upload_E-TIN62~39.pdf
PDF 85 KB Posted
- Contract number
- 27-426DOC-ROBIN-P-99135
- Issued by
- Illinois
About this file
This is a State of Illinois Taxpayer Identification Number (TIN) form, version 23.2, issued by the State of Illinois Chief Procurement Office General Services. The document pertains to E&N Service Company, a corporation not providing or billing medical and/or health care services, represented by Ethan Miller as the authorized signatory. The form was completed and signed on July 6, 2026.
The form documents the taxpayer identification information for E&N Service Company, which holds Employer Identification Number 92-2046429. The authorized representative certifies that the company is a U.S. entity not subject to backup withholding and that the provided EIN is correct. This form serves as official verification of the contractor's tax status and identification for purposes of state procurement and contracting with the State of Illinois.
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Other files
| File | Type | Posted |
|---|---|---|
| 27ROB0038 patient gowns BOA to be filled.docx | DOCX document | |
| upload_328132_BOA.pdf | ||
| Standard Terms and Conditions V23.2~98.pdf | ||
| notice of electronic submission only 23-1~42.pdf |
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Text version
STATE OF ILLINOIS
TAXPAYER IDENTIFICATION NUMBER
State of Illinois Chief Procurement Office General Services 10 Taxpayer Identification Number V.23.2
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: Ethan Miller
Business Name: E&N Service Company Taxpayer Identification Number:
Social Security Number:
or
Employer Identification Number: 92-2046429
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)
X Corporation NOT providing or billing C = corporation medical and/or health care services P = partnership
Signature of Authorized Representative:
Date: July 6, 2026
File details come from the government source that posted it. Updated .