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HomeMy WebLinkAboutPR 22504: ENROLLMENT IN THE ENTERGY SOLUTONS PROGRAM City of Port Arthur Transit Department Memorandum To: Ron Burton,City Manager From: Ivan Mitchell,Transit Director Nik Date: April 13,2022 Re: P.R.22504—City of Port Arthur's enrollment in the Entergy Solutions Program Nature of Request: Authorize the City Manager to enter into a contract with Entergy Texas,LLC for the City of Port Arthur's enrollment in the Entergy Solutions Program. Background: The Entergy Solutions Program by Entergy Texas,LLC (Entergy)is a voluntary program that allows them to partner with commercial and residential customers to address rising energy cost. Entergy will offer the City assistance in developing and implementing cost saving strategies while providing potential incentives for improvements in the City's energy efficiency. The incentives include providing rebates for new and retrofit projects involving HVAC,lighting, refrigeration,roofing,and other customized items related to energy efficiency. Recommendation: It is recommended that the City Council approve proposed P.R.22504 for the City of Port Arthur to participate in the Entergy Solutions Program. Budgetary/Fiscal Effect: There is no funding requirement for enrollment. P.R. 22504 4/13/2022 IM RESOLUTION NO. A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A LETTER OF INTENT WITH ENTERGY TEXAS, LLC OF THE WOODLANDS, TEXAS FOR THE CITY OF PORT ARTHUR TO ENROLL IN THE ENTERGY SOLUTIONS PROGRAM WHEREAS,the City of Port Arthur has received, reviewed, and agrees to the terms of the Entergy Solutions Program partnership presented by Entergy Texas,LLC; and, WHEREAS,the Entergy Solutions Program will offer the City assistance in developing and implementing cost saving strategies while providing potential incentives for improvements in the City's energy efficiency; and, WHEREAS, a Letter of Intent between the City of Port Arthur and Entergy Texas, LLC is attached hereto as Exhibit"A"; and, WHEREAS, this Letter of Intent recommends that the City of Port Arthur by its City Manager execute a contract with Entergy Texas, LLC, for enrollment in the Entergy Solutions Program as delineated in Exhibit"A". NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PORT ARTHUR: THAT,the facts and opinions in the preamble are true and correct. THAT, the City Manager is hereby authorized to execute a Letter of Intent with Entergy Texas, LLC of The Woodlands, Texas for the City of Port Arthur to enroll in the Entergy Solutions Program. THAT, a copy of the caption of this Resolution be spread upon the minutes of the City Council. READ,ADOPTED AND APPROVED this day of April, 2022 at a Regular Meeting of the City of Port Arthur, Texas by the following vote: AYES: Mayor: Councilmembers: P.R. 22504 4/13/2022 IM NOES: Thurman "Bill" Bartie, Mayor ATTEST: Sherri Bellard, City Secretary AP ROVED AS/ �TOFO�RM: Stit al Tizeno, City Attorney APPROVED FOR ADMINISTRATION: APPROVED AS TO AVAILABILITY OF FUNDS: Ronald Burton Kandy Dan City Manager Interim Director of Finance ek,LAIL, Clifto Williams, CPPB Ivan Mitchell Purchasing Manger Transit Director P.R. 22504 4/13/2022 IM Exhibit "A" LETTER OF I \TE \ T ENTERGY SOLUTIONS AN ENTERGY TEXAS PROGRAM Entergy Texas is committed to providing leadership by assisting its partners in developing and implementing strategies to address rising energy costs.We are proud to offer the Entergy Solutions Program,which is available to select Entergy Texas electric commercial customers. Both cash and non-cash incentives are available for implementing energy efficiency improvements during the program year. These incentives are available for qualifying measures that reduce peak electric demand installed in new construction and retrofit projects. Entergy Texas has contracted with CLEAResult to implement, promote and administer the program. The City of Port Arthur, Texas The Letter of Intent (LOI) is to confirm that , (herein referred to as the "Partner") is participating in the Entergy Solutions Program (the "Program"). By signing this document, I agree that: (1) I have reviewed the program description; (2) I represent the Partner during participation in this Program;and (3) I understand and agree to the following program elements: Voluntary Involvement This Program is voluntary and although I am not required to take any specific action, it is my intent to take advantage of one or more of the program offerings. Partner may terminate this LOI at any time,without penalty. Partner will automatically be re-enrolled in new program year if there are no changes to Partner information. Oversubscription The incentives (cash and non-cash) offered through this Program are limited. If more Entergy Texas Partner projects are submitted than program budgets can accommodate,the incentives will be awarded