State of Illinois Chief Procurement Office General Services 1 BOA under $50,000 V.23.2

ORDERING INFORMATION

One Time Charge Periodic Charge

Item Descrip on

(manufacturer, model, serial number, feature, etc.) Qty Unit Extension Unit Extension 1 Wix Oil Filter SKU: 51056 2 EA 19.50

Page Total: $39.00 BOA Total (if mulƟple pages): $

STATEOF ILLINOIS

BASIC ORDERING AGREEMENT (BOA) < $50,000

The terms and conditions of this BOA, including those terms and conditions set forth in the additional documents referenced below,and any continuation sheets, constitute the entire agreement between the parties with respect to the subject matter of this BOA. State documents will prevail in the event of a conflict between State and Vendor documents.

CONTACT INFORMATION

Vendor Name:Illinois Supply & Services Address: 900 Commerce Place, Suite #1062 Forsyth, IL 62535 Contact: Fullfill Department Phone #: 347-377-0143 Email: illinoissupplyservices@gmail.com Fax #: Click here to enter text.

State Agency Name: Danville Correctional Center Address: 3820 E Main St. Danville, IL 61834 Contact: Ashley Baker Phone #: 217-446-0441 ext. 218 Email: Ashley. A.baker@illinois.gov Fax#: 217-446-5098

Bill To:

Name: Rodney Dunham Address:

3820 E Main St.

Danville, IL 61834

Ship To:

Name: Rodney Dunham Address:

3820 E Main St.

Danville, IL 61834

CONTRACT INFORMATION

Contract #: 27-426DOC-DANVI-R-330985 Action: New Acquisition Type: Purchase Payment Cycle: Invoice Terms and Conditions: BOA Termsand Conditions

Term:

Begin Date:

Upon final signatures

End Date:

6/30/2026

State of Illinois Chief Procurement Office General Services 2 BOA under $50,000 V.23.2

ADDITIONAL INFORMATION / REFERENCES / ATTACHMENTS

1. Bid must be submiƩed through BidBuy. Only electronic submission will be accepted. All vendors must be registered in Bid Buy to be considered for contract award.

2. Delivery: Danville CorrecƟonal Center, AƩn: Business Administrator, Rodney Dunham

3. Pricing for all commodiƟes and/or equipment shall be in accordance with the unit of measure specified in the Pricing SecƟon and only one unit price shall be quoted per item unless otherwise stated. All extensions and totals requested shall be shown. Prices quoted must be net aŌer deducƟng all trade or quanƟty discounts.

4. Agency reserves the right to award bid in whole or in part.

5. Agency must have fully executed BOA, signed, and dated by both parƟes, prior to product being sent to the Agency by Vendor.

6. The vendor will be responsible for shipping or delivery of the parts to the Agency. All products must be received no later than 30 days from execuƟon of contract unless another Ɵmeframe is agreed upon between Vendor and Agency designee. Vendor is to include lead Ɵme with bid. Prices must be F.O.B. DESTINATION with all transportaƟon and handling included and paid by the Contractor. Deliveries are accepted Monday through Friday, 9:00 a.m. to 3:00 p.m., excluding state holidays.

Delivery to be made to the facility’s warehouse receiving dock.

7. Vendors, ensure this document is completed correctly prior to submiƫng.

8. COVID-19 PROTECTIONS -In response to the COVID-19 pandemic, Governor J.B. Pritzker issued ExecuƟve Order 2021-22 and 2021-23. These ExecuƟve Orders mandate certain contractors shall use face coverings, have COVID-19 vaccinaƟons, or undergo tesƟng for COVID-19 when in indoor public places, Health Care FaciliƟes, Schools, InsƟtuƟons of Higher EducaƟon, and State-owned and operated congregate faciliƟes. Vendor shall adhere to the requirements of these ExecuƟve Orders as applied by the Agency..

