STATE OF ILLINOIS

CONTRACT AMENDMENT

State of Illinois Chief Procurement Office for General Services 1 Contract Amendment V.23.1

The undersigned Agency and Vendor, Illinois Emergency Services Management Association (IESMA), (the Parties) agree that the following shall amend the Contract referenced herein. All terms and conditions set forth in the original Contract, not amended herein, shall remain in full force and effect as written. In the event of conflict, the terms of this Amendment shall prevail.

IN WITNESS WHEREOF, the Agency and the Vendor cause this Amendment to be executed on the dates shown below by representatives authorized to bind the respective PARTIES.

VENDOR

Vendor Name: Illinois Emergency Services Management Association (IESMA) Address: 120 N. Franklin St. Suite E Decatur, IL 62523

Signature: MMichael Graves Phone: 217-741-5632

Printed Name: Michael Graves Fax:

Title: Executive Director Email: contact@iesma.org

Date: 12 May 26

STATE OF ILLINOIS

Procuring Agency: Illinois Emergency Management Agency and Office of Homeland Security (IEMA-OHS) Phone:

Street Address: 4800 Wabash Ave, 3F-West Fax:

City, State ZIP: Springfield, IL 62711

Official Signatur Date:

Printed Name: Theodore D. Berger by Ashley Garcia

Official’s Title: Acting Director by Assistant Agency Procurement Officer

5/12/2026

State of Illinois Chief Procurement Office for General Services 3 Contract Amendment V.23.1

1. CONTRACT DESCRIPTION (including Original Purchase Order or Contract Number): 7700306679

2. CHANGE ORDER: Is this amendment a change order as defined in 30 ILCS 500/1-15.12 and 720 ILCS 5/33E?

Yes No

3. DESCRIPTION OF AMENDMENT (Check all that apply, complete blanks and explain as necessary):

3.1. The completion date will be extended, shortened or remain the same.

3.2. The method of determining compensation (e.g., hourly rate, fixed fee, etc.) will stay the same.

3.3. The cost will be increased, decreased or remain the same.

3.3.1. Original cost: $7,125.00.

3.3.2. Amount of change: $25.00.

3.3.3. Revised cost: $7,150.00.

3.4. The supplies or services to be provided will stay the same or be changed as follows: Adjusting Melissa Hahn’s fee to $150 non-member fee from the $125 member fee listed on the PO.

3.5. Subcontractors are being added, deleted, or remain the same?

4. EFFECTIVE DATE OF AMENDMENT: Date of Execution.

STATE OF ILLINOIS

TAXPAYER IDENTIFICATION NUMBER

State of Illinois Chief Procurement Office for General Services 4 Taxpayer Identification Number V23.1

I certify that:

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: Click here to enter text.

Taxpayer Identification Number:

Social Security Number: Click here to enter text.

or

Employer Identification Number : Click here to enter text.

Legal Status (check one):

Individual Governmental

Sole Proprietor Nonresident alien

Partnership Estate or trust

Legal Services Corporation Pharmacy (Non-Corp.)

Tax-exempt Pharmacy/Funeral Home/Cemetery (Corp.)

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

Corporation NOT providing or billing D = disregarded entity medical and/or health care services C = corporation

P = partnership

Signature of Authorized Representative:

Date: Click here to enter a date