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#18-7458 (Collier Property Specialist) FIXED TERM SERVICE AGREEMENT # 18-7458 for Nuisance Mowing and Debris Removal THIS AGREEMENT, made and entered into on this day of 1�` (embQX 20 a, by and between Collier Property Specialists, LLC , authorized to do business in the State of Florida, whose business address is 201 Griffin Road, Naples, Florida 34113 , (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. AGREEMENT TERM. The Agreement shall be for a three (3 ) year period, commencing II upon the date of Board approval e+[ e and terminating on three (3 ) year(s) from that date or until all outstanding Purchase Order(s) issued prior to the expiration of the Agreement period have been completed or terminated. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for two (2 ) additional one ( 1 ) year(s) periods. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. COMMENCEMENT OF SERVICES. The Contractor shall commence the work upon issuance of a El Purchase Order 11 Notice to Proceed. 3. STATEMENT OF WORK. The Contractor shall provide services in accordance with the terms and conditions of ^ Request for Proposal (RFP) Invitation to Bid (ITB) n Other ( )# 18-7458, including all Attachment(s), Exhibit(s) and Addenda and the Contractor's proposal referred to herein and made an integral part of this Agreement. • The Contractor shall also provide services in accordance with Exhibit A — Scope of Services attached hereto. Page 1 of 17 Fixed Term Service Agreement 42017-002(Ver,l) Odd 3.1 This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 4. THE AGREEMENT SUM. The County shall pay the Contractor for the performance of this Agreement based on Exhibit B- Fee Schedule, attached hereto and the price methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the County's Contract Administrative Agent/Project Manager, and in compliance with Chapter 218, Fla. Stats., otherwise known as the"Local Government Prompt Payment Act". 4.1 Price Methodology (as selected below): • • • , -- • - . - - - - - - - - -- - - - transferred from the-County to the contractor; and, as a busineac practice there are no hourly or material invoices presented, rather, the contractor must perform to the is authorized. • Time and Materials: The County agrees to pay the contractor for the amount of labor time spent by the contractor's employees and subcontractors to perform the work (number of hours times hourly rate), and for materials and equipment used in the project (cost of materials plus the contractor's markup). This methodology is generally used in projects in which it is not possible to accurately estimate the size of the project, or when it is expected that the project requirements would most likely change. As a general business practice, these contracts include back-up documentation of costs; invoices would include number of hours worked and billing rate by position (and not company (or subcontractor) timekeeping or payroll records), material or equipment invoices, and other reimbursable documentation for the project. i Unit Price: The County agrees to pay a firm total fixed price (inclusive of all costs, including labor, materials, equipment, overhead, etc.) for a repetitive product or service delivered (i.e. installation price per ton, delivery price per package or carton, etc.). The invoice must identify the unit price and the number of units received (no contractor inventory or cost verification). 4.2 Any County agency may obtain services under this Agreement, provided sufficient funds are included in their budget(s). 4.3 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of the Agreement. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. Page 2of17 Fixed Term Service Agreement#2017-002(Ver.1) 9 da 4.4 ❑ (check if applicable) _ - . _ _ _ - _ - _ - - _ - Travel and Reimbursements shall be at the following rates: Mileage $0.44.5 per mile Breakfast $6.00 Lunch $44-50 Dinner $19.00 Airfare Actual ticket cost limited to tourist or coach class fare Rental car • . .. -- . _ -- - -- -- - _ - -- - - vehicles Lodging • - -- -- - =-- - - . - - . cap of no more than $150.00 per night Pa-Fking Actual cost of parking Taxi or Airport Limousine Actual cost of either taxi or airport limousine long distance charges, fax charges, photocopying charges and postage. Reimbursable items will be paid enly after Centractor has provided all receipts. Contractor shall be responsible for all other costs and expenses aecociated with activities and solicitations undertaken pursuant to this Agreement. 5. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof,which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531C. 6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or emailed to the Contractor at the following: Company Name: Collier Property Specialists Address: 201 Griffin Road Naples, Florida 34113 Authorized Agent: Patrick Baldwin, Owner Attention Name & Title: Telephone: 239-259-6185 E-Mail(s): Sales@collierps.com All Notices from the Contractor to the County shall be deemed duly served if mailed or emailed to the County to: Page 3of17 Fixed Term Service Agreement#2017-002(Ver.1) ObJ Board of County Commissioners for Collier County, Florida Division Name: Code Enforcement Division Division Director: Mike Ossorio Address: 2800 Horseshoe Drive N. Naples, Florida 34104 Administrative Agent/PM: Marlene Serrano, Manager-Operations Telephone: 239-252-2487 E-Mail(s): Marlene.Serrano@colliercountyfl.gov The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 8. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor.The County will not be obligated to pay for any permits obtained by Subcontractors. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 9. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. Page 4 of 17 n(L Fixed Term Service Agreement#2017-002(Ver.1) )bJ 10. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of the non-performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 12. INSURANCE. The Contractor shall provide insurance as follows: A. IT Commercial General Liability: Coverage shall have minimum limits of $ 1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. B. ■ Business Auto Liability: Coverage shall have minimum limits of $500,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-Ownership. C. [j Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $ 1,000,000 for each accident. D. f] Professional Liabilit'j Shall be-maintained by the Contractor to ensure its legal liability for claims arising out of the performance of professional services under this this insurance. Such insurance shall have limits of not less than $ each claim and aggregate. 1= �]Cyber Liabilqi Coverage shall-have minimum limits of$ per claim. �l : Coverage shall have minimum limits of$ per claim. Page 5of17 cV) Fixed Term Service Agreement#2017-002(Ver.1) (");) Special Requirements: Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR, Collier County Government shall be listed as the Certificate Holder and included as an "Additional Insured" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Contractor's policy shall be endorsed accordingly. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County thirty (30) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: thirty (30) days prior written notice, or in accordance with policy provisions. Contractor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors comply with the same insurance requirements that the Contractor is required to meet. 13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall defend, indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, whether resulting from any claimed breach of this Agreement by Contractor, any statutory or regulatory violations, or from personal injury, property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 13 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. Page 6 of 17 Fixed Term Service Agreement#2017-002(Ver.1) O6J 14. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Code Enforcement Division . 15. CONFLICT OF INTEREST. Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 16. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: Contractor's Proposal, Insurance Certificate(s), © Exhibit A Scope of Services, Exhibit B Fee Schedule, ❑ RFP/ ❑ ITB/_ Other #18-7458 , including Exhibits, Attachments and Addenda/Addendum, 0 subsequent quotes, and E. Other Exhibit/Attachment: 17. APPLICABILITY. Sections corresponding to any checked box ( ■ ) expressly apply to the terms of this Agreement. 18. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 19. