2-Affirmation_and_Disclosure_Form.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the Ohio Department of Transportation (ODOT) and Dobbs Landscape & Plaza, LLC. The form addresses compliance with Executive Order 2022-02D, which prohibits the expenditure of public funds on services performed by Russian companies or institutions in response to the geopolitical situation involving Russia.

The form details the contractor's principal business location, service performance locations, and state data storage sites. It requires the contractor to affirm no services will be performed in Russia and to comply with restrictions on Russian business engagement. The document is signed by the company owner on 2/17/25, indicating the contractor's agreement to abide by the state's requirements regarding service delivery, subcontractor use, and potential contract termination if these conditions are not met. The form is part of a broader contractual agreement between the contractor and the state, with specific emphasis on transparency and ethical business practices.