QK_Signed_Disclosure.pdf

This document is an Affirmation and Disclosure Form completed by Qwick Kurs, Inc., located at 1916 US Highway 41 South in Ruskin, Florida 33570. The form is related to a state contract and is specifically designed to comply with Executive Order 2022-02D, which addresses restrictions on services performed by Russian companies or institutions. The document requires the contractor to affirm that no services will be performed in Russia and that the company understands the prohibitions on expenditure of public funds on services from Russian entities.

The form indicates that Qwick Kurs, Inc. will perform services at its primary business location in Ruskin, Florida, with no subcontractors listed. The company has committed to not using Russian companies or institutions for any services under the contract and acknowledges the State's right to terminate the contract if there are any changes in service locations or violations of the executive order. The document was signed by the company's President on December 6, 2024, and serves as a formal affirmation of compliance with specific government contracting requirements related to international service restrictions.