1-Affirmation_20250321145336.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing requirements under Executive Order 2022-02D and state procurement regulations. The form is completed by D&D Emulsions, Inc., a contractor affirming compliance with various state and federal guidelines, particularly regarding the performance of services and handling of state data. The document emphasizes restrictions on offshore services and requires disclosure of business locations and service performance sites.

The form indicates that N/A (not applicable) has been entered for principal business location, service performance locations, and subcontractor details. The contractor agrees to notify the state of any changes in service locations and affirms that no services will be performed in Russia, in accordance with the referenced executive order. The document is signed by Sheila Sims, Office Manager of D&D Emulsions, Inc., on 3-21-25, and serves as a formal acknowledgment of contract terms and conditions for a potential state and local contract indefinite delivery vehicle.