BOA Stamper.pdf

PDF 322 KB Posted Aug 3, 2026

Attached to: Open Market Small Purchase IL|27-426DOC-DANVI-P-100230
Contract number: 27-426DOC-DANVI-P-100230
Issued by: Illinois

About this file

Written by GovTribe AI · Aug 4, 2026

This is a Basic Ordering Agreement (BOA) under $50,000 between the State of Illinois, Department of Corrections, Danville Correctional Center, and Illinois Supply & Services, a limited liability company owned by Shaun Dew with an EIN of 42-2373542. The vendor is located at 900 Commerce Place, Suite #1062, Forsyth, Illinois 62535. The State Agency contact is Ashley Baker at the Danville Correctional Center, located at 3820 E Main Street, Danville, Illinois 61834. The contract is designated as Reference Number 27-426DOC-DANVI-R-331377 and was executed on July 26, 2026, with an effective date upon final signatures and a termination date of June 30, 2026. The procurement method used was a small purchase through BidBuy electronic submission.

The contract covers the purchase of one Cosco Self-inking Automatic Numbering Machine, Item #COS026138, Model #026138, at a unit price of $25.00 for a total contract value of $25.00. The acquisition type is a one-time purchase with invoice-based payment terms. Delivery is required to Danville Correctional Center's warehouse receiving dock with products to be received no later than 30 days from contract execution, Monday through Friday, 9:00 a.m. to 3:00 p.m., excluding state holidays. All pricing is F.O.B. destination with transportation and handling costs included and paid by the contractor. The contract is funded through fiscal year 2027 from the State's budget using Appropriation Account Code 001-42656-1300-1394.

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St and Terms~31.pdf	PDF	Aug 3, 2026
Unsigned BOA Stamper.docx	DOCX document	Aug 3, 2026

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R O F

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,r io ts ,l ab or di sp ut es re oo d, ex pl os io n, an d go ve rn m en ta lp ro hi bi on Th e no n-de cla rin g Pa rt ym ay ca nc el th e co nt ra ct w ith ou tp en al ty if pe rfo rm an ce do es no tr es um e w ith in th irt y (3 0) da ys of th e de cla ra on

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re ce iv ed in go od fa ith fro m a th ird

Pa rt y no ts ub je ct to an y co n de n al ity ob lig a on to th e di sc lo sin g Pa rt y;

no w is or la te rb ec om es pu bl icl y kn ow n th ro ug h no br ea ch of co n de n al ity ob lig a on by th e re ce iv in g Pa rt y;

or is in de pe nd en tly de ve lo pe d by th e re ce iv in g Pa rt y w ith ou tt he us e or be ne to ft he di sc lo sin g Pa rt y’ sc on de n al in fo rm a on

Al lw or k pe rfo rm ed or su pp lie s cr ea te d by

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Ve nd or ac kn ow le dg es th e St at e m ay us e th e w or k pr od uc t fo r an y pu rp os e.

Co n de n al da ta or in fo rm a on co nt ai ne d in su ch w or k sh al lb e su bj ec tt o co n de n al ity pr ov isi on so ft hi sc on tr ac t.

O N

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Ve nd or of an y of its ce r ca on s, re pr es en ta on s, w ar ra n es ,c ov en an ts or ag re em en ts b) an y ac tu al or al le ge d de at h or in ju ry to an y pe rs on

,d am ag e to an y re al or pe rs on al pr op er ty ,o r an y ot he rd am ag e or lo ss cla im ed to re su lt in w ho le or in pa rt fro m Ve nd or ’s ne gl ig en tp er fo rm an ce c) an y ac t, ac vi ty or om iss io n of

Ve nd or or an y of its em pl oy ee s, re pr es en ta ve s, su bc on tra ct or so ra ge nt s;

(d )a ny ac tu al or al le ge d cla im th at th e se rv ice s or go od s pr ov id ed un de rt hi s co nt ra ct in fri ng e, m isa pp ro pr ia te ,o ro th er w ise vi ol at e an y in te lle ct ua l pr op er ty

(p at en t, co py rig ht tra de se cr et or tra de m ar k) rig ht s of a th ird pa rt y.

