100-26_Aggregate_Affirmation_and_Disclosure.pdf

This document is an Affirmation and Disclosure Form for the Kimble Company, located at 3596 State Route 39 NW in Dover, Ohio 44622. The form is associated with Executive Order 2022-02D and relates to restrictions on performing services in Russia, with specific requirements outlined by the Ohio Department of Transportation (ODOT). The document requires the contractor to affirm and disclose details about business locations, service performance sites, and potential use of subcontractors, while adhering to state guidelines prohibiting certain offshore services.

The form specifically addresses the contractor's commitment to not perform any services under the contract in Russia, in compliance with state procurement regulations. All listed service locations are at the same address in Dover, Ohio, with no subcontractors currently identified. The document includes provisions for potential contract termination if the contractor fails to comply with location and service restrictions, and requires an original signature from an authorized company representative, in this case Keith Walker, Vice President of Finance, who signed the document on 2/26/23.