on a first-come, first-served basis,determined by available program funding. Decisions regarding approval of incentives offered under this Program are solely within the responsibility of Entergy Texas. Program Exclusivity For the specific facilities and projects identified in the Entergy Solutions Program,the Partner will not participate in other energy efficiency programs sponsored by Entergy Texas within the same calendar year,with the exception of the Entergy Texas Load Management Program. Program Promotion Partner will allow the Entergy Solutions Program to use Partner's name to promote participation in the program to entities such as potential program partners, utilities,federal,state, or local entities,and the general public. PRINCIPLES OF AGREEMENT I understand that to receive the benefits from the Program, I need to ensure that we complete the following steps: Opportunity Assessment The Opportunity Assessment (OPA) is a tool used to identify the energy efficiency of buildings or operations; if chosen, I will collaborate with CLEAResult to identify opportunities for the Partner. I may use any means I choose to identify the opportunities and this Program can provide assistance at my request. I may also submit any energy assessments that were completed prior to the date of this Letter of Intent.This Program does not endorse or require the use of any specific assessment provider and Entergy Texas,this Program and/or CLEAResult are not responsible for the assessment in any way. Enterg y II — �+ oWE POWER LIFE° Pre-Installation Inspection In order to receive any cash incentives offered under this Program, I need to collaborate with CLEAResult to permit a pre-installation inspection and provide other verifying project information including pictures, plans, submittals,savings summaries and invoices before installing the energy conservation measure(s). I may complete the project(s)without any communication or approval from CLEAResult if the Partner does not want to receive the incentives offered under this Program. Project Selection & Program Funds Reservation If I want to proceed with the energy improvement project(s) identified in the OPA, cash incentives from this Program will be reserved through a savings statement. The minimum project size is 10 kW. Project Installation After a pre-installation inspection,the Partner may install the efficiency project(s) utilizing any means or provider they choose. Entergy Texas and its Program Implementer, CLEAResult, will not sell, provide and/or warrant any materials or installation services for the project(s). Submit Documentation Partner agrees to submit to CLEAResult a copy of the original invoice for equipment cost, labor,and other costs associated with the project. If Partner uses internal labor and is therefore not invoiced for labor, Partner will submit to CLEAResult a copy of the equipment invoice and an estimate of internal labor spent. Your Program Representative can assist you in determining the cost. Post-Installation Inspection In order to receive cash incentives from this Program, I need to collaborate with CLEAResult to permit a post- installation inspection and/or provide other verifying information after installing the project(s). Partner or contractor must communicate to CLEAResult or Entergy Texas on any scope of work changes BEFORE post inspection is scheduled.Any changes may affect estimated energy savings and cash incentives. The Commercial Solutions Program will pay monetary incentives to Partner or contractor, as discussed in program materials, for eligible energy efficiency savings achieved by projects that are completed no later than November 15 of each program year. Payment of Cash Incentives Following project completion and energy reduction verification, Entergy Texas will issue a check to the Partner or contractor for the cash incentive. The amount of the incentive will be based upon the verified, qualifying measures completed. Incentive funds are limited to a Program budget. If the Program's budget is fully reserved, projects will be placed on a waitlist and will be reviewed based on the date received,as program funds become available. Partner acknowledges that projects that receive monetary incentives in the Entergy Solutions Program would not have been accomplished,or would have been completed with less efficient equipment, except for the incentives and other services provided by this Program. gi%Enterg y O n oWE POWER LIFE® ACCEPTANCE OF AGREEMENT By endorsing below,your organization accepts this agreement with the Entergy Solutions Program, sponsored by Entergy Texas and conducted by CLEAResult. This agreement should be signed by your energy manager, facilities manager or other upper-level management. Entergy Solutions Partner Entergy Texas Signature: Signature: Date: Date: Printed Name: Mark Delavan Program