QSP 2020-27 Supply and Install Window Shades~1.pdf

Lowell Housing Authority

Department of Finance and Procurement

350 Moody Street, Lowell, MA 01853

Small Purchase Quote (QSP)

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Date: August 5, 2020

Request #: QSP 2020-27 Supply & Install Window Shades

Pre-Bid Site Visit: Wednesday, August 12, 2020 @ 10:00 AM. Interested bidders shall meet at the front door of the City View Towers located at 657 Merrimack Street, Lowell, MA.

Contractors are urged to take their own measurements during this site visit. All measurements shall be confirmed by the LHA prior to commencement of work. Any verbal

Q&A discussed during the site visit will not be considered valid. All questions must be submitted in writing to the CPO at the email address listed below. Answers to bidders questions will be addressed via an Addendum issued and posted on our website at www.lhma.org/bids. Notification will be given to all who have downloaded this QSP from that

URL.

Deadline to submit written questions: Thursday, August 13, 2020 by 12:00 PM. The

Lowell Housing Authority has identified a sole point of contact with bidders for the purpose of this QSP. Any attempt to contact any other LHA employee or to circumvent these procedures in any manner may be grounds for disqualification of the bidder from the procurement process. All questions must be submitted in writing by the date stated above to rbrousseau@lhma.org.

Quotes Due: August 19, 2020 by 11:00 AM

Delivery of Quotes to: rbrousseau@lhma.org or hand delivered to the address listed above.

Scope of Work

The Lowell Housing Authority seeks bids from qualified contractors interested in providing and installing window shades in it’s Community Rooms agencywide. There are approximately 12 rooms with multiple windows that will require the removal of existing shades and the installation of new manual clutch shades.

Shades offered by the bidder shall be manual shades with the following features:

• Vertical Roll Down Blinds

• Manual Clutch System

• Front Fascia of 3”

• Metal bead chains

• Fabric shall be Antimicrobial, antibacterial and antifungal and meets ASTM G21 and

ASTM E2180 test methods

• Available in a variety of colors (color to TBD at time of contract award)

• Openness factor of 10% http://www.lhma.org/bids mailto:rbrousseau@lhma.org mailto:rbrousseau@lhma.org

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Work Schedule

All work to be performed Monday through Friday between 8 AM – 4:30 PM. Any change in the work schedule must be preapproved by LHA. Time is of the essence for this project.

Contractors are urged to schedule accordingly. Contractors are required to submit on the attached Form for Quote, the product lead time and earliest possible start date.

Wage Rates

The contractor is required to pay prevailing wages and/or Davis Bacon wages von all projects associated with this contract in accordance with attached Prevailing Wage Statement and

Davis Bacon Wage Statement. Certified payroll records must be submitted to the Lowell

Housing Authority, Attention: Brenda O’Keefe, 350 Moody Street, Lowell, MA 01853.

OSHA Requirement

Contactor awarded a contract shall furnish certification documents for all employees to be employed in the project subject to this bid showing that they have successfully completed a course in construction safety and health approved by the United States Occupational Safety and Health Administration that is at least (10) hours in duration.

Bidders must complete and submit with their bid the OSHA Certification sheet provided in this

IFB. No contract will be issued to a vendor without proof of OSHA certification pursuant to M.G.L. c. 149, §44A.

Rule for Award

A contract shall be awarded pursuant to M.G.L. c.149 to the responsive and responsible bidder offering the lowest total price.

Rejection of Quotes

LHA reserves the right to cancel this QSP or reject in whole or in part any and all quotes if the HA determines that cancellation or rejection serves the best interests of the HA.

Conflict of Interest Law

It is prohibited for any quote to be submitted that would constitute a violation of the conflict of interest statute, M.G.L. chapter 268A.

Payment

All invoices for this project shall be submitted to Lowell Housing Authority, Attention: Brenda

O’Keefe, 350 Moody Street, Lowell, MA 01853; provided the equipment, materials, supplies and/or services have been delivered/rendered as directed and accepted by the Lowell Housing

Authority.

References

Contractors shall submit references (sheet included herein) of at least three current projects similar in scope and size of this project.

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PROJECT LIST & MEASUREMENTS

Contractor will be responsible for confirming all measurements before commencement of project.

