Affirmation_and_Disclosure__1_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing compliance with Executive Order 2022-02D regarding services performed in or connected to Russia. The contractor is located at 1565 Youngstown Kingsville Rd in Vienna, Ohio 44473. Two subcontractors are named: MES/Warren Fire Equipment (6880 Todd Ave, Warren, Ohio 44481) and Mahan Welding (1779 Phelps Rd., Bristolville, Oh. 44402).

The form details the locations where contract services will be performed, which are identical to the principal business locations. The contractor affirms that services will be conducted in compliance with the referenced Executive Order, which prohibits state agencies from purchasing offshore services from Russia. The document requires disclosure of any potential changes in service locations and affirms the contractor's commitment to immediately notify the state of any shifts in service locations. The form was signed by Robert Cellars, Chief Inspector, on January 10, 2024, as part of the contractor's obligations under the state contract.