tTE OF LUNOS

ORDER) NO AGREEMENT ( <$50,000

terms and ndon f hA BOA, i udine thus's terms and conditions set em the aecitiona ducurnent:; wierenced below, and an' continuation sheets, cunstitute the entire necuement between the parties wuh espect to the subject ntiec uf is BAA. dsum e'st hi ins. .. ii tim eumsnt of sonfliut between State and Venriom documents.

CONTAflN FORMAON Vendor Name: ICS JAIL SUPPLIES, INC Add ross' P0 BOC 21056. WACO, TE'(AS 76702 Curmt c, EBYN WUIMAN Phone 4:800 5i4-54?7 Email Bi1ULSA0ICcwACQcoM Fax 4: 254 75J 0293 State O, cy mne: Sheridan Correctional Centem 4orsss C, 2.603rd Rd. Sheridan, IL 60551 contact,:

Michelle Grcmgan Phone 4: 8154962181 ext. 32006 CONTRACT lNi Ti iN Terre: Email: MicheIIe.GroganiIIjnois,gov Faxff: N/A Contract 4: 27426DOCSHERIR335453 Begin Date:

Action: New Upon Final Signatures .

Acquoition Type: Purchase BH To:

Payment Cycles Upon receipt End Date: Sheridan Correctional Center as and Conditions: BOA fermtms and Conditions 6/30/2027 Address: 4017 E. 2603rd Rd.

Sheridan, IL 60551

Ihi order requires delivery within 30 d's of P0 notification, please ensure I you are able to meet this timefrarne pear to submitting a quote.

OMPLEfED/SlGNED BASIC ORDERING AGREEMENT (BOA) IS TOBE

AU'ACHED WITH QUOTE IN B1DBU.

N/A. N/A

Stete of liSnois Chief Procurement Office Generel Services BOA under $50,000 v.23.2

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ShipTo:

Sheridan Correctional Ceer Address: 4017 E. 2603rd Rd.

Sheridan, IL 60551 t477

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STATF OSE ONLY

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Experueure Object Code: 1391. S Scection Me;iod. Su: Pun:ha.

te 4 Code C rdou Needed? No -4 0 ore emont Method SmaH Purchase Usng Agency Funding Source:

uocontractors UtdNed? No Fiscal Year: 2027

Subcontractors Disclosed? No e Type: State

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At A / NES / ATTACHMENTS

1. Bids must be submftted throuqh BidBuy Only eleconic submission w be acce, VENDOR, All the reuue", I ms to B. doys o7 pv-1 unless otherwise agreed upon by the vendor and facflity. The Agency requests items to L as listed.

P;1cin; fa o" modities at d/r -er 4 si-elI he n accordance sob I- the uni of measure specified in the Pricing Section and only one unit price shab he nuoted item unless otherwise stated. All extm'Sionc and totals requested shall be shown. Prices quoted must be net after deducting all trade or quantity discounts,

4. Agency reserves the right to award bid in whole-' in t.

c:-- cd °a '.,t. ii. fL ' thUr "-ds In b tbdBuv. Ager:y must have fully cIcuted BOA, signed and dated by both parties, prior to product being sent to the Agen / by Vendor, B The VCOdOI will UU rroponsihie br dipping or dehverv of the parts to the Agency. Prices must he FO,B. DESTINATION with all transpcrtetion and handling included and paid by the Contractor, Deliveries are accepted Monday through Friday, 8:00 a,m. to 1:30 excluding state holidays. Delivery to be made to the facilitys warehouse receiving dock. When a brand name or equal Specification is used in a sohcitetion,'the solicitation shall contain explanatory language that the use of a brand name is fOr the puipos of dmcrfting the StcO dard cf quality, peiformance arid characteristics desired and is not intended to limit or restrict competition 'Or equal" submissions will not he rejected because of minor differences in design, construction or features that do not affect the suitability of the product for its intended use, Burden of proof that the product is equal is on the bidder.

