1-015-26_affirmation.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing restrictions on services performed by Russian companies or institutions, as outlined in Executive Order 2022-02D. The form is completed by AFR Truck Jolar Inc., with a principal business location at 1650 E. Waterloo Rd in Akron, OH 44406. The document involves the Ohio Department of Transportation (ODOT) and references Executive Order 2019-12D, which prohibits state agencies from purchasing offshore services.

The form details the location of services to be performed as "same as above" and indicates Terra Drive Systems at 9098 W. Roos Brookton, IN 47925 as a potential subcontractor. The contractor affirms that no services will be performed in Russia and agrees to complete the attached Exhibit II, Contractor/Subcontractor Affirmation and Disclosure Form. The document is signed by Daniel Rollack in the role of President on June 10, 2025, and requires notification to the State of any changes in service locations before, during, or after contract execution.