Affirmation_and_Disclosure_Form.pdf

This document is an Affirmation and Disclosure Form related to a state contract with restrictions on services performed by Russian companies or institutions, pursuant to Executive Order 2022-02D. The form is completed by Bills Towing, with a principal business location at 307 4th St in a location with the zip code 93912, and a service location at 66855 Executive Dr in St. Clements, zip code 49350.

The form specifically addresses compliance with Executive Order 2019-12D, which prohibits the expenditure of public funds on services performed by Russian companies or institutions. The contractor (Bills Towing) affirms that no services under this contract will be performed in Russia, and they agree to notify the state immediately of any changes in service location or contract terms. The document requires the contractor to complete an attached Exhibit II and Contractor/Subcontractor Affirmation and Disclosure Form, with the primary focus on preventing any contract activities from occurring within Russia.