Affirmation_and_Disclosure_Form.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically executed by Tourbillon Enterprises LLC located in Rosemead, CA. The form addresses compliance with Executive Order 2022-02D, which prohibits state agencies from purchasing services from Russian companies or institutions. The contractor affirms understanding of the order's requirements and agrees to abide by its provisions, including potential contract termination if services are performed in Russia.

The form indicates that Tourbillon Enterprises LLC has no subcontractors and will not be performing services outside the United States. All fields related to subcontractor locations, service performance locations, and state data storage are marked as "N/A" (Not Applicable). The document was signed by a managing member on 6/5/2025, and it serves as a mandatory disclosure and affirmation that will be incorporated into any future contract with the state, ensuring transparency and compliance with current governmental restrictions.