003-24_Affirmation_and_Disclosure_Kevadiya.pdf

This document is an Affirmation and Disclosure Form (Invitation No. 003-24) completed by a contractor located at 100 N Saginaw St in Pontiac, Michigan 48432. The form is associated with ODOT (Ohio Department of Transportation) and addresses compliance with Executive Order 2022-02D regarding restrictions on services from Russian companies or institutions. The document requires the contractor to disclose their principal business location, service performance locations, and state data storage locations.

The form specifically prohibits the contractor from performing any services under this contract in Russia, in alignment with Executive Orders 2022-02D and 2019-12D. ODOT reserves the right to recover funds if the contractor violates these terms. The contractor, represented by H. David Lester (Director of Business Development), signed the document on July 6, 2023, affirming that no subcontractors will be used and that all services will be performed at their Pontiac, Michigan address. The document serves as a compliance mechanism to ensure transparency and adherence to government restrictions on international service delivery.