101G-26_Affirmation_Page_MAC.pdf

This document is an Affirmation and Disclosure Form related to Executive Order 2022-022, specifically addressing contract performance and public fund expenditures. The form is completed by Macillan Asphalt Co., with its principal business location at 5947 Whipple Ave NW in N. Canton, OH 44720. The document is associated with the Ohio Department of Transportation (ODOT) and focuses on compliance with requirements regarding services performed by contractors, particularly in relation to potential work involving Russian companies or institutions.

The form outlines the contractor's locations for business operations, service performance, and state data storage, all of which are located in N. Canton, OH 44720. The contractor affirms compliance with Executive Order 2022-022, which prohibits purchasing services from Russian companies or institutions, and agrees to notify the State immediately of any changes in contract locations or subcontractor involvement. The document was signed on 2-25-25 by Scott F. Oster, Vice President of Macillan Asphalt Co., certifying the company's understanding and agreement to the specified terms and conditions.