1-ODOT_ITB_312A-26_Rebuild_and_or_Repair_Guardrail_End_Treatment_Attenuator_Parts_District_9_AFFIRMATION.pdf

This document is an Affirmation and Disclosure Form from Lake Erie Construction Co., located at 25 South Norwalk Rd. W., P.O. Box 777 in Norwalk, Ohio 44857-0777. The form is related to a state contract and specifically addresses compliance with Executive Order 2022-02D regarding services performed by Russian companies or institutions. The document requires the contractor to affirm and disclose details about their business locations, service performance locations, and state data storage locations.

The form emphasizes that the contractor and any subcontractors are prohibited from performing services in Russia, in line with Executive Order 2022-02D. The contractor agrees to complete an attached Exhibit II, Contractor/Subcontractor Affirmation and Disclosure Form, and affirms no services under the contract will be performed in Russia. The document was signed by David P. Bleile, President of Lake Erie Construction Co., on November 19, 2025, indicating the company's commitment to compliance with the specified executive order and contract requirements.