Affirmation_and_Disclosure_Form_Kelly_Paving.pdf

This document is an Affirmation and Disclosure Form for Kelly Paving, Inc., related to a state contract with the Ohio Department of Transportation (ODOT). The form addresses compliance with Executive Order 2022-02D, which prohibits state agencies from purchasing services from Russian companies or institutions in response to geopolitical circumstances. The contractor, located in Zanesville, Ohio, is affirming its commitment to not use subcontractors and to provide full transparency about its business locations and data handling.

The contract appears to be an indefinite delivery vehicle with a specified period from 2022-02D, with the contractor agreeing to perform services at its primary business location at 3570 So. River Rd in Zanesville, OH 43701. No subcontractors are listed, and the form indicates that state data will be located at the same address. The document emphasizes the contractor's agreement to notify the state of any changes in service locations and to comply with restrictions on offshore services. The form is signed by Todd Young, Assistant Vice President of Kelly Paving, Inc., on February 26, 2025, and is part of the contractual documentation with ODOT.