AffirmationAndDisclosure.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the Ohio Department of Transportation (ODOT) and addressing restrictions on services performed by Russian companies under Executive Order 2022-02D. The form is completed by Advanced Tank Technologies, with the purpose of affirming the company's compliance with state requirements regarding offshore services and potential contract performance locations.

The form indicates that the contractor (Advanced Tank Technologies) has no principal business location, no subcontractors, and no specified locations where services will be performed. The document emphasizes compliance with state prohibitions on purchasing services from Russian companies, with the contractor agreeing to complete an attached Exhibit II and affirming that no services under this contract will be performed in Russia. The form was signed on 1-16-2025 by a representative of Advanced Tank Technologies, with the individual holding the title of Saler, and requires original signature as a key component of the contractual documentation.