ODOT_ITB_212A-26_End_Treatments_Attenuator_Parts_Affirmation.pdf

This document is an Affirmation and Disclosure Form for a contract with the Ohio Department of Transportation (ODOT), completed by Lake Erie Construction Co. located in Norwalk, Ohio. The form addresses requirements related to the Executive Order 2022-02D, which prohibits the use of public funds for services performed by Russian companies or institutions, and specifically relates to state contracts and service performance locations.

The document confirms that Lake Erie Construction Co. will perform contract services at 25 South Norwalk Rd. W., P.O. Box 777 in Norwalk, Ohio 44857-0777, with no subcontractors listed. The form emphasizes compliance with state regulations, including the obligation to immediately disclose any changes in service locations before, during, and after contract execution. The company's president, David P. Bleile, signed the document on 7.15.2025, affirming that no services will be performed in Russia and that the company agrees to the terms outlined in the Executive Order and contract requirements.