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any Agreement held by the individual and/or firm for cause. 20. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(b) as stated as follows: Page 7 of 17 �n Fixed Term Service Agreement#2017-002(Ver.1) '+17 IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone: (239) 252-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 21. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful Contractor extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful Contractor. Page 8 of 17 Fixed Term Service Agreement#2017-002(Ver.1) ,p6 ();),3' 22. PAYMENTS WITHHELD. The County may decline to approve any application for payment, or portions thereof, because of defective or incomplete work, subsequently discovered evidence or subsequent inspections. The County may nullify the whole or any part of any approval for payment previously issued and the County may withhold any payments otherwise due to Contractor under this Agreement or any other Agreement between the County and Contractor, to such extent as may be necessary in the County's opinion to protect it from loss because of: (a) defective Work not remedied; (b) third party claims failed or reasonable evidence indicating probable fling of such claims; (c) failure of Contractor to make payment properly to subcontractors or for labor, materials or equipment; (d) reasonable doubt that the Work can be completed for the unpaid balance of the Contract Amount; (e) reasonable indication that the Work will not be completed within the Contract Time; (f) unsatisfactory prosecution of the Work by the Contractor; or (g) any other material breach of the Contract Documents. If any conditions described above are not remedied or removed, the County may, after three (3) days written notice, rectify the same at Contractor's expense. The County also may offset against any sums due Contractor the amount of any liquidated or unliquidated obligations of Contractor to the County,whether relating to or arising out of this Agreement or any other Agreement between Contractor and the County. 23. C CLEAN UP. Contractor agrees to keep the Project site clean at all times of debris, rubbish and waste materials arising out of the Work. At the completion of the Work, Contractor shall remove all debris, rubbish and waste materials from and about the Project site, as well as all tools, appliances, construction equipment and machinery and surplus materials, and shall leave the Project site clean. 24. STANDARDS OF CONDUCT: PROJECT MANAGER, SUPERVISOR, EMPLOYEES. The Contractor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Contractor shall supply competent employees who are physically capable of performing their employment duties. The County may require the Contractor to remove an employee it deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment on Collier County projects is not in the best interest of the County. 25. Lj WARRANTY. Contractor expressly warrants that the goods, materials and/or equipment covered by this Agreement will conform to the requirements as specified, and will be of satisfactory material and quality production, free from defects, and sufficient for the purpose intended. Goods shall be delivered free from any security interest or other lien, encumbrance or claim of any third party.Any services provided under this Agreement shall be provided in accordance with generally accepted professional standards for the particular service. These warranties shall survive inspection, acceptance, passage of title and payment by the County. Contractor further warrants to the County that all materials and equipment furnished under the Contract Documents shall be applied, installed, connected, erected, used, cleaned and conditioned in accordance with the instructions of the applicable manufacturers, Page 9 of 17 �� Fixed Term Service Agreement#2017-002(Ver.1) O dJ fabricators, suppliers or processors except as otherwise provided for in the Contract Documents. If, within one (1) year after final completion, any Work is found to be defective or not in conformance with the Contract Documents, Contractor shall correct it promptly after receipt of written notice from the County. Contractor shall also be responsible for and pay for replacement or repair of adjacent materials or Work which may be damaged as a result of such replacement or repair. These warranties are in addition to those implied warranties to which the County is entitled as a matter of law. 26. 0 TESTS AND INSPECTIONS. If the Contract Documents or any codes, laws, ordinances, rules or regulations of any public authority having jurisdiction over the Project requires any portion of the Work to be specifically inspected, tested or approved, Contractor shall assume full responsibility therefore, pay all costs in connection therewith and furnish to the County the required certificates of inspection, testing or approval. All inspections, tests or approvals shall be performed in a manner and by organizations acceptable to the County. 27. 0 PROTECTION OF WORK. A. Contractor shall fully protect the Work from loss or damage and shall bear the cost of any such loss or damage until final payment has been made. If Contractor or anyone for whom Contractor is legally liable is responsible for any loss or damage to the Work, or other work or materials of the County or County's separate contractors, Contractor shall be charged with the same, and any monies necessary to replace such loss or damage shall be deducted from any amounts due Contractor. B. Contractor shall not load nor permit any part of any structure to be loaded in any manner that will endanger the structure, nor shall Contractor subject any part of the Work or adjacent property to stresses or pressures that will endanger it. C. Contractor shall not disturb any benchmark established by the County with respect to the Project. If Contractor, or its subcontractors, agents or anyone, for whom Contractor is legally liable, disturbs the County's benchmarks, Contractor shall immediately notify the County. The County shall re-establish the benchmarks and Contractor shall be liable for all costs incurred by the County associated therewith. 28. SUBMITTALS AND SUBSTITUTIONS. Any substitution of products/materials form specifications shall be approved in writing by the County in advance. 29. CHANGES IN THE WORK. The County shall have the right at any time during the progress of the Work to increase or decrease the Work. Promptly after being notified of a change, Contractor shall submit an estimate of any cost or time increases or savings it foresees as a result of the change. Except in an emergency endangering life or property, or as expressly set forth herein, no addition or changes to the Work shall be made except upon modification of the Purchase Order by the County, and the County shall not be liable to the Contractor for any increased compensation without such modification. No officer, employee or agent of the County is authorized to direct any extra or changed work orally. Any modifications to this Agreement shall be in compliance with the County Procurement Ordinance and Procedures in effect at the time such modifications are authorized. Page 10 of 17 Fixed Term Service Agreement#2017-002(Ver.1) OJ ) 30. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 31. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 32. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 33. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 34. - - _ • _ . -- -- - - ' - - - - - -- ---- - - - --as many people as necessary to complete the services on a timely basis, and ach person dates. The Contractor shall not change Key Personnel unlesv the following conditions are met: (1) Proposed replacements have substantially the same or better qualificationa • AGREEMENT STAFFING. The Contractor's personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Contractor shall assign as many people as necessary to complete required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet required services. Page 11 of 17 ,,, Fixed Term Service Agreement#2017-002(Ver.I) �b'J 35. n ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of solicitation the Contractor's Proposal, and/or the County's Board approved Executive Summary, the Contract Documents shall take precedence. I I ORDER OF PRECEDENCE (Grant Funded). In the event of any conf4iet between or among thc terms of any of the Contract Documents and/or the County's Board approved precedence over the Agreement. To the extent any conflict in the terms of the Contract the Agreement, thc conflict shall be resolved by imposing the more strict or costly 36. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. 37. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four(4)years. Ali of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPS@colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of$500 per incident. Page 12 of 17 Pr) Fixed Term Service Agreement#2017-002(Ver.]) 38. 0 SAFETY. All Contractors and subcontractors performing service for Collier County are required and shall comply with all Occupational Safety and Health Administration (OSHA), State and County Safety and Occupational Health Standards and any other applicable rules and regulations. Also, all Contractors and subcontractors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site. Collier County Government has authorized the Occupational Safety and Health Administration (OSHA) to enter any Collier County Facility, property and/or right-of-way for the purpose of inspection of any Contractor's work operations. This provision is non- negotiable by any division/department and/or Contractor. All applicable OSHA inspection criteria apply as well as all Contractor rights, with one exception. Contractors do not have the right to refuse to allow OSHA onto a project that is being performed on Collier County Property. Collier County, as the owner of the property where the project is taking place shall be the only entity allowed to refuse access to the project. However, this decision shall only be made by Collier County's Risk Management Division Safety Manager and/or Safety Engineer. (Intentionally left blank-signature page to follow) Page 13 of 17 Q� Fixed Term Service Agreement#2017-002(Ver.1) J IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or agent, have executed this Agreement on the date and year first written above. ATTEST: BOARD OF s NTY COMMI ONERS COLLIER 0 U , , FLO' Crystal K. Kinzel, Clerk of Courts ask• dlex • By. , ndy Solis, Esq. , Chairman Dated: fh�l(QUlb (SEAL) Attes,as to Chairman's wigess Contractor's Collier Property Specialist Contractor B � 6�. Y• C•�tractor's First Witness Signature ?µ7K/cic (3A1dw,4 (64&4( fb(cc TType/print signature and title TType/print witness nameT Contractor's Second Witness /11,h0,1 (30x iet TType/print witness name proved s to:i=7r m d Legality: / eP y County Attorney Scott R.Teach Print Name Page 14 of 17 Fixed Term Service Agreement#2017-002(Ve 1) Exhibit A Scope of Services n following this page (containing 4 pages) ❑ this exhibit is not applicable Page 15 of 17 Fixed Term Service Agreement#2017-002(Ver.l) ,I E18 7dSKNI!lk nce• Iawu .an gd •baarn101741 4 ,1 , OPtr OF W9-kg 3_ _ = The Contractor shall provide the following services which includes,but is not limited to:mowing,bush-hogging and litter/debris removal in accordance with Collier County Code of Laws and Ordinances Chapter 54,Article VI, Litter,Weed,and Exotic Control Ordinance and Florida Statutes 713.78 and 715.07. These specifications are intended to provide the information by which Contractor may understand the minimum requirements of Collier County relative to this Agreement. It is the responsibility of the awarded Contractor to adhere to these laws and regulations. Location of Work Areas: (lot sizes vary from< 1/8 acre to over 2 acres) • North District(Includes lmmokalee City) • South District(Includes Everglades City) The quantity and location of the service areas listed above are not guaranteed as the number of possible violations cannot be predicted. Generally, the County has 50-70 properties that require service at any given time and the frequency is determined by environmental conditions. The County reserves the right to order services as required during the contract term but does not guarantee any minimum or maximum. Due to changes in lot ownership, land development and lot owner exemptions, the County will not guarantee any number of lots for the term of this Agreement. The County intends to divide the two(2)categories of work into two districts with the dividing line between being Golden Gate Blvd, extending from the Gulf of Mexico to the Broward County line. The North District includes areas from North Naples to Immokalee City. The South District includes all unincorporated areas bordering the City of Naples and Marco Island.Also includes Copeland, Everglades City and incorporated areas in between. It is the County's intent to award a Primary Contractor the north and south districts: Category 1: Mowing; Category 2: Litter and Debris Removal. Assignment of Work Once the primary contractor is notified of work assignments, the contractor has three (3) days to accept the work assignment. Category 1: Mowing • Mandatory Work: The work is described as a public nuisance determined to exist three (3) or more times after July 15, 2001, on a particular lot or parcel of unimproved property while under the same ownership. The County maintains an average of 40 lots each month; however,this amount of properties is not guaranteed and is subject to decrease or increase each month. These properties are expected to be mowed every 2-4 weeks or as the County deems necessary. • Non-mandatory Work: The work is described as any accumulation of weeds, grass or similar non- protected overgrowth if any part of such accumulation is in excess of eighteen (18)inches in height and located on a mowable lot, in any Recorded or Unrecorded subdivision of Collier County. These properties are complaint driven and the amount can vary between 5 and 20 properties each month. These properties could require additional services to include edging, debris removal, minor tree branch trimming, and hedge trimming. (These additional services will be charged per Category 2 pricing; debris removal will be based on a cubic yard rate and the additional services will be based on the hourly rate) iz Page 1 of 4 ftt Category 2: Litter and Debris Removal Includes, but, is not limited to: clean-up, removal, proper disposal of appliances, motor vehicle parts, tires, scrap metal, or any other item large item as defined by the Division, and fill dirt if ordered. For both categories,the Contractor shall provide all labor(qualified personnel), material,supplies and equipment to perform required services, including but not limited to, mowing, bush-hogging and litter/trash removal in accordance with all specifications,terms and conditions specified herein and attached hereto. The County intends to use the awarded Contractor as described above for mandatory and non- mandatory mowing services,debris removal,and on-call large abatement services. 1. General Requirements: In all cases, prior to each abatement operation,the Contractor shall pick up all litter and vegetative debris, and remove it from all areas to be abated, to ensure clean abatement conditions and preserve Contractor equipment. The Contractor shall abate sites in such a manner to avoid bumping,girdling,and/or causing any other damage to trees,shrubs, plants,fences,and benches. The sites requiring abatement can and will be both public and private property which are under enforcement action taken by the County. Abatement is through authority provided under Ordinance and may be accompanied in some cases by Court Order which may or may not require an escort. 2. Initial Site Conditions: Contractor shall have the sole responsibility of satisfying themselves concerning the nature and location of the work and the general and local conditions, and particularly, but, without limitation, with respect to the following: physical conditions at the work-site and the project area as a whole. The failure of the Contractor to acquaint itself with any applicable conditions shall not relieve Contractor from any of his responsibilities to perform under this Agreement, nor shall it be considered the basis for any claim for additional compensation. 3. Abatement Conditions:The Contractor shall use mowing practices so not to create wheel ruts or worn areas in the turf.Any areas of turf that become water soaked during the term of this Agreement shall be mowed with twenty-one-inch (21" +/-) diameter hand walk behind type mowers to prevent wheel ruts in the turf caused by heavier type self-propelled rider mowers. The Contractor shall be responsible for repairing any ruts caused by their mowers at no additional costs to the County. 