STATEUSE ONLY

Reference Number: 27-426DOC-DANVI-R-330985 Source Selection Method: Small Purchase Is Financing Needed? No Using Agency Funding Source:

Fiscal Year: 2027 Type: State

Approp. Account Code: 001-42656-1200-1230 Detailed Expenditure Object Code: 1230 Award Code: C Original ProcurementMethod: Small Purchase Subcontractors Utilized? No Subcontractors Disclosed? No

STATE OF ILLINOIS

FORMS B CERTIFICATIONS AND DISCLOSURES

State of Illinois Chief Procurement Office 3 BOA over $25,000 V.13.4

SIGNATURES The undersigned parƟes agree to these terms and condiƟons.

Vendor State of Illinois

Signature: State Agency:

Printed Name: Shaun Dew Signature agency representaƟve:

Title: Managing Member Printed Name:

Date: 7/26/2026 Title:

Date:

State of Illinois State of Illinois

Signature agency representaƟve: Signature agency representaƟve:

Printed Name: Shannon Sprouls for Trent Allen Printed Name:

Title: TA Business Administrator/Warden Title:

Date: Date:

STANDARD TERMS AND CONDITIONS

State of Illinois Chief Procurement Office General Services 4 BOA under $50,000 V.23.2

1. PAYMENT TERMS AND CONDITIONS:

1.1. Late Payment: Payments, including late payment charges, will be paid in accordance with the State Prompt Payment Act and rules when applicable. 30 ILCS 540; 74 III. Adm. Code 900. This shall be Vendor’s sole remedy for late payments by the State. Payment terms contained on Vendor’s invoices shall have no force and effect.

1.2. Minority Contractor IniƟaƟve: Any Vendor awarded a contract under SecƟon 20-10, 20-15, 20-25 or 20-30 of the Illinois Procurement Code (30 ILCS 500) of $1,000 or more is required to pay a fee of $15. The Comptroller shall deduct the fee from the first check issued to the Vendor under the contract and deposit the fee in the Comptroller’s AdministraƟve Fund. 15 ILCS 405/23.9.

1.3. Expenses: The State will not pay for supplies provided or services rendered, including related expenses, incurred prior to the execuƟon of this contract by the ParƟes even if the effecƟve date of the contract is prior to execuƟon.

1.4. Prevailing Wage: As a condiƟon of receiving payment Vendor must (i) be in compliance with the contract,

(ii) pay its employees prevailing wages when required by law, (iii) pay its suppliers and subcontractors according to the terms of their respecƟve contracts, and (iv) provide lien waivers to the State upon request. Examples of prevailing wage categories include public works, prinƟng, janitorial, window washing, building and grounds services, site technician services, natural resource services, security guard and food services. The prevailing wages are revised by the Department of Labor and are available on the Department’s official website, which shall be deemed proper noƟficaƟon of any rate changes under this subsecƟon. Vendor is responsible for contacƟng the Illinois Department of Labor to ensure understanding of prevailing wage requirements at 217-782-6206 or (h ps://labor.illinois.gov/).

1.5. Federal Funding: This contract may be parƟally or totally funded with Federal funds. If federal funds are expected to be used, then the percentage of the good/service paid using Federal funds and the total Federal funds expected to be used will be provided in the award noƟce.

1.6. Invoicing: By submiƫng an invoice, Vendor cerƟfies that the supplies or services provided meet all requirements of the contract, and the amount billed and expenses incurred are as allowed in the contract.

Invoices for supplies purchased, services performed, and expenses incurred through June 30 of any year must be submiƩed to the State no later than July 31 of that year; otherwise Vendor may have to seek payment through the Illinois Court of Claims. 30 ILCS 105/25. All invoices are subject to statutory offset.

30 ILCS 210.

1.6.1. Vendor shall not bill for any taxes unless accompanied by proof that the State is subject to the tax.

If necessary, Vendor may request the applicable Agency/University state tax exempƟon number and federal tax exempƟon informaƟon.

