Affirmation_and_Disclosure_Form_-_signed.pdf

This document is an Affirmation and Disclosure Form for BP Machine Ltd, a company located at 4205 - 78 Avenue NW in Edmonton, Alberta, Canada. The form is related to a state contract and specifically addresses compliance with Executive Order 2022-02D, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The contractor affirms that no services will be performed in Russia and agrees to complete the attached Exhibit II, which is incorporated into the contract.

The form details the contractor's principal business location, service performance location, and state data location, all of which are at the same Edmonton, Alberta address. The document emphasizes compliance with executive orders regarding restrictions on services from Russian entities, including prohibitions on purchasing services from Russian companies and a requirement to immediately notify the State of any changes in service locations. The contractor acknowledges the State's right to terminate the contract if these conditions are not met, with no services to be performed in Russia under this agreement.