Xerox_Scan_01212025082919.pdf

This document is an Affirmation and Disclosure Form for Baldwin & Sours, Inc., located at 5263 Trabue Road in Columbus, Ohio 43228. The form relates to a contract governed by Executive Order 2022-02D, which prohibits expenditure of public funds on services performed by Russian companies or institutions. The contractor affirms compliance with this order and agrees to complete the attached Exhibit II, which becomes part of the contract.

The form indicates that no subcontractors are currently involved, and all services will be performed within the United States. The contractor agrees to disclose any changes in service locations before, during, and after contract execution, with the state retaining the right to immediately terminate the contract if such changes occur without proper notification. The document is signed by the company president on 1/20/2025, affirming the company's understanding and commitment to the specified contractual terms and restrictions on service performance.