4. Photograph Requirements:All photographs shall be time and date stamped.The before photo showing the violation prior to Contractor abatement, and the after photo showing the site immediately after Contractor abatement. Photos must be in color and submitted in electronic format to the designated County representative within two days of submitting the invoices. Photos are to be taken from same angle and wide view.As the photographs may be used as evidence, the Contractor shall retain originals of said photographs either until payment is received by the County or until such a time as deemed appropriate by any other government authority as required by law. 5. Supervision of Employees: The Contractor shall designate a competent Supervisor, and at least 2 employees to complete the jobs, who is familiar with the terms and conditions of the contract and has authority to act as a single point of contact for the work to be performed, at all times, during the term of this Agreement. If the designated Supervisor is not acceptable to the County, the Contractor will be notified in writing, and shall assign a new Supervisor within seven (7) calendar days of the County's notification. All communication,written or oral, shall be solely in the English language. 6. Contractor Equipment: The Contractor shall provide all equipment to perform requested services, including but not limited to, riding and push mowers, string trimmers, edger, sweepers, blowers, chain saws,bush-hogging equipment,etc.The Contractor shall keep all blades sharpened to provide a smooth, clean cut. The Contractor shall not use any chemicals in the lawn maintenance process unless written approval has been granted by County representative(s) inwriting. 7. Mowing: The Contractor shall mow at the interval identified in the individual abatement request, unless ci?otherwise specified by the type of lawn maintenance required. Certain properties may be enrolled in the rs Page2of4 0� County's Mandatory Lot Mowing Program which may require mowing bi-weekly during certain periods of heavy growth (May 1 through October 31), and monthly mowing from November 1st through April 30th, unless otherwise notified by Code Enforcement.The Contractor shall not mow under conditions wet enough to result in damage to turf or unsafe mowing conditions for the Contractor. 8. Scheduling Services The Contractor shall have seven (7) calendar days from the date of notice to proceed to complete work related to the abatement, unless otherwise directed in writing, or unless specified as an emergency by Code Enforcement. The Contractor shall take every precaution to ensure the safety of all citizens and animals on and around subject property during abatement operations. 9. Site Work Hours Regular work shall take place between the hours of 7:00 a.m. and 7:00 p.m., Monday through Sunday, unless preempted by scheduled activities. 10. Reports and Invoicing: The Contractor shall complete and submit with the invoice for payment, the form(s) provided to the Contractor with before and after photos-date and time stamped. Photos are to be taken from same angle and wide view. The Contractor will also be required to conduct on- site inspections with Code Enforcement or County's Representative on an as needed basis to verify satisfactory completion of Contract requirements. 11. Equipment Required for Services: • Tractor w/60"bush hog or greater(optional, however, must have access as needed) • Professional/Commercial Grade Riding Mower • Hand pushed mower(s)2+ • Weed eater(s)2+ • Power Blower(s) • Chainsaw • Power edger(s) • Trailer, dump trailer or dump truck suitable for hauling off debris from property clean up.This could be anything from garbage to appliances, furniture,tires, motor vehicle parts or other large items. • Brooms, rakes,shovels, hand trimmers,whatever may be needed to skillfully and safely perform the job in an efficient and timely manner. • Any other items necessary to accomplish the task. 12. Property Owner Complaint Process: For the purpose of reporting complaints, the Contractor shall contact the County's Project Manager with any complaints at(239)252-2240.The Contractor will contact the Code Enforcement representative to notify County personnel of any complaints received within twenty-four (24) hours. If directed by the Project Manager, the Contractor shall address all complaints within five (5) working days of notification of knowledge of the incident. Damages not responded to or not resolved to the reasonable satisfaction of the County,shall be deducted from the Contractor's invoice. The County is to receive copies of all complaints received (in writing)and, if applicable, have a record of theirdisposition/resolution. 13. Specifications a. Mowing: Assignment of job sites may require a one-time mowing or periodic frequency during the period from May 1st through October 31st, or monthly during the period from November 1st through April 30th. Mowing shall include all specified areas of the properties that are not currently maintained by the property owners, or as indicated on the Code Enforcement request. Swales and dry retention areas must be mowed prior to authorizing a vendor to enact the County's Mandatory Lot Mowing Program,the Contractor will be asked to make a site visit and confirm the property size and frequency with the assigned Code Enforcement Investigator. Page 3 of 4 �� Grass shall be cut at a height no less than three inches (3").The frequency of cutting will be determined by Code Enforcement. All clippings, cut grass, and vegetative material (including but not limited to palm fronds, leaves, branches,etc.) shall be mulched or removed by the Contractor. b. Edging: Edging of the turf shall be done along all sidewalk edges, back of concrete curbs, utility service boxes, street light bases, sign posts, headwalls, guardrails,timer pedestals, posts and trees. Grass root runners extending into the mulched areas shall be cut and removed when the edging is performed. Edging will also be required in all turf areas around isolated trees, sprinkler heads,valve boxes, shrubs, sign posts, manholes,etc.where they exist.All debris on streets,sidewalks or other areas resulting from edging shall be removed. No herbicide shall be used for edging. c. Blowing: All sidewalks, curbing and/or gutters including a four-foot (4') area from the face of the curb and sidewalk areas shall be cleaned after each service.All sidewalks shall be blown clean. No clippings or other debris shall be blown or allowed to be deposited on other adjacent property or accumulate on right-of-way areas. d. Trash and Vegetative Debris Removal:With each service, all site areas shall be cleaned by removing all trash and debris to include, but not be limited to: paper, bottles, cans, other trash, and horticultural debris. The disposal of all trash and debris must be at a proper landfill or disposal site.All disposal fees, tipping fees or charges are to be included in the base cost of these services. 111 (i) Page 4 of 4 Exhibit B Fee Schedule following this page (containing 1 pages) -Q112 Page 16 of 17 Fixed Term Service Agreement 42017-002(Ver.1) CT EXHIBIT B- FEE SCHEDULE Collier Property Specialist - NORTH DISTRICT SOUTH DISTRICT (Includes Immokalee) (Includes Port of the Item# Category I Description Isles/Goodland/Copelan Price to the County Per d)Price to the County, 1 .Parcel per Parcel 1. Mowing Up to and including twenty-four(24)inches high and up to one-half(.5) acres. $75.00 t5 7-5 00 2 Mowing Up to and including twenty-four(24)inches and from one-half(.5)10 one(1)acre $85 00 =595.00- `. 3 Mowing aUp to cres and Including twenty-four(24)inches and from one(1)—two(2) $ ` $ _85 00 85.00 4 Mowing Up to and including twenty-four(24)inches per acre(for lots greater than two(2)acres) $8$00 585.00 5 Mowing Twenty-four(24)inches and including thirty-six(36)inches and up to one-half(.5)acres 585 00 $85.00 6 Mowing Twenty-four(24)inches and including thirty-six(36)inches and one half(.5)to one(1)acre $8500 $85.00 7 Mowing Twenty-four(24)inches and including thirty-six(36)inches and from __ one(1)to two(2)acres $85 00 $85 00 8 Mowing Twenty-four(24)inches and including thirty-six(36)inches per acre = $9500 $95 00, (for lots greater than two(2)acres) 9 Mowing - Over thirty-six(36)inches and up to one-half(.5)acre $8500 .