BB PO P-86356 Net Inclusion Registration - Vendor Signed.pdf
PDF 32 KB Posted
- Contract number
- 26-420DCEO-STRTC-P-86356
- Issued by
- Illinois
About this file
This document is a State of Illinois Purchase Order issued by the CEO - Commerce and Economic Opportunity, with Purchase Order Number 26-420DCEO-STRTC-P-86356. The vendor is the National Digital Inclusion Alliance, located in Columbus, Ohio, with contact information including an email and phone number. The purchase order is for the state agency's procurement of conference registrations.
The purchase order covers 6 registrations for the DCEO - RED Net Inclusion Conference, with a total cost of $2,730.00. The contract period runs from 09/12/2025 to 02/28/2026. There are no discounts, taxes, or freight charges applied. The purchase order follows standard State of Illinois agency procurement requirements, including the need for full execution of the contract prior to commencing work. The document includes signature lines for various official approvals, with the vendor representative (Caitlin Kvammen, Director of Operations) signing on 10.25.
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Text version
26-420DCEO-STRTC-P-86356
Vendor Number: V00039360 National Digital Inclusion Alliance
3000 E Main St #50 Columbus, OH 43209 caitlin@digitalinclusion.org
(614) 593-9986
Purchase Order
CEO - Commerce and Economic Opportunity
26-420DCEO-STRTC-P-
86356
Contract/Ob #:
Purchase Order Number
Master Contract? N
S H I P
T O
Agency Procurement Officer 1011 S Second St Springfield, IL 62704
US
Email: ceo.procurement@illinois.gov
(217) 524-8148
VENDOR INSTRUCTIONS:
PURCHASE ORDER REQUIREMENTS - STATE OF ILLINOIS AGENCIES
Prior to commencement of billable work, delivery of supplies or rendering of any service on a Purchase Order:
--Initial Purchase Order/Contract - All parties, including the State and vendor, must fully execute the contract in its entirety.
--Release from an existing Purchase Order/Contract - The vendor must receive a Purchase Order signed by the State Agency and attached in BidBuy. Note, for any additional requirements see specific State Agency instruction.
PURCHASE ORDERS REQUIREMENTS - OTHER PURCHASING ENTITIES
--Please see specific requirements provided by the purchasing entity.
B I L L
T O
Financial Management 1011 S Second St Springfield, IL 62704
US
Email: ceo.accountspayable@illinois.gov
(217) 524-8148
Solicitation (Bid) No.: N/A
Shipping Method:
Shipping Terms:
Contract Begin Date: 09/12/2025 Contract End Date: 02/28/2026
V E N D O R
Freight Terms:
Payment Terms: NA
Delivery Calendar Day(s) A.R.O.: 0
Item # 1
Class-Item 963-37
DCEO - RED Net Inclusion Conf. Registration - 6 Registrations
Quantity UOMUnit Price Discount % Total Discount
Tax Rate Tax Amount
Freight Total Cost
1.00 EA$ 2,730.00 0.00 % $ 0.00 $ 0.00 $ 0.00 $ 2,730.00
TOTAL: $ 2,730.00
TAX: $ 0.00
FREIGHT: $ 0.00
26-420DCEO-STRTC-P-86356
APPROVED
By:
Phone#:
Elizabeth Fuiten
(217) 786-1795
BUYER
The undersigned agree to the Terms and Conditions as acknowledged by the Vendor and maintained in the State of Illinois' e-procurement system. This agreement consists of all terms as maintained in the state's e-procurement system inclusive of attached documents. The Vendor affirms that the Certifications and Financial Disclosures and Conflicts of Interest are true and accurate as of the date of the Vendor's execution of this Agreement. State documents will prevail in the event of a conflict between State and Vendor documents and information. The undersigned agree to the Terms and Conditions of this agreement:
OFFICIAL SIGNATURES:
Vendor Name: _______________________________
Vendor Signature: _________________________________
Printed Name: ______________________________
Title: _____________________________________
Phone #: ___________________________________
Email:______________________________________
Date: ______________________________________
State of Illinois Agency or Other Purchasing Entity Procuring State Agency or Entity: __________
Official Signature: _________________________________
Printed Name: ______________________________
Title: _____________________________________
Designee Signature: ________________________
Printed Name: ______________________________
Title: _____________________________________
Date: ______________________________________
Legal Signature: _________________________________
Printed Name: ______________________________
Title: _____________________________________
Date: ______________________________________
Fiscal Signature: _________________________________
Printed Name: ______________________________
Title: _____________________________________
Date: ______________________________________
FOR STATE OF ILLINOIS USE ONLY:
Acq. Type: ________________Source Sel. Method: _______________ Using Agency Funding Source:__________________________________ Detailed Expenditure Object Code:_____________________________ Approp. Acct Code: ___________________________________________ Award Code: __________________________________________________ Original Proc. Method:________________________________________ Subcontractors Disclosed:_____________________________________ Subcontractors Utilized:______________________________________ Publication Date:____________________ Financing Needed:_______ IPG Cert/Disclosure Yes_________ No__________________________ caitlin@digitalinclusion.org Free text National Digital Inclusion Alliance caitlin@digitalinclusion.org Signature caitlin@digitalinclusion.org Free text Caitlin Kvammen caitlin@digitalinclusion.org Free text Director of Operations caitlin@digitalinclusion.org Free text 614-593-9986 caitlin@digitalinclusion.org Free text Caitlin@digitalinclusion.org caitlin@digitalinclusion.org Free text 10.2.25
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