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Agreement No.HS-22-0071, 04-02 <br /> INTER-GOVERNMENTAL AGREEMENT <br /> � I <br /> i <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 <br /> at 2300 S. Dirksen Parkway, Springfield, IL 62764 <br /> and City of Decatur (Grantee)with its principal <br /> 1 Gary K Anderson Plaza, Decatur, IL 62523 <br /> and payment address(if different than principal office)at Same <br /> hereby enter into this Inter-Governmental Grant Agreement(Agreement), pursuant to the Intergovernmental Cooperation <br /> Act, 5 ILCS 220/1 et seq. Grantor and Grantee are collectively referred to herein as"Parties"or individually as a "Party." <br /> PART ONE-THE UNIFORM TERMS <br /> RECITALS <br /> WHEREAS, it is the intent of the Parties to perform consistent with all Exhibits and attachments hereto and pursuant <br /> to the duties and responsibilities imposed by Grantor under the laws of the state of Illinois and in accordance with the <br /> terms, conditions and provisions hereof. <br /> NOW, THEREFORE, in consideration of the foregoing and the mutual agreements contained herein, and for other <br /> good and valuable consideration, the value, receipt and sufficiency of which are acknowledged,the Parties hereto agree <br /> as follows: <br /> ARTICLE I <br /> AWARD AND GRANTEE SPECIFIC INFORMATION AND CERTIFICATION <br /> 1.1 DUNS Number, SAM Registration: Nature of Entity. Under penalties of perjury, Grantee certifies that <br /> 075613000 is Grantee's correct DUNS Number,that N/A is Grantee's correct <br /> UEI, if applicable, that 376001308 is Grantee's correct FEIN or Social Security Number, and that <br /> Grantee has an active State registration and 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 applicable <br /> ❑ Medical Corporation 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 submit a W-9 tax form <br /> with this Agreement. <br /> State of Illinois <br /> INTERGOVERNMENTAL GRANT AGREEMENT(U-IGA)FISCAL YEAR 2022/3 4 21 <br /> Page 1 of 41 <br />