1-ODOT_D10_ITB_312-26_Rebuild_and_or_Repair_Guardrail_End_Treatments_Attenuator_Parts_AFFIRMATION.pdf

This document is an Affirmation and Disclosure Form for Lake Erie Construction Co., pertaining to a contract with the Ohio Department of Transportation (ODOT). The form specifically addresses requirements related to Executive Order 2022-02D, which prohibits the purchase of services from Russian companies or institutions in response to the conflict in Ukraine. The contractor is based in Norwalk, Ohio, and is affirming compliance with this executive order for any potential contract work.

The form requires the contractor to disclose its principal business location, which is 25 South Norwalk Rd. W., P.O. Box 777 in Norwalk, OH 44857-0777. It stipulates that no services under this contract will be performed in Russia, and the contractor must immediately notify the state of any changes in service locations or subcontractor arrangements. The document is signed by the company president on 7.29.2025, confirming understanding of the restrictions on working with Russian entities and agreeing to abide by the terms of the executive order in any potential state contract.