Manager Company: Entergy Texas Title: 2107 Research Forest Drive The Woodlands, TX 77380 Address: Phone: Fax: Email: Entergy Account#. Not Applicable - Acct. #Varies Please identify one individual from the administrative/facilities/energy management department who will be the main point of contact while working with the Entergy Solutions Program. Approved Point of Contact Name (Mr./Ms./Dr.): 409 983-8793 Title: Transit Director Organization: Port Arthur Transit/City of Port Arthur Phone: 409 983-8793 Address: 344 Procter Street Fax: Port Arthur, TX 77640 Email: ivan.mitchell©portarthurtx.gov Please sign and mail, email or fax to: Entergy Texas ATTN: Entergy Solutions Team 2107 Research Forest Drive,The Woodlands,TX 77380 Phone: 281-297-2214 Fax: 281-297-2237 Email: entergytx@clearesult.com Specific steps will vary according to the needs of the project. CLEAResult is the implementation contractor for the Entergy Texas Commercial Solutions Program. A message from Entergy Texas,LLC©2021 Entergy Services,LLC. ___ All Rights Reserved.The Entergy Solutions program is an energy efficiency Entergy program and not affiliated with Entergy Solutions,LLC. a i • I i • @ ACCEPTANCE OF AGREEMENT By endorsing below,your organization accepts this agreement with the Entergy Solutions Program, sponsored by Entergy Texas and conducted by CLEAResult. This agreement should be signed by your energy manager, facilities manager or other upper-level management. Entergy Solutions Partner Entergy Texas Signature: Signature: Date: Date: Printed Name: Mark Delavan Program Manager Company: Entergy Texas Title: 2107 Research Forest Drive The Woodlands, TX 77380 Address: Phone: Fax: Email: Entergy Account#: Please identify one individual from the administrative/facilities/energy management department who will be the main point of contact while working with the Entergy Solutions Program. Approved Point of Contact Name (Mr./Ms./Dr.): 409 983-8793 Title: Transit Director Organization: Port Arthur Transit/City of Port Arthur Phone: 409 983-8793 Address: 344 Procter Street Fax: Port Arthur, TX 77640 Email: ivan.mitchell@portarthurtx.gov Please sign and mail, email or fax to: Entergy Texas ATTN: Entergy Solutions Team 2107 Research Forest Drive,The Woodlands, TX 77380 Phone: 281-297-2214 Fax: 281-297-2237 Email: entergytx@clearesult.com Specific steps will vary according to the needs of the project. CLEAResult is the implementation contractor for the Entergy Texas Commercial Solutions Program. A message from Entergy Texas,LLC©2021 Entergy Services,LLC. All Rights Reserved.The Entergy Solutions program is an energy efficiency Entergy program and not affiliated with Entergy Solutions,LLC. a • 0 Entergy New Base Supplier Form (Initial Set-Up) Any individual or entity paid by Entergy(or any of its Subsidiaries)Accounts Payable Department is considered a Supplier.Suppliers must complete this form prior to payment being issued.Information provided on this form is subject to verification,including,but not limited to,IRS Tox Identification Num- ber(TIN)Matching. Instructions for completing and submitting this form 1. Complete the form electronically and then print and sign the form;or print the form and complete by hand. 2. Send back to your Entergy Contact 3.Entergy Contact will submit a SNOW Request with this as an attachment Print Form 4.Supplier will receive a registration from esupplier@entergy.com to be able to maintain their information Section 1: General Information The Supplier name entered in this section will appear on Entergy issued payments,Purchase Orders,Contracts and iRS documents. Supplier Name City of Port Arthur Primary products/services provided to Entergy Energy Efficiency Your Entergy Contact(required) Name(Last,First) Delavan, Mark Phone 281-297-2214 Diversity Owned Businesses ` _ Diverse-Owned Business(for example,51%or more owned,controlled,and operated by members of the following groups:Minority[African American,Asian Pacific American,Asian Sub-Continent American,Hispanic American,&Native American], Women, Veteran,Service Disabled Veteran):Please check here ❑"I declare under penalty of perjury that the following responses are true and correct and i acknowledge that false representation is punishable under penalty of law." • If the box is checked,please indicate ownership type and percentage(%)in space provided. ❑ African-American 0 Hispanic-American 0 Aleut O Asian-American 0 European-American ❑ Pacific Islander ❑ Caucasian 0 Native American(American Indian) ❑ Woman Owned Diversity Category(As a federal prime contractor and pursuant to the requirements set forth in Public Law 95-507,Entergy is required to track its spending with small businesses and other diverse suppliers as outlined below. Please check the appropriate category ❑Small Disabled Veteran Owned Business ❑ Small Corporation Non Minority ❑ Large