103 JAIL SUPPLIES, INC.

P0, Sox ?1850

Waco, IX 76702-1056 Phone: 800-524-5427 Fax: 254-751-0299 www icswaco - corn bidsf3icswaco,com State of Illinois Chief Procurement Office General Services FE a # 2 /-1494351 BOA under $50,000

GSA Contract if CS 07F 05521) V212

Buy8oard Contract Holder

STATE OF I1UNOS

FO. . CERTFCA1iONS AND DSCLOSURES

State of ifinois Chief Procurement Office BOA over $25,000 V.13.4

.ate of Ullnois

State Agency:

ICS JAfL SUPPLl3, INC.

P.O. Bo 21056

Waco, TX 76702.1056 Phone: 800524-5427 Fax: 254-751.0299

WWWicswacocon bids$150s0ac00c)m 3F61D # 27-1494351

GSA Contract 2 OS 07F-0552U BuySoard Contract Holder

108 iAIL SUPPU T:8, 1NC

STATE OF ILUNOIS 6OX 21056

Weoc, TX 76702 1056 STANDARD TERMS AND CC f O0 "21 54,7 r' 2 4 Li 0.? J

WWWrCSW5'cocr,, 115 0 s do os waco c'r:rn _______ _______

FtD#2f4494351 GSA Cenlract d CS 07F-11J5521

BuyE3oar Conlracl Holder PAYMENT TERMS AND CONDITIONS:

Prompt Payment Act and rules when apphcable. 30 lLCS 540; 74 10, Adm. Code 900, This shall be Vendor's sole remedy for late payments by the State. Payment terms contained on Vendor's invoices shall have no force and effect.

Li. Late Payment: Payments, including late payment charges, will be paid in accordance with the State

1.2. Minority Contractor Initiative: Any Vendor awarded a contract under Section 20-10, 2045, 20-25 or 20- 30 of the Illinois Procurement Code (30 ILCS 500) of $1,000 or more is required to pay a fee of $15. The Comptroller shall deduct the fee from the first check issued to the Vendor under the contract and deposit the tee in the Comptroller's Administrative Fund. 15 ILCS 405/23.9.

1.3. Expenses: The State will 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 La execution.

1.4. Prevailing Wage: As a condition of receiving payment Vendor must (i) be in compliance with the contract,

(if) raY its employees prevailing wages when required by law, (iii) pay its suppliers and subcontractors acco'thng to the terms of their respective contracts, and (iv) provide lien waivers to the State upon celL. ::st. Examples of prevaiiing wage categohes include public works, printing, janitorial, window te:.oag, building and grounds services, site technician services, natural resource services, security guard md load services. The prevailing wages are revised by the Department of Labor and are available on the thPar:ment's official website, which shah be deemed ;o oper notification of any rate changes under this subsection. Vendor is responsible for contacting the liitnois Department of Labor to ensure understanding Pa roevailing wage requirements at 217-782-6206 or (htthsjoboillinqggv, LS. Federal Funding: This contract may be' partially or totally funded with 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 will be provided in the award notice.

1.5, invoicing: By submitting an invoice, Vendor certifies that the supplies or services provided meet all requirements of the contract, and the amount billed and expenses incurred are as allowed in the contract.

invoices for supplies purchased, services performed, and e15pen5e5 incurred through June 30 of any year must be submitted to the State no later than July 31 of that year; otherwise Vendor may have to seek payment through the Illinois Court of Claims. 30 iLCS 135/25. All invoices are subject to statutory offset.

30 ILCS 210.

1St. Vendor shall not bill for any taxes unless accurnpartted by proof that the State is subject to the tax. If necessary, Vendor may request the aoplicah:e Agency/University state tax exemption number and federal tax exemption information,

15.2. Vendor shall invoice at the ccanpletion Pa lIe contract unless invoicing is tied in the contract to milestones, delis erahies, or oh rco invoiciry: m.hmments agreed to in the contract.

