1-Affirmation_and_Disclosure__1_.pdf
PDF 255 KB Posted
- Attached to
- Competitive Selection OH|DOT10626-6
- Contract number
- DOT10626-6
- Issued by
- Ohio
About this file
The document is an Affirmation and Disclosure Form for the Ohio Department of Transportation (ODOT) contract with Traffic Control Products, located at 4565 Glenbrook Rd in Willoughby, OH 44094. The form specifically addresses requirements related to Executive Order 2022-02D, which prohibits state agencies from purchasing services from Russian companies or institutions, expanding upon a previous executive order precluding offshore service purchases.
The form confirms that all services and state data for this contract will be performed and located at the contractor's Willoughby, Ohio address, with no services to be conducted outside the United States. The contractor (Traffic Control Products) has affirmed compliance by completing this form, which requires disclosure of service locations and acknowledges ODOT's right to terminate the contract or recover funds if these stipulations are violated. The document is signed by Kimberly Weltz from Inside Sales, with an execution date of May 14, 2025, though specific contract details about goods or services are not elaborated in this particular form.
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Other files
| File | Type | Posted |
|---|---|---|
| 106-26_spec_Bid_Doc..pdf | ||
| 1-106-26_pricing.xlsx | XLSX spreadsheet | |
| Signature__4___1___002_.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:
_4565 Glenbrook Rd__________________ __Willoughby, OH 44094 ____
(Address) (City, State, Zip)
Name/Principal location of business of subcontractor(s):
(Name) (Address, City, State, Zip)
2. Location where services will be performed by Contractor:
__4565 Glenbrook Rd_________________ __Willoughby, OH 44094 ___________
Name/Location where services will be performed by subcontractor(s):
3. Location where state data will be located, by Contractor:
__4565 Glenbrook Rd ___________ ___Willoughby, OH 44094 _________
File details come from the government source that posted it. Updated .