HPSCAN_20240820160626192_2024-08-20_160800510.pdf

This document is an Affirmation and Disclosure Form related to a state contract, completed by Chaves Brother Management LLC, located in Boca Raton, FL. The form is designed to comply with Executive Order 2022-02D, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The contractor affirms their understanding of and compliance with the order, providing their principal business location and contact information.

The form requires the contractor to disclose the locations where services will be performed and where state data will be located, which in this case are both at 300 SW 8th St #17 in Boca Raton, FL 33432. The document emphasizes the contractor's commitment to not performing any services in Russia and agrees to immediate contract termination if there are any changes in service locations. The form was signed by Tyler Chaves, a Managing Member, on 8/20/24, and is intended to be incorporated as part of any contract the contractor may enter into with the state.