:06 AM
Completed Security Checked 2/4/2025 8:32:10 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of Denton (we, us or Company) may be required by law to provide to
you certain written notices or disclosures. Described below are the terms and conditions for
providing to you such notices and disclosures electronically through your DocuSign, Inc.
(DocuSign) Express user account. Please read the information below carefully and thoroughly,
and if you can access this information electronically to your satisfaction and agree to these terms
and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of
this document.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. For such copies, as long as you are an authorized user of the
DocuSign system you will have the ability to download and print any documents we send to you
through your DocuSign user account for a limited period of time (usually 30 days) after such
documents are first sent to you. After such time, if you wish for us to send you paper copies of
any such documents from our office to you, you will be charged a $0.00 per-page fee. You may
request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. To indicate to us that you are changing your mind, you must
withdraw your consent using the DocuSign 'Withdraw Consent' form on the signing page of your
DocuSign account. This will indicate to us that you have withdrawn your consent to receive
required notices and disclosures electronically from us and you will no longer be able to use your
DocuSign Express user account to receive required notices and consents electronically from us
or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or
made available to you during the course of our relationship with you. To reduce the chance of
you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Tim Dahltorp, Tim Dahltorp
How to contact City of Denton:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: purchasing@cityofdenton.com
To advise City of Denton of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at melissa.kraft@cityofdenton.com
and in the body of such request you must state: your previous e-mail address, your new e-mail
address. We do not require any other information from you to change your email address..
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
in your DocuSign account by following the process for changing e-mail in DocuSign.
To request paper copies from City of Denton
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an e-mail to purchasing@cityofdenton.com and in
the body of such request you must state your e-mail address, full name, US Postal address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with City of Denton
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your DocuSign account, and on the subsequent
page, select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an e-mail to purchasing@cityofdenton.com and in the body of such request you
must state your e-mail, full name, IS Postal Address, telephone number, and account
number. We do not need any other information from you to withdraw consent.. The
consequences of your withdrawing consent for online documents will be that transactions
may take a longer time to process..
Required hardware and software
Operating Systems: Windows2000? or WindowsXP?
Browsers (for SENDERS): Internet Explorer 6.0? or above
Browsers (for SIGNERS): Internet Explorer 6.0?, Mozilla FireFox 1.0,
NetScape 7.2 (or above)
Email: Access to a valid email account
Screen Resolution: 800 x 600 minimum
Enabled Security Settings:
•Allow per session cookies
•Users accessing the internet behind a Proxy
Server must enable HTTP 1.1 settings via
proxy connection
** These minimum requirements are subject to change. If these requirements change, we will
provide you with an email message at the email address we have on file for you at that time
providing you with the revised hardware and software requirements, at which time you will
have the right to withdraw your consent.
Acknowledging your access and consent to receive materials electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please verify that you
were able to read this electronic disclosure and that you also were able to print on paper or
electronically save this page for your future reference and access or that you were able to
e-mail this disclosure and consent to an address where you will be able to print on paper or
save it for your future reference and access. Further, if you consent to receiving notices and
disclosures exclusively in electronic format on the terms and conditions described above,
please let us know by clicking the 'I agree' button below.
By checking the 'I Agree' box, I confirm that:
• I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF
ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
• I can print on paper the disclosure or save or send the disclosure to a place where I can
print it, for future reference and access; and
• Until or unless I notify City of Denton as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to me by City of Denton during the course of my relationship with you.