AFFIRMATION_AND_DISCLOSURE_FORM__4_.pdf

This document is an Affirmation and Disclosure Form related to an Executive Order 2022-02D concerning state contracts, specifically involving BOCA Construction Inc. The form addresses restrictions on expenditure of public funds for services performed by Russian companies or institutions, in compliance with Executive Order 2019-12D. The contractor, located at 380 Eastpark Drive in Norwalk, OH 44857, affirms that no services under this contract will be performed in Russia and that the company is not using any subcontractors.

The form indicates that BOCA Construction Inc. will perform all contracted services at its primary business location in Norwalk, Ohio, with state data to be located at the same address. The document is part of a broader compliance effort stemming from Executive Order 2022-02D, which prohibits state agencies from purchasing offshore services from companies operating in Russia. By completing this form, the contractor acknowledges its obligation to disclose any changes in service locations and agrees to immediate notification to the state of any potential shifts in service performance locations.