State of Illinois Chief Procurement Office General Services 1 BOA under $50,000 V.23.2

ORDERING INFORMATION

Item Description

(manufacturer, model, serial number, feature, etc.) Qty One Time Charge Periodic Charge

Unit Extension Unit Extension 1 EOC Vest Kit for Large Local Government-

45 Position Live Action Safety. EOC Vest Kit for Large Local Government-45 Position(with Vest Window Option to allow for position naming modifications/tailorability Live Action Safety 3 sets are needed.

DMS-05757W

3 $2,379.00 $7,137.00

All items must be delivered and invoiced by July 15, 2026.

BOA Total: $7,137.00

STATE OF ILLINOIS

BASIC ORDERING AGREEMENT (BOA) < $50,000

The terms and conditions of this BOA, including those terms and conditions set forth in the additional documents referenced below, and any continuation sheets, constitute the entire agreement between the parties with respect to the subject matter of this BOA. State documents will prevail in the event of a conflict between State and Vendor documents.

CONTACT INFORMATION

Vendor Name: Holly’s Office Solutions SDVOSB Address: 18810 Oak Rest Rd. Brighton, IL 62012 Contact: Jade Cannon Phone #: 217-939-1101 Email: jade@hollysofficesolutions.com

State Agency Name: Illinois Emergency Management Agency and Office of Homeland Security (IEMA-OHS) Address: 4800 Wabash Ave 3-F West, Springfield, IL 62711 Contact: Nancy Buck Phone #: 217-557-4751 Email: Nancy.m.buck@illinois.gov

Bill To:

ema.accountspayable@illinois.gov

Ship To:

IEMA-OHS

Attn: Nancy Buck 4800 Wabash Ave 3-F West Springfield, IL 62711

CONTRACT INFORMATION

Contract #: 7700315834 Action: New Acquisition Type: Purchase Payment Cycle: Upon Invoice Terms and Conditions: BOA Terms and Conditions

Term:

Begin Date:

DOE

End Date:

6/30/2026

State of Illinois Chief Procurement Office General Services 2

V.23.2

ADDITIONAL INFORMATION / REFERENCES / ATTACHMENTS

SIGNATURES The undersigned parties agree to these terms and conditions.

Vendor State of Illinois

Signature: State Agency: Illinois Emergency Management Agency and Office of Homeland Security (IEMA-OHS)

Printed Name: Holly Pruiett Signature agency representat

Title: Owner Printed Name: Theodore D. Berger by Ashley Garcia

Date:06/15/2026 Title: Director by Agency Purchasing Officer

Date: 6/16/2026

State of Illinois State of Illinois

Signature agency representative: Signature agency representative:

Printed Name: Printed Name:

Title: Title:

Date: Date:

STATE USE ONLY

Reference Number: EM26150582 Source Selection Method: Small Purchase Is Financing Needed? No Using Agency Funding Source:

Fiscal Year: 2026 Type: State

Approp. Account Code: 001-58840-1900-0000-0000 Detailed Expenditure Object Code: 1599 Award Code: C Original Procurement Method: Small Purchase Subcontractors Utilized? No Subcontractors Disclosed? No

STATE O

F ILLINO

IS

STANDARD TERM

S AND CO

NDITIO

NS

State of Illinois Chief Procurem ent O ffice General Services

V.23.2

1.

PAYM

EN

T TERM

S AN

D CO

N

DITIO

NS:

1.1.

Late Paym ent: Paym ents, including late paym ent charges, w ill be paid in accordance w ith the State Prom pt Paym ent Act and rules w hen applicable. 30 ILCS 540; 74 III. Adm . Code 900. This shall be Vendor’s sole rem edy for late paym ents by the State. Paym ent term s contained on Vendor’s invoices shall have no force and effect.

1.2.

M inority Contractor Initiative: Any Vendor aw arded a contract under Section 20-10, 20-15, 20-25 or 20-

30 of the Illinois Procurem ent Code (30 ILCS 500) of $1,000 or m ore is required to pay a fee of $15. The Com ptroller shall deduct the fee from the first check issued to the Vendor under the contract and deposit the fee in the Com ptroller’s Adm inistrative Fund. 15 ILCS 405/23.9.

1.3.

Expenses: The State w ill not pay for supplies provided or services rendered, including related expenses, incurred prior to the execution of this contract by the Parties even if the effective date of the contract is prior to execution.

