Executed Contract P-98232 SUP 5 Day Janitorial L6345 Chicago_Redacted.pdf

of all daily cleaning assignments and annual schedule for accomplishment of all work specified to be performed once a week or less frequently.

1.3.3. Janitorial personnel must sign in upon entering the premises and sign out upon leaving.

The Sign-In/Sign-Out sheets will be provided by the Facility Manager and maintained on site. Verification of work performed will be based upon these sheets and visual inspection. Any days that janitorial personnel are to be on the premises cleaning and they do not sign-in or sign-out, will be considered a day of no work. The State will deduct a per diem rate based upon the monthly fee divided by the number of days to be worked in that month. For Example: If the monthly rate is $2,000 and there are 20 days of work that month, then $2,000 / 20 = $100 per day. That monthly rate of $2,000 will be deducted by $100 for each day the janitorial personnel does not sign-in or sign-out or does not perform the required tasks as outlined in Section 1.2 of the contract.

1.3.4. Vendor is required to utilize only employees that receive a W-9 and are covered under the Vendor's Workman Compensation Plan as well as Vendor's Liability Insurance. Vendor shall submit proof of insurance (ACCORD) that lists the actual work location address on the form. This shall include applicable liability and work compensation. This shall be submitted to the State Facility Manager along with the plan outlined in Section 1.3.2.

1.3.5. Fill in the number of estimated monthly hours anticipated to cover all services outlined in the contract. -'9""'0=---

1.3.6. Fill in the number of employees anticipated to cover the required minimum hours per month listed above to complete all requirements of the contract: ----=2=-----

1.3.7. Vendor shall designate an employee to be the contact person for this contract. The name, phone number, and email address of that designee shall be provided by the Vendor below.

Contact Name: -----=G=e=ne=-=Sa=m.a.=.p;;..;:ra=c __ t ______ (Vendor to complete)

Contact Phone: -----'-7=0=8-..;:;;5=2 =2-..;:;;3.;:;.9 ..... 46�----- (Vendor to complete)

Contact Email: _ _______ (Vendor to complete)

1.3.8. Vendor shall provide reporting to CMS Bureau of Strategic Sourcing (CMS BOSS) if requested. Reporting may include but not be limited to, annual veteran hiring, contract usage, and payments to approved subcontractors certified through the State of Illinois'

Business Enterprise Program, if applicable.

A} The information to be submitted in a format designated by CMS BOSS (e.g., Excel spreadsheet, portal). Contract usage reporting must include payments received from all State Agencies, governmental units, and qualified not-for-profit agencies as applicable to this contract.

State of Illinois Contract v.25.4 gsampract@sertomastar.org

0 Public Works Requirements (construction and maintenance of a public work} 820 ILCS

130/4.

Prevailing Wage Uanitorial deaning, window cleaning, building and grounds, site technician, natural resources, food services, security services, and printing, if valued at more than $200 per month or $2,000 per year) 30 ILCS 500/25-60. Information on prevailing wage may be obtained at https://www2.illinois.gov/idol/Pages/default.aspx

0 Agency Specific Terms and Conditions

0 Other (describe)

6. ATTACHMENTS

6.1.

State of Illinois Contract v.25.4

Financial Disclosures (including Illinois Procurement Gateway print-off if applicable)

AGENCV USE ONLY NOT PART OF CONTRACTUAL PROVISIONS

• Agency Reference #: 26-416CMS-BOPM4-R-314595

• Project Title: SUP 5 Day Janitorial L6345 Chicago

• Contract #: 26-416CMS-BOPM4-P-98232

• Procurement Method {IFB, RFP, Small Purchase, etc.): State Use

• Bid Buy/ Bulletin Reference#: 26-416CMS-BOPM4-B-52923

• BidBuy / Bulletin Publication Date: 06/15/26

• Award Code: H

• Subcontractor Utilization? D Yes l2SJ No Subcontractor Disclosure? D Yes IZJ No

• Funding Source:

• Obligation #:

• Small Business Set-Aside? D Yes� No

• Minority Owned Business? 0 Yes� No

• Women Owned Business? D Yes� No

• Persons with Disabilities Owned Business? 0 Yes IZJ No

• Veteran Owned Small Business? D Yes � No

• Other Preferences?

