Affirmation_and_Disclosure_-_Pickaway_Correctional.pdf

This document is an Affirmation and Disclosure Form related to a state contract, involving a contractor located in Delaware, Ohio. The form requires disclosure of business locations, service performance locations, and state data storage locations. The contractor, represented by Angela L. Mack, affirms compliance with Executive Orders regarding offshore services and restrictions on performance and data location, particularly concerning Russian institutions or companies.

The contractor's principal business location is 3700 Olentangy River Rd in Delaware, OH 43015, with service performance location at 11781 State Route 762 in Orient, OH 43146. State data will be located at 3788 Olentangy River Rd in Delaware, OH 43205. No subcontractors are indicated (marked as N/A). The document emphasizes the contractor's obligation to disclose any changes in service locations and agrees that the state can immediately terminate the contract if locations shift without proper notification. The form is signed by the Director of Development and dated 10/14/2025, suggesting it is part of a future contract preparation process.