In ac co rd an ce w ith

Ar cle

II,

Se c on

1( a) ,(b

)o ft he

Co ns tu on of th e St at e of

Ill in oi sa nd

Ill in oi s A or ne y Ge ne ra lO pi ni on

,t he

St at e m ay no ti nd em ni fy pr iva te pa r es ab se nt ex pr es ss ta tu to ry au th or ity pe rm i ng th e in de m ni ca on

Ne ith er

Pa rt y sh al lb e lia bl e fo ri nc id en ta l, sp ec ia l, co ns eq ue n al ,o rp un i ve da m ag es

Ve nd or sh al l, at al l m es du rin g th e te rm an d an y re ne w al s m ai nt ai n an d pr ov id e a Ce r ca te of In su ra nc e na m in g th e St at e as ad di on al ly in su re d fo ra ll re qu ire d bo nd sa nd in su ra nc e.

Ce r ca te sm ay no tb e m od i ed or ca nc el ed un la tl ea st th irt y(

)d ay s’ no ce ha sb ee n pr ov id ed to th e St at e.

Ve nd or sh al lp ro vi de a)

Ge ne ra lC om m er cia lL ia bi lit y oc cu rr en ce fo rm in am ou nt of $1 ,0

,0 pe ro cc ur re nc e (C om bi ne d Si ng le

Lim it

Bo di ly In ju ry an d Pr op er ty Da m ag e) an d $2 ,0

An nu al Ag gr eg at e;

(b )A ut o Lia bi lit y, in clu di ng

Hi re d Au to an d

No n-ow ne d Au to (C om bi ne d Si ng le

Lim it Bo di ly

In ju ry an d Pr op er ty

Da m ag e) in am ou nt of $1 ,0

,0 pe r oc cu rr en ce an d (c W or ke r’s

Co m pe ns a on In su ra nc e in am ou nt re qu ire d by la w.

In su ra nc e sh al ln ot lim it Ve nd or ’s ob lig a on to in de m ni fy ,d ef en d, or se le an y cla im s.

E O F

St at e of

Ill in oi sC hi ef

Pr oc ur em en tO ce Ge ne ra lS er vi ce s

A un de r$

Ve nd or sh al la ct as an in de pe nd en tc on tr ac to ra nd no ta n ag en to re m pl oy ee of ,o r jo in tv en tu re w ith th e St at e.

Al lp ay m en ts by th e St at e sh al lb e m ad e on th at ba sis

O N

Ve nd or sh al ln ot em pl oy an yp er so n em pl oy ed by th e St at e du rin g th e te rm of th is co nt ra ct to pe rfo rm an y w or k un de r th is co nt ra ct Ve nd or sh al lg iv e no ce im m ed ia te ly to th e Ag en cy ’s di re ct or if Ve nd or so lic its or in te nd st o so lic it St at e em pl oy ee st o pe rfo rm an y w or k un de rt hi sc on tr ac t.

E W

Th e Ve nd or ,i ts em pl oy ee s, ag en ts ,a nd su bc on tra ct or s sh al lc om pl y w ith al l ap pl ica bl e fe de ra l, st at e, an d lo ca ll aw s, ru le s, or di na nc es ,r eg ul a on s, or de rs ,f ed er al cir cu la rs an d al ll ice ns e an d pe rm it re qu ire m en ts in th e pe rfo rm an ce of th is co nt ra ct Ve nd or sh al lb e in co m pl ia nc e w ith ap pl ica bl e ta x re qu ire m en ts an d sh al lb e cu rr en ti n pa ym en to fs uc h ta xe s.

Ve nd or sh al lo bt ai n at its ow n ex pe ns e, al ll ice ns es an d pe rm iss io ns ne ce ss ar y fo rt he pe rfo rm an ce of th is co nt ra ct

W he ne ve r th e St at e de em s it re as on ab ly ne ce ss ar y fo rs ec ur ity re as on s, th e St at e m ay co nd uc t, at its ex pe ns e, cr im in al an d dr iv er hi st or y ba ck gr ou nd ch ec ks of Ve nd or ’s an d su bc on tra ct or ’s o ce rs em pl oy ee so ra ge nt s.

Ve nd or or su bc on tra ct or sh al lr ea ss ig n im m ed ia te ly an ys uc h in di vi du al w ho

,i n th e op in io n of th e St at e, do es no tp as st he ba ck gr ou nd ch ec k.

W Th is co nt ra ct sh al lb e co ns tr ue d in ac co rd an ce w ith an d is su bj ec tt o th e la w sa nd ru le s of th e St at e of

Ill in oi s.

L O

Th e

De pa rt m en t of

Hu m an

Ri gh ts Eq ua l Op po rt un ity re qu ire m en ts ar e in co rp or at ed by re fe re nc e.

