Xxxxx Xxxxxxxx Admin Fee Contact Email Admin Fee Contact Email 1 9 xxxxxxx@xx-xxxxxxxxxx.xxx Admin Fee Contact Phone Enter 10 digit phone number. (No dashes or extensions) Example: 8668398477 0 4098423737 Purchase Order Contact Name Purchase Order Contact Name. This person is responsible for receiving Purchase Orders from TIPS. Xxxxxx Xxxxxx Purchase Order Contact Email Purchase Order Contact Email 2 xxxxxxx@xx-xxxxxxxxxx.xxx Purchase Order Contact Phone Enter 10 digit phone number. (No dashes or extensions) Example: 8668398477 3 4098423737 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxxxxx.xxx Entity D/B/A's and Assumed Names 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 responded to this solicitation unless you organize otherwise with TIPS after award. 5 Industrial & Commercial Mechanical, LLC Primary Address Primary Address 2 6 0000 Xxxxxxxx Xxxxxx Primary Address City Primary Address City 7 Beaumont Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 77705 Search Words: Please list search words to be posted in the TIPS database about your company that TIPS website users might search. Words may be product names, manufacturers, or other words associated with the category of award. YOU MAY NOT LIST NON-CATEGORY ITEMS. (Limit 500 words) (Format: product, paper, construction, manufacturer name, etc.) 3 A/C, Air conditioning, heating, ductwork, sheet metal, refrigeration, cooler, freezer, ventilation, HVAC, HVAC/R Do you want TIPS Members to be able to spend Federal grant funds with you if awarded? Is it your intent to be able to sell to our members regardless of the fund source, whether it be local, state or federal? Most of our members receive Federal Government grants or other funding and they make up a significant portion of their budgets. The Members need to know if your company is willing to sell to them when they spend federal budget funds on their purchase. There are attributes that follow that include provisions from the federal regulations in 2 CFR part 200, etc. Your answers will determine if your award will be designated as eligible for TIPS Members to utilize federal funds with your company. Do you want TIPS Members to be able to spend Federal funds, at the Member's discretion, with you? Yes Yes - No Certification of Residency - The vendor's ultimate parent company or majority owner:
Xxxxxx 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 xxxxxx@xxxxxxxxxxxxxxxxx.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 3152473177 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxxxx.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. NGU Sports LIghting, LLC Primary Address Primary Address 6 0000 XXX Xxxx, Xxxxx 000 Primary Address City Primary Address City 2 7 Palm Beach Gardens Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 FL Primary Address Zip Primary Address Zip 9 33410 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. LED lighting, LED Sports Lighting, LED Indoor lighting, LED Field lighting, Sports lighting, Field lighting, Colored lighting, Convention Center Lighting Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
Xxxxxxx Xxxxxx LIMITED (a company registered in England and Wales with registered number 2104188), whose registered office is at 00 Xxx Xxxxxx, London EC4M 7EN (“Xxxxxxx Xxxxxx”);
Xxxxxxxx Xxxxx The Company is in compliance, in all material respects, with all applicable provisions of the Xxxxxxxx-Xxxxx Act of 2002 and the rules and regulations promulgated thereunder.
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
Xxxxxx 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 xxxxxxxxx@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 2105724900 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 2 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 Triun, LLC Primary Address Primary Address 6 0000 X. XX-00, Xxxxx 000, Primary Address City Primary Address City 2 San Antonio, Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 78230 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. Triun, LLC Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
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.
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:
Xxxx Xxxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 xxxx.xxxxxxxxx@xxxxxxxxxxxxxxx.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 3149517730 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxx.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. Tronicom, Inc. DBA Tech Electronics, Inc., DBA Tech Electronics of Kansas, LLC, DBA Tech Electronics of Illinois, LLC., DBA Tech Electronics of Indiana, LLC, DBA Tech Electronics of Colorado, LLC Primary Address Primary Address 2 0000 Xxxxxxxxxx Xxx. Primary Address City Primary Address City 7 St. Xxxxx Primary Address State Primary Address State (2 Digit Abbreviation) 8 MO Primary Address Zip Primary Address Zip 9 63139 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.
