Affirmation-Disc__1_.pdf

This document is an Affirmation and Disclosure Form for Green Lighting Wholesale, Inc., located in Gahanna, Ohio, related to a contract with the Ohio Department of Transportation (ODOT). The form addresses compliance with Executive Order 2022-02D, which prohibits the expenditure of public funds on services performed by Russian companies or institutions. The contractor affirms that no services under this contract will be performed in Russia and provides details about their business location and service performance sites.

The document indicates that the contract involves state data management, with all services to be performed at 950 Taylor Station RD, Suite I in Gahanna, OH 43046. No subcontractors are listed, and the form emphasizes the contractor's obligation to immediately notify the state of any changes in service location before, during, or after contract execution. The form is signed by the company's president and dated 11/5/24, and it serves as a mandatory disclosure and affirmation component incorporated into the contract, specifically addressing restrictions on Russian service providers under the referenced executive order.