State of lllinois Contract v.25.4

Percentage:

Percentage:

Percentage:

Percentage:

Percentage:

STATE OF ILLINOIS

IPG ACTIVE REGISTERED VENDOR DISCLOSURE

(formerly named FORMS B)

BidBuy Reference #: 26-416CMS-BOPM4-B-52923 Procurement/Contract#: 26-416CMS-BOPM4-P-98232

** STOP and READ THIS •• You may only submit this form if you have an ACTNE (unexpired and approved) registration in the Jllinois Procurement Gateway.

This IPG Active Registered Vendor Disclosure may be used when responding to an Invitation for Bid (IFB) or a Request for Proposal (RFP) if the vendor is registered in the Illinois Procurement Gateway (IPG) and has an active State of Illinois Vendor Registration Number. The IPG assigns each vendor a unique State of Illinois Vendor Registration Number and expiration date upon the Chief Procurement Office's acceptance of the vendor's IPG application.

If a vendor does not have an active State of Illinois Vendor Registration Number, then the vendor must complete and submit Vendor Disclosure (formerly named Forms A) with their response. Failure to do so may render the submission non-responsive and result In disqualification.

Please read this entire section and provide the requested information as applicable. All parts in the IPG Acti"e Registered Vendor Disdosure must be completed in full and submitte� along with the vendor's bid, offer, or response.

1. Certification of Illinois Procurement Gateway Registration My business has an active State of Illinois Vendor Registration Number.

To ensure that you have an active registration in the IPG, search for your business name In the IPG Registered Vendor Directory. If your company does not appear in the search results, then you do not have an active IPG registration.

State of Illinois Vendor Registration Number: IPG-0675632

IPG Expiration Date: 02/03/2027

2. Certification Timely to this Solicitation or Contract Vendor certifies it is not barred from having a contract with the State based upon violating the prohibitions related to either submitting/writing specifications or providing assistance to an employee of the State of Illinois by reviewing, drafting, directing, or preparing any invitation for bids, a request for proposal, or request of !!!_n,mation, or similar assistance (except as part of a public requestfor such information). 30 ILCS 500/50-10.5(e).

lJd'Yes D No

3. Disclosure of Lobbyist or Agent (Complete only if bid, offer, or contract has an annual value over $100,000) Is your company or parent entity(ies) represented by or do you or your parent entfty(les) employ a lobbyist required to register under the Lobbyis t Registration Act (lobbyist mu·st be registered pur5uant to the Act with the Secretary of State) or an agent who has communicated, is communicating, or may communicate with any State officer or employee concerning the bi�ffer? If yes, please identify each lobbyist and agent, including the name and address below. D Yes [B'°No, If yes, please identify each lobbyist and agent. including the name and address below. If you have a lobbyist that does not meet the criteria, then you do not have to disclose the lobbyist's information. Additional rows may be inserted into the table or an attachment may be provided if needed.

State of Hlfnois Chklf Procurement Office for General Services IPG Active Regfstll!R!d Vendcr Disclosure

V.26.1

STATE OF ILUNOIS

IPG ACTIVE REGISTERED VENDOR DISCLOSURE

(formerly named FORMS B)

Name Address Relationship to Disclosing Entity

De.scribe all costs/fees/compensation/reimbursements related to the assistance pr ovided by each representative lobbyist or other agent to obtain this Agency contract:

4. Disclosure of Current and Pending Contracts

Complete only if: (a) your business is for-profit and (b) the bid, offer, or contract has an annual value over

$100,000. Do not complete if you are a not-for-profit entity.

D Yes D No. Do you have any contracts, pending contracts, bids, proposals, subcontracts, leases or other ongoing procurement relationships with units of State of Illinois government?

lf "Yes", please specify below. Additional rows may be inserted into the table or an attachment in the same format may be provided if needed.

