1-Affirmation_and_Disclosure.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing restrictions on services performed by Russian companies or institutions. The form is completed by Brain Enterprises, located at 4650 Allen Rd. in Stow, OH 44224, and is designed to comply with Executive Order 2022-02D. The form requires the contractor to affirm that no services will be performed in Russia and that the company understands prohibitions on purchasing services from Russian companies or institutions.

The document indicates that the contractor agrees to complete the attached Exhibit II, which is incorporated into the contract. The form emphasizes compliance with executive orders regarding the expenditure of public funds, specifically prohibiting state agencies from purchasing services from Russian companies. The contractor must disclose the principal location of business, locations where services will be performed, and agrees to notify the state of any changes in service locations. The form is signed by the company's president and dated, serving as a formal affirmation of the company's compliance with the specified restrictions.