$05402:2:2 30 Mowing $95 00 _ $95 00 Over thirty-six(36)inches and from one-half(.5)to one(1)acre _- 11 Mowing • $95 00 -$95 00 Over thirty-six(36)inches per acre(for lots greater than one(1)acre) '- - NORTH DISTRICT . SOUTH DISTRICT (Includes Immokalee) (Includes Port of the ... P Index Category II Description Isles/Goodland/Copetan Price to the County Per d)Price to the County Cubic Yard per Cubic Yard • 13 Litter and Debris Litter and Debris Removal: which may include,and not be limited to = Removal abatement of Appliances,motor vehicle parts,grills,tires,scrap metal,construction material,vegetative debris,furniture,or any other ' $100.00 $100 00 item large Item as defined by the Department(inclusive of all disposal fees) - 14 Litter and Debris Litter and Debris Removal;Fill Dirt(per cubic yard) Removal '..535.00 `$35 00 • 15 Litter and Debris Hourly Labor rate for edging,hedge trimming,tree trimming, $4000 Removal blowing,and hazardous waste abatement $40.00 6c),- n Other Exhibit/Attachment Description: ❑ following this page (containing pages) $this exhibit is not applicable Page 17 of 17 e Fixed Term Service Agreement#2017-002(Ver 1) I DATE(MMIDDlYYYY) ACO CERTIFICATE OF LIABILITY INSURANCE 10/1MIDD THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: •If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: IAC,No.Ext)_239-393-34O7 — I FAX / (A/C,No): 88R-225-7171 INTEGRITY INSURANCE INTERNATIONAL INC ADDRESS: SFRVICFQIN GRITYELORIDA NFT 950 N COLLIER BLVD#301 INSURER(S)AFFORDING COVERAGE NAIC# _ MARCO ISLAND FL 34145 INSURER A: CYPRESS P&C — — INSURED INSURER B: PROGRESSIVE COLLIER PROPERTY-SPECIALISTS INSURER C: 3960 DEER CROSSING CT#202 INSURER D NAPLES;FI:3.4.114 INSURER E: INSURER F: COVERAGES •„• ' CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY T.HAT'THE-POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY,BE,I$SUED:OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR SURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS TYPE OF ININSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY _ EACH OCCURRENCE $ 1,000,000 DAMAGETURREFITED — X COMMERCIAL•GENEIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $5000 - A FGL501930500 81 05/17/2018 05/17/2019 PERSONAL&ADV INJURY $ 1,000,000 • -- GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000 000 S UT' —I POLICY lei,lei, ..` LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABIY ' • (Ea accident) S 500,000 CSL 1 BODILY INJURY(Per person) $500,000 CSL ANY ALINE BODILY INJURY(Per accident) s 500,000 CSL X ALL AUTOS I X,-AUTOS • . 06/12/2018 06/12SCHEDULED /2019 B '' NON-OWNED 07755986-0 PROPERTY DAMAGE $500,000 CSL (Per accident)HIRED AUTOS i -5.�-'AUTOS ( $ UMBRELLA LIAB - OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS UAB - • CLAIMS-MADE S DED RETENTIONS WC STATU- OTH- WORKERS COMPENSATION',- ' TORY LIMITS ER _ AND EMPLOYERS'LIABILITY. E.L.EACH ACCIDENT S ANY PROPRIETORIPARTNER/EXECUTIVE Y/N N/A . EXEMPT OFFICE/MEMBERoryinNEXCLUDED? �' E.L.DISEASE-EA EMPLOYEES (Mandatory infyHj,, _ , If yes,describe under E.L.DISEASE-POLICY LIMIT $ ITFSCRIPTION OF OPERATIONS below ,_ r n DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) COLLIER COUNTY BOARD;OF COUNTY COMMISSIONERS IS INCLUDED AS AN ADDITIONAL INSURED UNDER THE CAPTIONED COMMERCIAL GENERAL LIABILITY AND-AUTOMOBILE LIABILITY POLICIES,ON A PRIMARY NON-CONTRIBUTORY BASIS,IF AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT,FOR ANY AND ALL WORK PERFORMED IN COLLIER COUNTY. CERTIFICATE HOLDER- CANCELLATION COLLIER COUNTY-BOARD OF COUNTY COMMISIONERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3327'T'AN(IAMI TRAIL E ACCORDANCE WITH THE POLICY PROVISIONS. NAPLES,FL 34112 AUTH• IZED REP'ESENTATIVE ``' ©1988-2010 ACORD CORPORATION. All rights reserved. • ACORD 25(2010/05) The ACORD name and logo are regi red marks of ACORD JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION ** CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW** NON-CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 5/30/2018 EXPIRATION DATE: 5/29/2020 PERSON: PATRICK A BALDWIN EMAIL: SALES@COLLIERPS.COM FEIN: 830704662 BUSINESS NAME AND ADDRESS: COLLIER PROPERTY SPECIALISTS, LLC 201 GRIFFIN RD NAPLES, FL 34113 SCOPE OF BUSINESS OR TRADE: Domestic Workers- Buildings-or Property Residences-Full-Time Management-All Other Employees IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 Request for Taxpayer Give Form to the Form (Rev.November2017) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. Collier Property Specialists, LLC 2 Business name/disregarded entity name,if different from above `o 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to mfollowing seven boxes. certain entities,not individuals;see instructions on page 3): o ❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate s, single-member LLC Exempt payee code(if any) ui c o ✓❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► p 2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting +• H LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code(if any) c another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that a. o is disregarded from the owner should check the appropriate box for the tax classification of its owner. ❑ Other(see instructions)► (Applies to accounts maintained outside the U.S.) to 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional) a 201 Griffin Rd. 6 City,state,and ZIP code Naples, FL 34113 7 List account number(s)here(optional) Part I Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number backup withholding.For individuals,this is generally your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later. For other — - entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN,later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number Number To Give the Requester for guidelines on whose number to enter. g 3 _ 0 7 0 4 6 6 2 -- Certification Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.I am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later. Sign Signature of Patrick Baldwin 10-22-2018 Here U.S.person► Date 10. General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number Use Form W-9 only if you are a U.S.person(including a resident (EIN),to report on an information return the amount paid to you,or other alien),to provide your correct TIN. amount reportable on an information return. Examples of information returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099 INT(interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.11-2017) Form W-9(Rev.11-2017) Page 2 By signing the filled-out form,you: Example.Article 20 of the U.S.-China income tax treaty allows an 1.Certify that the TIN you are giving is correct(or you are waiting for a exemption from tax for scholarship income received by a Chinese number to be issued), student temporarily present in the United States.Under U.S.law,this student will become a resident alien for tax purposes if his or her stay in 2.Certify that you are not subject to backup withholding,or the United States exceeds 5 calendar years.However,paragraph 2 of 3.Claim exemption from backup withholding if you are a U.S.exempt the first Protocol to the U.S.-China treaty(dated April 30,1984)allows the provisions of Article 20 to continue to apply even after the Chinese payee.If applicable,you are also certifying that as a U.S.person,your student becomes a resident alien of the United States.A Chinese allocable share of any partnership income from a U.S.trade or business student who qualifies for this exception(under paragraph 2 of the first is not subject to the withholding tax on foreign partners'share of protocol)and is relying on this exception to claim an exemption from tax effectively connected income,and on his or her scholarship or fellowship income would attach to Form 4.Certify that FATCA code(s)entered on this form(if any)indicating W-9 a statement that includes the information described above to support that exemption. that you are exempt from the FATCA reporting,is correct.See What is If you are a nonresident alien or a foreign entity,give the requester the FATCA reporting, later,for further information. appropriate completed Form W-8 or Form 8233. Note:If you are a U.S.person and a requester gives you a form other than Form W-9 to request your TIN,you must use the requester's form if Backup Withholding it is substantially similar to this Form W-9. What is backup withholding?Persons making certain payments to you Definition of a U.S.person.For federal tax purposes,you are must under certain conditions withhold and pay to the IRS 28%of such considered a U.S.person if you are: payments.This is called"backup withholding." Payments that may be •An individual who is a U.S.citizen or U.S.resident alien; subject to backup withholding include interest,tax-exempt interest, •A partnership, or association created or dividends,broker and barter exchange transactions,rents,royalties, organized in the United corporation,company,s or uunythe laws of the United States; nonemployee pay,payments made in settlement of payment card and third party network transactions,and certain payments from fishing boat •An estate(other than a foreign estate);or operators.Real estate transactions are not subject to backup •A domestic trust(as defined in Regulations section 301.7701-7). withholding. Special rules for partnerships.Partnerships that conduct a trade or You will not be subject to backup withholding on payments you business in the United States are generally required to pay a withholding receive if you give the requester your correct TIN,make the proper tax under section 1446 on any foreign partners'share of effectively certifications,and report all your taxable interest and dividends on your connected taxable income from such business.Further,in certain cases tax return. where a Form W-9 has not been received,the rules under section 1446 Payments you receive will be subject to backup withholding if: require a partnership to presume that a partner is a foreign person,and 1.You do not furnish your TIN to the requester, pay the section 1446 withholding tax.Therefore,if you are a U.S.person that is a partner in a partnership conducting a trade or business in the 2.You do not certify your TIN when required(see the instructions for United States,provide Form W-9 to the partnership to establish your Part II for details), U.S.status and avoid section 1446 withholding on your share of 3.The IRS tells the requester that you furnished an incorrect TIN, partnership income. 