Affirmation_And_Disclosure_Form.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically for Hocking Valley Concrete Inc., located at 35255 Hocking Drive in Logan, Ohio 43138. The form is designed to comply with Executive Order 2022-02D, which addresses restrictions on services from Russian companies or institutions. The contractor affirms compliance with state data handling requirements and provides details about their principal business location and potential subcontractors.

The form indicates that the contractor will perform services within the United States, with state data to be located at their Logan, Ohio address. The document emphasizes the contractor's agreement to abide by prohibitions on purchasing services from Russian companies or institutions, as outlined in the Executive Order. No specific details about the contracted goods or services are provided in this form, which appears to be a standard compliance document for entering into a state contract, focusing primarily on location, data handling, and restrictions related to Russian service providers.