1.6.2. Vendor shall invoice at the compleƟon of the contract unless invoicing is Ɵed in the contract to milestones, deliverables, or other invoicing requirements agreed to in the contract.

State of Illinois Chief Procurement Office General Services 5 BOA under $50,000 V.23.2

2. ASSIGNMENT: This contract may not be assigned, transferred in whole or in part by Vendor without the prior wriƩen consent of the State.

3. SUBCONTRACTING: For purposes of this secƟon, subcontractors are those with contracts with an annual value exceeding $100,000 and who are specifically hired to perform all or part of the work covered by the contract.

Vendor must receive prior wriƩen approval before use of any subcontractors in the performance of this contract.

Vendor shall describe, in an aƩachment if not already provided, the names and addresses of all authorized subcontractors to be uƟlized by Vendor in the performance of this contract, together with a descripƟon of the work to be performed by the subcontractor and the anƟcipated amount of money that each subcontractor is expected to receive pursuant to this contract. If required, Vendor shall provide a copy of any subcontracts within fiŌeen (15) days aŌer execuƟon of this contract. All subcontracts must include the same cerƟficaƟons that Vendor must make as a condiƟon of this contract. Vendor shall include in each subcontract the Standard Illinois CerƟficaƟon form available from the State. If at any Ɵme during the term of the Contract, Vendor adds or changes any subcontractors, then Vendor must promptly noƟfy, by wriƩen amendment to the Contract, the State Purchasing Officer or the Chief Procurement Officer of the names and addresses, the expected amount of money that each new or replaced subcontractor will receive pursuant to the Contract , and the general type of work to be performed. 30 ILCS 500/20-120.

4. AUDIT/RETENTION OF RECORDS: Vendor and its subcontractors shall maintain books and records relaƟng to the performance of the contract or subcontract and necessary to support amounts charged to the State pursuant the contract or subcontract. Books and records, including informaƟon stored in databases or other computer systems, shall be maintained by the Vendor for a period of three (3) years from the later of the date of final payment under the contract or compleƟon of the contract, and by the subcontractor for a period of three (3) years from the later of final payment under the term or compleƟon of the subcontract. If Federal funds are used to pay contract costs, the Vendor and its subcontractorsmust retain their respecƟve records for five (5) years. Books and records required to bemaintained under this secƟon shall be available for review or audit by representaƟves of: the procuring Agency, the Auditor General, the ExecuƟve Inspector General, the Chief Procurement Officer, State of Illinois internal auditors or other governmental enƟƟes with monitoring authority, upon reasonable noƟce and during normal business hours. Vendor and its subcontractors shall cooperate fully with any such audit and with any invesƟgaƟon conducted by any of these enƟƟes. Failure to maintain books and records required by this secƟon shall establish a presumpƟon in favor of the State for the recovery of any funds paid by the State under this contract or any subcontract for which adequate books and records are not available to support the purported disbursement. The Vendor or subcontractors shall not impose a charge for audit or examinaƟon of the Vendor’s or subcontractor’s books and records. 30 ILCS 500/20-65.

5. TIME IS OF THE ESSENCE: Time is of the essence with respect to Vendor’s performance of this contract. Vendor shall conƟnue to perform its obligaƟons while any dispute concerning the contract is being resolved unless otherwise directed by the State.

6. NO WAIVER OF RIGHTS: Except as specifically waived in wriƟng, failure by a Party to exercise or enforce a right does not waive that Party’s right to exercise or enforce that or other rights in the future.

7. FORCE MAJEURE: Failure by either Party to perform its duƟes and obligaƟons will be excused by unforeseeable circumstances beyond its reasonable control and not due to its negligence, including acts of nature, acts of terrorism, riots, labor disputes, fire, flood, explosion, and governmental prohibiƟon. The non-declaring Party may cancel the contract without penalty if performance does not resume within thirty (30) days of the declaraƟon.

