affirmation__6_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the Ohio Department of Transportation (ODOT). The primary contractor is identified as located at 181 Oak Leaf Oval in Oakwood Village, Ohio, with Alta Enterprises LLC as a subcontractor located in Livonia, Michigan. The form addresses compliance with Executive Order 2022-02D regarding services performed by Russian companies or institutions, with a clear prohibition on such services.

The document outlines the locations where services will be performed, which are primarily in Oakwood Village, Ohio, with an additional subcontractor location (Midwest Mines) in Hillard, Ohio. The form requires the contractor to affirm that no services under this contract will be performed in Russia, and mandates disclosure of any changes in service locations before, during, and after contract execution. The signatory, Donald B. D'Onofrio from Alta Enterprises LLC, signed the document on 06/20/2024 in the capacity of Governmental Segment Manager, affirming compliance with the specified contractual requirements.