1-20250428172240640.pdf

This document is an Affirmation and Disclosure Form for a state contract, specifically related to Executive Order 2022-02D, which prohibits services from Russian companies or institutions. The form is completed by Rusty's Towing Service Inc., located at 4845 Opetz Reese Rd in Columbus, Ohio 43207. The contractor affirms compliance with federal and state requirements regarding the performance of services, particularly in relation to restrictions on Russian companies.

The contractor indicates that services will be performed at "Various Locations" and that state data will also be stored in various locations. There are no subcontractors listed on the form (marked as "N/A"). The document emphasizes that no services will be performed in Russia, and the company agrees to immediately disclose any changes in service locations to the state. The form was signed by William R McQuiet, President, on 04/28/25, representing Rusty's Towing Service Inc.'s commitment to the contract's terms and conditions.