Minority Business Enterprise ❑Small Hub Zone Business El Small Veteran Owned Business ❑Large Veteran Owned Business ❑Small Minority Business Enterprise ❑ Small LGBT Owned Business ❑ Large Woman Owned Business Enterprise Small Business as defined by the SBA ❑ Large Disabled Veteran Owned Business Large Hub Zone Business ['Small Woman Owned Business Enterprise ❑ Large LGBT Owned Business --------------- Potential Conflicts of Interests YES NO Are you or any principal owner of your company of the following:A)an Entergy employee,B)in a business relationship with an Entergy employee,C)a ❑ ❑ family member of an Entergy employee,or D)a member of the same household(regardless of relationship)as a Entergy employee.If yes,please iden- tify the Entergy employees.retiree,or former employee and your relationship to that employee. ❑ ❑ Are you or any employee of your company a former employee,including a retiree,of an Entergy system company(Note that answering"yes"does not mean that your company cannot be a vendor to Entergy,but requires steps to comply with Entergy's Procurement Policy.)? Entergy Code of Conduct Entergy requires its suppliers to comply with its Suppliers'Code of Conduct.This document can be found at entergy.com/suppliers under Supplier Code of Conduct.By entering today's'date you are acknowledging that your company has reviewed the Entergy Suppliers'Code of Conduct. Date: Section 2: Payment Information Bank Name Bank Routing Number Bank Account Number Remittance Advice E-mail Address Page 1 of 2 Revised 07/12/2018 Remit to Address Address City State Postal Code Country Contact Information Name(Last,First) 1 Phone E-mail Address [— I Regarding Payments:Ger•-ral payment/invoice status inquiries con call the Entergy Shored Services Support Center at 844-387-9675(844-ETR-WORK). Purchase Order/Sales Address Address City State Postal Code Country Section 3: Taxpayer Information for Form W-9 (Instructions below) Entergy is required to file Form 1099 annually with the IRS disclosing reportable payments issued to suppliers.The information supplied in this section will enable us to determine whether we are required to report any payments issued to you during the year. Nonresidentalien and joreign entities: Complete and attach IRS Form W-8;you are not required to complete this section_ Name(as shown on your income tax return) City of Port Arthur Business name/disregarded entity name,if different from above Check appropriate box for federal tax classification(required): ❑ Individual/sole proprietor❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate Limited liabilitycompany.Enter the tax classification(C=C corporation,S=S corporation,P= rtnershi 0 Exe ❑ P Y P P Pa PI ❑ Other(see instructions) Address(number,street,and apt.or suite no.) Re.uester's name and address o.tional PO Box 1089 City,state,and ZIP code Port Arthur,TX 77641-1089 • List account number(s)here(optional) Social security number Part I Taxpayer Identification Number(TIN) - - Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name" line to avoid backup withholding.For individuals,this is your social security number(SSN).However, Employer identification number for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3. For other entities,it is your employer identification number(EIN).If you do not have a 7 4 - 6 0 0 1 8 8 5 number,see how to get a TIN on Page 3. Part II 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). 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 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 on page 4. Sign Signature of Here U.S.person j. Date Supplier Type: Supplier Number: 1099 Reportable: ❑ Yes ❑ No Entergy A/P Supplier Requested By: Entered By: Duplicate Vendor: Use Only p Yes ❑ No Verification: ❑ TIN Matching Date: Duplicate Account Yes ❑ No Form W-9 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number(TIN)to report,for example,income paid to you, real estate transactions,mortgage interest you paid,acquisition or abandonment of secured property,cancellation of debt,or contributions you made to an IRA. Use Form W-9 only if you are a U.S.person(including a resident alien),to provide your correct TIN to the person requesting it(the requester)and,when applicable,to: 1.Certify that the TIN you are giving is correct(or you are waiting for a number to be issued), 2.Certify that you are not subject to backup withholding,or 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If applicable,you are also certifying that as a U.S.person,your allocable share of any partnership income from a U.S.trade or business is not subject to the withholding tax on foreign partners'share of effectively connected income. Note: If a requester gives you a form other than Form W-9 to request your TIN,you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S.person: For federal tax purposes,you are considered