Affirmation_and_Disclosure_MH_Corbin.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the Ohio Department of Transportation (ODOT) and MH Corbin LLC. The form addresses requirements for contracts involving services potentially performed outside the United States, with specific reference to restrictions on expenditures related to Russian companies or institutions under Executive Order 2019-12D.

The contractor, MH Corbin LLC, located at 4353 Tuller Road Suite D in Dublin, Ohio 43017, has completed this form to affirm that services will be performed at their primary business location. The document highlights compliance with state data handling requirements, including restrictions on sending state data outside the United States without proper waivers. The form was signed by the company's president on 3/3/2025, and it serves as a critical component of the contractor's agreement with the state, emphasizing transparency about service locations and potential subcontractor involvement.