1-AFFIRMATION_AND_DISCLOSURE_FORM-Sarver.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the State of Ohio and the Ohio Department of Transportation (ODOT). The form is completed by Sarver Pump Co., with their principal business location at 1208 Masters Ave. in Ashland, Ohio. The document addresses requirements for performing services under a state contract, with specific attention to restrictions on services performed by Russian companies or institutions, as outlined in Executive Order 2022-02D.

The form confirms that Sarver Pump Co. will perform services at their Ashland, Ohio location and agrees to comply with state requirements regarding service delivery, data handling, and potential changes in service locations. The contractor affirms understanding of prohibitions on offshore services and commits to immediate notification of any shifts in service locations. While specific contract details are not fully elaborated in this form, it serves as a critical compliance document ensuring the contractor's adherence to state guidelines, particularly those related to geographical restrictions and data management for state-contracted services.