Pioneer_CTC_-_Updated_Affirmation_and_Disclosure_Form.pdf

This document is an Affirmation and Disclosure Form for a contractor, with details specific to a state contract. The contractor's principal business location is at 27 Ryan Rd in Shelby, OH 44875, and the location where services will be performed is at 1150 N Main St in Mansfield, OH 44902. The form requires the contractor to affirm understanding of Executive Orders regarding prohibitions on offshore services, locating state data offshore, and purchasing from Russian institutions or companies.

The document does not specify the exact goods or services under contract. However, it requires the contractor to disclose all locations where services will be performed and where state data will be located. The contractor agrees to immediately notify the State of any changes in service locations and understands that the State can terminate the contract if services are moved outside the United States without a signed waiver. The form was signed by Gregory Nickoli, Superintendent, on 6/25/25, indicating the contractor's commitment to these terms and conditions.