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Agreement No. 4953(19-1141-9499) <br /> GRANT AGREEMENT <br /> ,.., <br /> � <br /> n16 <br /> BETWEEN <br /> THE STATE OF ILLINOIS, ILLINOIS DEPARTMENT OF TRANSPORTATION <br /> AND <br /> CITY OF DECATUR <br /> The illinois Department of Transportation (Grantor),with its principal office at <br /> 2300 South Dirksen Parkway,Springfield IL.62764, <br /> and City of Decatur (Grantee),with its principal o�ce at <br /> 1 Gary K Ande�son Plaza, Decatur, IL 62523, <br /> and payment address(if different than principal o�ce)at Same <br /> hereby enter into this Grant Agreement(Agreement).Grantor and Grantee are collectively referred to herein <br /> as"Parties°or individually as a°Parfy." <br /> PART ONE—THE UNIFORM TERMS <br /> RECITALS <br /> WHEF2EAS, it is the intent of the Parties to perform consistent with all Exhibits and attachments hereto <br /> and pursuant to the duties and responsibilities imposed by Grantor under the laws of the State of Illinois and <br /> in accordance with the terms,conditions and provisions hereof. <br /> NOW,THEREFORE, in consideration of the foregoing and the mutual agreements contained herein,and <br /> for other good and vatuable consideration,the value, receipt and sufficiency of which are acknowledged,the <br /> Parties hereto agree as follows: <br /> ARTICLE I <br /> AWARD AND GRANTEE SPECtFIC INFORMATION AND CERTIFICATION <br /> 1.1 DUNS Number:SAM Reqistration: Nature of Entitv. Under penafties of perjury,Grantee <br /> certifies that 075613000 is Grantee's correct DUNS number,that 376001308 <br /> is Grantee's correct FEIN or Social Security Number, and that Grantee has an active State registration and <br /> SAM registration.Grantee is doing business as a(check one): <br /> ❑ Individual ❑ Pharmacy-Non Corporate <br /> ❑ Sole Proprietorship ❑ Pharmacy/Funeral Home/Cemetery Corp. <br /> ❑ Partnership ❑ Tax Exempt • <br /> ❑ Corporation(includes Not For Profit} ❑ Limited Liability Company(select <br /> ❑ Medical Corporatian applicable tax classification) <br /> � Governmental Unit ❑ P=partnership <br /> ❑ Estate or Trust ❑ C=corporation <br /> If Grantee has not received a payment from the State of Illinois in the last two years.Grantee must <br /> submit a W-9 tax form with this Agreement. <br /> 1.2 Amount of Agreement. Grant Funds(check one) ❑ shall not exceed or � are estimated to be <br /> State of Illinois <br /> ���y���� GRANT AGREEMENT(UGA)FISCAL YEAR 2U19/21418 <br /> � Page 1 of 46 <br />