Affirmation___Disclosure_CAM.pdf

This document is an Affirmation and Disclosure Form for Cuyahoga Asphalt Materials, LLC, related to a state contract with the Ohio Department of Transportation (ODOT). The primary contractor is Cuyahoga Asphalt Materials, LLC, located in Fredericktown, OH, with Kokosing Construction Co., Inc. listed as a subcontractor. 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 contract involves services to be performed across various 101-G Projects in Ohio, with state data to be located at 17531 Waterford Rd in Fredericktown, OH. Kokosing Construction Co., Inc. will perform services at various project locations with an address of 6325 Westerville Rd, Westerville, OH. The document emphasizes the contractor's commitment to not using Russian companies or subcontractors and affirms compliance with state procurement restrictions related to Russian entities. The form is signed by Raymond E. Schloss III, Corporate President, on 02-12-2025, indicating the contract's current validity and the company's ongoing obligations.