1.4.

Prevailing W age: As a condition of receiving paym ent Vendor m ust (i) be in com pliance w ith the contract,

(ii) pay its em ployees prevailing w ages w hen required by law , (iii) pay its suppliers and subcontractors according to the term s of their respective contracts, and (iv) provide lien w aivers to the State upon request. Exam ples of prevailing w age categories include public w orks, printing, janitorial, w indow w ashing, building and grounds services, site technician services, natural resource services, security guard and food services. The prevailing w ages are revised by the Departm ent of Labor and are available on the

Departm ent’s official w ebsite, w hich shall be deem ed proper notification of any rate changes under this subsection. Vendor is responsible for contacting the Illinois Departm ent of Labor to ensure understanding of prevailing w age requirem ents at 217-782-6206 or (https://labor.illinois.gov/).

1.5.

Federal Funding: This contract m ay be partially or totally funded w ith Federal funds. If federal funds are expected to be used, then the percentage of the good/service paid using Federal funds and the total Federal funds expected to be used w ill be provided in the aw ard notice.

1.6.

Invoicing: By subm itting an invoice, Vendor certifies that the supplies or services provided m eet all requirem ents of the contract, and the am ount billed and expenses incurred are as allow ed in the contract.

Invoices for supplies purchased, services perform ed, and expenses incurred through June 30 of any year m ust be subm itted to the State no later than July 31 of that year; otherw ise Vendor m ay have to seek paym ent through the Illinois Court of Claim

s. 30 ILCS 105/25. All invoices are subject to statutory offset.

30 ILCS 210.

1.6.1.

Vendor shall not bill for any taxes unless accom panied by proof that the State is subject to the tax. If necessary, Vendor m ay request the applicable Agency/University state tax exem ption num ber and federal tax exem ption inform ation.

1.6.2.

Vendor shall invoice at the com pletion of the contract unless invoicing is tied in the contract to m ilestones, deliverables, or other invoicing requirem ents agreed to in the contract.

2.

ASSIGN

M ENT: This contract m ay not be assigned, transferred in w hole or in part by Vendor w ithout the prior ritten consent of the State.

IS

STAN

DARD TERM

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V.23.2

3.

SUBCO

N TRACTING: For purposes of this section, subcontractors are those w ith contracts w ith an annual value exceeding $100,000 and w ho are specifically hired to perform all or part of the w ork covered by the contract.

Vendor m ust receive prior w ritten approval before use of any subcontractors in the perform ance of this contract.

Vendor shall describe, in an attachm ent if not already provided, the nam es and addresses of all authorized subcontractors to be utilized by Vendor in the perform ance of this contract, together w ith a description of the w ork to be perform ed by the subcontractor and the anticipated am ount of m oney that each subcontractor is expected to receive pursuant to this contract. If required, Vendor shall provide a copy of any subcontracts w ithin fifteen (15) days after execution of this contract. All subcontracts m ust include the sam e certifications that Vendor m ust m ake as a condition of this contract. Vendor shall include in each subcontract the Standard Illinois Certification form available from the State. If at any tim e during the term of the Contract, Vendor adds or changes any subcontractors, then Vendor m ust prom ptly notify, by w ritten am endm ent to the Contract, the State

Purchasing O fficer or the Chief Procurem ent O fficer of the nam es and addresses, the expected am ount of m oney that each new or replaced subcontractor w ill receive pursuant to the Contract , and the general type of w ork to be perform

ed. 30 ILCS 500/20-120.

4.

AUDIT/RETEN

TIO

N

O

F RECO

RDS: Vendor and its subcontractors shall m aintain books and records relating to the perform ance of the contract or subcontract and necessary to support am ounts charged to the State pursuant the contract or subcontract. Books and records, including inform ation stored in databases or other com puter system s, shall be m aintained by the Vendor for a period of three (3) years from the later of the date of final paym ent under the contract or com pletion of the contract, and by the subcontractor for a period of three (3) years from the later of final paym ent under the term or com pletion of the subcontract. If Federal funds are used to pay contract costs, the Vendor and its subcontractors m ust retain their respective records for five (5) years. Books and records required to be m aintained under this section shall be available for review or audit by representatives of: the procuring Agency, the Auditor General, the Executive Inspector General, the Chief Procurem ent Officer, State of Illinois internal auditors or other governm ental entities w ith m onitoring authority, upon reasonable notice and during norm al business hours. Vendor and its subcontractors shall cooperate fully w ith any such audit and w ith any investigation conducted by any of these entities. Failure to m aintain books and records required by this section shall establish a presum ption in favor of the State for the recovery of any funds paid by the State under this contract or any subcontract for w hich adequate books and records are not available to support the purported disbursem ent. The Vendor or subcontractors shall not im pose a charge for audit or exam ination of the Vendor’s or subcontractor’s books and records. 30 ILCS 500/20-65.