4.The IRS tells you that you are subject to backup withholding In the cases below,the following person must give Form W-9 to the because you did not report all your interest and dividends on your tax partnership for purposes of establishing its U.S.status and avoiding return(for reportable interest and dividends only),or withholding on its allocable share of net income from the partnership 5.You do not certify to the requester that you are not subject to conducting a trade or business in the United States. backup withholding under 4 above(for reportable interest and dividend •In the case of a disregarded entity with a U.S.owner,the U.S.owner accounts opened after 1983 only). of the disregarded entity and not the entity; Certain payees and payments are exempt from backup withholding. •In the case of a grantor trust with a U.S.grantor or other U.S.owner, See Exempt payee code,later,and the separate Instructions for the generally,the U.S.grantor or other U.S.owner of the grantor trust and Requester of Form W-9 for more information. not the trust;and Also see Special rules for partnerships,earlier. •In the case of a U.S.trust(other than a grantor trust),the U.S.trust (other than a grantor trust)and not the beneficiaries of the trust. What is FATCA Reporting? Foreign person.If you are a foreign person or the U.S.branch of a The Foreign Account Tax Compliance Act(FATCA)requires a foreign bank that has elected to be treated as a U.S.person,do not use participating foreign financial institution to report all United States Form W-9.Instead,use the appropriate Form W-8 or Form 8233(see account holders that are specified United States persons.Certain Pub.515,Withholding of Tax on Nonresident Aliens and Foreign payees are exempt from FATCA reporting.See Exemption from FATCA Entities). reporting code,later,and the Instructions for the Requester of Form Nonresident alien who becomes a resident alien.Generally,only a W-9 for more information. nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S.tax on certain types of income.However,most tax Updating Your Information treaties contain a provision known as a"saving clause."Exceptions You must provide updated information to any person to whom you specified in the saving clause may permit an exemption from tax to claimed to be an exempt payee if you are no longer an exempt payee continue for certain types of income even after the payee has otherwise and anticipate receiving reportable payments in the future from this become a U.S.resident alien for tax purposes. person.For example,you may need to provide updated information if If you are a U.S.resident alien who is relying on an exception you are a C corporation that elects to be an S corporation,or if you no contained in the saving clause of a tax treaty to claim an exemption longer are tax exempt.In addition,you must furnish a new Form W-9 if from U.S.tax on certain types of income,you must attach a statement the name or TIN changes for the account;for example,if the grantor of a to Form W-9 that specifies the following five items. grantor trust dies. 1.The treaty country:Generally,this must be the same treaty under which you claimed exemption from tax as a nonresident alien. Penalties 2.The treaty article addressing the income. Failure to furnish TIN.If you fail to furnish your correct TIN to a 3.The article number(or location)in the tax treaty that contains the requester,you are subject to a penalty of$50 for each such failure saving clause and its exceptions. unless your failure is due to reasonable cause and not to willful neglect. 4.The type and amount of income that qualifies for the exemption Civil penalty for false information with respect to withholding.If you from tax. make a false statement with no reasonable basis that results in no 5.Sufficient facts to justify the exemption from tax under the terms of backup withholding,you are subject to a$500 penalty. the treaty article. 1 Form W-9(Rev.11-2017) Page 3 Criminal penalty for falsifying information.Willfully falsifying IF the entity/person on line 1 is THEN check the box for... certifications or affirmations may subject you to criminal penalties a(n)... including fines and/or imprisonment. Misuse of TINs.If the requester discloses or uses TINs in violation of • Corporation Corporation federal law,the requester may be subject to civil and criminal penalties. • Individual Individual/sole proprietor or single- • Sole proprietorship,or member LLC Specific Instructions • Single-member limited liability company(LLC)owned by an Line 1 individual and disregarded for U.S. You must enter one of the following on this line;do not leave this line federal tax purposes. blank.The name should match the name on your tax return. • LLC treated as a partnership for Limited liability company and enter If this Form W-9 is for a joint account(other than an account U.S.federal tax purposes, the appropriate tax classification. maintained by a foreign financial institution(FFI)),list first,and then • LLC that has filed Form 8832 or (P=Partnership;C=C corporation; circle,the name of the person or entity whose number you entered in 2553 to be taxed as a corporation, or S=S corporation) Part I of Form W-9.If you are providing Form W-9 to an FFI to document or a joint account,each holder of the account that is a U.S.person must • LLC that is disregarded as an provide a Form W-9. entity separate from its owner but a. Individual.Generally,enter the name shown on your tax return.If the owner is another LLC that is you have changed your last name without informing the Social Security not disregarded for U.S.federal tax Administration(SSA)of the name change,enter your first name,the last purposes. name as shown on your social security card,and your new last name. Note:ITIN applicant:Enter your individual name as it was entered on ' Partnership Partnership your Form W-7 application,line 1 a.This should also be the same as the • Trust/estate Trust/estate name you entered on the Form 1040/1040A/1040EZ you filed with your Line 4, Exemptions application. p b. Sole proprietor or single-member LLC.Enter your individual If you are exempt from backup withholding and/or FATCA reporting, name as shown on your 1040/1040A/1040EZ on line 1.You may enter enter in the appropriate space on line 4 any code(s)that may apply to your business,trade,or"doing business as"(DBA)name on line 2. you. Exempt payee code. c. Partnership,LLC that is not a single-member LLC,C • Generally,individuals(including sole proprietors)are not exempt from corporation,or S corporation.Enter the entity's name as shown on the backup withholding. entity's tax return on line 1 and any business,trade,or DBA name on line 2. • Except as provided below,corporations are exempt from backup d. Other entities.Enter your name as shown on required U.S.federal withholding for certain payments,including interest and dividends. tax documents on line 1.This name should match the name shown on the • Corporations are not exempt from backup withholding for payments charter or other legal document creating the entity.You may enter any made in settlement of payment card or third party network transactions. business,trade,or DBA name on line 2. • Corporations are not exempt from backup withholding with respect to e. Disregarded entity.For U.S.federal tax purposes,an entity that