044-25_Affirmation___Disclosure__1_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, involving Stoops Freightliner - Quality Trailer as the primary contractor and K E Rose Company as a subcontractor. The contract involves locations in Ohio, specifically Dayton and Huber Heights, with the principal business address at 7800 Center Point 70 Blvd in Dayton, OH 45424. The form addresses compliance with Executive Order 2022-02D, particularly concerning restrictions on services performed by Russian companies or institutions.

The document indicates that services will be performed at 7800 Center Point 70 Blvd in Dayton, OH, with state data being saved in a company-wide database system. The contractor affirms that no services under this contract will be performed in Russia, and agrees to abide by the executive order's requirements. The form was signed by Gary Schmaltz, a Sales Representative, on 10/3/2024, and includes provisions for disclosure of any changes in service locations or potential contract modifications, with the state retaining the right to terminate the contract if necessary.