Office_Copier_20250204_101105.pdf

This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing requirements for contractors performing services under Executive Order 2022-02D. The form is completed by Leonard Truck & Trailer Inc., with its principal business location at 12800 Leonard Parkway in North Jackson, OH 44451. The document is designed to provide detailed information about the contractor's business operations, service locations, and compliance with state regulations regarding public fund expenditures and potential restrictions on services performed in Russia.

The form confirms that Leonard Truck & Trailer Inc. will perform services at its primary business address in North Jackson, Ohio, and includes a subcontractor, Leonard Truck & Trailer Inc., at the same location. The document emphasizes the contractor's obligation to disclose any changes in service locations before, during, and after contract execution, and requires immediate notification to the state of any such shifts. The form was signed by Shannon Horkey, the Controller, on February 4, 2025, and is part of a contractual process that appears to involve compliance with specific state procurement guidelines and executive orders related to service performance and fund usage.