ILL

. A

. C O

T O

An y cla im ag ai ns tt he

St at e ar isi ng ou to ft hi s co nt ra ct m us tb e le d ex clu siv el y w ith th e Ill in oi s Co ur to fC la im s.

ILC

S 5/ 1.

Th e St at e sh al ln ot en te ri nt o bi nd in g ar bi tr a on to re so lv e an y di sp ut e ar isi ng ou to ft hi sc on tr ac t.

Th e St at e of

Ill in oi sd oe s no tw ai ve so ve re ig n im m un ity by en te rin g in to th is co nt ra ct

Th e o cia lt ex to ft he st at ut es cit ed he re in is in co rp or at ed by re fe re nc e.

An un o cia l ve rs io n ca n be vi ew ed at

(w w w .il ga

.g ov /le gi sla on /il cs /il cs .a sp

-T

If Ve nd or do es no tp ur su e an y cla im or ca us e of ac on it ha sa ris in g un de rf ed er al or st at e an tr us t la w s re la ng to th e su bj ec t m a er of th e co nt ra ct ,t he n up on re qu es t of th e Ill in oi s A or ne y Ge ne ra l, Ve nd or sh al la ss ig n to th e St at e rig ht s, tle an d in te re st in an d to th e cla im or ca us e of ac on

:T he Ag en cy th at sig ns fo rt he

St at e of

Ill in oi ss ha llb e th e on ly St at e en ty re sp on sib le fo rp er fo rm an ce an d pa ym en tu nd er th e co nt ra ct W he n th e Ch ie fP ro cu re m en tO ce ro ra ut ho riz ed de sig ne e sig ns in ad di on to an Ag en cy ,t he yd o so as ap pr ov in g o ce ra nd sh al lh av e no lia bi lit y to

Ve nd or .W he n th e Ch ie f

Pr oc ur em en tO ce ro ra ut ho riz ed de sig ne e, or

St at e Pu rc ha sin g O ce rs ig ns a m as te rc on tr ac to n be ha lf of

St at e ag en cie s, on ly th e Ag en cy th at pl ac es an or de rw ith th e Ve nd or sh al lh av e an y lia bi lit y to

Ve nd or fo rt ha to rd er

Ex ce pt in lim ite d cir cu m st an ce s, no bu sin es s or m em be ro fa un ita ry bu sin es sg ro up

,a s de ne d in th e Ill in oi s In co m e Ta x Ac t, sh al ls ub m it a bi d fo ro re nt er in to a co nt ra ct w ith a St at e ag en cy if th at bu sin es so ra ny m em be ro ft he un ita ry bu sin es sg ro up is an ex pa tr ia te d en ty

E O F

St at e of

Ill in oi sC hi ef

Pr oc ur em en tO ce Ge ne ra lS er vi ce s

A un de r$

No ce s an d ot he r co m m un ica on s pr ov id ed fo r he re in sh al lb e gi ve n in w ri ng vi a el ec tr on ic m ai l w he ne ve rp os sib le .I ft ra ns m iss io n vi ae le ct ro ni cm ai lis no tp os sib le ,t he n no ce sa nd ot he rc om m un ica on ss ha ll be gi ve n in w ri ng vi a re gi st er ed or ce r ed m ai lw ith re tu rn re ce ip tr eq ue st ed

,v ia re ce ip te d ha nd de liv er y, vi a co ur ie r(

S, Fe de ra lE xp re ss or ot he rs im ila ra nd re lia bl e ca rr ie r), or vi a fa cs im ile sh ow in g th e da te an d m e of su cc es sf ul re ce ip t.

No ce ss ha ll be se nt to th e in di vi du al sw ho sig ne d th is co nt ra ct us in g th e co nt ac ti nf or m a on fo llo w in g th e sig na tu re s.

Ea ch su ch no ce sh al lb e de em ed to ha ve be en pr ov id ed at th e m e it is ac tu al ly re ce iv ed

By gi vi ng no ce ,e ith er Pa rt y m ay ch an ge its co nt ac ti nf or m a on

M O

Am en dm en ts ,m od i ca on s an d w ai ve rs m us t be in w ri ng an d sig ne d by au th or ize d re pr es en ta ve so ft he

Pa r es .A ny pr ov isi on of th is co nt ra ct o cia lly de cla re d vo id ,u ne nf or ce ab le ,o r ag ai ns tp ub lic po lic y, sh al lb e ig no re d an d th e re m ai ni ng pr ov isi on ss ha ll be in te rp re te d, as fa ra sp os sib le ,t o gi ve e ec t to th e Pa r es ’i nt en t.

