1-Affirmation_and_Disclosure-_FPO_Signed_6-17-25.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving Flexible Pavements of Ohio as the primary contractor. The form pertains to Executive Order 2022-02D, which prohibits state agencies from purchasing services from Russian companies or institutions in response to the conflict in Ukraine. The contract involves the Ohio Department of Transportation (ODOT) and will be performed at the Ohio University Lancaster Campus, with the contractor's principal business location in Dublin, Ohio.

The contract includes a subcontractor, Larry Shively, located in Thornville, Ohio, and will be performed at the Ohio University Lancaster Campus, Herrold Hall, Room 102. The document outlines the locations where services will be performed, where state data will be located, and affirms compliance with the executive order prohibiting business with Russian entities. The form is signed by the Executive Director, dated 6/17/25, and serves as a formal disclosure of the contractor's business locations, subcontractor details, and commitment to not engage in services with Russian companies under the specified executive order.