1-082-25_Affirmation___Disclosure.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the Ohio Department of Transportation (ODOT) and Executive Order 2022-02D, which prohibits the purchase of offshore services by state agencies. The form is completed by Osborn Associates Inc., located in Logan, OH, and serves as a mandatory disclosure for contractors performing services under the contract.

The contractor has identified their principal business location as PO Box 912 in Logan, OH, with services to be performed at 11931 St. Rt. 93 N, also in Logan. The state data will be located at 9383 Yamette Rd in the same city. No subcontractors are listed (marked as N/A), and the form affirms that no services will be performed in Russia. The document emphasizes compliance with state regulations regarding service locations, data handling, and potential contract termination if location requirements are not met. The form was signed by a bid agent on 6/13/25, indicating the contract's current or upcoming operational status.