1-AFFIRMATION_AND_DISCLOSURE_FORM.pdf

The document is an Affirmation and Disclosure Form for Eberl Iron Works, Inc., a contractor based in Buffalo, NY, related to a state contract with the Ohio Department of Transportation (ODOT). The form specifically addresses compliance with Executive Order 2022-02D, which prohibits the expenditure of public funds on services performed by Russian companies or institutions. The contractor affirms that no services under this contract will be performed in Russia, and provides their principal business location at 128 Sycamore St. in Buffalo, NY.

The form indicates that the contractor will perform services at the same Buffalo, NY address, with no subcontractors listed. The document emphasizes compliance with restrictions on Russian business interactions, noting that ODOT reserves the right to recover funds paid for services performed in Russia in violation of the executive order. The form was signed by the CFO on 3/28/2025, and serves as a mandatory disclosure and affirmation document that will be incorporated into any potential contract with the state, ensuring transparency about the contractor's business operations and geographical service locations.