1-affirmationanddisclosure.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing requirements under Executive Order 2022-02D. The primary contractor is Montage Enterprises, Inc., located at 140 Route 94 in Blairstown, NJ 07825. The form lists two subcontractors: Steinke Tractor (located in Eaton, OH) and Vernon Dell Tractor (with locations in Liverpool and Grove City, OH). The document is designed to ensure compliance with state procurement regulations, particularly focusing on prohibitions against performing services in Russia.

The form details service locations for the contractor and subcontractors, including multiple addresses in Ohio where services may be performed. It affirms that no services will be conducted outside the United States without state approval, and confirms compliance with Executive Order 2019-12D regarding offshore services. The document requires immediate disclosure of any changes in service locations and emphasizes the contractor's obligation to notify the state of any shifts in contract performance locations. The form was signed by Erinn Allison, Office Manager of Montage Enterprises, Inc., on 3/26/25, indicating the company's commitment to the specified contractual and regulatory requirements.