Signed PO r337485_09022026110139.pdf

25-416CMS-BOSS4-P-76320:261

DOC - Corrections Release Order Number

Purchase Order

Vendor Number: V00004121 Malcolm Eaton Enterprises

E 570WLammrd N Freeport, IL 61032

D maker@ma1c01meat0n0g o (815) 235-7181

R

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.

25-416CMS-BOSS4-P-

76320:261

Master Contract? Y

Master Con/Ref ýý: 9100001932

Contract/PO #: P-76320

Michelle Grogan s 4017 E. 2603rd Road

H Melissa Morsch Sheridan, IL 60551

I US

p Email: Michelle.grogan@illinois.gov

(815) 496-2181

T

Michelle Grogan

B 4017 E. 2603rd Road Melissa Morsch Sheridan, IL 60551

L US

L Email: Michelle.grogan@illinois.gov

(815) 496-2181

T

I Shipping Method: I Freight Terms:

Shipping Terms: I I Payment Terms:

I Solicitation (Bid) No.: N/A I

Release Begin Date: 09/01/2026 Release End Date: 06/30/2027 Delivery Calendar Day(s) A.R.O.: 20 I Item 4 1

Class- Item 640-75

TISSUE, TOILET, 1 PLY, 1000 SHEETS, NOT WRAPPED. MINIMUM ORDER = 200 CASES SPECIFICATIONS: 1. INDIVIDUAL ROLLS ARE NOT WRAPPED 2. WHITE 3. 4.5" WIDE AND PERFORATED AT 3.75" INTERVALS, APPROXIMATE 4. CORE DIAMETER 1-1/4" TO 1-1/2" 5.

100% POST-CONSUMER RECYCLED CONTENT 6. 1000 SHEETS/ROLL 7. 96 ROLLS/CASE. BRAND: Spirit MODEL: 1270+200 PACKAGING: Case

Quantity Unit Price I UOM Discount % ITotal Discount' I Tax Rate I Tax Amountl Freight I Total Cost I

Amt.

200.00 $49.12 CV 0.00% $0.00 $0.00 $0.00 $ 9,824.00

TAX: $0.00

FREIGHT: $0.00

TOTAL: $9,824.00

25-416CMS-BOSS4-P-76320:261

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 s-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 #:

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:_________________________

APPROVED

By: Amanda Crisman

Phone#: (Ri c dQR-21 Ri

BUYER

Publication Date:_______________________ Financing Needed:________ IPG CertlDisclosure Yes__________ No__________________________