2-Affirmation___Disclosure_Form_-_Signed.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing compliance with Executive Order 2022-020D regarding the expenditure of public funds. The form is completed by TST Western Star, with a principal business location at 385 S. Bailey Rd in N. Jackson, OH 44448. The document focuses on affirming that no services will be performed in Russia and adhering to regulations surrounding offshore services.

The form requires the contractor to specify locations where services will be performed, state data will be located, and to acknowledge restrictions on service performance, particularly in relation to Russian companies or institutions. The contractor agrees to complete an attached Exhibit II, Contractor/Subcontractor Affirmation and Disclosure Form, which becomes part of the contract. The document is signed by William Moore, President of TST Western Star, on 9/25/23, and emphasizes the contractor's commitment to not expending public funds on services from Russian companies and to immediately notify the State of any changes in service locations.