State of Illinois Chief Procurement Office General Services 6 BOA under $50,000 V.23.2

8. CONFIDENTIAL INFORMATION: Each Party, including its agents and subcontractors, to this contract may have or gain access to confidenƟal data or informaƟon owned or maintained by the other Party in the course of carrying out its responsibiliƟes under this contract. Vendor shall presume all informaƟon received from the State or to which it gains access pursuant to this contract is confidenƟal. Vendor informaƟon, unless clearly marked as confidenƟal and exempt from disclosure under the Illinois Freedom of InformaƟon Act, shall be considered public.

No confidenƟal data collected, maintained, or used in the course of performance of the contract shall be disseminated except as authorized by law and with the wriƩen consent of the disclosing Party, either during the period of the contract or thereaŌer. The receiving Party must return any and all data collected, maintained, created or used in the course of the performance of the contract, in whatever form it is maintained, promptly at the end of the contract, or earlier at the request of the disclosing Party, or noƟfy the disclosing Party in wriƟng of its destrucƟon. The foregoing obligaƟons shall not apply to confidenƟal data or informaƟon lawfully in the receiving Party’s possession prior to its acquisiƟon from the disclosing Party; received in good faith from a third Party not subject to any confidenƟality obligaƟon to the disclosing Party; now is or later becomes publicly known through no breach of confidenƟality obligaƟon by the receiving Party; or is independently developed by the receiving Party without the use or benefit of the disclosing Party’s confidenƟal informaƟon.

9. USE AND OWNERSHIP: All work performed or supplies created by Vendor under this contract, whether wriƩen documents or data, goods or deliverables of any kind, shall be deemed work for hire under copyright law and all intellectual property and other laws, and the State of Illinois is granted sole and exclusive ownership to all such work, unless otherwise agreed in wriƟng. Vendor hereby assigns to the State all right, Ɵtle, and interest in and to suchwork including any related intellectual property rights, and/or waives any and all claims that Vendor may have to such work including any so-called "moral rights" in connecƟon with the work. Vendor acknowledges the State may use the work product for any purpose. ConfidenƟal data or informaƟon contained in such work shall be subject to confidenƟality provisions of this contract.

10. INDEMNIFICATION AND LIABILITY: The Vendor shall indemnify and hold harmless the State of Illinois, its agencies, officers, employees, agents and volunteers from any and all costs, demands, expenses, losses, claims, damages, liabiliƟes, seƩlements and judgments, including in-house and contracted aƩorneys’ fees and expenses, arising out of: (a) any breach or violaƟon by Vendor of any of its cerƟficaƟons, representaƟons, warranƟes, covenants or agreements; (b) any actual or alleged death or injury to any person, damage to any real or personal property, or any other damage or loss claimed to result in whole or in part from Vendor’s negligent performance; (c) any act, acƟvity or omission of Vendor or any of its employees, representaƟves, subcontractors or agents; or (d) any actual or alleged claim that the services or goods provided under this contract infringe, misappropriate, or otherwise violate any intellectual property (patent, copyright, trade secret, or trademark) rights of a third party. In accordance with ArƟcle VIII, SecƟon 1(a),(b) of the ConsƟtuƟon of the State of Illinois and 1973 Illinois AƩorney General Opinion 78, the State may not indemnify private parƟes absent express statutory authority permiƫng the indemnificaƟon. Neither Party shall be liable for incidental, special, consequenƟal, or puniƟve damages.

11. INSURANCE: Vendor shall, at all Ɵmes during the term and any renewals maintain and provide a CerƟficate of Insurance naming the State as addiƟonally insured for all required bonds and insurance. CerƟficates may not be modified or canceled unƟl at least thirty (30) days’ noƟce has been provided to the State. Vendor shall provide: (a) General Commercial Liability occurrence form in amount of $1,000,000 per occurrence (Combined Single Limit Bodily Injury and Property Damage) and $2,000,000 Annual Aggregate; (b) Auto Liability, including Hired Auto and Non-owned Auto, (Combined Single Limit Bodily Injury and Property Damage) in amount of $1,000,000 per occurrence; and (c) Worker’s CompensaƟon Insurance in amount required by law. Insurance shall not limit Vendor’s obligaƟon to indemnify, defend, or seƩle any claims.

State of Illinois Chief Procurement Office General Services 7 BOA under $50,000 V.23.2

12. INDEPENDENT CONTRACTOR: Vendor shall act as an independent contractor and not an agent or employee of, or joint venture with the State. All payments by the State shall be made on that basis.

13. SOLICITATION AND EMPLOYMENT: Vendor shall not employ any person employed by the State during the term of this contract to perform any work under this contract. Vendor shall give noƟce immediately to the Agency’s director if Vendor solicits or intends to solicit State employees to perform any work under this contract.

14. COMPLIANCE WITH THE LAW: The Vendor, its employees, agents, and subcontractors shall comply with all applicable federal, state, and local laws, rules, ordinances, regulaƟons, orders, federal circulars and all license and permit requirements in the performance of this contract. Vendor shall be in compliance with applicable tax requirements and shall be current in payment of such taxes. Vendor shall obtain at its own expense, all licenses and permissions necessary for the performance of this contract.

15. BACKGROUND CHECK: Whenever the State deems it reasonably necessary for security reasons, the State may conduct, at its expense, criminal and driver history background checks of Vendor’s and subcontractor’s officers, employees or agents. Vendor or subcontractor shall reassign immediately any such individual who, in the opinion of the State, does not pass the background check.

16. APPLICABLE LAW:

16.1. PREVAILING LAW: This contract shall be construed in accordance with and is subject to the laws and rules of the State of Illinois.

16.2. EQUAL OPPORTUNITY: The Department of Human Rights’ Equal Opportunity requirements are incorporated by reference. 44 ILL. ADM. CODE 750.

16.3. COURT OF CLAIMS; ARBITRATION; SOVEREIGN IMMUNITY: Any claim against the State arising out of this contract must be filed exclusively with the Illinois Court of Claims. 705 ILCS 505/1. The State shall not enter into binding arbitraƟon to resolve any dispute arising out of this contract. The State of Illinois does not waive sovereign immunity by entering into this contract.

16.4. OFFICIAL TEXT: The official text of the statutes cited herein is incorporated by reference. An unofficial version can be viewed at (www.ilga.gov/legisla on/ilcs/ilcs.asp).

17. ANTI-TRUST ASSIGNMENT: If Vendor does not pursue any claim or cause of acƟon it has arising under federal or state anƟtrust laws relaƟng to the subject maƩer of the contract, then upon request of the Illinois AƩorney General, Vendor shall assign to the State rights, Ɵtle and interest in and to the claim or cause of acƟon.

18. CONTRACTUALAUTHORITY: The Agency that signs for the State of Illinois shall be the only State enƟty responsible for performance and payment under the contract. When the Chief Procurement Officer or authorized designee signs in addiƟon to an Agency, they do so as approving officer and shall have no liability to Vendor. When the Chief Procurement Officer or authorized designee, or State Purchasing Officer signs a master contract on behalf of State agencies, only the Agency that places an order with the Vendor shall have any liability to Vendor for that order.

19. EXPATRIATED ENTITIES: Except in limited circumstances, no business or member of a unitary business group, as defined in the Illinois Income Tax Act, shall submit a bid for or enter into a contract with a State agency if that business or any member of the unitary business group is an expatriated enƟty.

