Affirmation_and_Disclosure_Form__2_.pdf

This document is an Affirmation and Disclosure Form for a contract governed by Executive Order 2022-02D, involving American Roadway Logistics as the contractor. The company is located at 2681 Barber Rd in Norton, OH 44203, with state data to be located at 7 Petersburg Circle in Port Colborne, Ontario. The form specifically addresses requirements related to services potentially performed outside the United States and compliance with restrictions on engaging with Russian companies or institutions.

The contractor affirms compliance with Executive Order 2019-12D, which prohibits the purchase of services from Russian companies or institutions. The document requires disclosure of business locations, service performance locations, and state data storage sites. No subcontractors are listed, and the form is signed by the company's Chief Operating Officer on 10-16-2024. The contract includes provisions for immediate termination if the contractor fails to notify the state of any changes in service locations or performs services in violation of the specified restrictions.