Scan_2024_08_28_11_25_06_966__1__Affirmtion__1_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing compliance with Executive Order 2022-02D. The form is completed by North Dixie Truck & Trailer Inc., located at 2050 N. Dixie Hwy in Lima, OH 45801. The document is designed to ensure the contractor's adherence to regulations regarding service performance, particularly in relation to restrictions on services performed by Russian companies or institutions.

The form confirms that the contractor will perform all services at the specified location in Lima, OH, and will not engage in any contract activities involving Russian companies or institutions. The document highlights compliance with Executive Order 2019-12D, which prohibits the purchase of offshore services from the State of Ohio. The contractor affirms that no services will be performed in Russia, and they are bound by the terms of the Executive Order 2022-02D. The form serves as a critical compliance document for the contractor's engagement in the state contract, with the company's president signing and dating the document on 8/27/24.