1-Complete_A_D_Form.pdf

This document is an Affirmation and Disclosure Form for a contract involving Abutillon Co., Inc. DBA Abco Truck Equipment, located at 701 N. Westwood Ave. in Toledo, Ohio 43607. The form is associated with the Ohio Department of Transportation (ODOT) and relates to Executive Order 2022-02D, which prohibits the expenditure of public funds on services performed by Russian companies or institutions in response to ongoing geopolitical tensions.

The form outlines the contractor's principal business location, service performance location, and state data storage location, all of which are at the same Toledo, Ohio address. The document emphasizes the contractor's agreement to comply with restrictions on Russian-affiliated services, with ODOT reserving the right to terminate the contract if these conditions are not met. The form is signed by Matthew Zimmerman, Vice President, on 4/4/2025, and serves as a formal affirmation of the contractor's compliance with the specified executive order and contract requirements.