2. ASSIGNMENT: This contract may not be assigned. trarofci'red in whole or in part by Vendor without the prior written cono.emfl: of the State.

State ci rWnos COeI Procurement Office General Servicer soc unmr ocean vet iCS JAiL SUPPEJ INC.

P.O. itox21P5fi

''r c . Phone: 500-0244427 Fax: 254-751 0290 c

FEP5f 27149.35

EuyBmm 3. SUBCONTRACTING: For purposes of this section, subcontractors are those with contracts with an annihiaIue exceeding S 100,000 and who are specifically hired to pm form .U or part of the work covered by the contract.

Vendor must receive prior written approval before use of any rmhcontractors in the performance of this contract.

Vendor shah describe, in an attachment if not already provided, the names and addresses of all authorized subcontractors to be utilized by \/endor in the performance of this contract, together with a description of the work to he performed by the subcontractor and the anti :ipetsd amount of money that each subcontractor is expected to receive pursuant to this contract if required, Vendor shall provide a copy of any subcontracts within fifteen (15) days after execution of this contract. All subcontract.s must include the same certifications that Vendor must make as a condition of this contract. Vendor shall include in each subcontract the Standard Illinois Certification form available from the State. if at any time during the term of the Contract, Vendor adds or changes any subcontractors, then Vendor must nrornptiy notify, by w'itten amendment to the Contract, the State Purchasing Officer or the Chief Procurement Officer of the names and addresses, the expected amount of money thor each new or replaced subcontractor will receive pursuant to the Contract, and the general type of work to be performed. 38 ILCS 508/20420.

4, AUOIT/REPENTiOI 0, ECORDS: Vendor anti its subcontractors snail maintain books and records relating to the pen ormc'me of the contract or subcontract and necessary to support amounts charged to the State pursuant the contract or subcontract. Books and records, including information stored in databases or other computer systems, shall he moO :ained by the Vendor for a period of three (3) years irons the later of the date of final payment under the contr c,i"' completion cf the contract, ann by the sub;c' 0ractor for a period of three (3) years from the later of final poy rent under the tem or cornpletusx 01 the subcoe acm. lf Federal funds are used to pay contract costs, the: \thnd,,r .nd its subcontractors must retain their respecs0ve records for five (5) years. Books and records required th maintained under this section shall be availabie for review or audit by representatives of: the procuring 7gancy, the Auditor General, the Executive inspector General, the Chief Procurement Officer, State of Illinois internal auditors or other governmental entides with risonitoring authority, upon reasonable notice and during normal business hours, Vendor and its subcontractors shall cooperate fully with any such audit and with any inveshgation conducted by any of these entities. Failure to maintain books and records required by this section shah establish a presumption in favor of the State.fer the recovery of any funds paid by the State under this contract or any subcontract for which adecsuate books and records are not available to support the purported ciisbursenent. The Vendor or subcontractors shall not impose a chapge for audit or examination of the Vendor's or subcontractor's books and records. 30 ILCS 500/20-65.

5. TiME IS OP I HE ESSENCE: Time is of the essence with respect o Vendor's performance of this contract. Vendor shall coeLnue to perform its obligations while any dispute concerning the contract is being resolved unless otherwise directed by the State.

6. NO WAlVfR OP RIGHTS: Except as specificaiiy waived irs writing, failure by a Party to exercise or enforce a right does rant waive that Party's right to exercise or enforce that or other rights in the future.

7, FORCE : Failure by either Party to perform it d' and obligations will be excused by unforeseeable ciccumst:. noes beyond its reasonable control and not due to its negligence, including acts of nature, acts of terrorism, riots, labor disputes, fire., flood, explosion, and governmental prohibition. The non-declaring Party may cancel the coocrac without penalty if performance does rot resume within thirty (30) days of the declaration.

