20240821_105757.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically associated with the Ohio Department of Transportation (ODOT). The contractor is Osburn Associates Inc., located at 11931 St Rt 93 in Logan, Ohio, 43138. The form addresses requirements under Executive Order 2022-02D, which prohibits state agencies from purchasing offshore services and mandates disclosure of service locations and potential subcontractors.

The form confirms that all services will be performed at the company's Logan, Ohio location, with no subcontractors currently identified. The document emphasizes compliance with Ohio's executive order restricting offshore service purchases, particularly from Russian companies or institutions, in response to geopolitical circumstances. The contractor agrees to immediately notify the state of any changes in service location and understands that the state reserves the right to terminate the contract if services are performed outside the United States. The form was signed by a sales representative on 8-21-24, indicating recent preparation for a potential state contract engagement.