Affirmation_and_Disclosure_Form_5-20-24_fillable_form.pdfAffirmation_and_Disclosure_Form_5-20-24_fillable_form.pdf

This is an Affirmation and Disclosure Form associated with a Request for Quote (RFQ) issued by the State of Ohio for crane services in Hardin County. The contract opportunity, designated RFQ-2113, seeks crane rental services with operator for a culvert installation project located at approximately 5280 OH-656 in Marengo, Ohio. The crane must possess a working radius sufficient to set box culverts (10 feet by 4 feet, weighing a maximum of 29,000 pounds) to the center of a 32-foot-wide trench extending 34 feet from the road centerline in each direction, with an approximate 65-foot working radius center to center. The project scope includes mobilization and demobilization of the crane, trucks, and personnel, fuel, and support equipment. Services are required to be ready for box placement by 9:00 AM on or around September 16, 2026, with the exact date to be coordinated with Sam Morrison at 740-833-8023.

The Affirmation and Disclosure Form is a fillable document designed to collect bidder certifications and disclosures required for participation in this procurement process. Prospective vendors must complete and submit this form as part of their bid package to demonstrate compliance with applicable state requirements and regulations. No specific pricing terms, set-aside provisions, incumbent information, or detailed funding sources are detailed within the form document itself, as it serves primarily as a compliance and certification instrument rather than a pricing or financial disclosure document.