scan0001.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing requirements for contractors performing services under Executive Order 2022-02D. The form is associated with ODOT (Ohio Department of Transportation) and involves Mosolutions, a company located in New York City, which is completing this disclosure for potential contract work.

The document stipulates that the contractor affirms it will not perform services outside the United States and will not use subcontractors located in Russia. The company has indicated its principal business location is in New York City, with services to be performed at the same location. The form requires disclosure of any potential changes in service locations before, during, and after contract execution, and mandates immediate notification to the state of any shifts in service locations. The document is part of an executive order that prohibits state agencies from purchasing offshore services and requires contractors to comply with specific geographical and operational restrictions.