AFFIRMATION_AND_DISCLOSURE_FORM__9_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving Sign Solutions USA, LLC and the Ohio Department of Transportation (ODOT). The form addresses compliance with Executive Order 2022-022, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The contractor, located at 2501 8th Ave NW in West Fargo, North Dakota, affirms that no services under this contract will be performed in Russia.

The form indicates that the contractor has no subcontractors and will perform all services at their West Fargo, North Dakota location. The document emphasizes compliance with restrictions on offshore services, particularly those related to Russian companies or institutions, as part of the state's response to international political circumstances. The contractor acknowledges the requirement to disclose any changes in service locations or contractor details and understands that the state retains the right to terminate the contract if these provisions are violated.