1-20250528_070511.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving VarTech Industries Inc. as the contractor. The form is associated with the Ohio Department of Transportation (ODOT) and addresses compliance with Executive Order 2022-02D regarding restrictions on services performed by Russian companies or institutions. The primary location of business for VarTech Industries Inc. is 4115 Minnesota Street in Alexandria, MN 56308.

The document details the contractor's commitment to not perform any services in Russia and to comply with the executive order's prohibitions on purchasing services from Russian companies. The contractor affirms that all services will be performed at their Minnesota Street address, with no services to be conducted in Russia. The form requires disclosure of the contractor's and any subcontractors' business locations and includes a signed affirmation by Eric Holland, Vice President of Manufacturing, dated 05-28-2025, confirming compliance with the specified requirements.