Affirmation_and_Disclosure__3_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing compliance with Executive Order 2022-02D regarding restrictions on services performed by Russian companies or institutions. The form is completed by Site Safe, LLC, with a principal business location in Litchfield, KY. The contractor affirms its commitment to not perform services in Russia and to abide by the specified executive order restrictions on public funds and service procurement.

The document indicates that the contractor's services will be performed at 1500 Oleta Rd. in Columbus, Ohio, which is also the location where state data will be stored. The form requires the contractor to disclose any potential changes in service locations and acknowledges the state's right to terminate the contract if such changes occur. While specific details about the contracted goods or services are not provided in this document, the form is primarily focused on ensuring compliance with executive orders related to Russian service restrictions and maintaining transparency about service locations and potential subcontractors.