Affirmation_and_Disclosure_Form__3_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing requirements outlined in Executive Order 2022-02D. The form is completed by Mc.B Parking, located at 1145 Cleveland Avenue in Ashland, OH 44805. The document pertains to restrictions on services performed by Russian companies or institutions, in accordance with state and federal guidelines prohibiting offshore services and purchases from Russian entities.

The contractor indicates that services will be performed at various locations in Ohio, with the principal business location and state data location being the same address in Ashland. The form emphasizes compliance with Executive Order 2019-12D, which generally precludes the purchase of offshore services by the State of Ohio. The contractor affirms that no services will be performed in Russia, and they agree to immediately notify the state of any changes in service locations or contract execution. The document serves as a formal disclosure and affirmation of the contractor's commitment to these regulatory requirements.