Scan_20250219.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving the Ohio Department of Transportation (ODOT). The form outlines restrictions on expenditure of public funds, particularly concerning services performed by Russian companies or institutions, in accordance with Executive Order 2019-12D. The contractor's principal business location is listed at 1282 Spore Branchvine Rd in Bucyrus, Ohio 44820.

The form indicates that services will be performed at various locations, with state data to be located in Bucyrus, Ohio. The contract is subject to strict provisions prohibiting the purchase of offshore services, especially those connected to Russia, as part of broader state agency restrictions. The document serves as a compliance mechanism for the contractor to affirm their adherence to state guidelines regarding service performance, subcontractor usage, and geographical limitations on contract execution. The form is part of a larger contract framework that appears to be tied to Executive Order 2022-02D, which governs state agency procurement and service delivery standards.