Affirmation___Disclosure_Form-signed_2-26-25.pdf

This document is an Affirmation and Disclosure Form related to an Ohio state contract, specifically executed by Cumberland Limestone, LLC in compliance with Executive Order 2022-02U regarding services performed by Russian companies or institutions. The form involves Cumberland Limestone, LLC as the primary contractor, with Maysville Materials, LLC listed as a subcontractor. The primary business location and service performance location is 53681 Spencer Rd in Cumberland, OH 43732, with the subcontractor located at 6535 Old Town Rd in Mt. Perry, OH 43760.

The form requires the contractor to disclose locations where state data will be stored, accessed, or maintained, and affirms compliance with restrictions on offshore services by Russian companies under the Executive Order 2019-12D. The document emphasizes the contractor's obligation to notify the state immediately of any changes in service locations and affirms that no services will be performed in Russia. The form was signed on 02/26/2025 by Tricia Rodgers, Office Manager of Cumberland Limestone, LLC, and is part of a broader contractual agreement with the state, though specific contract details about goods or services are not explicitly outlined in this disclosure document.