Affirmation_and_disclosure_statement.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically involving Southeastern Equipment Co., Inc. as the contractor. The form is aligned with Executive Order 2022-02D, which addresses restrictions on services performed by Russian companies or institutions. The contractor's principal business location is at 10874 East Pike Rd in Cambridge, Ohio 43725, and the document requires disclosure of service locations, subcontractors, and compliance with state procurement guidelines.

The form emphasizes that the contractor shall not perform services outside the United States and will not use subcontractors from Russia. The contractor agrees to immediately notify the state of any changes in service locations or contract details. While specific contract details are not fully elaborated in this document, it appears to be a compliance document ensuring that the contractor adheres to state procurement restrictions, particularly those related to potential Russian involvement in state contract work. The document requires an original signature and was signed by Chris Kurz, the Regional Sales Manager, on 11-22-2024.