DGM__Affirmation_and_Disclosure.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving DGM, Inc. dba Tow Path Ready Mix, located in Beaver, OH 45613. The form addresses compliance with Executive Order 2022-02D, which prohibits state agencies from purchasing services from Russian companies or institutions. The contractor affirms its principal business location is at 1881 Adams Road in Beaver, OH, with services to be performed at 12360 SR 104, 1668 Kessinger School Road in Lucasville, Jackson County, OH 45648.

The contract involves service performance locations in Ohio, with the contractor agreeing to complete an attached Exhibit II form and abide by state restrictions on offshore services. No specific subcontractors are listed, and the form indicates "na" for subcontractor details. The document is signed by Mark Salisbury, Vice President of DGM, Inc., with a signature date of 04-11-2025, suggesting a contract or agreement period ending on or around that date. The form emphasizes the contractor's commitment to not perform services in Russia and to immediately disclose any changes in service locations to the state.