affirmation_and_Disclosure__1_.pdf

This document is an Affirmation and Disclosure Form for a contract involving Adams Bros Concrete Products, located at 8465 East Pike in Norwich, Ohio 43767. The form is specifically related to compliance with Executive Order 2022-02D, which prohibits the purchase of services from Russian companies or institutions. The form requires the contractor to disclose the principal location of business, service performance locations, and state data storage locations.

The contractor, Adams Bros Concrete Products, indicates multiple service locations and affirms that they will not perform any services in Russia or use Russian subcontractors. The document requires the company to immediately notify the State of any changes in service locations and grants the State the right to terminate the contract if services are performed outside the United States. The form was signed by Tyler Culbans in the Sales and Quality Control role on 4/3/05, and it serves as a mandatory disclosure and compliance document for potential state contract work.