8. ' ENTIAL I .F. . : Each Party, including its agents and subcontractors, to this contract may have or ;sccess to confidential data or information owned or maintained by the other Party in the course of carrying

Out it:, reoosihilities under this contract. Vendor hali presume all info-mation received from the State or to oI 7.:, " Ch,:f Oocurrnurnt OOic c7eneral 5errce

4: 'Cr

STATE 0° ICS LdLSUPpLp pC sT uElcic'

_____27 2

L access pur uaqt to th Lor t a s ca al 'ic udo uformation R1 cjqarly marked as Pm n a and exemot f om dsclosi under the Ii no do r cA l'dormaton hdlPbe sfderdpublc

No confdental data collected, maintained, or used in the course of performar ht&&htuShCll be thsseminated except as authorized by law and with the written consent of the disclosing Party, either during the period of the contract or thereafter. The receiving Party must return any and all data collected, maintained, created or used in the course of the performance of the cort'ct, in whatever form it is maintained, promptly at the end of the contract, or earlier at the repuest of the disdosng, Party, or notify the disclosing Party in writing of its destruction, The foregoing obligations shall not apply to confidential data or information lawfully 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 becomspublicly known through no breach of confidentiality obligation by the receiving Party; or is independently developdd by the receiving Party" ithout the use or benefit of the disclosing Party s confidential information, 9, USE AND C SliP: All work performed ur supplies created oy Vendor under this contrac, whether written documents or data, goods or deliverables ,: any kind, shall be deemed work for hire under copyright law and all intellectual property and other laws, and the State of !linuis it granted sole and exclusive ownership to all such work. unhss otherwise agreed in writing. Vendor hereby acaigas to the State all right, title, and interest in and to such wortheciuding any reicted intellectual property rights, ann/or waives any and all claims that Vendor may havcos rich work including any smcailed 'moral rights' is connection with the work. Vendor acknowledges the Stats' met the work product for any purpese. Confkler:thil rsatn or infonnation contained in such work shall hi subjer scrrrfidentiaiity provisions of dcc contract.

INDEMNIFIC41ION AND LIABILITY: The Vendoi shall adc'mnify and hold harmless the State of Illinois, its agcncrm. cthcers, employees, agents and vo:unteers from cr:a and all costs, demands, expenses, losses, claims, dartragrss, iabhicies, settlements and judgments, incicdrng in rouse and contracte:d attorneys' fees and expenses, arising out of: (a) any breach or violation by Vendor of any of its certifications, representations, warranties, covenants or agreements; (b) any actual or alieged death or ininry to any person, damage to any real or personal oroperty, or any other damage or loss claimed to result in whoic or in part from Vendor's negligent performance;

(c) any act, activity or omission of Vendor o any of its ernplovrzcs, representatives, subcontractors or agents; or Id) any actual or alleged claim that the services or goods provides: under this contract infringe, misappropriate, or otherwise violate any intellectual property (patent, copyright, trade secret, or trademark) rights of a third party.

In accordance with Article Viii, Section 1(a),(b) of the Constitution of the State of Illinois and 1973 Illinois Attorney General Donron 78, the State may not indemnify private parties absent express statutory authority permitting the inderrrnificaton, Neither Party shari he liable for incidenta, special, consequential, or punitve damages.

11. gy5rJgcg Vendor shall, at all times during the term arm emuj renewals maintain and provide a Certificate of insurance rarning the State as additionally irrsureo for all ecle:rei bonds arid irrsurance. Certificates may not be mockled or canceled until at least thirty (30) days' notice has rroen provided to toe State, Vendor shall provide:

aj General Commercial Liability occurrence for mu immamourt ot S1000,000 per occurrence (Combined Single Limit f'cdliv Ir dry and Property Damage) and $2,000,000 Annual i\ggrcgate; (b) iuto Liability, including Hired Auto and Nor':" wrccd ,kutc, (Combined Single limit bodily injury and Property Damage) in amount of $1,000,000 per occurrence: aid (c) Worker's Coropersation Insurance r amount required by law, Insurance shall not limit vendor's ur;igation to indemnify, defend, or settle any clams..

