1-Trip_Affirmation_Page.pdf

This document is an Affirmation and Disclosure Form for a contract involving Maverick's Towing LLC, located at 2997 Westerville Rd in Columbus, OH 43224. The form is related to an Executive Order 2022-02D concerning restrictions on services from Russian companies or institutions, and is part of a contract with the Ohio Department of Transportation (ODOT) for the 2022-02D bid period.

The form indicates that all services will be performed at the company's primary business location in Columbus, OH, with no subcontractors involved. The contractor affirms that no services will be performed in Russia and agrees to immediately notify the State of any changes in service location. The document is signed by the owner, Randy Manyard, on 4/28/25, and serves as a mandatory disclosure and affirmation document for the contract, ensuring compliance with state procurement regulations and executive order restrictions.