LN

Location

# of

Windows Height Width

1 198 South Street 6 7’ 1 3/16” 2’ 11 3/8”

2 1 6’ 4 3/8” 3’ 11 5/8”

3 1 6’ 4 3/8” 4’ 7 ½”

4 1 6’ 4 3/8” 4’ 4 5/8”

5 (wood door) 1 6’ 2’ 2”

6 (coffee seating area) 1 4’ 4 7/8” 6’ 6 5/8”

7 1 4’ 4 7/8” 8’ 0 3/8”

8 1 4’ 4 7/8” 6’ 5”

9 1 4’ 4 7/8” 3’ 1 1/8”

10 1 4’ 4 7/8” 2’ 6 1/8”

11 130 South Street 2 3’ 11 7/8” 4’ 7 3/16”

12 1 3’ 11 7/8” 3’ 11 1/16”

13 50 Summer Street 2 4’ 2 9/16” 4’ 0 1/8”

14 65 Summer Street 4 4’ 2 9/16” 4’ 0 1/8”

15 43 Summer Street 4 4’ 2 9/16” 4’ 0 1/8”

16 145 Gorham Street 4 4’ 2 9/16” 4’ 0 1/8”

17 183 Gorham Street 4 4’ 2 9/16” 4’ 0 1/8”

18 227 Gorham Street 4 4’ 2 9/16” 4’ 0 1/8”

19 350 Moody Street (community room) 33 5’0” to 5’4” 8’ 4”

20 (over door) 1 1’ 10” 3’ 8”

350 Moody Street (Leasing Office-basement) 4 3’ 10 1/8” 5’ 10 1/16”

22 111 Hildreth Street 2 3’ 10 5/16” 6’ 11”

23 1 3’ 10 5/16” 5’ 10”

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FORM FOR QUOTE

Complete and include in quote submittal.

The undersigned proposes to furnish all labor and materials required for QSP 2020-27

Supply & Install Window Shades, for the Lowell Housing Authority in Lowell Massachusetts in accordance with the Contract Documents for the contract price specified below.

Extraneous numbers, prices, comments, etc., appearing elsewhere on this bid shall be deemed to have no effect on the prices offered in the designated locations and will not be considered. Bid prices/fees are final and all inclusive. No extra charges shall be billed to the

Authority.

Shades Offered Mfg. ___________________ 10% openness Y or N (circle one)

Product Lead Time ____________________________

Earliest Possible Start Date _____________________

Contractor awarded final contract will be required to submit swatches for shades being offered to allow LHA to choose color and texture.

LN

Location

# of

Windows Unit Price Total

1 198 South Street 6 $ $

2 1 $ $

3 1 $ $

4 1 $ $

5 (wood door) 1 $ $

6 (coffee seating area) 1 $ $

7 1 $ $

8 1 $ $

9 1 $ $

10 1 $ $

11 130 South Street 2 $ $

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LN

Location

# of

Windows Unit Price Total

12 1 $ $

13 50 Summer Street 2 $ $

14 65 Summer Street 4 $ $

15 43 Summer Street 4 $ $

16 145 Gorham Street 4 $ $

17 183 Gorham Street 4 $ $

18 227 Gorham Street 4 $ $

350 Moody Street (community room) 33 $ $

20 (over door) 1 $ $

350 Moody Street (Leasing

Office-basement) 4 $ $

22 111 Hildreth Street 2 $ $

23 1 $ $

Total Bid Price $

Prompt Pay Discount _____% net ______ days

Non-Collusion. The undersigned certifies under the penalties of perjury that this quote/bid is in all respects bona fide, fair and made without collusion or fraud with any other person.

As used in this paragraph the word "person" shall mean any natural person, joint venture, partnership, corporation or other business or legal entity.

Tax Compliance. Pursuant to M.G.L. c.62(c) §49(a), the individual signing this Contract on behalf of the Contractor, hereby certifies, under the penalties of perjury, that to the best of their knowledge and belief the Contractor has complied with all laws of the Commonwealth relating to taxes, reporting of employees and contractors, and withholding and remitting child support.

Authorized Signature ___________________________ Date _____________

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Company Name_________________________________________________________

FID or SS # ____________________________

Contact Name & Title ____________________________________________________

Contact Email/Telephone _________________________________________________

City/State/Zip __________________________________________________________

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OSHA COMPLIANCE CERTIFICATION

Any person submitting a bid for, signing a contract to work on, the construction, reconstruction, alteration, remodeling or repair of any building or public works project undertaken by a public awarding authority in Massachusetts and estimated to cost more than $10,000 must certify on the bid or contract, under penalties of perjury, as follows:

1. That he/she is able to furnish labor than can work in harmony with all other elements of labor employed or to be employed at the work

2. All employees to be employed at the worksite will have successfully completed a course in construction safety and health approved by the United States Occupational

Safety and Health Administration that is at least 10 hours in duration at the time the employee begins work and who shall furnish documentation of successful completion of said course with the first certified payroll report for each employee; and

3. That all employees to be employed in the work subject to this bid have successfully completed a course in construction safety and health approved by the United States

Occupational Safety and Health Administration that is at least 10 hours in duration.