a U.S.person if you are: •An individual who is a U.S.citizen or U.S.resident alien, •A partnership,corporation,company,or association created or •An estate(other than a foreign estate),or •A domestic trust(as defined in Regulations section 301.7701-7). Special rules for partnerships.Partnerships that conduct a trade or business in the United State are generally required to pay a withholding tax on foreign partner's share of income from such business.Further,in certain cases where a Form W-9 has not been received,a partnership is required to presume that a partner is a foreign person,and pay the withholding tax.Therefore,if you are a W.S.person that is a partner in a partnership conducting a trade or business in the United States,provide Form W-9 to the partnership to establish your U.S.status and avoid withholding on your share of partnership income. The person who gives Form W-9 to the partnership for purposes of establishing its U.S.status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: •The U.S.owner of a disregarded entity and not the entity, •The U.S.grantor or other owner of a grantor trust and not the trust, and •The U.S.trust(other than a grantor trust)and not the beneficiaries of the trust Foreign person. If you are a foreign person,do not use Form W-9lnstead,use the appropriate Form W-8(see Publication 515,Withholding of Tax on Nonresident Aliens and Foreign Entities.) Nonresident alien who becomes a resident alien.Generally,only a 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 specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S.resident alien for tax purposes. If you are a U.S.resident alien who is replying on a exception contained in the saving clause of a tax treaty to claim an exemption from U.S.tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1.The treaty country.Generally,this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2.The treaty article addressing the income 3.The article number(or location)in the tax treaty that contains the saving clause and its exceptions. 4.The type and amount of income that qualifies for the exemption from tax. 5.Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example.Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese 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 the United States exceeds 5 calendar years.However, paragraph 2 of 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 student becomes a resident alien of the United States.A Chinese student who qualifies for this exception(under paragraph 2 of the first protocol)and is relying on this exception from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity not'subject to backup withholding,give the requester the appropriate completed Form W-8. What is backup withholding?Persons making certain payments to you must under certain conditions withhold and pay to the IRS a percentage of such payments. This is called"backup withholding."Payments that may be subject to backup withholding include interest,tax-exempt interest,dividends,broker and barter exchange transactions,rents,royalties,non employee pay,and certain payments from fishing boar operations.Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN,make the proper certifications,and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1.You do not furnish you TIN to the requester, • 2.You do not certify TIN when required(see the Part II instructions on page 3 for details), 3.The IRS tells the requester that you furnished an incorrect TIN, 4.The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return(for reportable interest and dividends only),or 5.You do not certify to the requester that you are not subject to backup withholding under 4 above(for reportable interest and dividend accounts after 1983 only.) Certain payees and payments are exempt from backup withholding.See the instructions below and the separate instructions for the Requester of Form W-9. Also see Special rules for partnerships on page 1. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person.Form example,you may need to provide updated information if you are a C corporation that elects to bean S corporation,or if you no the name or TIN changes for the account,for example,if the grantor of a grantor trust dies. Penalties Failure to furnish TIN.If you fail to furnish your correct TIN to a requester,you are subject to a penalty of$50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding.If you make a false statement with no reasonable basis that results in no backup withholding,you are subject to a S500 penalty. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law,the requester may be subject to civil and criminal penalties. Specific Instructions Name If you are an individual,you must generally enter the name shown on your income tax return.However,if you have changed your last name,for insurance,due to marriage without informing the Social Security Administration of the name change,enter your first name,the last name shown on your social security card,and your new last name. If the account is in joint names,list first,and then circle,the name of the person or entity whose number you entered in Part I of the form. Sole Proprietor.Enter your individual name as shown on your income tax return on the"Name"line.You may enter your business,trade,or"doing business as(DBA)" name on the"Business name/disregarded entity name"line. Partnership,C Corporation,or S Corporation.Enter the entity's name on the"Name"line and any business,trade,or"doing business as(DBA)name"on the"Business name/disregarded entity name"line. Disregarded Entity. Enter the owner's name on the"Name"line.The name of the entity entered on the"Name"line should never be a disregarded entity.The name on the"Name"line must be the name shown on the income tax return on which the income will be reported.For example,if a foreign LLC that is treated as a disregarded entity for U.S.federal tax purposes has a domestic owner,the domestic owner's name is required to be provided on the"Name"line.if the direct owner of the entity is also a disregarded entity,enter the first owner that is not disregarded for federal tax purposes.Enter the disregarded entity's name on the"Business name/disregarded entity name"line.If the owner of the disregarded entity is a foreign person,you must complete an appropriate Form W-8. Note: Check the appropriate box for the federal tax classification of the person whose name is entered on the"Name"line(Individual/sole proprietor,Partnership, C Corporation,S Corporation,Trust/estate). Limited Liability Company(LLC).If the person identified on the"name"line is an LLC,check the"Limited Liability company"box only and enter the appropriate code for the tax classification in the space provided.If you are an LLC that is treated as a partnership for federal tax purposes,enter"P"for partnership.If you are an LLC that has filed a Form 8832 or a Form 2553 to be taxed as a corporation,enter"C"for C corporation or"S"for S corporation.If you are an LLC that is disregarded as an entity separate from its owner under regulation section 301.7701-3(except for employment and excise tax),do not check the LLC box unless the owner of the LLC(required to be identified on the"Name"line)is another LLC that is not disregarded for federal tax purposes.If the LLC is disregarded as an entity separate from its owner,enter the appropriate tax classification of the owner identified on the"Name"line. Other Entities. Enter your business name as shown on required federal tax documents on the"Name"line,this name should match the name shown on the charter or other legal document creating the entity.You may enter any business,trade,or DBA name on the"Business name/disregarded entity name"line. Exempt Payee If you are exempt from backup withholding,enter you name as described above and check the appropriate box for your status,then check the"Exempt payee"box in the line following the"Business name/disregarded entity name,"sign and date the form. Generally,individuals(including sole proprietors)are not exempt from backup withholding.Corporations are exempt from backup withholding for certain payments,such as interest and dividends. Note.if you are exempt from backup withholding,you should still complete this form to avoid possible erroneous backup withholding: The following payments are exempt from backup withholding: 1.An organization exempt from tax under section 501(a),any IRA,or a custodial account under section 403(b)(7)if the account satisfies the requirements of section 401(f) (2), 2.The United States or any of its agencies or instrumentalities, 3.A state,the District of Columbia,a possession of the United States,or any of their political subdivisions or instrumentalities,or 4.A foreign government or any of its political subdivisions,agencies,or instrumentalities,or 5.An international organization or any of its agencies,or instrumentalities. Other payee that may be exempt from backup withholding include: 6.A corporation, 7.A foreign central bank of issue, 8.A dealer in securities or commodities required to register in the United States,the District of Columbia,or a possession of the United States, 9.A futures commission merchant registered with the Commodity Futures Trading Commission, 10.A real estate investment trust, 11.An entity registered at all times during the tax year under the Investment Company Act of 1940, 12.A common trust fund operated by a bank under section 584(a), 13.A financial institution, 14.A middleman known in the investment community as a nominee or custodian,or 15.A trust exempt from tax under section 664 or described in section 4947. The following chart shows types of payments that may be exempt from backup withholding.The chart applied to the exempt payees listed above,1 through 15. IF the payment is for... THEN the payment is exempt for... Interest and dividend payments All exempt payees except for 9 Broker transactions Exempt payees 1 through S and 7 through 13. Also,C corporations. Barter exchange transactions and Exempt payees 1 through 5 patronage dividends Payments over$600 required to be Generally,exempt payees 1 through 7(2) reported and direct sales over $5,000(1) 1 See Form 1099-MISC,Miscellaneous Income,and its instructions. 