12. INDEPENDENT CONTRAcTOR: Vendor shall act as an independent contractor and not an agent or employee of, or joist 'm:'rture with the State. All payments cry the Stare shall be rrade on that oasis.

cur Pr,curern,1t 00cm rtcrmrr 5m'vcru.

rro..s j':ucr ,:'LSj'..'c, ICS JJiL 3J?DLi%", INC 7t0 2G

Wo, TX 76702.i cTha U525427 Fax: 254-751 0299

WWW,jcxwacoce m

75:4)5 27-1494351

13. SOLiCITATION AND EMPLOYMENT: Vendor abcS not enipoy any person em dnbItate, wing the term of this contract to perform any work under this contract. Vendor shall give ncff h 'i'' tba Agency's director if VLndor solicits or intends to solicit State employ .. ri perForm any work under this contract,

14. COMPLiANCE WITH THE LAW: The Vendo', its employee , agents, and subcontractors shall comply with all apolicabie federal, state, and local laws, rules nrdinarrs, r tnlat'ons, orders, federal circulars and all license and termit reOurements in the performance of this contract. ' endor shall he in compliance with applicable tax requirements and shall be current in payment of such taxes. Vencaor shall obtain at its own expense, all licenses ccci permesons necessary for the performance of this contract, Is, 55C%GRCGR"D CHECK: Whenever the State deems it reasonably necessary for security reasons, the State may conc.vcc, at 55 expense, criminal and d-ivc- r history background checks of Vendor's and subcontractor's officers, rs agents. Vendor or subcontractor shall raassigr. immediately any such individual who, in the opinion ci tue State, does not pass the background check.

16. APPLiCABLE LAW:

lbs. PREVAILING LAW: This contracs shall be construec ri accoidance with and is subject to the laws and rules of she State of Illinois.

:ib.2. A5 OPPORTUNITY: 'use Depart nertol Huan Rights' Equal Opportunity requirements are ieee aerated by reicrenca', 44 irs. Ac.sr. Coms 555.

19,3 COURT OF CLAIMS; ARBITRATION; SOVEREIGN IMMUNITY: Any claim against the State arising out of this contract must be filed exciusivelv w4h the illinois Sours of Claims. 705 ILCS SOS/I. The State shall not srsse into binding arbitration to resolve any dispute aSsing out of this contract. The State of Illinois does not waive sovereign immunity by entering into this contract.

16.4. OPSICiAL TEXT: The official rext of the statutes c:ited herein is incorporated by reference. An unofficial version can be viewed at J(gqoeq/s/atJon.4/cs/'lcs,osp).

17. ANn-TRUST A5S'C .T; If Vendor does no: pursue any ciaimn or cause of action it has arising under federal or state antitrust laws relating to the subject matter of the contract, then upon request of the Illinois Attorney General, Vendor shall assign to the State righ a, ttle are niersas in and to the claim or cause of action.

18. C(;NTRAGTiiAL AUTH. S The Agency 6 st signs V:' S.c State of Illinois shall be the only State entity responsible For perfomn snce and payment usd01 the contrct. 'A'hen the Chief Procurement Officer or authorized designee signs in addition so an Agency. they do so as approving officer and shall have no liability to Vendc a a the Chief Si ecurement Offcer or authors aec designee, o State Purchasing Officer signs a master contra :t on behalf of State agencies, only the Agency tbzt plares cr order with the Vendor shall have any liability to Venuor 'ft'r that eraser.

19. EXPATRIMSgD ENTITIES: Except irs lirrised ci'curnstancco, 'so easiness or member of a unitary business group, as dtciined is. ma illinois lncomne Tax Act, shah submit a bsd or us enter into a contract with a State agency if that business or any member of the unitary business group ii a expatriated entity.

