Affm_Discl_180.25__1_.pdf

This document is an Affirmation and Disclosure Form for Bayside Supply, LLC, related to a contract with the Ohio Department of Transportation (ODOT). The form addresses compliance with Executive Order 2022-02D, specifically regarding services performed and potential restrictions on Russian companies or institutions. The contractor is located at 2175 S Bristol Dr in Marblehead, Ohio, and will be performing services at various ODOT locations for material delivery.

The contract involves material delivery to ODOT locations, with the contractor's principal business location and state data location being the same address in Marblehead, Ohio. No subcontractors are listed as applicable for this contract. The document emphasizes the contractor's commitment to not perform any services in Russia and to comply with state procurement restrictions related to offshore services. The form is signed by the company manager and dated November 5, 2024, and serves as a formal declaration of the contractor's understanding and adherence to specified executive order requirements for state contract work.