2-01_-_ODOT_023A-26_Affirmation___Disclosure_Form_-_Stoops_Freightliner.pdf

This document is an Affirmation and Disclosure Form for a contract involving Stoops Freightliner - Quality Trailer, located at 7800 Center Point 70 Blvd in Dayton, Ohio 45424. The form is specifically related to compliance with Executive Order 2022-02D, which addresses restrictions on services performed by Russian companies or institutions, and is part of a contract with the State of Ohio's Department of Transportation (ODOT).

The form confirms that the contractor will perform services exclusively within the United States, with all business locations, service performance locations, and state data storage occurring at the same Dayton, Ohio address. The contractor agrees to abide by the executive order's requirements, which prohibit the purchase of services from Russian companies or institutions, and affirms that no services under this contract will be performed in Russia. The document is signed by Gary Schmaltz, a Sales Representative, with a contract date of 7/16/2025, and notes that only sales information will be saved in the company's data system.