Affirmation_and_Disclosure_-_signed.pdf

This document is an Affirmation and Disclosure Form for a contract involving Delaware Sheds and Barns, located at 8153 US Highway 23 N in Delaware, OH 43015. The form is associated with the Ohio Department of Transportation (ODOT) and addresses compliance with Executive Order 2022-02D regarding restrictions on services performed by Russian companies or institutions. The primary contractor is Delaware Sheds and Barns, with a subcontractor named Country Lane Custom Buildings located at 21372 Pealer Mill Road, Danville, OH 43014.

The contract involves services to be performed at the contractor's primary business location in Delaware, OH, with state data to be located at the same address. The document emphasizes compliance with Executive Order 2019-12D, which prohibits the purchase of offshore services by state agencies from Russian institutions. The contractor affirms that no services will be performed outside the United States, and the company is prohibited from engaging in services in Russia that would violate the executive order. The form is signed by Larry Cimini, President of Delaware Sheds and Barns, on 9/28/2024, and requires full disclosure of any changes in service locations or subcontractor arrangements.