Standard_Affirmation_and_Disclosure_form.pdf

This document is a Standard Affirmation and Disclosure Form related to Executive Orders 2019-12D & 2022-02D, specifically governing the expenditure of public funds on offshore services and responding to Russia's unjust war. The form is completed by a contractor located at 77 N. Ardmore Rd. in Bexley, Ohio 43209, who affirms understanding of executive orders prohibiting offshore services, locating state data offshore, or purchasing from Russian institutions or companies.

The contractor indicates that all services will be performed at their primary business location in Bexley, Ohio, with no subcontractors involved (marked as "n/a" on the form). The document requires the contractor to disclose locations where services will be performed and where state data will be located, which in this case are identical to their primary business address. The form is part of a compliance mechanism ensuring that contractors adhere to specific restrictions on offshore services and data management, particularly in response to geopolitical circumstances involving Russia.