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Agreement No.5063(20-1141-13467� <br /> GRANT AGREEMENT <br /> � <br /> i <br /> �����(, <br /> THE S7ATE OF IL.LiNO1S, ILLlNOI� DEPARTI9�ENT OF TRANSPORTATION <br /> AND <br /> CITY OF DE�ATUR 1�LENOIS <br /> The Iltinois Department of Transportation (Grantar)with its principa(ofifice at <br /> 230fl South D'rrksen Parlcway,Speingfieid IL.62764 <br /> and City of Decatur tilinois (Grantee)with its principai office at <br /> 1 Gary K.Anderson Plaza, Decatut, IL 62523 <br /> and payment address(if different#han principal affice)at Sarne <br /> hereby enter into this Grant Agreement(Agreement).Grantor and Grantee are collectively referred to herein as"Parties" <br /> or individua(ly as a"Pa�#y" <br /> PART UNE-THE UNtFQ�M TERMB <br /> RECI7�L5 <br /> WHEREAS, it is the intent of the Parkiss ta perform consistent with al! Exhibits and attachments hereto and pursuant <br /> to the duties and responsibilities imposed by Grantor under the laws Qf the state of Iflinois and in sccordance with the <br /> terms, conditions and provisions hereof. <br /> iVdW, TNEREFORE, in consideraftan of the foregoing�and the mutual agreements contained herein,and for other <br /> good and valuable cansideration,the value, receipt and sufficiency of which are acknowledged,the Parties hereta agree <br /> as foiiaws: <br /> AR71Cl.E 1 <br /> AWARD AND GRANTEE SPEClFIC INFORMATION AND CERTIFICATION <br /> 1.1 Q�tNS,�(umber SAtv�Regi�#,ration� Nature af E*�t's#v Under penalties of perjury, Grantee ceRi€es that <br /> Q75613000 is Grantee's correct DUNS number, 376001308 is Grantee's coRect FEIN <br /> or Social Security Number,and that Granfee has an activ�State registration and SAM registration.Grantee is doing <br /> business as a(check one); <br /> ❑ lndividual ❑ Pharmac�y-Non Corporate <br /> ❑ Sole Proprietorship ❑ Pharma�y/Funerai Mome/Cemetery Corp. <br /> ❑ Pa�tnership ❑ 7ax Exempt <br /> ❑ Corparation(includes Not for Profit) ❑ Limited Liability Company(select appticable <br /> ❑ Medicai Corporation tax classification) <br /> � Gov�rnmental Unit ❑ P=partnersFtip <br /> ❑ Estate or Trust ❑ C=aorparation <br /> ##Grantee has not received a paymen#from#he state of 1!lonois in the I�st two years,Grantee must submit a W-9 tax form <br /> with this Agreement. <br /> , SCate of iilinais <br /> GRANT AGREEMENT FISCAL YEAR 2q20(1 7 19 <br /> Page i of 43 <br />