ODOT_047-26_AFFIRMATION_AND_DISCLOSURE.docx.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing restrictions on services performed by Russian companies. The form is completed by The Chas. E. Phipps Company (a Distributor), with a principal business location at 4560 Willow Parkway in Cleveland, OH 44125. The document references Executive Order 2022-02D and Executive Order 2019-12D, which prohibit state agencies from purchasing offshore services and impose restrictions on interactions with Russian companies.

The form indicates that no subcontractors will be used, and no services will be performed outside the United States. The contractor affirms compliance with Ohio state regulations regarding offshore services and Russian companies, agreeing to immediately disclose any changes in service locations or contract terms. The document was signed by the company president on 5.22.25, and serves as a mandatory disclosure and affirmation for potential state contract participation, highlighting the contractor's commitment to adhering to state procurement guidelines and geopolitical restrictions.