5.

TIM

E IS O

F THE ESSENCE: Tim e is of the essence w ith respect to Vendor’s perform ance of this contract. Vendor shall continue to perform its obligations w hile any dispute concerning the contract is being resolved unless otherw ise directed by the State.

6.

N

O W

AIVER O

F RIGHTS: Except as specifically w aived in w riting, failure by a Party to exercise or enforce a right does not w aive that Party’s right to exercise or enforce that or other rights in the future.

7.

FO

RCE M

AJEURE: Failure by either Party to perform its duties and obligations w ill be excused by unforeseeable circum stances beyond its reasonable control and not due to its negligence, including acts of nature, acts of terrorism , riots, labor disputes, fire, flood, explosion, and governm ental prohibition. The non-declaring Party m ay cancel the contract w ithout penalty if perform ance does not resum e w ithin thirty (30) days of the declaration.

8.

CO

N

FIDEN

TIAL IN

FO

RM

ATIO

N : Each Party, including its agents and subcontractors, to this contract m ay have or gain access to confidential data or inform ation ow ned or m aintained by the other Party in the course of carrying out its responsibilities under this contract. Vendor shall presum e all inform ation received from the State or to

IS

STAN

DARD TERM

S AND CO

V.23.2 w hich it gains access pursuant to this contract is confidential. Vendor inform ation, unless clearly m arked as confidential and exem pt from disclosure under the Illinois Freedom of Inform ation Act, shall be considered public.

No confidential data collected, m aintained, or used in the course of perform ance of the contract shall be dissem inated except as authorized by law and w ith the w ritten consent of the disclosing Party, either during the period of the contract or thereafter. The receiving Party m ust return any and all data collected, m aintained, created or used in the course of the perform ance of the contract, in w hatever form it is m aintained, prom ptly at the end of the contract, or earlier at the request of the disclosing Party, or notify the disclosing Party in w riting of its destruction. The foregoing obligations shall not apply to confidential data or inform ation law fully in the receiving Party’s possession prior to its acquisition from the disclosing Party; received in good faith from a third

Party not subject to any confidentiality obligation to the disclosing Party; now is or later becom es publicly know n through no breach of confidentiality obligation by the receiving Party; or is independently developed by the receiving Party w ithout the use or benefit of the disclosing Party’s confidential inform ation.

9.

USE AND O

W N

ERSHIP: All w ork perform ed or supplies created by Vendor under this contract, w hether w ritten docum ents or data, goods or deliverables of any kind, shall be deem ed w ork for hire under copyright law and all intellectual property and other law s, and the State of Illinois is granted sole and exclusive ow nership to all such w ork, unless otherw ise agreed in w riting. Vendor hereby assigns to the State all right, title, and interest in and to such w ork including any related intellectual property rights, and/or w aives any and all claim s that Vendor m ay have to such w ork including any so-called "m oral rights" in connection w ith the w ork. Vendor acknow ledges the

State m ay use the w ork product for any purpose. Confidential data or inform ation contained in such w ork shall be subject to confidentiality provisions of this contract.

10.

IN

DEM

NIFICATIO

N AND LIABILITY: The Vendor shall indem nify and hold harm less the State of Illinois, its agencies, officers, em ployees, agents and volunteers from any and all costs, dem ands, expenses, losses, claim s, dam ages, liabilities, settlem ents and judgm ents, including in-house and contracted attorneys’ fees and expenses, arising out of: (a) any breach or violation by Vendor of any of its certifications, representations, w arranties, covenants or agreem ents; (b) any actual or alleged death or injury to any person, dam age to any real or personal property, or any other dam age or loss claim ed to result in w hole or in part from

Vendor’s negligent perform ance;

(c) any act, activity or om ission of Vendor or any of its em ployees, representatives, subcontractors or agents; or

(d) any actual or alleged claim that the services or goods provided under this contract infringe, m isappropriate, or otherw ise violate any intellectual property (patent, copyright, trade secret, or tradem ark) rights of a third party.

