Affirmation___Disclosure_Form_012-25_Signed_by_MMS_10-29-2024.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing compliance with Executive Order 2022-02D regarding restrictions on services performed by Russian companies or institutions. The form is completed by Morganty Machinery + Supply Inc., located at 143 Broadway St. in Toledo, OH 43604. The contractor affirms that services will be performed in Ohio and that no services will be conducted in Russia or by Russian entities.

The form indicates that the contractor has no subcontractors and will be performing services entirely within Ohio. The document requires compliance with prohibitions on purchasing services from Russian companies, as outlined in Executive Order 2019-12D. The contractor agrees to complete an attached Exhibit II and acknowledges the state's right to immediately terminate the contract if there are any undisclosed changes in service locations or violations of the specified executive order restrictions.