1-affirmation_form_25.pdf

This document is an Affirmation and Disclosure Form related to an Ohio Department of Transportation (ODOT) contract, specifically addressing requirements under Executive Order 2022-02D concerning services performed by Russian companies or institutions. The form is completed by Bubba's Towing & Recovery LLC, located at 10101 Garden Rd, Monclova, OH 43542, and is designed to affirm the contractor's compliance with state regulations regarding service performance locations and subcontractor disclosures.

The form indicates that all services for this contract will be performed at the company's primary business location in Monclova, Ohio, with no subcontractors involved. The document emphasizes the contractor's agreement to abide by Executive Order 2022-02D, which prohibits offshore performance of services in Russia and requires immediate disclosure of any changes in service locations. The form was signed by the company president on 4/20/25, and it serves as a formal acknowledgment of the contractor's obligations and understanding of the contract's geographical and operational restrictions.