101 Dale Smith.pdf
PDF 77 KB Posted
- Attached to
- Release State Use/Facilities for Persons with Severe Disabilities IL|25-416CMS-BOSS4-P-75951
- Contract number
- 25-416CMS-BOSS4-P-75951
- Issued by
- Illinois
About this file
This is a Business Card Request Form submitted by Dale Smith (Respondent 101) on October 8, 2026, with a completion time of 4 minutes and 56 seconds. The form indicates a re-order with changes to an existing business card design. The requestor is affiliated with the Arson Division and provides an Illinois state government email address (dale.smith2@illinois.gov), indicating this is a state of Illinois procurement request.
Dale Smith's business card will display the name "Dale Smith" with the title "Commander" in the Arson Division, located at 1035 Stevenson Drive. Contact information includes office number 217-785-4713, cell number 217-720-5835, and email dale.smith2@illinois.gov. The fax number field contains "0," indicating no fax capability. The order specifies a quantity of 500 business cards to be delivered to the Springfield location. The primary change noted is updating the title to "Commander" on the card. A photograph of the current business card was attached to support the request.
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Other files
| File | Type | Posted |
|---|---|---|
| 101 Dale Smith.jpg | JPG image | |
| 100 Mike Dade.pdf |
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Text version
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Dale Smith 04:56 Time to complete
Respondent
Re-order with NO CHANGES
Re-Order, SEE CHANGES BELOW
New Order
Order Request * 1.
IMG_0369_Dale Smith.JPG
Please attach a picture of your current business card with this order. Please mark any changes on the business card or make notes below.
2.
10/8/26, 2:44 PM Business Card Request Form https://forms.cloud.microsoft/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=nwgia7qOPEaE9TFxIQ-QBYd4wejjQSBNhNZZ… 1/3 https://ilgov-my.sharepoint.com/personal/clint_everetts_illinois_gov/Documents/Apps/Microsoft%20Forms/Business%20Card%20Request%20Form/Question/IMG_0369_Dale%20Smith.JPG
Division * 3.
Arson
Name (as appears on card) * 4.
Dale Smith
Title * 5.
Commander
Address * 6.
1035 Stevenson Drive
Office Number * 7.
217-785-4713
Cell Number * 8.
217-720-5835
Fax Numer * 9.
10/8/26, 2:44 PM Business Card Request Form https://forms.cloud.microsoft/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=nwgia7qOPEaE9TFxIQ-QBYd4wejjQSBNhNZZ… 2/3
Email * 10.
dale.smith2@illinois.gov
List of changes, notes, or additions11.
Change title to Commander
Quantity * 12.
Springfield
Chicago
Deliver to * 13.
10/8/26, 2:44 PM Business Card Request Form https://forms.cloud.microsoft/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=nwgia7qOPEaE9TFxIQ-QBYd4wejjQSBNhNZZ… 3/3
File details come from the government source that posted it. Updated .