20230606_534A-24_AFFIRMATION_AND_DISCLOSURE_FORM_CSI.pdf

This document is an Affirmation and Disclosure Form (Invitation No. 534A-24) for a contract involving a contractor located in Round Rock, TX, and the Ohio Department of Transportation (ODOT) located in Columbus, OH. The form addresses the expenditure of public funds on services performed by the contractor, with specific restrictions related to services performed in Russia under Executive Order 2022-02D, which prohibits certain transactions and service provisions.

The contractor's principal business location is 2261 Gattis School Rd. #255 in Round Rock, TX 78664, and services will be performed at the ODOT Central Office in Columbus, OH. The document indicates that no subcontractors will be used for this contract, and all state data will be located at the ODOT Central Office. The form emphasizes compliance with executive orders regarding the prohibition of service purchases from Russian companies or institutions, and requires the contractor to affirm that no services under the contract will be performed in Russia.