Affirmation_and_Disclosure_2025.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving Roger Lake Materials Inc., located at 12340 McKinley Drive in New Concord, OH 43762. The form addresses 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 geopolitical context of offshore services.

The form indicates that the contractor (Roger Lake Materials Inc.) will perform services within New Concord, Ohio, and has committed to not conducting any work in Russia or using Russian subcontractors. The document serves as a formal disclosure of the company's business location, service performance location, and state data storage location, while affirming adherence to specific executive order restrictions on international service procurement. The form was signed by the company president on 02/19/2025, indicating it is a forward-looking contract or agreement preparation document.