123-25_Affirmation_and_Disclosure_-_Vermeer.pdf

This document is an Affirmation and Disclosure Form from Vermeer Mid Atlantic, LLC dba Vermeer All Roads, located in Medina, Ohio. The form is associated with a contract governed by Ohio Department of Transportation (ODOT) requirements, specifically addressing compliance with Executive Order 2022-02D regarding services performed by Russian companies or institutions. The form requires the contractor to disclose key location details for their business operations and service performance.

The contract involves services to be performed at 2389 Medina Road in Medina, Ohio 44256, with the contractor affirming they will not perform any services in Russia or use Russian companies/institutions. The document highlights restrictions on expenditure of public funds related to Russian entities, stemming from the 2019-12D Purchase Order. The form requires the contractor to notify the state immediately of any changes in service locations or contract terms, and includes provisions for potential contract termination if the contractor fails to comply with the specified requirements.