Affirmation___Disclosure__Piqua_.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing compliance with Executive Order 2022-02D regarding services performed outside the United States. The contractor is Piqua Materials, located at 1750 W Statler Rd in Piqua, Ohio 45356. The form emphasizes restrictions on services performed by Russian companies or institutions and outlines the contractor's obligations to disclose locations where contract services and data will be performed or stored.

The document indicates that Piqua Materials will perform all contract services at its primary business location in Piqua, Ohio. No subcontractors are listed, and the company affirms that it will not perform any services in Russia. The form requires the contractor to notify the State immediately of any changes in service locations and grants the State the right to terminate the contract if services are moved outside the United States. The form was signed on 2/18/24 by a sales manager, signifying the company's agreement to the specified terms and conditions.