Agency Project Title Status Value Contract

Reference/P.O./IIDnols

Procurement Bulletin#

5. Vendor certifies that no procurement or laundering of apparel provided to the State under the contract has been or will be provided through the use of forced labor exploitation. 30 ILCS 500/25-210.

6. Signature

As of the date signed below, I certify that:

• My business' information and the certifications made in the Illinois Procurement Gateway are truthful and accurate.

• The certifications and disclosures made in this IPG Active Registered Vendor Disclosure are truthful and accurate.

This IPG Active Registered Vendor Disclosure is signed by an authorized officer or employee on behalf of the bidder, offerer, or vendor pursuant to Sections 50-13 and 50-35 of the Illinois Procurement Code, and the affirmation of the accuracy of the financial disclosures is made under penalty of perjury.

This disclosure information is submitted on behalf of:

Vendor Name: Sertoma Star Services Phone: 708-371-9700

Street Address: 4343 West 123rd Street Email: bdunlap@sertomastar.org

City, State, Zip: Alsip IL 60803 Vendor Contact: Gene Sampract

State of llllnols Chief Procurement Office for General Services 2

IPG Active Registered Vendor Disclosure

STATE OF ILLINOIS

TAXPAYER IDENTIFICATION NUMBER

I certify that:

The number shown on th is 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) l 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 EJN.

• 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/8/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 CP2n).

• For all other entities, enter the name of the entity as used to apply for the entity's EIN and the EIN.

Name: Sertoma Star Sertives

Business Name: Sertoma Star Services

Taxpayer Identification Number:

Social Security Number:

or

Employer Identification Number:

Legal Status (check one):

0 Individual

0 Sole Proprietor

D Partnership

D L� Services Corporation

0'rax-exempt D Corporation providing or billing medical and/or health care services D Corporation NOT providing or billing medical and/or health care services

• i • ture of-A�nzed ·R

Date: May 28, 2026

0 Governmental

D Nonresident alien

D Estate or trust D Pharmacy (Non-Corp.)

D Pharmacy/Funeral Home/Cemetery (Corp.)

D Limited Liability Company

(select applicable tax classification) D C = corporation D P = partnership

Stall! of Illinois Olief Procurement Office for General Services I PG Active Resistared Vendor Disclosure

Overview Section

Overview Supplier Name Sertoma Star Services, Inc. IPG NUMBER IPG-0675632

SUBMIT DATE 02/02/2026 REVIEW DATE 02/02/2026

STATUS Active (Accepted) FLAGS Yes

DBA COMPANY NAME

ADDRESS 4343 West 123rd Street, Alsip, Illinois, United States, 60803

REGISTERING AS A Prime SMALL BUSINESS SET-ASIDE

PROGRAM (SBSP)

REGISTERED

No

General Information

Overview BUSINESS NAME Sertoma Star Services, Inc. DBA NAME

FEDERAL EMPLOYER ID

NUMBER

23-7294685

Corporate Headquarters COMPANY ADDRESS LINE 1 4343 West 123rd Street CITY Alsip

COUNTY Cook STATE Illinois

ZIP/POSTAL CODE 60803 COMPANY PHONE (708) 371-9700

COMPANY FAX (708) 371-9747 COMPANY EMAIL bdunlap@sertomastar.org

COMPANY WEBSITE www.sertomastar.org

Primary Contact CONTACT NAME Bryan Dunlap TITLE Chief Business Officer

PHONE NUMBER (708) 371-9700 MOBILE NUMBER (708) 937-5048

FAX NUMBER (708) 371-9747 EMAIL bdunlap@sertomastar.org

NIGP Information

NIGP Codes 910 - 03 - Building Cleaning Services, Exterior

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(Sertoma Star Services, Inc.)

Active (Accepted)

910 - 25 - Flooring Maintenance and Repair, Including Refinishing and Sealing Services

910 - 39 - Janitorial and Custodial Services

915 - 58 - Mailing Services: Addressing, Collating, Packaging, Sorting and Delivery

926 - 77 - Recycling Services

952 - 08 - Assisted Living Services

952 - 15 - Case Management

952 - 39 - Employment Generating Activities

952 - 59 - Human Services (Not Otherwise Classified)

961 - 26 - Material Handling Services: Crating and Packing Services for Transportation

Ownership Information

Ownership Information COMPANY TYPE Non Profit COMPANY ETHNICITY

Form A. Business Information

A. Business Information

1. Your Business is registering as a

Prime 2. Name of CEO/Business Owner

Kelly Berardelli

3. Annual Sales/Gross Receipts

7500000 4. When was your Business Established?

