Affirmation_and_Disclosure_Form.pdf
PDF 85 KB Posted
- Attached to
- Arc Tool Robotic Welding Training
- Solicitation number
- SRC0000038094
- Issued by
- Meigs County, Ohio
About this file
This is an Affirmation and Disclosure Form required by the State of Ohio for contractors bidding on the Arc Tool Robotic Welding Training opportunity at Marion Correctional Institution in Marion, Ohio. The form mandates that contractors affirm compliance with executive orders prohibiting offshore service performance, offshore data location, and purchases from Russian institutions or companies. Contractors must disclose the principal business location, all service performance locations, and all state data storage locations for both the contractor and any subcontractors. The training project involves a five-day onsite FANUC America ArcTool Robotic Welding System training program for four staff members at the correctional institution, covering operator, technician, engineer, and programmer setup and programming procedures.
Contractors must submit all-inclusive pricing that encompasses training delivery, preparatory materials, books, and travel expenses in a single quote. The form emphasizes that failure to provide location information may result in no award. Contractors and subcontractors bear a duty to disclose any changes or shifts in service locations before, during, and after contract execution, with immediate notification required to the State. The State reserves the right to terminate the contract immediately if services are performed outside the United States without a duly signed waiver. The signatory must be duly authorized to execute the form on behalf of the contractor, and the form becomes incorporated into any resulting contract with the State.
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Other files
| File | Type | Posted |
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| EO_2019-12D.pdf | ||
| EO_2022-02D__2.pdf | ||
| OhioBuys Fact Sheet for Bidders_Suppliers.pdf |
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Text version
AFFIRMATION AND DISCLOSURE FORM
Rev. 3/22 Page 1 of 2
Contractor affirms that Contractor has read and understands the applicable Executive Orders regarding the prohibitions of performance of offshore services, locating State data offshore in any way, or purchasing from Russian institutions or companies.
Contractor shall provide all the name(s) and location(s) where services under this Contract will be performed and where data is located in the spaces provided below or by attachment. Failure to provide this information may result in no award. If the Contractor will not be using subcontractors, indicate “Not
Applicable” in the appropriate spaces.
1. Principal location of business of Contractor:
(Address) (City, State, Zip)
Name/Principal location of business of subcontractor(s):
(Name) (Address, City, State, Zip)
2. Location where services will be performed by Contractor:
Name/Location where services will be performed by subcontractor(s):
Rev. 3/22 Page 2 of 2
3. Location where state data will be located, by Contractor:
Name/Location(s) where state data will be located by subcontractor(s):
Contractor affirms, understands, and agrees that Contractor and its subcontractors are under a duty to disclose to the State any change or shift in location of services performed by Contractor or its subcontractors before, during and after execution of any contract with the State. Contractor agrees it shall so notify the
State immediately of any such change or shift in location of its services. The State has the right to immediately terminate the contract, unless a duly signed waiver from the State has been attained to perform the services outside the United States.
On behalf of the Contractor, I acknowledge that I am duly authorized to execute this Affirmation and
Disclosure Form and have read and understand that this form is a part of any Contract that Contractor may enter into with the State and is incorporated therein.
By:
Contractor
Print Name:
Title:
Date:
File details come from the government source that posted it. Updated .