In accordance w ith Article VIII, Section 1(a),(b) of the Constitution of the State of Illinois and 1973 Illinois Attorney General O pinion 78, the State m ay not indem nify private parties absent express statutory authority perm itting the indem nification. Neither Party shall be liable for incidental, special, consequential, or punitive dam ages.

11.

INSURANCE: Vendor shall, at all tim es during the term and any renew als m aintain and provide a Certificate of

Insurance nam ing the State as additionally insured for all required bonds and insurance. Certificates m ay not be m odified or canceled until at least thirty (30) days’ notice has been provided to the State. Vendor shall provide:

(a) General Com m ercial Liability occurrence form in am ount of $1,000,000 per occurrence (Com bined Single Lim it

Bodily Injury and Property Dam age) and $2,000,000 Annual Aggregate; (b) Auto Liability, including Hired Auto and

Non-ow ned Auto, (Com bined Single Lim it Bodily Injury and Property Dam age) in am ount of $1,000,000 per occurrence; and (c) W orker’s Com pensation Insurance in am ount required by law

. Insurance shall not lim it

Vendor’s obligation to indem nify, defend, or settle any claim s.

12.

IN

DEPEN

DEN

T CO

NTRACTO

R: Vendor shall act as an independent contractor and not an agent or em ployee of, or joint venture w ith the State. All paym ents by the State shall be m ade on that basis.

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V.23.2

13.

SO

LICITATIO

N AN

D EM

PLO

YM

ENT: Vendor shall not em ploy any person em ployed by the State during the term of this contract to perform any w ork under this contract. Vendor shall give notice im m ediately to the Agency’s director if Vendor solicits or intends to solicit State em ployees to perform any w ork under this contract.

14.

CO

M

PLIANCE W

ITH THE LAW

: The Vendor, its em ployees, agents, and subcontractors shall com ply w ith all applicable federal, state, and local law s, rules, ordinances, regulations, orders, federal circulars and all license and perm it requirem ents in the perform ance of this contract. Vendor shall be in com pliance w ith applicable tax requirem ents and shall be current in paym ent of such taxes. Vendor shall obtain at its ow n expense, all licenses and perm issions necessary for the perform ance of this contract.

15.

BACKGRO

UN

D CHECK: W

henever the State deem s it reasonably necessary for security reasons, the State m ay conduct, at its expense, crim inal and driver history background checks of Vendor’s and subcontractor’s officers, em ployees or agents. Vendor or subcontractor shall reassign im m ediately any such individual w ho, in the opinion of the State, does not pass the background check.

16.

APPLICABLE LAW

16.1.

PREVAILING LAW

: This contract shall be construed in accordance w ith and is subject to the law s and rules of the State of Illinois.

16.2.

EQ

UAL O

PPO

RTUNITY: The Departm ent of Hum an Rights’ Equal O pportunity requirem ents are incorporated by reference. 44 ILL. A

DM

. CO

DE 750.

16.3.

CO

URT O

F CLAIM

S; ARBITRATIO

N

; SO

VEREIGN IM

M

UN

ITY: Any claim against the State arising out of this contract m ust be filed exclusively w ith the Illinois Court of Claim

s. 705 ILCS 505/1. The State shall not enter into binding arbitration to resolve any dispute arising out of this contract. The State of Illinois does not w aive sovereign im m unity by entering into this contract.

16.4.

O

FFICIAL TEXT: The official text of the statutes cited herein is incorporated by reference. An unofficial version can be view ed at (w w w .ilga.gov/legislation/ilcs/ilcs.asp).

17.

ANTI-TRUST ASSIGN

M ENT: If Vendor does not pursue any claim or cause of action it has arising under federal or state antitrust law s relating to the subject m atter of the contract, then upon request of the Illinois Attorney

General, Vendor shall assign to the State rights, title and interest in and to the claim or cause of action.

18.

CO

NTRACTUAL AUTHO

RITY: The Agency that signs for the State of Illinois shall be the only State entity responsible for perform ance and paym ent under the contract. W hen the Chief Procurem ent O fficer or authorized designee signs in addition to an Agency, they do so as approving officer and shall have no liability to Vendor. W hen the Chief Procurem ent O fficer or authorized designee, or State Purchasing O fficer signs a m aster contract on behalf of State agencies, only the Agency that places an order w ith the Vendor shall have any liability to Vendor for that order.