Al lp ro vi sio ns th at by th ei r na tu re w ou ld be ex pe ct ed to su rv iv e, sh al ls ur vi ve te rm in a on .I n th e ev en to fa co n ict be tw ee n th e St at e’ s an d th e Ve nd or ’s te rm s, co nd i on sa nd a ac hm en ts th e St at e’ st er m s, co nd i on sa nd a ac hm en ts sh al lp re va il.

Up on re qu es to ft he

St at e, Ve nd or sh al lm ee tt o di sc us sp er fo rm an ce or pr ov id e co nt ra ct pe rfo rm an ce up da te st o he lp en su re pr op er pe rfo rm an ce of th e co nt ra ct .T he St at e m ay co ns id er

Ve nd or ’s pe rfo rm an ce un de rt hi sc on tr ac ta nd co m pl ia nc e w ith la w an d ru le to de te rm in e w he th er to co n nu e th e co nt ra ct ,s us pe nd Ve nd or fro m do in g fu tu re bu sin es s w ith th e St at e fo ra sp ec i ed pe rio d of m e, or w he th er

Ve nd or ca n be co ns id er ed re sp on sib le on sp ec i cf ut ur e co nt ra ct op po rt un i es

M O F

Th is co nt ra ct an d al lr el at ed pu bl ic re co rd s m ai nt ai ne d by ,p ro vi de d to or re qu ire d to be pr ov id ed to th e St at e ar e su bj ec tt o th e Ill in oi s Fr ee do m of

In fo rm a on

Ac t(

ILC

S 0) no tw ith st an di ng an y pr ov isi on to th e co nt ra ry th at m ay be fo un d in th is co nt ra ct

O F W O

An y w or k pe rfo rm ed on

St at e pr em ise ss ha ll be do ne du rin g th e ho ur s de sig na te d by th e

St at e an d pe rfo rm ed in a m an ne rt ha td oe sn ot in te rfe re w ith th e St at e an d its pe rs on ne l.

Ve nd or w ar ra nt s th at th e su pp lie s fu rn ish ed un de r th is co nt ra ct w ill (a co nf or m to th e st an da rd s, sp ec i ca on s, dr aw in g, sa m pl es or de sc rip on s fu rn ish ed by th e St at e or fu rn ish ed by th e Ve nd or an d ag re ed to by th e St at e, in clu di ng bu tn ot lim ite d to al ls pe ci ca on s a ac he d as ex hi bi ts he re to b) be m er ch an ta bl e, of go od qu al ity an d w or km an sh ip ,a nd fre e fro m de fe ct sf or a pe rio d of tw el ve m on th so r lo ng er if so sp ec i ed in w ri ng ,a nd ta nd su cie nt fo rt he in te nd ed us e;

(c )c om pl y w ith al lf ed er al an d st at e la w s, re gu la on s an d or di na nc es pe rta in in g to th e m an uf ac tu rin g, pa ck in g, la be lin g, sa le an d de liv er yo ft he su pp lie s;

(d )b e of go od tle an d be fre e an d cle ar of al lli en sa nd en cu m br an ce sa nd e) no t in fri ng e an y pa te nt ,c op yr ig ht or ot he ri nt el le ct ua lp ro pe rt y rig ht s of an y th ird pa rt y.

Ve nd or ag re es to re im bu rs e th e St at e fo ra ny lo ss es ,c os ts ,d am ag es or ex pe ns es ,i nc lu di ng w ith ou tl im ita on s, re as on ab le a or ne y’ sf ee sa nd ex pe ns es ,a ris in g fro m fa ilu re of th e su pp lie st o m ee ts uc h w ar ra n es

Ve nd or sh al lin su re th at al lm an uf ac tu re rs ’w ar ra n es ar e tra ns fe rr ed to th e St at e an d sh al lp ro vi de a co py of th e w ar ra nt y.

Th es e w ar ra n es sh al lb e in ad di on to al lo th er w ar ra n es ,e xp re ss ,im pl ie d or st at ut or y, an d sh al ls ur vi ve th e St at e’ sp ay m en t, ac ce pt an ce ,i ns pe c on or fa ilu re to in sp ec tt he su pp lie s.

