Ahmed_Yusuf_s_A_and_D.pdf

This document is an Affirmation and Disclosure Form for a contract involving a contractor located in Columbus, Ohio. The form appears to be associated with a state or local government contract, with the contractor's principal business address at 4615 Northmorne Blvd, Columbus, OH 43228. The services will be performed at 16 LM State Route 104 in Chillicothe, OH 45601. There are no subcontractors listed on the form, with "N/A" entered in those sections.

The form does not provide specific details about the goods or services under contract. However, it serves as a formal disclosure document where the contractor affirms compliance with Executive Orders regarding prohibitions on offshore services and data location. The document was signed by the contractor on 5/1/2025, with the signatory named as Ahmed Yusuf. While the exact nature of the contract is not detailed, the form suggests it involves some form of service provision with potential data or location-specific requirements.