ODOT_068-25_Affirmation__1_.pdf

This document is an Affirmation and Disclosure Form for Lake Erie Construction Co., located at 25 South Norwalk Rd. W., P.O. Box 777 in Norwalk, OH 44857-0777. The form is associated with the Ohio Department of Transportation (ODOT) and relates to Executive Order 2022-02D concerning services performed by Russian companies or institutions. The contractor affirms compliance with specific requirements regarding service locations, data handling, and restrictions on working with Russian entities.

The form specifies that Lake Erie Construction Co. will perform services at its primary business location in Norwalk, Ohio, and commits to not providing services in Russia or using Russian subcontractors. The document emphasizes strict adherence to Executive Order 2022-02D, which prohibits the purchase of services from Russian companies. The contractor agrees to immediately disclose any changes in service locations or subcontractor arrangements and acknowledges that failure to comply could result in contract termination. The document was signed by the company president on 09/03/2024, indicating current relevance and active contractual obligations.