ODOT_Afiirm.pdf

This document is an Affirmation and Disclosure Form related to an Executive Order concerning Russian Companies and Institutions, specifically addressing contract performance restrictions. The form is completed by Madison True Landscape LLC, located at 3180 Glodo Run Rd. in West Jefferson, OH 43162, and appears to be associated with the Ohio Department of Transportation (ODOT) contract requirements.

The form requires the contractor to disclose locations where services will be performed, state data will be located, and affirms compliance with Executive Order 2022-02D, which prohibits state agencies from purchasing offshore services from Russia. The contractor indicates services will be performed in "Various" locations, with primary business and state data located at the West Jefferson, OH address. The document emphasizes the contractor's agreement to not perform services in Russia and to immediately notify the State of any changes in service locations or contract terms.