19.

EXPATRIATED EN

TITIES: Except in lim ited circum stances, no business or m em ber of a unitary business group, as defined in the Illinois Incom e Tax Act, shall subm it a bid for or enter into a contract w ith a State agency if that business or any m em ber of the unitary business group is an expatriated entity.

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DARD TERM

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V.23.2

20.

N

O TICES: Notices and other com m unications provided for herein shall be given in w riting via electronic m ail w henever possible. If transm ission via electronic m ail is not possible, then notices and other com m unications shall be given in w riting via registered or certified m ail w ith return receipt requested, via receipted hand delivery, via courier (UPS, Federal Express or other sim ilar and reliable carrier), or via facsim ile show ing the date and tim e of successful receipt. Notices shall be sent to the individuals w ho signed this contract using the contact inform ation follow ing the signatures. Each such notice shall be deem ed to have been provided at the tim e it is actually received. By giving notice, either Party m ay change its contact inform ation.

21.

M

O

DIFICATIO

NS AN

D SURVIVAL: Am endm ents, m odifications and w aivers m ust be in w riting and signed by authorized representatives of the Parties. Any provision of this contract officially declared void, unenforceable, or against public policy, shall be ignored and the rem aining provisions shall be interpreted, as far as possible, to give effect to the Parties’ intent. All provisions that by their nature w ould be expected to survive, shall survive term ination. In the event of a conflict betw een the State’s and the Vendor’s term s, conditions and attachm ents, the State’s term s, conditions and attachm ents shall prevail.

22.

PERFO

RM

ANCE RECO

RD / SUSPEN

SIO

N : Upon request of the State, Vendor shall m eet to discuss perform ance or provide contract perform ance updates to help ensure proper perform ance of the contract. The State m ay consider Vendor’s perform ance under this contract and com pliance w ith law and rule to determ ine w hether to continue the contract, suspend Vendor from doing future business w ith the State for a specified period of tim e, or w hether Vendor can be considered responsible on specific future contract opportunities.

23.

FREEDO

M O

F IN

FO

RM

ATIO

N ACT: This contract and all related public records m aintained by, provided to or required to be provided to the State are subject to the Illinois Freedom of Inform ation Act (FO

IA) (50 ILCS 140)

notw ithstanding any provision to the contrary that m ay be found in this contract.

24.

SCHEDULE O

F W O

RK: Any w ork perform ed on State prem ises shall be done during the hours designated by the

State and perform ed in a m anner that does not interfere w ith the State and its personnel.

25.

W

ARRANTIES FO

R SUPPLIES AN

D SERVICES:

25.1.

Vendor w arrants that the supplies furnished under this contract w ill: (a) conform to the standards, specifications, draw ing, sam ples or descriptions furnished by the State or furnished by the Vendor and agreed to by the State, including but not lim ited to all specifications attached as exhibits hereto; (b) be m erchantable, of good quality and w orkm anship, and free from defects for a period of tw elve m onths or longer if so specified in w riting, and fit and sufficient for the intended use; (c) com ply w ith all federal and state law s, regulations and ordinances pertaining to the m anufacturing, packing, labeling, sale and delivery of the supplies; (d) be of good title and be free and clear of all liens and encum brances and; (e) not infringe any patent, copyright or other intellectual property rights of any third party. Vendor agrees to reim burse the State for any losses, costs, dam ages or expenses, including w ithout lim itations, reasonable attorney’s fees and expenses, arising from failure of the supplies to m eet such w arranties.

25.2.

Vendor shall insure that all m anufacturers’ w arranties are transferred to the State and shall provide a copy of the w arranty. These w arranties shall be in addition to all other w arranties, express, im plied or statutory, and shall survive the State’s paym ent, acceptance, inspection or failure to inspect the supplies.

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25.3.

Vendor w arrants that all services w ill be perform ed to m eet the requirem ents of the contract in an efficient and effective m anner by trained and com petent personnel. Vendor shall m onitor perform ances of each individual and shall reassign im m ediately any individual w ho is not perform ing in accordance w ith the contract, w ho is disruptive or not respectful of others in the w orkplace, or w ho in any w ay violates the contract or State policies.

26.

