TAX ID PAGE 1~33.docx
DOCX document 43 KB Posted
- Solicitation number
- 26-494DOT-FINAD-B-50431
- Issued by
- Illinois
About this file
This is a Taxpayer Identification Number (TIN) form issued by the State of Illinois Chief Procurement Office under the General Services division for use in IFB or RFP solicitations. The form requires bidders to provide their correct taxpayer identification information, including either a Social Security Number for individuals and sole proprietors or an Employer Identification Number for entities such as partnerships, corporations, limited liability companies, and other business structures. Bidders must certify that they are not subject to backup withholding by the Internal Revenue Service and confirm their U.S. person status. The form requires selection of legal status category, signature by an authorized representative, and the date of submission.
This form is associated with a change order notice for Automated Weather Observation Services (AWOS) in Illinois, which extends the current contract through March 28, 2026, with an effective date beginning December 29, 2025. The change order provides additional funding to prevent a coverage lapse as the existing contract expires December 28, 2025, and allows sufficient time for the state to rebid the IFB and secure a new contract. The vendor shall continue performing maintenance on all non-federal AWOS sites throughout Illinois to ensure compliance with Federal Aviation Administration maintenance requirements.
View the file
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
STATE OF ILLINOIS
TAXPAYER IDENTIFICATION NUMBER
I certify that:
The number shown on this 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) I 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 EIN.
· 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/B/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 CP277).
· For all other entities, enter the name of the entity as used to apply for the entity’s EIN and the EIN.
Name: Click here to enter text.
Business Name: Click here to enter text.
Taxpayer Identification Number:
Social Security Number: Click here to enter text.
or Employer Identification Number: Click here to enter text.
Legal Status (check one):
| |_| Individual | |_| Governmental | ||||
| |_| Sole Proprietor | |_| Nonresident alien | ||||
| |_| Partnership | |_| Estate or trust | ||||
| |_| Legal Services Corporation | |_| Pharmacy (Non-Corp.) | ||||
| |_| Tax-exempt | |_| Pharmacy/Funeral Home/Cemetery (Corp.) | ||||
| |_| Corporation providing or billing | |_| Limited Liability Company | ||||
| medical and/or health care services | (select applicable tax classification) | ||||
| |_| Corporation NOT providing or billing | |_| C = corporation | ||||
| medical and/or health care services | |_| P = partnership |
Signature of Authorized Representative:
Date: Click here to enter a date.
State of Illinois Chief Procurement Office General Services 21 IFB or RFP Solicitation: Forms A: Taxpayer Identification Number V.23.1
File details come from the government source that posted it. Updated .