Signed po r-329399_07142026060712.pdf
PDF 282 KB Posted
- Attached to
- Release State Use/Facilities for Persons with Severe Disabilities IL|25-416CMS-BOSS4-P-75628
- Contract number
- 25-416CMS-BOSS4-P-75628
- Issued by
- Illinois
About this file
This is a Purchase Order Release document issued by the State of Illinois Department of Corrections (DOC) to Elm City Rehabilitation Center, Inc., a vendor located in Sheridan, Illinois. The purchase order is identified as P-75628, Release Order Number 25-416CMS-BOSS4-P-75628:311, and is issued under Master Contract #9100001941. The contracting parties include the State of Illinois agency represented by buyer Amanda Crisman and the vendor represented by contact Michelle Grogan. The document was officially signed by a state representative on 7/13/26.
The purchase order is for the procurement of non-flexible thumb toothbrushes in cartons of 720 units per carton, brand Security. The order specifies a quantity of 4.00 cartons at a unit price of $95.00 per carton, resulting in a total contract value of $380.00. No discounts, taxes, or freight charges apply to this order. The release period begins on July 13, 2026, and ends on June 30, 2027, with a delivery requirement of 20 calendar days after receipt of order (A.R.O.). Payment terms are listed as not applicable (NA), and the order requires freight and shipping terms to be determined separately.
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Text version
25-416CMS-BOSS4-P-75628:311
DOC - Corrections
Purchase Order
Release Order Number
Master Contract? Y
Master Con/Ref #: 9100001941
Contract/PO #: P-75628
Michelle Grogan Vendor Number: V00001985
V Elm City Rehabilitation Center, Inc. s 4017 E. 2603rd Road
H Melissa Morsch
E 1314W Walnut Sheridan, IL 60551 N Jacksonville, IL 62650 I US
D ECC@elmcity.org p Email: Michelle.grogan@illinois.gov o (217) 245-9504 (815) 496-2181
R T
VENDOR INSTRUCTIONS: - _______________________________________
PURCHASE ORDER REQUIREMENTS - STATE OF ILLINOIS AGENCIES Michelle Grogan
B 4017 E. 2603rd Road Prior to commencement of billable work, delivery of supplies or rendering of any Melissa Morsch service on a Purchase Order: Sheridan, IL 60551 --Initial Purchase Order/Contract - All parties, including the State and vendor, must L US fully execute the contract in its entirety. L Email: Michelle.grogan@illinois.gov --Release from an existing Purchase Order/Contract - The vendor must receive a (815) 496-2181 Purchase Order signed by the State Agency and attached in BidBuy. Note, for any additional requirements see specific State Agency instruction. T
PURCHASE ORDERS REQUIREMENTS - OTHER PURCHASING ENTITIES
--Please see specific requirements provided by the purchasing entity. -
Shipping Method: Freight Terms:
Shipping Terms: Payment Terms: NA Solicitation (Bid) No.: N/A
Release Begin Date: 07/13/2026 Release End Date: 06/30/2027 Delivery Calendar Day(s) A.R.O.: 20
Item # 1
Class-Item 652-84
THUMB TOOTHBRUSH, NON-FLEXIBLE, 720/CARTON. BRAND: Security PACKAGING: 720/carton
Quantity Unit Price UOM I Discount % ITotal Discountl I Tax Rate I 'Tax Amountl Freight Total Cost mt.
4.00 $ 95.00 CAR 0.00 % $0.00 $ 0.00 $0.00 $ 380.00
25-416CMS-BOSS4-P-
75628:311
TAX: $ 0.00
FREIGHT: $0.00
TOTAL: $ 380.00
25-416CMS-BOSS4-P-75628:311
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: a'
Printed Name: C. & Tifle: USQxJL C\ Designee Signature: ___________________________
Printed Name: ________________________________
Title:
Date: I .
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:_________________________
APPROVED
By: Amanda Crisman
Phone#:(815) 496-2181
BUYER
Publication Date:_______________________ Financing Needed:________ IPG Cert/Disclosure Yes________ No_______________________
File details come from the government source that posted it. Updated .