E O F

St at e of

Ill in oi sC hi ef

Pr oc ur em en tO ce Ge ne ra lS er vi ce s

A un de r$

Ve nd or w ar ra nt s th at al ls er vi ce s w ill be pe rfo rm ed to m ee t th e re qu ire m en ts of th e co nt ra ct in an e cie nt an d e ec ve m an ne rb y tra in ed an d co m pe te nt pe rs on ne l.

Ve nd or sh al lm on ito rp er fo rm an ce s of ea ch in di vi du al an d sh al lr ea ss ig n im m ed ia te ly an yi nd iv id ua lw ho is no tp er fo rm in g in ac co rd an ce w ith th e co nt ra ct ,w ho is di sr up ve or no tr es pe c ul of ot he rs in th e w or kp la ce ,o rw ho in an yw ay vi ol at es th e co nt ra ct or

St at e po lic ie s.

G, ST

D M O

N S:

Ve nd or sh al lim m ed ia te ly no fy th e St at e of an y ev en t th at m ay ha ve a m at er ia li m pa ct on

Ve nd or ’s ab ili ty to pe rfo rm th e co nt ra ct

Ve nd or sw ho hi re qu al i ed ve te ra ns an d ce rt ai n ex -o en de rs m ay be el ig ib le fo rt ax cr ed its .3

ILC

S 5/ 6, 5/ 7.

Pl ea se co nt ac tt he

Ill in oi sD ep ar tm en to fR ev en ue (te le ph on e 7- 4-

)f or in fo rm a on ab ou tt ax cr ed its

Th e St at e m ay te rm in at e th is co nt ra ct ,i n w ho le or in pa rt ,i m m ed ia te ly up on no ce to th e Ve nd or if:

(a th e St at e de te rm in es th at th e ac on s or in ac on s of th e Ve nd or ,i ts ag en ts ,e m pl oy ee s or su bc on tra ct or sh av e ca us ed

,o rr ea so na bl y co ul d ca us e, je op ar dy to he al th ,s af et y, or pr op er ty ,o r( b) th e Ve nd or ha sn o ed th e St at e th at it is un ab le or un w ill in g to pe rfo rm th e co nt ra ct

If Ve nd or fa ils to pe rfo rm to th e St at e’ s sa sfa c on an y m at er ia lr eq ui re m en t of th is co nt ra ct is in vi ol a on of am at er ia lp ro vi sio n of th is co nt ra ct ,o rt he

St at e de te rm in es th at th e Ve nd or la ck st he na nc ia l re so ur ce st o pe rfo rm th e co nt ra ct ,t he

St at e sh al lp ro vi de w ri en no ce to th e Ve nd or to cu re th e pr ob le m id en ed w ith in th e pe rio d of m e sp ec i ed in th e St at e’ s w ri en no ce .I fn ot cu re d by th at da te th e

St at e m ay ei th er a) im m ed ia te ly te rm in at e th e co nt ra ct w ith ou ta dd i on al w ri en no ce or

(b )e nf or ce th e te rm sa nd co nd i on so ft he co nt ra ct

Fo rt er m in a on du e to an y of th e ca us es co nt ai ne d in th is Se c on

,t he

St at e re ta in si ts rig ht st o se ek an y av ai la bl e le ga lo re qu ita bl e re m ed ie sa nd da m ag es

Th e St at e m ay ,f or its co nv en ie nc e an d w ith th irt y (3 0) da ys pr io r w ri en no ce to

Ve nd or ,t er m in at e th is co nt ra ct in w ho le or in pa rt an d w ith ou tp ay m en to fa ny pe na lty or in cu rr in g an y fu rt he ro bl ig a on to th e Ve nd or

Th e Ve nd or sh al lb e en tle d to co m pe ns a on up on su bm iss io n of in vo ice sa nd pr oo fo fc la im fo rs up pl ie s an d se rv ice sp ro vi de d in co m pl ia nc e w ith th is co nt ra ct up to an d in clu di ng th e da te of te rm in a on

O F

O N:

Th is co nt ra ct is co n ng en tu po n an d su bj ec tt o th e av ai la bi lit y of fu nd s.

