ODOT_179-25_Affirmation_and_Disclosure_Form.pdf

This document is an Affirmation and Disclosure Form related to an Ohio Department of Transportation (ODOT) contract, specifically addressing potential services involving Russian companies or institutions. The form is completed by ACE Truck Body, with principal business location at 1600 Thrailkill Road in Grove City, OH 41123. Two subcontractors are listed: Stellar Industries (located in Garner, IA) and Dayton Crane (located in Xenia, OH). The document is connected to Executive Order 2022-02D and references Executive Order 2019-12D, which prohibit state agencies from purchasing offshore services.

The form details the locations where contract services will be performed, all of which are within the United States. The contractor affirms that no services will be performed in Russia and agrees to immediately disclose any changes in service locations or contractor/subcontractor details. The document is signed by Rick Tschiggrfe, Sales Manager, on November 16, 2024, and is part of a broader contractual agreement with the State of Ohio. While specific contract details are not fully elaborated, the form emphasizes compliance with state regulations regarding service performance and data management, particularly in relation to restrictions on offshore service procurement.