1-Affirmation_and_Disclosure__Form.pdf

This is an Affirmation and Disclosure Form for a contract between Peak Electric Inc. (located in Toledo, Ohio) and a state agency, specifically addressing compliance with Executive Order 2022-02D regarding services and subcontractors. The document identifies Monroe Truck Equipment Inc. (located in Chicago, Illinois) as a subcontractor/manufacturer, and affirms the contractor's commitment to not performing services in Russia in accordance with the specified executive order.

The form confirms that services will be performed at Peak Electric Inc.'s primary business location at 320 North Byrne in Toledo, Ohio 43607, with Monroe Truck Equipment Inc. serving as a subcontractor/manufacturer. The document emphasizes compliance with restrictions on expenditure of public funds on services performed by Russian companies or institutions, and requires disclosure of any changes in service locations or subcontractor arrangements. The form is signed by Milton T McIntyre Jr., President of Peak Electric Inc., with an execution date of 4/05/2025, and is part of a broader contractual agreement with the state.