Affirmation_and_Disclosure_Form__7_.pdf

The document is an Affirmation and Disclosure Form related to a state contract, specifically addressing compliance with Executive Order 2022-02D regarding services performed by Russian companies or institutions. The form is completed by Forterra Pipe & Precast LLC dba Rinker Materials, located at 1500 Haul Rd in Columbus, Ohio 43207. The contractor affirms that no services will be performed in Russia and acknowledges the prohibitions on purchasing offshore services from Russian entities as outlined in the executive order.

The form details the principal location of business, subcontractors, and locations where services and state data will be performed, all of which are situated in Columbus, Ohio. The contractor agrees to complete the attached Exhibit II and affirms that neither the contractor nor its subcontractors will perform any services in Russia. The document emphasizes compliance with restrictions on expenditure of public funds on services performed by Russian companies, and provides the state with the right to terminate the contract if there are any changes in the location of services or potential violations of the executive order.