07/27/1973

5. In what ILLINOIS County (ies) are you conducting Business?

The business conducts business statewide

6. Contact Person for this Vendor Registration

Bryan Dunlap

Contact Person Title Chief Business Officer Contact Person Phone 7083719700

Contact Person Email bdunlap@sertomastar.org

Form B. Additional Information

B. Additional Information

1. How did you learn about the Illinois Procurement Gateway? (Select ALL that apply)

Other Name of referral Have been a vendor for over 50 years

Form C. Small Business Set-Aside Program

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C. Small Business Set-Aside Program

1. Would you like to apply or requalify for the Small Business Set Aside Program

No

Form D. Department of Human Rights (DHR)

D. Department of Human Rights (DHR)

1. Highest number of employees (including full and part time employees) at any time during the past year

630 2. Select the DHR Status of your Business

My Business had 15 or more employees at any time within the past year

Enter Illinois DHR Public Contract Number

94951-00

Form E. Authorized to do Business in Illinois

E. Authorized to do Business in Illinois Is your Business Registered and Authorized to do business in Illinois?

Yes - registered and in good standing with the Illinois Secretary of State

Form F. Certifications

F. Certifications

1. Vendor certifies it is not prohibited by federal agencies pursuant to a United States Department of Homeland Security Binding Operational Directive due to cybersecurity risks. 30 ILCS 500/25-90

Yes 2. This applies to individuals, sole proprietorships, general partnerships, and single member LLCS, but is not otherwise applicable. Vendor certifies he/she is not in default on an educational loan. 5 ILCS 385/3

N/A

3. Vendor certifies that it has reviewed and will comply with the Department of Employment Security Law (20 ILCS 1005/1005-47) as applicable

Yes 4. Vendor certifies it has neither been convicted of bribing or attempting to bribe an Officer or Employee of the State of Illinois or any other State, nor made an admission of guilt of such conduct that is a matter of record. 30 ILCS 500/50-5

Yes

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5. If Vendor has been convicted of a felony, vendor certifies at least five years have passed since the date of completion of the sentence for such felony, unless no person held responsible by a prosecutor's office for the facts upon which the conviction was based continues to have any involvement with the business. vendor further certifies that it is not barred from being awarded a contract. 30 ILCS 500/50-10

Yes 6. If vendor or any Officer, Director, Partner, or other Managerial Agent of Vendor has been convicted of a felony under the Sarbanes- Oxley act of 2002, or a class 3 or class 2 felony under the Illinois Securities Law of 1953, Vendor certifies at least five years have passed since the date of the conviction.

Vendor further certifies that it is not barred from being awarded a contract. 30 ILCS 500/50-10.5

Yes

7. Vendor certifies that it and its affiliates are not delinquent in the payment of any debt to the University or the State (or if delinquent, have entered into a deferred payment plan to pay the debt or are actively disputing or seeking resolution). 30 ILCS 500/50-11, 50-60

Yes 8. Vendor certifies that it and all affiliates shall collect and remit Illinois use Tax on all sales of tangible personal property into the state of Illinois in accordance with provisions of the Illinois use Tax act. 30 ILCS 500/50-12

Yes

9. Vendor certifies that it has not been found by a Court or the Pollution Control Board to have committed a willful or knowing violation of the Environmental Protection Act within the last five years, and is therefore not barred from being awarded a contract. 30

ILCS 500/50-14

Yes 10. Vendor certifies it has neither paid any money or valuable thing to induce any person to refrain from bidding on a state contract, nor accepted any money or other valuable thing, or acted upon the promise of same, for not bidding on a State contract. 30 ILCS 500/50-25

Yes

11. Vendor certifies it has read, understands and is not knowingly in violation of the "revolving door" provision of the Illinois Procurement Code. 30 ILCS 500/50-30

