ARC_Affirmation_and_Disclosure_Form_01-24-2024.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing requirements under Executive Order 2022-02D concerning Russian companies and institutions. The form is completed by a contractor located at 1429 Jeffrey Drive in Addison, IL 60101, with services to be performed at ODIT, 166 W. Broad St. in Columbus, OH 43223. The document emphasizes compliance with state regulations regarding service performance, data handling, and restrictions on offshore services.

The contractor, who has signed the form as a Senior Account Manager, affirms that no services will be performed in Russia and that the company is not using any subcontractors for this contract. The form highlights restrictions on expenditure of public funds, specifically prohibiting services by Russian companies or institutions, and requires disclosure of any changes in service locations or contract execution. The document is dated 01/24/2024 and appears to be a standard compliance document for state contract participation, ensuring transparency about the contractor's business operations and service delivery locations.