C' ('Dm 'T

ST1' 'UNO1S

c':n, .\7i3f('rrv3

STANDARD 1 i .2 ND CONDTf1'ONS8OO5245427 Fax: 254-751gj www.icswaco 00m

FEID # 274494351

28. NOIUCES. Notices and other communications provided for herein shafl be F41OnC mail

. uy mm Uon fact Holder wiieneve possible. If transmission via electronic mail is not possible, then notices and ot er communications shall he given in writing via registered or certified mafl with return receipt requested, via receipted hand delivery, via courier (UPS, Federal Express or other Urnimr and reliable carrier), or via facsimile showing the date and time of successui receipt. Notices shall be sent to the individuals who signed this contract using the contact information foilowing the signatures. Each s:J cti..o. shai he deemed to have been provided at the time it is actuaily recuived, By giving notice, either Party may change its contact information,

21. MOOtFIC;TIONS AND SURVIVAL: Amendments, modifications and waivers must be in writing and signed by authorized representatives of the Parties. Any provision of this contract officially declared void, unenforceable, m against public policy, shall be ignored and the remaining provisions shaH be interpreted, as far as possible, to give effect to the Parties' intent. All provisions that by thei nature would be expected to survive, shall survive termination. In tne event of a conflict between the State's and the Vendor's terms, conditions and attachments, the State's terms, conditions and attachments shall preaii.

22. PERFORMANCE RET' / SUSPENSION: reque.s t c' the State, Vendor shall meet to discuss performance or provide contract performance updates to ne1p ensure iroper performance of the contract. The State may consider Vendor's performance under this contract and compliance with law and rule to determine whether to reotbine tit' contract, suspend Vendor from doing future business with the State for a specified period of time, or w:lett,or truaclor can he considered responsble on specific luture contract opportunities.

23. .:flEr'r\Qri OPIN EORMATle3N ACT: lhit co . act and a re';ated public records maintained by, provided to or ia provided to the Stato a:a subject to tht ;:ir:Ois reedom of Information Act (FOIA) (50 ILCS 140) n.:twithranr, any provision t the coorrur', that may Lu found in this contract.

24, SC,NSDUL OF WORK: Any work performed on State prenisee shall be done during the hours designated by the StrVe and pc'rlm med in a manner that does rot interfere' with the State and its personnel.

25. WAR.RANTiES FOR SUPPLIES AND SERVICES:

25.1 \"encior warrants that the supplies furnished under this contract will: (a) conform to the standards, specifications, drawing, samples or oescr:ptions uiniahed by the State or furnished by the Vendor and agreed to by the State, including but not limttec( to all specifications attached as exhibits hereto; (b) be merchantable, of good quality nd wkmnanship, and free from defects for a period of twelve months or crigar if so specified in writing, and fif and suff'ciemo for the intended use; (c) comply with all federal and starr' laws, regulations and ordinances pertaio'r to the manufacturing, packing, labeling, sale and de;livery of the supplies; (d) he of goon title and be free and clear of all liens and encumbrances and; (e) ci iniringe any patent, copyright or cther intellectual property rights of any third party. Vendor agrees to reimburse the State for any losses, costs, damages or expenses, including without limitations, reasonable attorney's fees and expenses, arising train failure of the supplies to meet such warranties, 25,2, Vendor shall insure that au manufacturers' warranoes are transferred to the State and shall provide a copy of the warranty. These warranties shall be n addition to all other warranties, express, implied or statutory, and shall survive the State's payment, acceptance, inspection or failure to inspect the supplies.

