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Xxxxxxx Xxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 2 Xxxxxxx@XXXXX.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 9542922732 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 XXX.XXXXX.XXX Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 AMG, LLC Primary Address Primary Address 2 6 0000 Xxxxx Xx Primary Address City Primary Address City 7 Titusville Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 FL Primary Address Zip Primary Address Zip 9 32780 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation. 0 General Contracting, Electrical Contracting, Logistics Products & Services, Fire Alarm, Fire Alarm Design, Fire Suppression, Fire Detection Systems, Electronic Security, Supply Chain, Mod Move Services, Graphic & Web Design, Digital Antenna System, Building Automation & Control Systems, Professional Consulting Services, RF Signal Strength Survey Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
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Xxxxx Xxxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 2 xxxxxxx@xxxxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 5013512221 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 Arkansas Service One HVAC, Inc. Primary Address Primary Address 2 0000 Xxxxxxxxx Xxxxxx Xx Primary Address City Primary Address City 7 Bryant Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 Arkansas Primary Address Zip Primary Address Zip 9 72022 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation. 0
Xxxxxxxx Xxxxxx Xxxxxxxx@xxx.xxx Xxx Xxxxxx Xxxxxx.Xxxxxx@xxx.xxx Xxx X. Hershey Xxx.Xxxxxxx@xxx.xxx Date: Subject: [•], 20[•] Equity Distribution Agreement – Placement Notice Gentlemen: Pursuant to the terms and subject to the conditions contained in the Equity Distribution Agreement between Inhibikase Therapeutics, Inc. ( “Company”), and Xxxxx Xxxxxxx & Co. ( “Agent”) dated May 16, 2022 (the “Agreement”), the Company hereby requests that Agent sell up to [ ] shares of the Company’s common stock, par value $0.001 per share, at a minimum market price of $[ ] per share. Sales should begin on the date of this Placement Notice and shall continue until [ ] /[all shares are sold]. SCHEDULE 2 NOTICE PARTIES Inhibikase Therapeutics, Inc. Xxxxxx X. Xxxxxx, Ph.D. Xxxxxx X. Xxxxxxxxxx Xxxxx Xxxxxxx & Co. Xxxx X. Riley Xxxx.Xxxxx@xxx.xxx Xxxxxxx X. Bassett Xxxxxxx.Xxxxxxx@xxx.xxx Connor X. Xxxxxxxx Xxxxxx.Xxxxxxxx@xxx.xxx Xxx Xxxxxx Xxxxxx.Xxxxxx@xxx.xxx Xxx X. Hershey Xxx.Xxxxxxx@xxx.xxx SCHEDULE 3 FORM OF REPRESENTATION CERTIFICATE PURSUANT TO SECTION 3(q) OF THE AGREEMENT [Date] Xxxxx Xxxxxxx & Co. 000 Xxxxxxxx Xxxx Xxxxxxxxxxx, XX 00000 Sir: The undersigned, the duly qualified and elected [ ], of Inhibikase Therapeutics, Inc., a Delaware corporation (the “Company”), does hereby certify in such capacity and on behalf of the Company, pursuant to Section 3(q) of the Equity Distribution Agreement, dated May 16, 2022 (the “Equity Distribution Agreement”), between the Company and Xxxxx Xxxxxxx & Co., that to the best of the knowledge of the undersigned:
Xxxxxxx Xxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 2 xxxxxxxx@xxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 9728241762 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 2 4 xxx.xxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 Connect Technology Group Primary Address Primary Address 6 0000 XxxXxxxxx Xx. Xxxxx 000 Primary Address City Primary Address City 7 Carrollton Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 75007 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation.