Yes 12. Vendor certifies that if it hires a person required to register under the lobbyist registration act to assist in obtaining any State contract, that none of the lobbyist's costs, fees, compensation, reimbursements or other remuneration will be billed to the State. 30 ILCS 500/50-38

Yes

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13. Vendor certifies that it will not retain a person or entity to attempt to influence the outcome of a procurement decision for compensation contingent in whole or in part upon the decision or procurement.30

ILCS 500/50-38

Yes 14. Vendor certifies it will report to the Illinois Attorney General and the Chief Procurement Officer any suspected collusion or other anti-competitive practice among any Bidders, Offerors, Contractors, Proposers, or Employees of the State. 30

ILCS 500/50-40, 50-45, 50-50

Yes

15. Vendor certifies that if it is awarded a contract through the use of the preference required by the Procurement of Domestic Products Act, then it shall provide products pursuant to the contract or a subcontract that are manufactured in Illinois or the United States. 30 ILCS

Yes 16. Vendor certifies that if awarded a contract for public works, steel products used or supplied in the performance of that contract shall be manufactured or produced in the United States, unless the executive head of the Procuring Agency/University grants an exception in writing. 30 ILCS 565

Yes

17. If vendor is awarded a contract worth more than $5,000 and employs 25 or more employees, vendor certifies it will provide a drug free workplace pursuant to the Drug Free Workplace Act.

30 ILCS 580

Yes 18. If vendor is an individual and is awarded a contract worth more than $5,000, vendor certifies it shall not engage in the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance during the performance of the contract pursuant to the drug free workplace act. 30

ILCS 580

N/A

19. Vendor certifies that neither vendor nor any substantially owned affiliate is participating or shall participate in an international boycott in violation of the U.S Export Administration Act of 1979 or the applicable regulations of the United States Department of Commerce. 30 ILCS 582

Yes 20. Vendor certifies that no foreign-made equipment, materials, or supplies furnished to the Agency/University under any contract have been or will be produced in whole or in part by forced labor or indentured labor under penal sanction.

30 ILCS 583

Yes

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21. Vendor certifies that no foreign-made equipment, materials, or supplies furnished to the Agency/University under any contract have been produced in whole or in part by the labor or any child under the age of 12. 30 ILCS 584

Yes 22. Vendor certifies that if awarded a contract including Information Technology, Electronic Information, Software, Systems and Equipment, developed or provided under any contract, it will comply with the applicable requirements of the Illinois Information Technology Accessibility Act Standards. 30 ILCS 587

Yes

23. Vendor certifies that if it owns residential buildings, that any violation of the Lead Poisoning Prevention Act has been mitigated. 410 ILCS 45

Yes 24. Vendor certifies it has not been convicted of the offense of bid rigging or bid rotating or any similar offense of any State or of the United States.

720 ILCS 5/33 E-3, E-4, E-11

Yes

25. Vendor certifies it complies with the Illinois Department of Human Rights act and rules applicable to public contracts, which include providing equal employment opportunity, refraining from unlawful discrimination, and having written sexual harassment policies. 775 ILCS 5/2-105

Yes 26. Vendor certifies it does not pay dues to or reimburse or subsidize payments by its Employees for any dues or fees to any "discriminatory club." 775 ILCS 25/2

Yes

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27. Vendor warrants and certifies that it and, to the best of its knowledge, its subcontractors have and will comply with executive order

no. 1 (2007). The order generally prohibits vendors and subcontractors from hiring the then-serving governor's family members to lobby procurement activities of the state, or any other Government in Illinois including local Governments if that procurement may result in a contract valued at over $25,000. This prohibition also applies to hiring for that same purpose any former State Employee whose procurement authority at any time during the one-year period preceding the procurement lobbying activity.

Yes 28. Vendor certifies that it has read, understands and is in compliance with the registration requirements of the Illinois Elections Code (10 ILCS 5/9-35) and the restrictions on making political contributions and related requirements of the Illinois Procurement Code. 30 ILCS 500/20-160 and 50-37 vendor will not make a political contribution that will violate these requirements.

