AFFIRMATION_AND_DISCLOSURE_FORM_signed.pdf

This document is an Affirmation and Disclosure Form for Certified Stainless Services Inc., doing business as West-Mark, located at 518 Industry Way in Atwater, California. The form is specifically related to compliance with Executive Order 2022-02D, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The document requires the contractor to affirm that no services will be performed in Russia and that they will abide by restrictions on purchasing services from Russian entities.

The form indicates that West-Mark will perform services at its primary business location in Atwater, California, and notes that there are no subcontractors involved in this contract. The document emphasizes the contractor's commitment to not utilizing Russian companies or offshore services, in alignment with state procurement guidelines. The form was signed on 9/5/24 by Jeff Hurst in a government contracting role, and it serves as a mandatory disclosure and affirmation mechanism for state contract participation, ensuring transparency and compliance with current executive orders regarding international service providers.