Standard Affirmation Form.pdf

The document is an Affirmation and Disclosure Form designed for contractors engaging with a state government contract. The form requires contractors to affirm their understanding of Executive Orders related to prohibitions on performance of offshore services, locating state data offshore, or purchasing from Russian institutions or companies. Contractors must provide detailed information about their principal business location, service performance locations, and any subcontractors' locations, with a clear requirement to disclose any changes in service locations immediately to the state.

The form emphasizes strict compliance with geographic service restrictions, with a specific provision that allows the state to immediately terminate the contract if services are proposed to be performed outside the United States without a duly signed waiver. The contractor must acknowledge their understanding that this form is incorporated into any potential contract with the state, and the authorized representative must sign, print their name, provide their title, and date the document. The form is version-controlled (Rev. 3/22) and spans two pages, providing multiple sections for comprehensive location and subcontractor disclosure.