Common use of Ownership Share Clause in Contracts

Ownership Share. If you selected Option 1.A., 2.A., 2.B., 3.A., or 4.A. in Step 1, provide the name and address of each individual and their percentage of ownership if said percentage exceeds 5%, or the dollar value of their ownership if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – X Name Address Percentage of Ownership $ Value of Ownership Distributive Income – If you selected Option 1.A., 2.A., 3.A., or 4.A. in Step 1, provide the name and address of each individual and their percentage of the disclosing vendor’s total distributive income if said percentage exceeds 5% of the total distributive income of the disclosing entity, or the dollar value of their distributive income if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – Y Name Address % of Distributive Income $ Value of Distributive Income Please certify that the following statements are true. I have disclosed all individuals or entities that hold an ownership interest of greater than 5% or greater than $106,447.20. Yes No I have disclosed all individuals or entities that were entitled to receive distributive income in an amount greater than $106,447.20 or greater than 5% of the total distributive income of the disclosing entity. Yes No OPTION B – Disclosure of Board of Directors (Not-for-Profits) If you selected Option 5 in Step 1, list members of your board of directors. Please include an attachment if necessary. TABLE – Z Name Address STEP 3 DISCLOSURE OF LOBBYIST OR AGENT (Complete only if bid, offer, or contract has an annual value over $25,000) (Subcontractors with subcontract annual value of more than $50,000 must complete) Yes No. Is your company represented by or do you employ a lobbyist or other agent required to register under the Lobbyist Registration Act (lobbyist must be registered pursuant to the Act with the Secretary of State) or other agent who is not identified through Step 2, Option A above and who has communicated, is communicating, or may communicate with any State/Public University officer or employee concerning the bid or offer? If yes, please identify each lobbyist and agent, including the name and address below. Name Address Relationship to Disclosing Entity Describe all costs/fees/compensation/reimbursements related to the assistance provided by each representative lobbyist or other agent to obtain an Agency/University contract:

Ownership Share. If you selected Option 1.A., 2.A., 2.B., 3.A., or 4.A. in Step 1, provide the name and address of each individual and their percentage of ownership if said percentage exceeds 5%, or the dollar value of their ownership if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – X Name Address Percentage of Ownership $ Value of Ownership Distributive Income – If you selected Option 1.A., 2.A., 3.A., or 4.A. in Step 1, provide the name and address of each individual and their percentage of the disclosing vendor’s total distributive income if said percentage exceeds 5% of the total distributive income of the disclosing entity, or the dollar value of their distributive income if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – Y Name Address % of Distributive Income $ Value of Distributive Income Please certify that the following statements are true. I have disclosed all individuals or entities that hold an ownership interest of greater than 5% or greater than $106,447.20. Yes No I have disclosed all individuals or entities that were entitled to receive distributive income in an amount greater than $106,447.20 or greater than 5% of the total distributive income of the disclosing entity. Yes No OPTION B – Disclosure of Board of Directors (Not-for-Profits) If you selected Option 5 in Step 1, list members of your board of directors. Please include an attachment if necessary. TABLE – Z Name Address STEP 3 DISCLOSURE OF LOBBYIST OR AGENT (Complete only if bid, offer, or contract has an annual value over $25,000) (Subcontractors with subcontract annual value of more than $50,000 must complete) Yes No. Is your company represented by or do you employ a lobbyist or other agent required to register under the Lobbyist Registration Act (lobbyist must be registered pursuant to the Act with the Secretary of State) or other agent who is not identified through Step 2, Option A above and who has communicated, is communicating, or may communicate with any State/Public University officer or employee concerning the bid or offer? If yes, please identify each lobbyist and agent, including the name and address below. Name Address Relationship to Disclosing Entity Describe all costs/fees/compensation/reimbursements related to the assistance provided by each representative lobbyist or other agent to obtain an Agency/University contract: Step 4 must be completed for each person disclosed in Step 2, Option A and for sole proprietors identified in Step 1, Option 6 above. Please provide the name of the person for which responses are provided:

