Pioneer__Affirmation_and_Disclosure_Form__3_.pdf

This document is an Affirmation and Disclosure Form for a state contract, specifically pertaining to a contractor located in Shelby, Ohio. The form requires the contractor to affirm understanding of Executive Orders related to offshore services, data location, and purchasing restrictions from Russian institutions. The principal place of business is 27 Ryan Rd in Shelby, OH 44875, with service performance location at 1150 N Main St in Mansfield, OH 44902. No subcontractors are indicated on the form (marked as N/A).

The document outlines the contractor's obligations regarding service and data locations, with a specific requirement to immediately disclose any changes in service locations to the state. The contractor must notify the state of any shift in service locations, and the state retains the right to terminate the contract if services are moved outside the United States without proper waiver. The form is signed by Gregory Nickoli, whose title is Superintendent, with an execution date of 9/6/2024. The form emphasizes compliance with state regulations concerning service performance and data handling.