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This document is an Affirmation and Disclosure Form related to a state contract, specifically addressing restrictions on services performed by Russian companies or institutions. The form is associated with Executive Order 2022-02D and pertains to a contractor named Mosolutions, located in Plain City, Ohio. The document requires the contractor to affirm that no services will be performed outside the United States and that no state data will be sent, accessed, tested, maintained, backed-up, stored, or made available remotely outside of the United States.

The contractor has indicated that all services will be performed at 8235 Estetes Pkwy in Plain City, OH 44064, with no subcontractors involved. The form emphasizes compliance with Executive Order 2019-12D, which prohibits state agencies from purchasing offshore services, and requires immediate notification of any changes in service location. The document serves as a formal declaration that the contractor will not use Russian companies or institutions in the performance of the contract and agrees to potential immediate termination if such violations occur.