TravelersMarketing_AffirmationandDisclosure.pdf
PDF 278 KB Posted
- Attached to
- Competitive Selection OH|DOT50626-1
- Contract number
- DOT50626-1
- Issued by
- Ohio
About this file
This is an Affirmation and Disclosure Form for a state contract, specifically involving Travelers Marketing, a company located at 209 W Central St., Ste 101 in Natick, MA 01760. The document is associated with the Ohio Department of Transportation (ODOT) and includes compliance with Executive Order 2022-02D, which prohibits the purchase of services from Russian companies or institutions. Bach Lees Design, located at 37 Jason St, Arlington, MA 02476, is listed as a subcontractor for this contract.
The form details the locations where services will be performed and where state data will be located, which are exclusively within Massachusetts (Natick and Arlington). The contractor affirms that no services will be performed outside the United States and that any changes in service locations must be immediately disclosed to the state. The document is signed by Brian Lee, Managing Partner of Travelers Marketing, with an execution date of 4/29/2025, though specific details about the contracted goods or services are not provided in this affirmation document.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Score_Notes.docx | DOCX document | |
| TechnicalProposal_TravelersMarketing_ODOTRFPFSPSponsorship.pdf | ||
| FeeProposal_TravelersMarketing_ODOTRFPFSPSponsorship.pdf | ||
| Signature.pdf | ||
| 506-26.pdf | ||
| Score_Sheet.xlsx | XLSX spreadsheet |
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Text version
AFFIRMATION AND DISCLOSURE FORM
By the signature affixed hereto, the Contractor affirms and understands that if awarded a contract, both the Contractor and any of its subcontractors shall perform no services requested under this Contract outside of the United States, not allow State data to be sent, taken, accessed, tested, maintained, backed-up, stored or made available remotely(located) outside of the United States unless a duly signed waiver from the State has been attained.
The Contractor shall provide all the name(s) and location(s) where services under this Contract will be performed and where data is located in the spaces provided below or by attachment. Failure to provide this information may result in no award. If the Contractor will not be using subcontractors, indicate “Not Applicable” in the appropriate spaces.
EXPENDITURE OF PUBLIC FUNDS ON SERVICES PERFORMED BY RUSSIAN COMPANIES OR INSTITUTIONS.
The Contractor affirms to have read and understands Executive Order 2022-02D and shall abide by those requirements in the performance of this Contract. Pursuant to this Executive Order, all state agencies are prohibited from the purchase of services from Russian companies or institutions. This prohibition is in addition to and expands upon Executive Order 2019-12D which generally precludes the purchase of offshore services by the State of Ohio. Notwithstanding any other terms of this Contract, ODOT reserves the right to recover any funds paid for services the Contractor performs in Russia in violation of this Executive Order. ODOT does not waive any other rights and remedies provided to ODOT in this Contract.
The Contractor agrees to complete the attached Exhibit II, Contractor/Subcontractor Affirmation and Disclosure Form, to abide with Executive Order 2022-02D, which is incorporated and becomes a part of this Contract, affirming no services of the Contractor or its subcontractors under this Contract will be performed in Russia.
1. Principal location of business of Contractor:
(Address)
(City, State, Zip)
Name/Principal location of business of subcontractor(s):
(Name) (Address, City, State, Zip)
(Name) (Address, City, State, Zip)
2. Location where services will be performed by Contractor:
(Address) (City, State, Zip)
Name/Location where services will be performed by subcontractor(s):
(Name) (Address, City, State, Zip)
(Name) (Address, City, State, Zip)
3. Location where state data will be located, by Contractor:
(Address) (City, State, Zip)
209 W Central St., Ste 101 Natick, MA 01760
209 W Central St., Ste 101 Natick, MA 01760
37 Jason St, Arlington, MA 02476Bach Lees Design
Bach Lees Design 37 Jason St, Arlington, MA 02476
Natick, MA 01760209 W Central St., Ste 101
Name/Location(s) where state data will be located by subcontractor(s):
(Name) (Address, City, State, Zip)
(Name) (Address, City, State, Zip)
(Name) (Address, City, State, Zip)
Contractor also affirms, understands and agrees that Contractor and its subcontractors are under a duty to disclose to the State any change or shift in location of services performed by Contractor or its subcontractors before, during and after execution of any contract with the State. Contractor agrees it shall so notify the State immediately of any such change or shift in location of its services. The State has the right to immediately terminate the contract, unless a duly signed waiver from the State has been attained by the Contractor to perform the services outside the United States.
On behalf of the Contractor, I acknowledge that I am duly authorized to execute this Affirmation and Disclosure Form and have read and understand that this form is a part of any Contract that Contractor may enter into with the State and is incorporated therein.
(AN ORIGINAL SIGNATURE IS REQUIRED)
Company Name: _____________________________
Signature: __________________________________
Print Name: ________________________________
Title: ______________________________________
Date: ______________________________________
37 Jason St, Arlington, MA 02476Bach Lees Design
Travelers Marketing
Brian Lee
Managing Partner
4/29/2025
File details come from the government source that posted it. Updated .