Yes

29. This applies to individuals, sole proprietorships, general partnerships, and single member LLC'S, but is not otherwise applicable. vendor certifies that he/she has not received an early retirement incentive prior to 1993 under section 14-108.3 or 16-133.3 of the Illinois Pension Code or an early retirement incentive on or after 2002 under section 14-108.3 or 16-133.3 of the Illinois Pension Code.

(30 ILCS 105/15a; 40 ILCS 5/14

-108.3; 40 ILCS 5/16-133

N/A 30. Vendor certifies that no procurement or laundering of apparel provided to the State under the contract has been or will be provided through the use of forced labor exploitation. 30 ILCS 500/25- 210.

Yes

Form G. Board of Elections (BOE)

G. Board of Elections (BOE)

1. Is your Business registered with the Board of Elections

(BOE)?

No - I certify my business is a non-profit or a governmental entity and therefore not required to register with BOE.

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Form H. Iran Disclosure

H. Iran Disclosure

1. Do you or any of your corporate parents or subsidiaries have any business operations that must be disclosed?

No business operations to disclose

Form I. Financial Disclosure & Conflicts of Interest

I. Financial Disclosure & Conflicts of Interest A. Identify the applicable entity type

Not-for-profit entity B. Is there a parent entity that owns 100% of the Business?

No

C. Instrument of Ownership or Beneficial Interest

Not-for-Profit 1. Is there any individual or entity who meets any of the following thresholds: (a) owns more than 5% of the business, (b) holds ownership share of the business valued in excess of $142,740.00, (c) is entitled to more than 5% of the business' distributive income, or (d) is entitled to more than $142,740.00 of the business' distributive income?

Not applicable - Not-for-Profit Entity

2. Please certify that the following statement is true:

all individuals or entities that hold an ownership interest in the business of greater than 5% or valued greater than $142,740.00 have been disclosed in question 1.

Not applicable - Not-for-Profit Entity

3. Please certify that the following statement is true:

all individuals or entities that were entitled to receive distributive income in an amount greater than $142,740.00 or greater than 5% of the total distributive income of the business have been disclosed in question 1.

Not applicable - Not-for-Profit Entity

4. Disclosure of Board of Directors for Not-for-Profit Entities

Not-for-Profit entity Attach a document providing the name(s) and addresses for all board members. - Board Members

FY26 Board of Directors wAddresses_13410908651137 7055.pdf,FY26 Board of Directors wAddresses_13410908713756 7971.pdf

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5. For the individuals disclosed above in question 1 and for sole proprietors, are any of them a person who holds an elective office in the state of Illinois or holds a seat in the general assembly, or are they the spouse or minor child of such person?

Not applicable - Not-for-Profit Entity

6. For the individuals disclosed above in question 1 and for sole proprietors, are any of them appointed to or employed in any offices or agencies of state government and receive compensation for such employment in excess of 60% ($142,740.00) of the salary of the governor, or are any of them the spouse or minor child of such person?

Not applicable - Not-for-Profit Entity

7. For the individuals disclosed above in question 1 and for sole proprietors, are any of them an officer or employee of the capital development board or the Illinois toll highway authority, or are any of them the spouse or minor child of such person?

Not applicable - Not-for-Profit Entity

8. For the individuals disclosed above in question 1 and for sole proprietors, are any of them appointed as a member of a board, commission, authority, or task force authorized or created by state law or by executive order of the governor, or are they the spouse or an immediate family member who currently resides or resided with such person within the last 12 months?

Not applicable - Not-for-Profit Entity

9. If any question in 5-8 above is answered yes, please answer the following: Do any of the individuals identified, their spouse, or minor child receive from the entity more than 7.5% of the entity's total distributable income or an amount of distributable income in excess of the salary of the Governor ($237,900.00)?

Not applicable - Not-for-Profit Entity

10. If any question in 5-8 above is answered yes, please answer the following: Is there a combined interest of any individual identified along with their spouse or minor child of more than 15% in the aggregate of the entity's distributable income or an amount of distributable income in excess of two times the salary of the Governor ($475,800.00)?

