TIN form blank~59.docx

This is a Taxpayer Identification Number (TIN) form from the State of Illinois used for contractor verification and tax compliance purposes in conjunction with a 5-day janitorial services procurement for location L6961 at 110 West Lawrence Avenue, Springfield, Illinois 62704. The form requires contractors to provide their legal entity information, including name, business name, and appropriate taxpayer identification number (either Social Security Number for individuals or Employer Identification Number for entities). Contractors must certify their correct TIN status, confirm they are not subject to backup withholding by the Internal Revenue Service unless specific conditions apply, and declare their U.S. person status. The form includes checkboxes for various legal entity classifications including individual, sole proprietor, partnership, corporation, limited liability company, and tax-exempt organizations, with specific guidance provided for different business structures.

The procurement is designated exclusively for Small Business Set Aside Program vendors, restricting eligible bidders to certified small businesses. The janitorial services contract encompasses a 5-day service schedule at the specified Springfield location. Contractors submitting proposals are required to complete and submit this TIN form as part of their bid documentation to establish their tax compliance status and eligibility to contract with the State of Illinois. The form serves as a prerequisite verification document to ensure that selected contractors maintain proper tax identification and withholding compliance before contract award and performance.