Tax ID~21.pdf
PDF 51 KB Posted
- Solicitation number
- 22-551HDA-INFOT-B-25737
- Issued by
- Cook County, Illinois
About this file
This document is a taxpayer identification number form for the State of Illinois Chief Procurement Office. The form requires the company name, taxpayer identification number, and legal status for the purpose of obtaining a contract with the State of Illinois. The form does not provide details on a specific solicitation, but rather serves as a general tax identification requirement for vendors seeking to do business with the State.
The document outlines the legal status options that can be selected, including individual, sole proprietor, partnership, corporation, limited liability company, and various tax-exempt designations. Vendors must provide their taxpayer identification number, which can be a Social Security Number or an Employer Identification Number. The authorized representative must sign and date the form.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Bluebeam quote.PDF |
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
State of Illinois Chief Procurement Office General Services 1 IFB or RFP Solicitation: Forms A: Taxpayer Identification Number V.15.2a
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:
Business Name:
Taxpayer Identification Number:
Social Security Number:
or
Employer Identification Number:
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:
Bluebeam, Inc.
Bluebeam, Inc.
71-0886329
10/18/2021
Alyssa Leon Lead AR Specialist
File details come from the government source that posted it. Updated .