affirmation_10_24__1_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving Alta Equipment Company located in Oakwood Village, Ohio. The form addresses compliance with Executive Order 2022-02D, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The primary contractor is Alta Equipment Company, with Midwest Mine Services listed as a subcontractor, both based in Ohio.

The form outlines the locations where services will be performed, which are 181 Oak Leaf Oval in Oakwood Village, Ohio 44146, and 5050 Nike Drive in Hillard, Ohio 43026. The document requires the contractor to affirm that no services under this contract will be performed in Russia, in accordance with state regulations. The form is signed by Donald B. D'Onofrio, Governmental Segment Manager of Alta Equipment Company, on 10/07/2024, and serves as a mandatory disclosure and compliance document for state contracting procedures.