ODOT_Affirmation_Form.pdf

The document is an Affirmation and Disclosure Form related to the Ohio Department of Transportation (ODOT) contract, specifically addressing requirements under Executive Order 2022-02D regarding services performed by Russian companies or institutions. The form is completed by Newman I Factor LLC, located in Verona, KY, and is associated with a contract period extending through Executive Order 2022-2020, which prohibits state agencies from purchasing offshore services from Russia.

The contractor has specified their principal business location as 2841 Verona Murdock Road in Verona, KY, and the location where services will be performed as 66640 Executive Drive in St. Clairsville, OH. No subcontractors are listed on the form, with "Not Applicable" noted in the relevant sections. The form affirms that the contractor will perform services within the United States and agrees to disclose any changes in service locations to the state before, during, and after contract execution. The document was signed by Matt Sawyer, VP of Sales, on 1.22.2025, indicating compliance with the state's requirements for contractor disclosure and affirmation.