is attorneys'fees or gross proceeds paid to attorneys,and corporations disregarded as an entity separate from its owner is treated as a that provide medical or health care services are not exempt with respect "disregarded entity." See Regulations section 301.7701-2(c)(2)(iii).Enter to payments reportable on Form 1099-MISC. the owner's name on line 1.The name of the entity entered on line 1 The following codes identify payees that are exempt from backup should never be a disregarded entity.The name on line 1 should be the withholding.Enter the appropriate code in the space in line 4. name shown on the income tax return on which the income should be 1—An organization exempt from tax under section 501(a),any IRA,or reported.For example,if a foreign LLC that is treated as a disregarded a custodial account under section 403(b)(7)if the account satisfies the entity for U.S.federal tax purposes has a single owner that is a U.S. requirements of section 401(f)(2)person,the U.S.owner's name is required to be provided on line 1.If the direct owner of the entity is also a disregarded entity,enter the first 2—The United States or any of its agencies or instrumentalities owner that is not disregarded for federal tax purposes.Enter the 3—A state,the District of Columbia,a U.S.commonwealth or disregarded entity's name on line 2,"Business name/disregarded entity possession,or any of their political subdivisions or instrumentalities name."If the owner of the disregarded entity is a foreign person,the 4—A foreign government or any of its political subdivisions,agencies, owner must complete an appropriate Form W-8 instead of a Form W-9. or instrumentalities This is the case even if the foreign person has a U.S.TIN. 5—A corporation Line 2 6—A dealer in securities or commodities required to register in the If you have a business name,trade name,DBA name,or disregarded United States,the District of Columbia,or a U.S.commonwealth or entity name,you may enter it on line 2. possession Line 3 7—A futures commission merchant registered with the Commodity Futures Trading Commission Check the appropriate box on line 3 for the U.S.federal tax 8—A real estate investment trust classification of the person whose name is entered on line 1.Check only 9—An entity registered at all times during the tax year under the one box on line 3. Investment Company Act of 1940 10—A common trust fund operated by a bank under section 584(a) 11—A financial institution 12—A middleman known in the investment community as a nominee or custodian 13—A trust exempt from tax under section 664 or described in section 4947 Form W-9(Rev.11-2017) Page 4 The following chart shows types of payments that may be exempt M—A tax exempt trust under a section 403(b)plan or section 457(g) from backup withholding.The chart applies to the exempt payees listed plan above,1 through 13. Note:You may wish to consult with the financial institution requesting IF the payment is for... THEN the payment is exempt this form to determine whether the FATCA code and/or exempt payee for... code should be completed. Interest and dividend payments All exempt payees except Line 5 for 7 Enter your address(number,street,and apartment or suite number). Broker transactions Exempt payees 1 through 4 and 6 This is where the requester of this Form W-9 will mail your information through 11 and all C corporations. returns.If this address differs from the one the requester already has on S corporations must not enter an file,write NEW at the top.If a new address is provided,there is still a exempt payee code because they chance the old address will be used until the payor changes your are exempt only for sales of address in their records. noncovered securities acquired prior to 2012. Line 6 Barter exchange transactions and Exempt payees 1 through 4 Enter your city,state,and ZIP code. patronage dividends Part I. Taxpayer Identification Number (TIN) Payments over$600 required to be Generally,exempt payees Enter your TIN in the appropriate box.If you are a resident alien and reported and direct sales over 1 through 52 you do not have and are not eligible to get an SSN,your TIN is your IRS $5,0001 individual taxpayer identification number(ITIN). Enter it in the social Payments made in settlement of Exempt payees 1 through 4 security number box.If you do not have an ITIN,see How to get a TIN below. payment card or third party network transactions If you are a sole proprietor and you have an EIN,you may enter either your SSN or EIN. 1 See Form 1099-MISC,Miscellaneous Income,and its instructions. If you are a single-member LLC that is disregarded as an entity 2 separate from its owner,enter the owner's SSN(or EIN,if the owner has However,the following payments made to a corporation and reportable on Form 1099 MISC are not exempt from backup one).Do not enter the disregarded entity's EIN.If the LLC is classified as withholding:medical and health care payments,attorneys'fees,gross a corporation or partnership,enter the entity's EIN. proceeds paid to an attorney reportable under section 6045(f),and Note:See What Name and Number To Give the Requester,later,for payments for services paid by a federal executive agency. further clarification of name and TIN combinations. Exemption from FATCA reporting code.The following codes identify How to get a TIN.If you do not have a TIN,apply for one immediately. payees that are exempt from reporting under FATCA.These codes To apply for an SSN,get Form SS-5,Application for a Social Security apply to persons submitting this form for accounts maintained outside Card,from your local SSA office or get this form online at of the United States by certain foreign financial institutions.Therefore,if www.SSA.gov.You may also get this form by calling 1-800-772-1213. you are only submitting this form for an account you hold in the United Use Form W-7,Application for IRS Individual Taxpayer Identification States,you may leave this field blank.Consult with the person Number,to apply for an ITIN,or Form SS-4,Application for Employer requesting this form if you are uncertain if the financial institution is Identification Number,to apply for an EIN.You can apply for an EIN subject to these requirements.A requester may indicate that a code is online by accessing the IRS website at www.irs.gov/Businesses and not required by providing you with a Form W-9 with"Not Applicable"(or clicking on Employer Identification Number(EIN)under Starting a any similar indication)written or printed on the line for a FATCA Business.Go to www.irs.gov/Forms to view,download,or print Form exemption code. W-7 and/or Form SS-4. Or,you can go to www.irs.gov/OrderForms to A—An organization exempt from tax under section 501(a)or any place an order and have Form W-7 and/or SS-4 mailed to you within 10 individual retirement plan as defined in section 7701(a)(37) business days. B—The United States or any of its agencies or instrumentalities If you are asked to complete Form W-9 but do not have a TIN,apply for a TIN and write"Applied For"in the space for the TIN,sign and date C—A state,the District of Columbia,a U.S.commonwealth or the form,and give it to the requester.For interest and dividend possession,or any of their political subdivisions or instrumentalities payments,and certain payments made with respect to readily tradable D—A corporation the stock of which is regularly traded on one or instruments,generally you will have 60 days to get a TIN and give it to more established securities markets,as described in Regulations the requester before you are subject to backup withholding on section 1.1472-1(c)(1)(i) payments.The 60-day rule does not apply to other types of payments. E—A corporation that is a member of the same expanded affiliated You will be subject to backup withholding on all such payments until group as a corporation described in Regulations section 1.1472-1(c)(1)(i) you provide your TIN to the requester. F—A dealer in securities,commodities,or derivative financial Note:Entering"Applied For"means that you have already applied for a instruments(including notional principal contracts,futures,forwards, TIN or that you intend to apply for one soon. and options)that is registered as such under the laws of the United Caution:A disregarded U.S.entity that has a foreign owner must use States or any state the appropriate Form W-8. G—A real estate investment trust Part II. Certification H—A regulated investment company as defined in section 851 or an To establish to the withholding agent that you are a U.S.person,or entity registered at all times during the tax year under the Investment resident alien,sign Form W-9.You may be requested to sign by the Company Act of 1940 withholding agent even if item 1,4,or 5 below indicates otherwise. I—A common trust fund as defined in section 584(a) For a joint account,only the person whose TIN is shown in Part I J—A bank as defined in section 581 should sign(when required).In the case of a disregarded entity,the K—A broker person identified on line 1 must sign.Exempt payees,see Exempt payee L—A trust exempt from tax under section 664 or described in section code,earlier. 