20250324122221473__1_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing potential services involving Russian companies or institutions. The form is associated with McClelland Inc. dba OK Coal & Concrete, a supplier located at 98 E. LaSalle St. in Zanesville, OH 43701. The document references Executive Order 2022-02D and pertains to restrictions on services performed by Russian companies, in alignment with Ohio state policies and broader federal guidelines.

The form requires the contractor to disclose the principal location of business, potential subcontractors, and locations where services and state data will be performed or stored. The contractor affirms that no services will be performed outside the United States without proper authorization, and agrees to immediately notify the state of any changes in service locations. The document is signed by Kevin Knapp, Vice President, on 3/24/25, and is part of a contractual agreement that includes specific provisions about offshore services and compliance with state and federal executive orders.