1-013-26_Affirmation_Page.pdf

This document is an Affirmation and Disclosure Form for H.Y.O., Inc. dba PENGWYN, located in Columbus, OH, related to a state contract with ODOT (Ohio Department of Transportation). The form addresses compliance with Executive Order 2022-02D regarding restrictions on services performed by Russian companies or institutions, and requires disclosure of business locations and service performance sites.

The contractor confirms that all services will be performed at 2650 W 5th Ave in Columbus, OH 43204, with no subcontractors listed. The document emphasizes prohibitions on purchasing offshore services from Russian entities and requires the contractor to abide by specific executive order guidelines. No specific contract value, goods, or services are detailed in this form, which primarily serves as a compliance and location disclosure document for the state contract.