4947(a)(1) Signature requirements.Complete the certification as indicated in items 1 through 5 below. Form W-9(Rev.11-2017) Page 5 1.Interest,dividend,and barter exchange accounts opened For this type of account: Give name and EIN of: before 1984 and broker accounts considered active during 1983. 14.Account with the Department of The public entity You must give your correct TIN,but you do not have to sign the Agriculture in the name of a public certification. entity(such as a state or local 2.Interest,dividend,broker,and barter exchange accounts government,school district,or opened after 1983 and broker accounts considered inactive during prison)that receives agricultural 1983.You must sign the certification or backup withholding will apply.If program payments you are subject to backup withholding and you are merely providing your correct TIN to the requester,you must cross out item 2 in the 15.Grantor trust filing under the Form The trust certification before signing the form. 1041 Filing Method or the Optional 3.Real estate transactions.You must sign the certification.You may Form 1099 Filing Method 2(see cross out item 2 of the certification. Regulations section 1.671-4(b)(2)(i)(B)) 4.Other payments.You must give your correct TIN,but you do not ' List first and circle the name of the person whose number you furnish. have to sign the certification unless you have been notified that you If only one person on a joint account has an SSN,that person's number have previously given an incorrect TIN."Other payments"include must be furnished. payments made in the course of the requester's trade or business for 2 Circle the minor's name and furnish the minor's SSN. rents,royalties,goods(other than bills for merchandise),medical and health care services(including payments to corporations),payments to 3 You must show your individual name and you may also enter your a nonemployee for services,payments made in settlement of payment business or DBA name on the"Business name/disregarded entity" card and third party network transactions,payments to certain fishing name line.You may use either your SSN or EIN(if you have one),but the boat crew members and fishermen,and gross proceeds paid to IRS encourages you to use your SSN. attorneys(including payments to corporations). 4 List first and circle the name of the trust,estate,or pension trust.(Do 5.Mortgage interest paid by you,acquisition or abandonment of not furnish the TIN of the personal representative or trustee unless the secured property,cancellation of debt,qualified tuition program legal entity itself is not designated in the account title.)Also see Special payments(under section 529),ABLE accounts(under section 529A), rules for partnerships,earlier. IRA,Coverdell ESA,Archer MSA or HSA contributions or distributions,and pension distributions.You must give your correct *Note:The grantor also must provide a Form W-9 to trustee of trust. TIN,but you do not have to sign the certification. Note:If no name is circled when more than one name is listed,the number will be considered to be that of the first name listed. What Name and Number To Give the Requester For this type of account Give name and SSN of: Secure Your Tax Records From Identity Theft 1.Individual The individual Identity theft occurs when someone uses your personal information 2.Two or more individuals(joint The actual owner of the account or,if such as your name,SSN,or other identifying information,without your account)other than an account combined funds,the first individual on permission,to commit fraud or other crimes.An identity thief may use maintained by an FFI the account' your SSN to get a job or may file a tax return using your SSN to receive a refund. 3.Two or more U.S.persons Each holder of the account To reduce your risk: (joint account maintained by an FFI) •Protect your SSN, 4.Custodial account of a minor The minor (Uniform Gift to Minors Act) •Ensure your employer is protecting your SSN,and 5.a.The usual revocable savings trust The grantor-trustee' •Be careful when choosing a tax preparer. (grantor is also trustee) If your tax records are affected by identity theft and you receive a b.So-called trust account that is not The actual owner' notice from the IRS,respond right away to the name and phone number a legal or valid trust under state law printed on the IRS notice or letter. 6.Sole proprietorship or disregarded The owner' If your tax records are not currently affected by identity theft but you entity owned by an individual think you are at risk due to a lost or stolen purse or wallet,questionable credit card activity or credit report,contact the IRS Identity Theft Hotline 7.Grantor trust filing under Optional The grantor' at 1-800-908-4490 or submit Form 14039. Form 1099 Filing Method 1(see Regulations section 1.671-4(b)(2)(i) For more information,see Pub.5027,Identity Theft Information for (A)) Taxpayers. For this type of account: Give name and EIN of: Victims of identity theft who are experiencing economic harm or a 8.Disregarded entity not owned by an The owner systemic problem,or are seeking help in resolving tax problems that individual have not been resolved through normal channels,may be eligible for Taxpayer Advocate Service(TAS)assistance.You can reach TAS by 9.A valid trust,estate,or pension trust Legal entity4 calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 10.Corporation or LLC electing The corporation 1-800-829-4059. corporate status on Form 8832 or Protect yourself from suspicious emails or phishing schemes. Form 2553 Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites.The most common act 11.Association,club,religious, The organization is sending an email to a user falsely claiming to be an established charitable,educational,or other tax- legitimate enterprise in an attempt to scam the user into surrendering exempt organization private information that will be used for identity theft. 12.Partnership or multi-member LLC The partnership 13.A broker or registered nominee The broker or nominee Form W-9(Rev.11-2017) Page 6 The IRS does not initiate contacts with taxpayers via emails.Also,the Privacy Act Notice IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers,passwords,or similar secret access Section 6109 of the Internal Revenue Code requires you to provide your information for their credit card,bank,or other financial accounts. correct TIN to persons(including federal agencies)who are required to file information returns with the IRS to report interest,dividends,or If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov.You may also report misuse certain other income paid to you;mortgage interest you paid;the of the IRS name,logo,or other IRS property to the Treasury Inspector acquisition or abandonment of secured property;the cancellation of General for Tax Administration(TIGTA)at 1-800-366-4484.You can debt;or contributions you made to an IRA,Archer MSA,or HSA.The forward suspicious emails to the Federal Trade Commission at person collecting this form uses the information on the form to file information returns with the IRS,reporting the above information. spam@uce.gov or report them at www.ftc.gov/complaint.You can contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT(877-438-4338). Routine uses of this information include giving it to the Department of If you have been the victim of identity theft,see www.IdentityTheft.gov Justice for civil and criminal litigation and to cities,states,the District of and Pub.5027. Columbia,and U.S.commonwealths and possessions for use in administering their laws.The information also may be disclosed to other Visit www.irs.gov/IdentityTheft to learn more about identity theft and countries under a treaty,to federal and state agencies to enforce civil how to reduce your risk. and criminal laws,or to federal law enforcement and intelligence agencies to combat terrorism.You must provide your TIN whether or not you are required to file a tax return.Under section 3406,payers must generally withhold a percentage of taxable interest,dividend,and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.