2-Affirmative_and_disclosure_form_-_final.pdf

This document is an Affirmation and Disclosure Form completed by Southeastern Equipment Co, a contractor located at 10874 East Pike Rd in Cambridge, OH 43725. The form is designed to affirm the contractor's compliance with Executive Orders regarding offshore services, data location, and interactions with Russian institutions. The document requires detailed disclosure of the company's business locations and potential service performance locations.

The form indicates that Southeastern Equipment Co has not listed any subcontractors and has left the sections detailing service locations blank. The contractor acknowledges a duty to disclose any changes in service locations before, during, and after contract execution, with the understanding that the State retains the right to terminate the contract if services are performed outside the United States without a signed waiver. The document was signed by Chris Kurz, Regional Sales Manager, on November 4, 2025, formally attesting to the company's commitments and compliance.