2 However,the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding:medical and health care payments,attorneys'fees,gross proceeds paid to an attorney,and payments for services paid by a federal executive agency. Part I.Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box. if you are a resident alien and you do not have and are not eligible to get an SSN,you TIN is your IRS individual taxpayer dentification number(ITIN).Enter it in the social security number box.If you do not have an ITIN,see How to get a TIN below. f you are a sole proprietor and you have an EIN,you may enter either your SSN or EIN.However,the IRS prefers that you use your SSN, f you are a single-member LLC that is disregarded as an entity separate from its owner(see Limited Liability Company(LLC)on Page 2),enter the owner's SSN(or EIN,if the owner has one).Do not enter the disregarded entity's EIN.If the LLC is classified as a corporation or partnership,enter the entity's EIN. Mote.See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN.If you do not have a TIN,apply for one immediately.To apply for a SSN,get Form SS-5,Application for a Social Security Card,from your local Social Security 4dministration office or get this form online at www.ssa.gov.You may also get this for by calling 1-800-772-1213.use Form W-7,Application for IRS Individual Taxpayer dentification Number,to apply for an EIN.You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification \lumber(EIN)under Starting a Business.You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM(1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN,write"Applied For"in the space for the TIN,sign and date the form,and give it to the requester.For interest )nd dividend payments,and certain payments made with respect to readily tradable instruments,generally you will have 60 days to get a TIN and give it you the requester before you are subject to backup withholding on payments.The 60-day rule does not apply to other types of payments.You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note.Entering"Applied For"means that you have already applied for a TIN or that you intend to apply for one soon. :aution.A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8. Part II. Certification To established to the withholding agent that you are a U.S.person,or resident alien,sign Form W-9.You must be requested to sign by the withholding agent even if item 1, Jelow,and items 4 and 5 on page 4 indicate otherwise. :or a joint account,only the person whose TIN is shown in Part I should sign(when required).In the case of a disregarded entity,the person identified on the"Name"line must sign.Exempt payees,see Exempt Payee on page 3. Signature requirements.Complete the certification as indicated in items 1 through 3,below and items 4 and 5 on page 4. 1.Interest,dividend,and barter exchange accounts opened before 1984 and broker accounts considered active during 1983.You must give your correct TIN,but you do not have to sign the certification. 2.Interest,dividend,broker,and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983.You must sign the certification x backup withholding will apply.If 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 :ertification before signing the form. 3.Real Estate transactions.You must sign the certification.You mat cross out item 2 of the certification. 4.Other payments.You must give you correct TIN,but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. 'Other payments"include payments made in the course of the requester's trade or business for rents,royalties,goods(other than bills for merchandise),medical and health :are services(including payments to corporation),payments to a non employee for services,payments to certain fishing boat crew members and fishermen,and gross proceeds paid to attorneys(including payments to corporations). 5.Mortgage interest paid by you,acquisition or abandonment of secured property,cancellation of debt,qualified tuition program payments(under section 529), RS,Coverdell ESA,Archer MSA or HSA contributions or distributions,and pension distributions.You must give your correct TIN,but you do not have to sign the :ertification. What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1.Individual The Individual 2.Two or more individuals(joint account) The actual owner of the account or,if combined funds,the first individual on 3.Custodian account of a minor the account(1) (Uniform Gift to minors Act) The minor(2) 4.a.The usual revocable savings trust (grantor is also trustee) The grantor-trustee(1) b.So-called trust account that is not a legal or valid trust under state law The actual owner(1) 5.Sole proprietorship or disregarded entity owned by an individual The owner(3) 6.Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulation section 1.671*4(b)(2)(i)(A)) The grantor* For this type of account: Give name and SSN of: 7.Disregarded entity not owned by an The owner 11.Partnership or multi-member individual LLC The partnership 8.A valid trust,estate,or pension trust Legal entity(4) 12.A broker or registered nominee The broker or nominee 9.Corporation or LLC electing corporate The corporation 13.Account with the Dept of Agricu- The public entity status on Form 8832 or Form 2553 Iture in the name of a public entity (such as a state or local government, 10.Association,club,religious,charitable, school district,or prison)that receives educational,or other tax-exempt The organization agricultural program payments organization Cont.What Name and Number To Give The Requester 14.Grantor trust filing under the Form 1041 Filing Method or the Optional The trust Form 1099 Filing Method 2(see Regulation section 1.671*4(b)(2)(i)(B)) (1)List first and circle the name of the person whose number you furnish.If only one person on a joint account has an SSN,that person's number must be furnished. (2)Circle the minor's name and furnish the minor's SSN. (3)You must show your individual name and you may also enter your business or"DBA"name on the"Business name/disregarded entity"name line.You may use either your SSN or EIN(if you have one),but the IRS encourages you to use your 55N. (4)List first and circle the name of the trust,estate,or pension trust.(Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.)Also see Special rules for partnerships on page 1. *Note.Grantor also must provide a Form W-9 to trustee of trust Note.If no name is circles when more than one name is listed,the number will be considered to be that of the first name listed. Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal information such as your name,social security(SSN),or other identifying information,without your permission,to commit fraud or other crimes.An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. to reduce your risk: *Protect your SSN, *Ensure your employer is protecting your SSN,and *Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS,respond right away to the name and phone number printed on the IRS notice or letter. If your records are not currently affected by identity theft but you 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 at 1-800-908-4490 or submit Form 14039. For more information,see Publication 4535,Identity Theft Prevention and Victim Assistance. Victims of identity theft who are experiencing economic harm or a system problem,or are seeking help in resolving tax problems that have not been resolved through norm. channels,may be eligible for Taxpayer Advocate Service(TAS)assistance.You can reach TSA by calling the TAS toll-free intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes.Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites.The most common act is sending an email to a user fasely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. The IRS does not initiate contacts with taxpayers via emails.Also,the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords,or similar secret access information for their credit card,bank,or other financial accounts. If you receive an unsolicited email claiming to be from the IRS,forward this message to phishing@irs.gov.You may also report misuse of the IRS name,logo,or other IRS property to the Treasury Inspector General for Tax Administration at 1-800-366-4484.You can forward suspicious emails to the Federal Trade Commission at: spam@uce.gov or contact them atwww.ftc.gov/idtheft or 1-877-IDTHEFT(1-877-438-4338). Visit IRS.gov to learn more about identity theft and how to reduce your risk. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons(including federal agencies)who are required to file information returns with the IRS to report interest,dividends,or certain other income paid to you;mortgage interest you paid;the acquisition or abandonment of secured property;the cancellation of debt;or contributions you made to an IRA,Archer MSA,or HSA.The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information.Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities,states,the District of Columbia,and U.S.possessions for use in administering their laws.The information also may be disclosed to other countries under a treaty,to federal and state agencies to enforce civil 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.