247A-24_AaD.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the Ohio Department of Transportation (ODOT). The form is completed by a contractor located at 2550 W 5th Ave in Columbus, Ohio, 43204. The document focuses on 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 ongoing geopolitical situation.

The form indicates that no subcontractors will be used for this contract, and all services will be performed at the contractor's primary business location in Columbus, Ohio. The contractor affirms that no services will be performed in Russia and agrees to immediately notify the state of any changes in service location. The document is signed by Charles Hoskins, Vice President, on 04/03/24, and serves as a formal affirmation of the contractor's commitment to comply with state regulations regarding service performance and data handling.