ODOT_Signed_Affirmation.pdf

This document is an Affirmation and Disclosure Form related to Executive Order 2022-02D, which pertains to restrictions on services performed by Russian companies or in Russia. The form is submitted by VanCuren Services, Inc., a contractor located in Newbury, Ohio, and is designed to affirm compliance with state and federal guidelines regarding offshore services and state data restrictions.

The contractor indicates that services will be performed at various locations in Ohio, with the principal business address and state data location both situated at 10555 Kinsman Rd. in Newbury, OH. The document explicitly notes no subcontractors will be used, marking those sections as "Not Applicable". The form acknowledges prohibitions on purchasing offshore services and requires the contractor to disclose any changes in service locations before, during, and after contract execution. The document is signed by the Corporate Counsel on 9.2.2025, affirming the company's commitment to not perform services in Russia and to comply with all specified executive order requirements.