Th e

St at e, at its so le op on ,m ay te rm in at e or su sp en d th is co nt ra ct ,i n w ho le or in pa rt ,w ith ou tp en al ty or fu rt he r pa ym en t be in g re qu ire d, if (1 th e Ill in oi s Ge ne ra lA ss em bl y or th e fe de ra lf un di ng so ur ce fa ils to m ak e an ap pr op ria on su cie nt to pa y su ch ob lig a on ,o ri ff un ds ne ed ed ar e in su cie nt fo ra ny re as on

ILC

S 0/

(2 th e Go ve rn or de cr ea se s th e De pa rt m en t’s fu nd in g by re se rv in g so m e or al l of th e De pa rt m en t’s ap pr op ria on

(s pu rs ua nt to po w er de le ga te d to th e Go ve rn or by th e Ill in oi s Ge ne ra l As se m bl y, or (3 th e

De pa rt m en t de te rm in es ,i n its so le di sc re on or as di re ct ed by th e O ce of th e Go ve rn or ,t ha ta re du c on is ne ce ss ar y or ad vi sa bl e ba se d up on ac tu al or pr oj ec te d bu dg et ar y co ns id er a on s.

Co nt ra ct or w ill be no ed in w ri ng of th e fa ilu re of ap pr op ria on or of a re du c on or de cr ea se

E O F

O N

St at e of

Ill in oi sC hi ef

Pr oc ur em en tO ce Ge ne ra lS er vi ce s

Ta xp ay er

Id en ca on

Nu m be r V.

Ic er fy th at

Th e nu m be rs ho w n on th is fo rm is m y co rr ec tt ax pa ye ri de n ca on nu m be r( or

Ia m w ai ng fo ra nu m be rt o be iss ue d to m e) ,a nd

Ia m no ts ub je ct to ba ck up w ith ho ld in g be ca us e:

(a )I am ex em pt fro m ba ck up w ith ho ld in g, or

(b )I ha ve no tb ee n no ed by th e In te rn al Re ve nu e Se rv ice

(IR

S) th at Ia m su bj ec tt o ba ck up w ith ho ld in g as a re su lt of a fa ilu re to re po rt al li nt er es to r di vi de nd s, or

(c )t he

S ha sn o ed m e th at

Ia m no lo ng er su bj ec tt o ba ck up w ith ho ld in g, an d

Ia m a U.

pe rs on

(in clu di ng a U.

re sid en ta lie n)

If yo u ar e an in di vi du al ,e nt er yo ur na m e an d

N as it ap pe ar so n yo ur

So cia lS ec ur ity

Ca rd

If yo u ar e as ol e pr op rie to r, en te rt he ow ne r’s na m e on th e na m e lin e fo llo w ed by th e na m e of th e bu sin es s an d th e ow ne r’s

N or

If yo u ar e a sin gl e-m em be rL

th at is di sr eg ar de d as an en ty se pa ra te fro m its ow ne r, en te rt he ow ne r’s na m e on th e na m e lin e an d th e D/ B/ A on th e bu sin es sn am e lin e an d en te rt he ow ne r’s

N or

If th e

C is a co rp or a on or pa rt ne rs hi p, en te rt he en ty ’s bu sin es sn am e an d

N an d fo rc or po ra on s, a ac h

S ac ce pt an ce le er

(C P2 or

Fo ra ll ot he re n es , e nt er th e na m e of th e en ty a s u se d to a pp ly fo r t he e n ty ’s

N an d th e

Na m e:

S ha un D ew Bu sin es s N am e:

Il lin oi s S up pl y

S er vi ce s

Ta xp ay er

Id en ca on

N um be r:

So cia lS ec ur ity

Nu m be r:

Cl ick he re to en te rt ex t.

or Em pl oy er

Id en ca on

Nu m be r:

-2

Le ga lS ta tu s( ch ec k on e)

In di vi du al Go ve rn m en ta l

So le Pr op rie to r

No nr es id en ta lie n

Pa rt ne rs hi p

Es ta te or tr us t

Le ga lS er vi ce sC or po ra on

Ph ar m ac y (N on

-C or p.

Ta x-ex em pt Ph ar m ac y/ Fu ne ra lH om e/ Ce m et er y (C or p.

Co rp or a on pr ov id in g or bi lli ng

Lim ite d Lia bi lit y Co m pa ny m ed ica la nd

/o rh ea lth ca re se rv ic es

(s el ec ta pp lic ab le ta x cla ss i ca on

Co rp or a on

T pr ov id in g or bi lli ng

C co rp or a on m ed ica la nd

/o rh ea lth ca re se rv ic es

P pa rt ne rs hi p

Si gn at ur e of

Au th or ize d Re pr es en ta ve

Da te :7 /2 6/

File details come from the government source that posted it. Updated Aug 4, 2026.