Affirmation_and_Disclosure_Form.pdf

This document is an Affirmation and Disclosure Form for Specialized Construction Inc., located at 711 Harvard Avenue in Cuyahoga Heights, Ohio 44105. The form is related to compliance with Executive Order 2022-02D, specifically addressing restrictions on expenditure of public funds for services performed by Russian companies or institutions. The contractor affirms that no services under this contract will be performed in Russia, and the company will abide by prohibitions on purchasing offshore services from Russian companies or institutions.

The form indicates that services will be performed at various locations within Ohio, with the primary business and state data location being the company's address in Cuyahoga Heights. No subcontractors are listed (marked as N/A), and the document requires the contractor to disclose any changes in service locations to the state. The form was signed by Brian E. Hall, President of Specialized Construction Inc., on 2-11-25, and requires immediate contract termination by the state if the contractor performs services in Russia without a signed waiver.