1-Affirmation_and_Disclosure___Signed_7-21-25.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing restrictions on services performed by Russian companies or institutions. The form is completed by Nuwar Equipment Company LLC, located at 1905 S. Moorland Rd. in New Berlin, WI 53151, and appears to be associated with the Ohio Department of Transportation (ODOT). The document implements requirements from Executive Order 2022-02D, which prohibits the expenditure of public funds on services performed by Russian companies or institutions.

The form outlines the contractor's principal business location, service performance location, and state data location, all of which are specified as 1905 S. Moorland Rd. in New Berlin, Wisconsin. The contractor affirms compliance with the executive order, which restricts services from Russia and requires disclosure of any potential changes in service locations. The document does not provide specific details about the goods or services under contract, but emphasizes the contractor's agreement to abide by the restrictions on Russian-based services and the potential for contract termination if these conditions are not met.