mmi_adf_25.pdf

This document is an Affirmation and Disclosure Form related to Executive Order 2022-02D, specifically addressing restrictions on services performed by Russian companies or institutions. The form is completed by Morite Materials, with their principal business location at 859 Fulleys Dr., Midland, OH 44805. The document is part of a contract with the state, likely Ohio Department of Transportation (ODOT), and focuses on compliance with specific executive order provisions regarding Russian business interactions.

The form affirms that the contractor will not perform any contract services in Russia and is prohibited from purchasing services from Russian companies or institutions under the terms of the executive order. The contractor agrees to complete Exhibit II, which is incorporated into the contract, and confirms that no services will be performed in Russia. The document requires disclosure of business locations, service performance locations, and data storage locations, though in this instance, only the contractor's primary business address is filled out. The form was signed by a VP of Morite Materials on 3-25-25, demonstrating the company's commitment to adhering to the specified contractual and executive order requirements.