State of Illinois Chief Procurement Office General Services 8 BOA under $50,000 V.23.2

20. NOTICES: NoƟces and other communicaƟons provided for herein shall be given in wriƟng via electronic mail whenever possible. If transmission via electronic mail is not possible, then noƟces and other communicaƟons shall be given in wriƟng via registered or cerƟfied mail with return receipt requested, via receipted hand delivery, via courier (UPS, Federal Express or other similar and reliable carrier), or via facsimile showing the date and Ɵme of successful receipt. NoƟces shall be sent to the individuals who signed this contract using the contact informaƟon following the signatures. Each such noƟce shall be deemed to have been provided at the Ɵme it is actually received. By giving noƟce, either Party may change its contact informaƟon.

21. MODIFICATIONS AND SURVIVAL: Amendments, modificaƟons and waivers must be in wriƟng and signed by authorized representaƟves of the ParƟes. Any provision of this contract officially declared void, unenforceable, or against public policy, shall be ignored and the remaining provisions shall be interpreted, as far as possible, to give effect to the ParƟes’ intent. All provisions that by their nature would be expected to survive, shall survive terminaƟon. In the event of a conflict between the State’s and the Vendor’s terms, condiƟons and aƩachments, the State’s terms, condiƟons and aƩachments shall prevail.

22. PERFORMANCE RECORD / SUSPENSION: Upon request of the State, Vendor shall meet to discuss performance or provide contract performance updates to help ensure proper performance of the contract. The Statemay consider Vendor’s performance under this contract and compliancewith law and rule to determinewhether to conƟnue the contract, suspend Vendor from doing future business with the State for a specified period of Ɵme, or whether Vendor can be considered responsible on specific future contract opportuniƟes.

23. FREEDOM OF INFORMATION ACT: This contract and all related public records maintained by, provided to or required to be provided to the State are subject to the Illinois Freedom of InformaƟon Act (FOIA) (50 ILCS 140) notwithstanding any provision to the contrary that may be found in this contract.

24. SCHEDULE OF WORK: Any work performed on State premises shall be done during the hours designated by the State and performed in a manner that does not interfere with the State and its personnel.

25. WARRANTIES FOR SUPPLIES AND SERVICES:

25.1. Vendor warrants that the supplies furnished under this contract will: (a) conform to the standards, specificaƟons, drawing, samples or descripƟons furnished by the State or furnished by the Vendor and agreed to by the State, including but not limited to all specificaƟons aƩached as exhibits hereto; (b) be merchantable, of good quality and workmanship, and free from defects for a period of twelve months or longer if so specified in wriƟng, and fit and sufficient for the intended use; (c) comply with all federal and state laws, regulaƟons and ordinances pertaining to the manufacturing, packing, labeling, sale and delivery of the supplies; (d) be of good Ɵtle and be free and clear of all liens and encumbrances and; (e) not infringe any patent, copyright or other intellectual property rights of any third party. Vendor agrees to reimburse the State for any losses, costs, damages or expenses, including without limitaƟons, reasonable aƩorney’s fees and expenses, arising from failure of the supplies to meet such warranƟes.

25.2. Vendor shall insure that all manufacturers’ warranƟes are transferred to the State and shall provide a copy of the warranty. ThesewarranƟes shall be in addiƟon to all other warranƟes, express, implied or statutory, and shall survive the State’s payment, acceptance, inspecƟon or failure to inspect the supplies.

State of Illinois Chief Procurement Office General Services 9 BOA under $50,000 V.23.2

25.3. Vendor warrants that all services will be performed to meet the requirements of the contract in an efficient and effecƟve manner by trained and competent personnel. Vendor shall monitor performances of each individual and shall reassign immediately any individual who is not performing in accordance with the contract, who is disrupƟve or not respecƞul of others in the workplace, or who in any way violates the contract or State policies.

26. REPORTING, STATUS ANDMONITORING SPECIFICATIONS: Vendor shall immediately noƟfy the State of any event that may have a material impact on Vendor’s ability to perform the contract.