Ownership Share. If you selected Option 1.A., 2.A., 2.B., 3.A., or 4.A. in Step 1, provide the name and address of each individual and entity and their percentage of ownership if said percentage exceeds 5%, or the dollar value of their ownership if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – X Name Address Percentage % of Ownership $ Value of Ownership Distributive Income – If you selected Option 1.A., 2.A., 3.A., or 4.A. in Step 1, provide the name and address of each individual and their percentage of the disclosing vendor’s total distributive income if said percentage exceeds 5% of the total distributive income of the disclosing entity, or the dollar value of their distributive income if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – Y Name Address % of Distributive Income $ Value of Distributive Income Please certify that the following statements are true. I have disclosed all individuals or entities that hold an ownership interest of greater than 5% or greater than $106,447.20. Yes No I have disclosed all individuals or entities that were entitled to receive distributive income in an amount greater than $106,447.20 or greater than 5% of the total distributive income of the disclosing entity. Yes No OPTION B – Disclosure of Board of Directors (Not-for-Profits) If you selected Option 5 in Step 1, list members of your board of directors. Please include an attachment if necessary. TABLE – Z Name Address STEP 3 DISCLOSURE OF LOBBYIST OR AGENT (Complete only if bid, offer, or contract has an annual value over $25,000) (Subcontractors with subcontract annual value of more than $50,000 must complete) Yes No. Is your company represented by or do you employ a lobbyist or other agent required to register under the Lobbyist Registration Act (lobbyist must be registered pursuant to the Act with the Secretary of State) or other agent who is not identified through Step 2, Option A above and who has communicated, is communicating, or may communicate with any State/Public University officer or employee concerning the bid or offer? If yes, please identify each lobbyist and agent, including the name and address below. Name Address Relationship to Disclosing Entity Describe all costs/fees/compensation/reimbursements related to the assistance provided by each representative lobbyist or other agent to obtain an Agencya State/Public University contract:

Ownership Share. If you selected Option 1.A., 2.A., 2.B., 3.A., or 4.A. in Step 1, provide the name and address of each individual and entity and their percentage of ownership if said percentage exceeds 5%, or the dollar value of their ownership if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – X Name Address Percentage of Ownership $ Value of Ownership Distributive Income – If you selected Option 1.A., 2.A., 3.A., or 4.A. in Step 1, provide the name and address of each individual and their percentage of the disclosing vendor’s total distributive income if said percentage exceeds 5% of the total distributive income of the disclosing entity, or the dollar value of their distributive income if said dollar value exceeds $106,447.20. Check here if including an attachment with requested information in a format substantially similar to the format below. TABLE – Y Name Address % of Distributive Income $ Value of Distributive Income Please certify that the following statements are true. I have disclosed all individuals or entities that hold an ownership interest of greater than 5% or greater than $106,447.20. Yes No I have disclosed all individuals or entities that were entitled to receive distributive income in an amount greater than $106,447.20 or greater than 5% of the total distributive income of the disclosing entity. Yes No OPTION B – Disclosure of Board of Directors (Not-for-Profits) If you selected Option 5 in Step 1, list members of your board of directors. Please include an attachment if necessary. TABLE – Z Name Address STEP 3 DISCLOSURE OF LOBBYIST OR AGENT (Complete only if bid, offer, or contract has an annual value over $25,000) (Subcontractors with subcontract annual value of more than $50,000 must complete) Yes No. Is your company represented by or do you employ a lobbyist or other agent required to register under the Lobbyist Registration Act (lobbyist must be registered pursuant to the Act with the Secretary of State) or other agent who is not identified through Step 2, Option A above and who has communicated, is communicating, or may communicate with any State/Public University officer or employee concerning the bid or offer? If yes, please identify each lobbyist and agent, including the name and address below. Name Address Relationship to Disclosing Entity Describe all costs/fees/compensation/reimbursements related to the assistance provided by each representative lobbyist or other agent to obtain an Agencya State/Public University contract: