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This document is an Affirmation and Disclosure Form for Baldwin & Sours, Inc., located at 5263 Trabue Road in Columbus, OH 43228. The form is specifically related to compliance with Executive Order 2022-02D, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The document is associated with the Ohio Department of Transportation (ODOT) and requires the contractor to affirm and disclose details about their business location and service performance.

The form requires the contractor to confirm that no services will be performed in Russia, and that the company understands and will abide by restrictions on purchasing services from Russian companies or institutions. No subcontractors are listed on this form, and the principal location of business is the Columbus, Ohio address. The document was signed by the company president on 5/30/2024, affirming compliance with the executive order and acknowledging that the State has the right to immediately terminate the contract if these conditions are not met.