Affirmation_and_Disclosure_Form_Mar-Zane.pdf

This document is an Affirmation and Disclosure Form for Mar-Zane, Inc., a contractor located in Zanesville, OH, related to a state contract with the Ohio Department of Transportation (ODOT). The form addresses compliance with Executive Order 2022-02D, specifically concerning restrictions on expenditure of public funds for services performed by Russian companies or institutions. The contractor affirms understanding and agreement to abide by the requirements of this executive order.

The form indicates that Mar-Zane, Inc. will perform services with its principal business location at 3570 So. River Rd in Zanesville, OH 43701. No subcontractors are listed as applicable for this contract. The document emphasizes that the contractor will not use, send, access, or perform services related to this contract in Russia, and agrees to immediately notify the state of any potential changes in service location. The form was signed by Todd Young, Assistant Vice President, on February 26, 2025, and is part of a contract process that prohibits the purchase of services from Russian companies pursuant to the specified executive order.