1-_835-26_Central_Hydraulic_Systems__Affirmation_and_Disclosure._Signed.docx
DOCX document 298 KB Posted
- Attached to
- Competitive Selection OH|DOT83526-3
- Contract number
- DOT83526-3
- Issued by
- Ohio
About this file
This document is an Affirmation and Disclosure Form for a state contract involving Central Hydraulic Systems, located in Cincinnati, Ohio, and submitted to the Ohio Department of Transportation (ODOT). The form addresses compliance with Executive Order 2022-02D, which prohibits purchasing services from Russian companies, and includes details about the contractor and its subcontractor, Pengwyn Products, also based in Ohio.
The document focuses on affirming that all contract services will be performed within the United States and will not involve any offshore or Russian-based service delivery. The contractor (Central Hydraulic Systems) and its subcontractor (Pengwyn Products) have both listed their principal business locations and service performance locations in Ohio. While specific service details are not elaborated, the form emphasizes strict compliance with state regulations regarding service location, data management, and prohibitions on international service delivery, particularly from Russian entities.
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Other files
| File | Type | Posted |
|---|---|---|
| 1-MBE_-_Certificate_1-24_thru_1-26.pdf | ||
| 1-835-26_Pricing.xlsx | XLSX spreadsheet | |
| Signature__4___1___002_.pdf | ||
| hydraulics_835-26_BID.pdf |
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Text version
AFFIRMATION AND DISCLOSURE FORM
By the signature affixed hereto, the Contractor affirms and understands that if awarded a contract, both the Contractor and any of its subcontractors shall perform no services requested under this Contract outside of the United States, not allow State data to be sent, taken, accessed, tested, maintained, backed-up, stored or made available remotely(located) outside of the United States unless a duly signed waiver from the State has been attained.
The Contractor shall provide all the name(s) and location(s) where services under this Contract will be performed and where data is located in the spaces provided below or by attachment. Failure to provide this information may result in no award. If the Contractor will not be using subcontractors, indicate “Not Applicable” in the appropriate spaces.
EXPENDITURE OF PUBLIC FUNDS ON SERVICES PERFORMED BY RUSSIAN COMPANIES OR INSTITUTIONS.
The Contractor affirms to have read and understands Executive Order 2022-02D and shall abide by those requirements in the performance of this Contract. Pursuant to this Executive Order, all state agencies are prohibited from the purchase of services from Russian companies or institutions. This prohibition is in addition to and expands upon Executive Order 2019-12D which generally precludes the purchase of offshore services by the State of Ohio. Notwithstanding any other terms of this Contract, ODOT reserves the right to recover any funds paid for services the Contractor performs in Russia in violation of this Executive Order. ODOT does not waive any other rights and remedies provided to ODOT in this Contract.
The Contractor agrees to complete the attached Exhibit II, Contractor/Subcontractor Affirmation and Disclosure Form, to abide with Executive Order 2022-02D, which is incorporated and becomes a part of this Contract, affirming no services of the Contractor or its subcontractors under this Contract will be performed in Russia.
1. Principal location of business of Contractor:
| 237 Baxter Avenue | Cincinnati, OH 45220 | ||
| __________________________________ | _________________________________ | ||
| (Address) | (City, State, Zip) |
Name/Principal location of business of subcontractor(s):
| Pengwyn Products | 2550 W. 5th Ave, Columbus, OH 43204 | ||
| ___________________________________ | _________________________________ | ||
| (Name) | (Address, City, State, Zip) |
| ___________________________________ | _________________________________ | |
| (Name) | (Address, City, State, Zip) |
2. Location where services will be performed by Contractor:
| 237 Baxter Avenue | Cincinnati, OH 45220 | ||
| ___________________________________ | _________________________________ | ||
| (Address) | (City, State, Zip) |
Name/Location where services will be performed by subcontractor(s):
| Pengwyn Products | 2550 W. 5th Ave, Columbus, OH 43204 | ||
| ___________________________________ | _________________________________ | ||
| (Name) | (Address, City, State, Zip) |
| ___________________________________ | _________________________________ | |
| (Name) | (Address, City, State, Zip) |
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