90 Brett Clark.pdf
PDF 79 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 Brett Clark, an employee of the State of Illinois. The form was completed on May 14, 2026, and took 73 minutes and 40 seconds to submit. Clark is employed in the Petroleum & Chemical Safety Division and works at the state office located at 1035 Stevenson Drive, Springfield, Illinois 62703-4359.
Clark selected a re-order option with no changes to his existing business cards. He requested 500 business cards to be delivered to the Springfield location. The cards will display his name as Brett Clark with his title as Storage Tank Safety Specialist. His contact information includes office number 217-785-1020, cell number 309-520-3679, and email address Brett.Clark2@illinois.gov. The form notes field for fax number contains the text "Need more business cards," indicating this may have been a notation rather than an actual fax number. No changes, notes, or additions were specified in the designated field on the form.
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Other files
| File | Type | Posted |
|---|---|---|
| 89 Robert Gorman.jpg | JPG image | |
| 89 - Robert Gorman.pdf | ||
| 90 Brett Clark.jpg | JPG image |
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Text version
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Brett Clark 73:40 Time to complete
Respondent
Re-order with NO CHANGES
Re-Order, SEE CHANGES BELOW
New Order
Order Request * 1.
IMG_1535.JPG Buisness Card_Brett Clark.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.
5/14/26, 1:08 PM Business Card Request Form https://forms.office.com/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=nwgia7qOPEaE9TFxIQ-QBYd4wejjQSBNhNZZyWb… 1/3 https://ilgov-my.sharepoint.com/personal/clint_everetts_illinois_gov/Documents/Apps/Microsoft%20Forms/Business%20Card%20Request%20Form/Question/IMG_1535.JPG%20Buisness%20Card_Brett%20Clark.JPG
Division * 3.
Petroleum & Chemical Safety
Name (as appears on card) * 4.
Brett Clark
Title * 5.
Storage Tank Safety Specialist
Address * 6.
1035 Stevenson Drive Springfield, IL 62703-4359
Office Number * 7.
217-785-1020
Cell Number * 8.
309-520-3679
Fax Numer * 9.
Need more business cards
5/14/26, 1:08 PM Business Card Request Form https://forms.office.com/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=nwgia7qOPEaE9TFxIQ-QBYd4wejjQSBNhNZZyWb… 2/3
Email * 10.
Brett.Clark2@illinois.gov
List of changes, notes, or additions11.
Quantity * 12.
Springfield
Chicago
Deliver to * 13.
5/14/26, 1:08 PM Business Card Request Form https://forms.office.com/Pages/DesignPageV2.aspx?origin=NeoPortalPage&subpage=design&id=nwgia7qOPEaE9TFxIQ-QBYd4wejjQSBNhNZZyWb… 3/3
File details come from the government source that posted it. Updated .