1-Affirmation_Disclosure.pdf

This document is an Affirmation and Disclosure Form for Mast Lepley Silo, Inc., located at 7787 East Lincoln Way in Apple Creek, OH 44606. The form is related to a state contract and specifically addresses compliance with Executive Order 2022-02D, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The document requires the contractor to affirm that no services under this contract will be performed in Russia, and details the contractor's principal location of business, service locations, and state data storage location.

The form indicates that the contractor, Mast Lepley Silo, Inc., has no subcontractors and will perform all services at its primary business address in Apple Creek, Ohio. The document emphasizes the contractor's agreement to abide by restrictions on performing services in Russia, in line with the referenced Executive Order. While specific contract details are not elaborated, the form serves as a mandatory disclosure and affirmation document that must be completed as part of entering into a contract with the state, with the signatory being Sheldon Stauffer in the role of Sales Manager, who signed the document on 5/8/2025.