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1281 H u m b ra ch t C ircle, S uite G , B a rtle tt, IL 60103 C ontact: M ich e le

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: 630-213-9022 E m ail: m lchele@ cym balcom m

.com F ax#: N /A tate A gency N am e:

Logan C orrectional C enter

A ddress:

1096 1 th S

t. Lincoln, II. 62656 C ontact: C hristi W ith e rs P h o n e

: 217-735-5581 E m ail: C hristi.w ithers@ illinois.gov

B Iii To:

Ship To:

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doc.loganaccountspayable@ illinois.gov

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he undersigned parties agree to th e se te rm s and conditions.

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P rinted N am e: M ich e le H ish

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: D ire c to r o f O p e ra tio n s

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S ignature agency representative:

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S tate o f Illinois

S ignature agency representative:

P rinted N am e:

T itle:

D ate:

I certify that:

STATE OF ILLINOIS

TAXPAYER IDENTIFICATION NUMBER

The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and

I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

I am a U.S. person (including a U.S. resident alien).

• If you are an individual, enter your name and SSN as it appears on your Social Security Card .

• If you are a sole proprietor, enter the owner's name on the name line followed by the name of the business and the owner's SSN or EIN.

• If you are a single-member LLC that is disregarded as an entity separate from its owner, enter the owner's name on the name line and the D/B/A on the business name line and enter the owner's SSN or EIN.

• If the LLC is a corporation or partnership, enter the entity's business name and EIN and for corporations, attach IRS acceptance letter (CP261 or CP277).

• For all other entities, enter the name of the entity as used to apply for the entity's EIN and the EIN .

Name: Click here to enter text.

Business Name: Cymbal Communications

Taxpayer Identification Number: 32-0145942

Social Security Number: Click here to enter text.

or

Employer Identification Number: Click here to enter text.

Legal Status (check one):

D Individual

D Sole Proprietor

D Partnership

D Legal Services Corporation

D Tax-exempt

D Corporation providing or billing

D Governmental

0 Nonresident alien

D Estate or trust

D Pharmacy (Non-Corp.)

D Pharmacy/Funeral Home/Cemetery (Corp.)

D Limited Liability Company medical and/or health care services (select applicable tax classification)

[8:1 Corporation NOT providing or billing D C = corporation medical and/or health care services D P = partnership

Signature of Authorized Representative: k ~~ Date: March 27, 2026

State of Illinois Chief Procurement Office General Services Taxpayer Identification Number V.23.2

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