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This document is an Affirmation and Disclosure Form for Impact Recovery Systems, Inc., located at 4955 Stout Dr in San Antonio, TX 78219. The form appears to be related to a state contract that requires compliance with Executive Order 2022-02D, which prohibits state agencies from purchasing services from contractors performing work in Russia. The document is designed to affirm the contractor's commitment to not conducting business in Russia and to disclose key information about the company's business locations and service performance sites.

The form indicates that Impact Recovery Systems, Inc. has no subcontractors and will perform services at its primary business address in San Antonio, Texas. The company agrees to complete an attached Exhibit II, Contractor/Subcontractor Affirmation and Disclosure Form, and affirms that no services will be performed in Russia. The document is signed by the company's president, Greg Hannah, on 12/19/2024, and includes provisions that require the contractor to notify the state of any changes in service locations or contract performance sites, with the state retaining the right to immediately terminate the contract if such changes conflict with the order's requirements.