27. EMPLOYMENT TAX CREDIT: Vendors who hire qualified veterans and certain ex-offenders may be eligible for tax credits. 35 ILCS 5/216, 5/217. Please contact the Illinois Department of Revenue (telephone #: 217-524-4772) for informaƟon about tax credits.

28. TERMINATION FOR CAUSE: The Statemay terminate this contract, in whole or in part, immediately upon noƟce to the Vendor if: (a) the State determines that the acƟons or inacƟons of the Vendor, its agents, employees or subcontractors have caused, or reasonably could cause, jeopardy to health, safety, or property, or (b) the Vendor has noƟfied the State that it is unable or unwilling to perform the contract.

28.1. If Vendor fails to perform to the State’s saƟsfacƟon any material requirement of this contract, is in violaƟon of amaterial provision of this contract, or the State determines that the Vendor lacks the financial resources to perform the contract, the State shall provide wriƩen noƟce to the Vendor to cure the problem idenƟfied within the period of Ɵme specified in the State’s wriƩen noƟce. If not cured by that date the State may either: (a) immediately terminate the contract without addiƟonal wriƩen noƟce or (b) enforce the terms and condiƟons of the contract.

28.2. For terminaƟon due to any of the causes contained in this SecƟon, the State retains its rights to seek any available legal or equitable remedies and damages.

29. TERMINATION FOR CONVENIENCE: The State may, for its convenience and with thirty (30) days prior wriƩen noƟce to Vendor, terminate this contract in whole or in part and without payment of any penalty or incurring any further obligaƟon to the Vendor.

29.1. The Vendor shall be enƟtled to compensaƟon upon submission of invoices and proof of claim for supplies and services provided in compliance with this contract up to and including the date of terminaƟon.

30. AVAILABILITY OF APPROPRIATION: This contract is conƟngent upon and subject to the availability of funds. The State, at its sole opƟon, may terminate or suspend this contract, in whole or in part, without penalty or further payment being required, if (1) the Illinois General Assembly or the federal funding source fails to make an appropriaƟon sufficient to pay such obligaƟon, or if funds needed are insufficient for any reason (30 ILCS 500/20- 60), (2) the Governor decreases the Department’s funding by reserving some or all of the Department’s appropriaƟon(s) pursuant to power delegated to the Governor by the Illinois General Assembly, or (3) the Department determines, in its sole discreƟon or as directed by the Office of the Governor, that a reducƟon is necessary or advisable based upon actual or projected budgetary consideraƟons. Contractor will be noƟfied in wriƟng of the failure of appropriaƟon or of a reducƟon or decrease.

TAXPAYER IDENTIFICATION NUMBER

State of Illinois Chief Procurement Office General Services 10 Taxpayer IdenƟficaƟon Number V.23.2

I cerƟfy that:

The number shown on this form is my correct taxpayer idenƟficaƟon number (or I am waiƟng 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 noƟfied 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 noƟfied 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 enƟty 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 corporaƟon or partnership, enter the enƟty’s business name and EIN and for corporaƟons, aƩach IRS acceptance leƩer (CP261 or CP277).

For all other enƟƟes, enter the name of the enƟty as used to apply for the enƟty’s EIN and the EIN.

Name: Illinois Supply & Services Business Name: Shaun Dew Taxpayer IdenƟficaƟon Number:

Social Security Number: Click here to enter text.

or

Employer IdenƟficaƟon Number: 42-2373542 Legal Status (check one):

Individual Governmental

Sole Proprietor Nonresident alien

Partnership Estate or trust

Legal Services CorporaƟon Pharmacy (Non-Corp.)

Tax-exempt Pharmacy/Funeral Home/Cemetery (Corp.)

CorporaƟon providing or billing Limited Liability Company medical and/or health care services (select applicable tax classificaƟon)

CorporaƟon NOT providing or billing C = corporaƟon medical and/or health care services P = partnership

Signature of Authorized RepresentaƟve:

Date: 7/26/2026