Affirmation___Disclosure.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing restrictions on services performed by Russian companies or institutions. The form is completed by CEI Of America, LLC, located in Sarasota, Florida, and is tied to Executive Order 2022-02D, which prohibits state agencies from purchasing services from Russian companies or institutions. The contractor affirms that no services under this contract will be performed in Russia, and the company's principal business location and service performance location are both at 5016 Calle Minorga in Sarasota, Florida 34242.

The document requires the contractor to disclose the locations where services will be performed and where state data will be located, with the current form indicating all activities will occur in Sarasota, Florida. There are no subcontractors listed, and the form emphasizes the contractor's obligation to immediately notify the state of any changes in service locations or potential use of subcontractors. The form is signed by the Director of Government Programs, William R. Britt, with a signature date of 9/16/2024, and serves as a mandatory disclosure and affirmation for any contract the company may enter into with the state.