affirmation_and_disclosure_form_25_.pdf

This document is an Affirmation and Disclosure Form related to a contract involving the State and a contractor named Rogue Tree Solutions LLC, with specific reference to Executive Order 2022-020 concerning Russian companies and services. The form addresses potential contract performance restrictions associated with Russian companies, focusing on expenditure of public funds and prohibitions on purchasing services from Russian entities.

The form requires the contractor to disclose details about their business locations, service performance sites, and data storage locations, though in this instance all fields are marked "NOT Applicable". The document emphasizes compliance with executive orders prohibiting state agencies from purchasing services connected to Russia, with the contractor agreeing to provide notification of any changes in service locations or subcontractor arrangements. The form is signed by the CEO/President of Rogue Tree Solutions LLC on 9/5/25, affirming understanding and agreement with the specified contract terms and restrictions.