Signed_Affirmation___Disclosure_100-26.pdf

This document is an Affirmation and Disclosure Form for the contractor National Lime and Stone, located at 551 Lake Cascades Pkwy in Findlay, Ohio 45840. The form addresses compliance with Executive Order 2022-02D, which prohibits state agencies from purchasing services from Russian companies or institutions. The contractor affirms that no services will be performed in Russia, and they are providing details about their business locations and service performance areas.

The form indicates that services will be performed in multiple locations, with no specific subcontractors listed. The contractor agrees to disclose any changes in service locations to the State and understands that the State can immediately terminate the contract if services are performed outside the United States without a signed waiver. The document is signed by Tony Price, Vice President of Sales, on February 25th, 2025, and requires an original signature to validate the contractor's commitments regarding service locations and compliance with the specified executive order.