Affirmation_and_Disclosure__9_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing requirements under Executive Order 2022-02D regarding Russian companies and institutions. The form is completed by Proshot Concrete, Inc., located at 4158 Musgrove Drive in Florence, Alabama 35630, and is associated with contract compliance for services potentially performed within or outside the United States.

The form stipulates that Proshot Concrete, Inc. will perform contract services at its primary business location in Florence, Alabama, with state data also to be maintained at the same address. The document highlights restrictions on expenditure of public funds for services performed by Russian companies or institutions, in alignment with an Executive Order that prohibits state agencies from purchasing offshore services from Russia. The contractor (Proshot Concrete) affirms understanding of these restrictions and agrees to notify the state of any changes in service locations or subcontractor arrangements, with an emphasis on maintaining compliance with the specified executive order.