REPO

RTING, STATUS AN

D M

O N

ITO

RING SPECIFICATIO

N S: Vendor shall im m ediately notify the State of any event that m ay have a m aterial im pact on Vendor’s ability to perform the contract.

27.

EM

PLO

YM

EN

T TAX CREDIT: Vendors w ho hire qualified veterans and certain ex-offenders m ay be eligible for tax credits. 35 ILCS 5/216, 5/217. Please contact the Illinois Departm ent of Revenue (telephone #: 217-524-4772) for inform ation about tax credits.

28.

TERM

INATIO

N

FO

R CAUSE: The State m ay term inate this contract, in w hole or in part, im m ediately upon notice to the Vendor if: (a) the State determ ines that the actions or inactions of the Vendor, its agents, em ployees or subcontractors have caused, or reasonably could cause, jeopardy to health, safety, or property, or (b) the Vendor has notified the State that it is unable or unw illing to perform the contract.

28.1.

If Vendor fails to perform to the State’s satisfaction any m aterial requirem ent of this contract, is in violation of a m aterial provision of this contract, or the State determ ines that the Vendor lacks the financial resources to perform the contract, the State shall provide w ritten notice to the Vendor to cure the problem identified w ithin the period of tim e specified in the State’s w ritten notice. If not cured by that date the State m ay either: (a) im m ediately term inate the contract w ithout additional w ritten notice or (b) enforce the term s and conditions of the contract.

28.2.

For term ination due to any of the causes contained in this Section, the State retains its rights to seek any available legal or equitable rem edies and dam ages.

29.

TERM

INATIO

N

FO

R CO

N

VEN

IENCE: The State m ay, for its convenience and w ith thirty (30) days prior w ritten notice to Vendor, term inate this contract in w hole or in part and w ithout paym ent of any penalty or incurring any further obligation to the Vendor.

29.1.

The Vendor shall be entitled to com pensation upon subm ission of invoices and proof of claim for supplies and services provided in com pliance w ith this contract up to and including the date of term ination.

30.

AVAILABILITY O

F APPRO

PRIATIO

N : This contract is contingent upon and subject to the availability of funds. The

State, at its sole option, m ay term inate or suspend this contract, in w hole or in part, w ithout penalty or further paym ent being required, if (1) the Illinois General Assem bly or the federal funding source fails to m ake an appropriation sufficient to pay such obligation, or if funds needed are insufficient for any reason (30 ILCS 500/20- 60), (2) the Governor decreases the Departm ent’s funding by reserving som e or all of the Departm ent’s appropriation(s) pursuant to pow er delegated to the Governor by the Illinois General Assem bly, or (3) the

Departm ent determ ines, in its sole discretion or as directed by the O ffice of the Governor, that a reduction is necessary or advisable based upon actual or projected budgetary considerations. Contractor w ill be notified in riting of the failure of appropriation or of a reduction or decrease.

IS

TAXPAYER IDENTIFICATIO

N NUM

BER

State of IllinoisChief Procurem

Taxpayer Identification Num ber V.23.2

I certify that:

The num ber show n on this form is m y correct taxpayer identification num ber (or I am w aiting for a num ber to be issued to m e), and

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

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

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

If you are a sole proprietor, enter the ow ner’s nam e on the nam e line follow ed by the nam e of the business and the ow ner’s SSN or EIN.

If you are a single-m em ber LLC that is disregarded as an entity separate from its ow ner, enter the ow ner’s nam e on the nam e line and the D/B/A on the business nam e line and enter the ow ner’s SSN or EIN.

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

For all other entities, enter the nam e of the entity as used to apply for the entity’s EIN and the EIN.

Nam e: Holly Pruiett Business Nam e: Holly’s O ffice Solutions SDVO

SB

Taxpayer Identification Num ber:

Social Security Num ber: Click here to enter text.

or Em ployer Identification Num ber: 93-3579797

Legal Status (check one):

Individual

Governm ental

Sole Proprietor

Nonresident alien

Partnership

Estate or trust

Legal Services Corporation

Pharm acy (Non-Corp.)

Tax-exem pt

Pharm acy/Funeral Hom e/Cem etery (Corp.)

Corporation providing or billing

Lim ited Liability Com pany m edical and/or health care services

(select applicable tax classification)

Corporation NO T providing or billing

C = corporation m edical and/or health care services P = partnership

Signature of Authorized Representative:

Date: June 15, 2026