AFFIRMATION___DISCLOSURE_FORM.pdf

This document is an Affirmation and Disclosure Form related to an official contract, specifically addressing requirements under Executive Order 2022-02D. The form involves Decision Analytics LLC as the contractor, with a principal business location in Bowling Green, Ohio. The document pertains to state contract regulations, particularly addressing restrictions on services performed in Russia and compliance with state procurement guidelines.

The contractor indicates services will be performed in Rector, Ohio, with state data to be located at the company's primary business address in Bowling Green, Ohio. No subcontractors are listed, with "Not Applicable" noted in those sections. The form emphasizes compliance with Executive Order 2022-02D, which prohibits state agencies from purchasing offshore services from Russian companies and requires disclosure of service locations. The document was signed on January 19, 2025, by a representative from Decision Analytics LLC, specifically an individual with the title of Hour Reviewer, affirming the company's commitment to these contractual and regulatory requirements.