Not applicable - Not-for-Profit Entity

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11. For the individuals and for sole proprietors, do any of them currently have, or in the previous 3 years had state employment, including contractual employment of services? this does not include contracts to provide goods or services to the state as a vendor.

Not applicable - Not-for-Profit Entity

12. For the individuals disclosed above in question 1 and for sole proprietors, have their spouse, father, mother, son, or daughter, had State employment, including contractual employment for services, in the previous 2 years? This does not include contracts to provide goods or services to the State as a vendor.

Not applicable - Not-for-Profit Entity

13. For the individuals disclosed above in question 1 and for sole proprietors, do any of them currently hold or have held in the previous 3 years elective office of the state of Illinois, the government of the united states, or any unit of local government authorized by the constitution of the state of Illinois or the statutes of the state of Illinois?

Not applicable - Not-for-Profit Entity

14. For the individuals disclosed above in question 1 and for sole proprietors, do any of them have a relationship to anyone (spouse, father, mother, son, or daughter) holding elective office currently or in the previous 2 years?

Not applicable - Not-for-Profit Entity

15. For the individuals disclosed above in question 1 and for sole proprietors, do any of them hold or have held in the previous 3 years any appointive government office of the state of Illinois, the united states of America, or any unit of local government authorized by the constitution of the state of Illinois or the statutes of the state of Illinois, which office entitles the holder to compensation in excess of expenses incurred in the discharge of that?

Not applicable - Not-for-Profit Entity

16. For the individuals disclosed above in question 1 and for sole proprietors, do any of them have a relationship to anyone (spouse, father, mother, son, or daughter) holding appointive office currently or in the previous 2 years?

Not applicable - Not-for-Profit Entity

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17. For the individuals and for sole proprietors, do any of them currently have or in the previous 3 years had employment as or by any registered lobbyist of the state government?

Not applicable - Not-for-Profit Entity

18. For the individuals disclosed above in question 1 and for sole proprietors, do any of them currently have or in the previous 2 years had a relationship to anyone (spouse, father, mother, son, or daughter) that is or was a registered lobbyist?

Not applicable - Not-for-Profit Entity

19. For the individuals disclosed above in question 1 and for sole proprietors, do any of them currently have or in the previous 3 years had compensated employment by any registered election or re-election committee registered with the secretary of state or any county clerk in the state of Illinois, or any political action committee registered with either the secretary of state or the federal board of elections?

Not applicable - Not-for-Profit Entity

20. For the individuals disclosed above in question 1 and for sole proprietors, do any of them currently have or in the previous 2 years had a relationship to anyone (spouse, father, mother, son, or daughter) who is or was a compensated employee of any registered election or reelection committee registered with the secretary of state or any county clerk in the state of Illinois, or any political action committee registered with either the secretary of state or the federal board of elections?

Not applicable - Not-for-Profit Entity

21. Has there been any suspension or debarment from contracting with any governmental entity within the previous ten years? This applies to all sole proprietors, for-profit entities, not-for-profit entities, and for the individuals disclosed in question 1 above.

No 22. Has there been any professional licensure discipline within the previous ten years? this applies to all sole proprietors, for-profit entities, not-for-profit entities, and for the individuals disclosed in question 1 above.

No

23. Has there been any bankruptcy within the previous ten years? this applies to all sole proprietors, for-profit entities, not-for-profit entities, and for the individuals disclosed in question 1 above.

No 24. Have there been any adverse civil judgments and/or administrative findings within the previous ten years? this applies to all sole proprietors, for-profit entities, not-for-profit entities, and for the individuals disclosed in question 1 above.

No

Page 11 of 12 6/9/2026 7:49:49 AM

IPG - Supplier Registration Summary

(Registration Submitted on 02/02/2026)

25. Have there been any criminal felony convictions within the previous ten years? this applies to all sole proprietors, for-profit entities, not-for-profit entities, and for the individuals disclosed in question 1 above

No

Page 12 of 12 6/9/2026 7:49:49 AM

IPG - Supplier Registration Summary

(Registration Submitted on 02/02/2026)