S

103 JA1L SUPPLi3 INC.

STATE OF ftUNO1S °O. Etc 21056

STANDARD TERMS AND CONDONS

1VicSwaCo.com

FEID 227.1494351

25.3. Vendor warrants that all services wiii be performed to meet the in an

'Y O1rd (2 'Or efficient and effective mariner by tramed and competent personnel. Vend'or hai trdilYtherformances ot each nthvdual and shall reassign irnmediatel any individual who is not performing in accordance with the contract, who is disruptive or not respectful of others in the workplace, or who in any way violates the contract or State policies.

26. REPORTING, STATUS AND MONITORING SPE FlCATJON5,vnoor shall immediately notify the State of any event that may have a material impact on Vendor's ability to perform the contract.

27. EMPLOYMENT TAX CREDIT: Vendors who hire qualified veterans and certain ex-offenders may be eligible for tax credits. 35 ILCS 5/216, 5/217. Please contact fy lliois Decartment of Revenue (telephone #: 217-5244772) for information about tax credits.

28. TERMINAIlON FOR CAUSE; file State may terminate this contract, in whole or in part, immediately upon notice to the Vendor f; (a) the State determines that the actions or inactions of the Vendor, its agents, employees or subcontractors have caused, or reasonably could cause, jeopardy to health, safety, or property, or (b)the Vendor hoc cotd ,uO the State that it is unable or unwilling to pefor n the contract.

28:1. If Vendor fails to perform to tile State's satisfaction any material requirement of this contract, is in .:..7on of a mactrial itrosicn of hir cooscact, r the State determines that the Vendor lacks the ic aicial resources to percorm th¬. contract, the Stan shall provide written notice to the Vendor to cure tt;n the pec:od of time ed in the State's written notice. If not cured by

(a) immediately t:

.. ne contract without additional written notice cetheterms . sotchecontrac ow :er . uwwco"nc'' Oat Section, the State retains its rights to seek any

29. T .5: The Scam may, for . nience and with thirty (30) days prior written sc:ontractn c'.ceo n pa.........ciithoutpaymentofanypenaltyorincurringany

.3 u;ft,i, 7.5.1,. The endor shall he entitled . . esation noon submission of invoices and proof of claim for supplies ed servtces provided n come 0; to scat con <mats up to and including the date of termination,

30. . . . This coiunsct is conorca S.,. . n, rn minate or suspend trOt cm l1 me lliinis (enerai Tnt

0 tt to pa such obigation or S 65 , decreases she DepadmerO r r . r. cant to power delegaced to the o : . .

, mc its sole discretion om as ct' d upon actual or Projectec

................................pmupnation or of a mduct;on or ccc t a and subject to the availability of funds. The :t, in whole or in part, without penalty or further r the federal funding source fails to make an d are insufficient for any reason (30 ILCS 500/2O y reserving some or all of the Department's moor by the Illinois General Assembly, or (3) the by the Office of the Governor, that a reduction is y considerations. Contractor will be notified in rca se.

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ICSJ/;INC

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I-FiB 27-14S45' certfy GSA Contrac A G 07F.552U

The nun'. ,, : , this form is my correct t r identification number (or (ft9P1& kbr to be issued to me), am not a withholding because: (-' I am exempt from ckup withholding, or (b) I have not been notified by the ma Service (IRS) that I an. so a backue ing as a result of a failure to report afl interest or divide: a. IRS has notified me that r no longer saL. .

. backup withholding, and I am a U.......(a Lading a U.S. resident alien).

:are an indiaidual, enter your name and SSN as appears on your Social Security Card.

if a: a sole proprietor, enter the ownor's name on the name line followed by the name of the business

,ie own"s SSN or FiN, If 'are as' so ember LLC that is do: entity separate from its owner, enter the owner's m i:. line and the U/B/A on '

' e line and enter the owner's SSN or EIN.

lIthe aLC is a corporaton or parmneai::a, tom ys business name and EIN and for corporations, attach IRS acceptance atter (CR251 or CR2.7.

In eli ether entit:es, enter the tame of the entity as used to apply for the entity's FIN and the EIN.

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