2-Affirmation_and_Disclosure_Form_7-15-2025.pdf

This document is an Affirmation and Disclosure Form related to an Ohio state contract, involving TSI Western Star as the contractor located at 385 South Bailey Road in North Jackson, Ohio. The form addresses compliance with Executive Order 2022-02D, which prohibits the purchase of services from Russian companies and institutions in response to geopolitical circumstances. The contractor affirms that all services will be performed within the United States and provides details about its principal business location and potential subcontractors.

The form specifically outlines that services will be performed at the 385 South Bailey Road address in North Jackson, Ohio, and that no state data will be sent, accessed, tested, maintained, or stored outside the United States. The contractor agrees to complete an attached Exhibit II, which incorporates this affirmation as part of the contract. No specific details about the goods or services are provided in this document, which appears to be a compliance and location disclosure form focused on ensuring all contract work remains within U.S. boundaries and does not involve Russian companies or institutions.