1-Affirmation_signed_2026.pdf

This document is an Affirmation and Disclosure Form related to a state contract, completed by Northcoast Products, located at 8641 County Rd 18 in Wauseon, OH 43567. The form is associated with Executive Order 2019-12D, which prohibits the purchase of services from Russian companies or institutions and restricts state agencies from engaging with entities that perform services in Russia. The form requires the contractor to disclose business locations, potential subcontractors, and affirm compliance with state requirements regarding service locations and data management.

The document indicates that James Bernath, the President of Northcoast Products, has signed the form, affirming that the company will not perform any contract services in Russia and will immediately notify the state of any changes in service locations. The form is part of a broader state contract process, with an execution date of 3-24-2025, and requires the contractor to provide detailed information about business and service locations. The form emphasizes compliance with state regulations concerning the expenditure of public funds and restrictions on services related to Russian companies or institutions.