Affirmation_and_disclosure_form__8_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing restrictions on services from Russian companies or institutions pursuant to Executive Order 2022-02D. The form is associated with the Ohio Department of Transportation (ODOT) and involves Southwestern Equipment Co., located in Cleveland, Ohio, as the primary contractor.

The form indicates that the contractor will not perform services outside the United States, nor will they use subcontractors from Russia. The document requires disclosure of business locations, service performance locations, and state data storage locations, with the contractor noting "n/a" for these sections. The form is part of a broader state directive prohibiting state agencies from purchasing services from Russian companies or institutions, with ODOT reserving the right to recover funds paid for services under this contract. The document was signed on June 17, 2024, by Chris Kute, Regional Sales Manager of Southwestern Equipment Co.