1-JEM_AFFIRMATION___DISCLOSUR-E06-19-2025.pdf

This document appears to be an Affirmation and Disclosure Form for a state and local contract, likely an Indefinite Delivery Vehicle (IDV) contract. The form is designed for a contractor to provide key information about their business, with multiple signature lines indicating potential involvement of multiple jurisdictions or agencies. While specific state names are handwritten, the document is structured to capture details about the contractor's business operations, compliance, and contractual commitments.

The form requires detailed disclosures about the contractor's funding sources, service locations, and performance capabilities. It includes sections for listing principal locations of business, naming key personnel, and documenting where services will be performed. The document seems to be part of a comprehensive contracting process that requires transparency about the contractor's organizational structure, geographical reach, and ability to provide services across potentially multiple state or local government jurisdictions. The form's layout suggests it is part of a standardized procurement process for establishing a broad, flexible contract vehicle that can be utilized by various government entities.