(MGL. c. 30, Section 39S (a))

Pursuant to M.G.L. c. 30, Section 39M and M.G.L. c. 149, I certify under penalties of perjury that, to the best of my Knowledge and belief, I am in compliance with the OSHA requirements as stated above.

Company Name ____________________________

Authorized Signatory _________________________________ Date _________________

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REFERENCES

Bidders must list below at least three references from current or most recent projects similar in scope and size to this QSP. Do not use the Lowell Housing Authority contract(s) as a reference.

1. Contact ____________________________________________

Company Name _____________________________________

Address ____________________________________________

Phone _____________________________________________

Brief Description of project ________________________________________________

2. Contact ______________________________________________

Company Name _______________________________________

Address ______________________________________________

Phone _______________________________________________

3. Contact _______________________________________________

Company Name ________________________________________

Address _______________________________________________

Phone _________________________________________________

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1.0 LOWELL HOUSING AUTHORITY’S (LHA’s) RESERVATION OF RIGHTS

Terms and Conditions, Quotations for Small Purchases (“Solicitation” or “QSP”)

1.1 The LHA reserves the right to reject any or all quotations, waive technicalities and informalities or to terminate and cancel the Solicitation process at any time, if deemed by the LHA to be in its best interests.

1.2 The term “or equal” shall be presumed to follow any specified brand name, trade- or service mark. The quality/equality determination of any product or service is reserved to the LHA.

1.3 The LHA reserves the right not to award or not award a purchase order agreement or contract pursuant to this solicitation in whole or in part. The LHA reserves the right to terminate any contract awarded pursuant to this

Solicitation at any time for its convenience and in the LHA’s best interest upon written notice to the successful bidder(s). Sub-contracting may invalidate any quote or award and may subject a contractor to liability for damages unless allowed in advance by written authorization.

1.4 The LHA reserves the right to determine the days, hours and locations that the successful bidder(s) shall provide services or deliveries called for in this Solicitation. LHA delivery terms: F.O.B.-Destination Prepaid unless LHA specifies otherwise. Delivery shall be within the business days ARO (After Receipt of Order) in priority: (1) on P.O.,

(2) in QSP, or (3) quotation/bid. Invoices to include: Delivery/Date(s) of Svc. & Description, Invoice No., Contractor, Address, Phone, Units/Rates/Ext. /Ttl. Prices, PO/Contract Nos.

1.5 The LHA reserves the right to retain all quotes submitted and not permit withdrawal for a period of up to 30 days (or more when specified) subsequent to the deadline for receiving quotations without the written consent of the LHA

Contracting Officer (CO).

1.6 The LHA reserves the right to reject and not consider any quotation that does not conform to or meet the Solicitation requirements in whole or in part, including but not limited to incomplete quotations, non-specified items and/or non-requested services and forms substituting those provided by the LHA.

1.7 The LHA shall have no obligation to compensate any potential supplier or vendor for any costs incurred in responding to this Solicitation. The LHA is a tax-exempt government purchaser pursuant to M.G.L. c.64H, §6 & c.121B. MA

Certificate of Exemption #E046-003-186.

https://malegislature.gov/Laws/GeneralLaws/PartI/TitleIX/Chapter64H/Section6 https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter121B

1.8 The LHA shall reserve the right to at any time during the Solicitation or contract process to prohibit any further participation by a prospective contractor or reject any quotation submitted that does not conform to any of the requirements detailed herein.

1.9 By submission of a quote/bid for this Solicitation, the prospective contractor agrees to abide by all terms, conditions, specifications and attachments, which are hereby incorporated and further agrees to promptly inform the LHA in writing of any ambiguity, inconsistency or error that it may discover upon examining the solicitation documents, or with any site or local condition relevant to the Solicitation. Failure to do so shall relieve the LHA, but not the prospective contractor of any responsibility pertaining to such issue.

1.10 By submitting its quote, the vendor’s representative certifies under penalties of perjury that this quotation (bid) has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word “person” shall mean any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals. Contractors shall submit weekly/project certified payrolls

(MA & Fed. Prev. Wages). http://www.dol.gov/whd/forms/wh347.pdf http://www.mass.gov/lwd/docs/dos/prevaling-wage/pw-payroll.pdf http://www.mass.gov/lwd/docs/dos/prevaling-wage/pw-compliance.pdf

1.11 Pursuant to M.G.L. Chapter 62C, §49A, the prospective contractor’s representative hereby certifies, under the penalties of perjury, that, to the best of his/her knowledge and belief, he/she is in compliance with all the laws of the

Commonwealth relating to taxes, reporting of employees and contractors, and withholding and remitting child support.

1.12 The Contractor covenants, that (1) presently, there is no financial interest and shall not acquire any such interest, direct or indirect, which would conflict in any manner or degree with the performance of services required to be performed under this Agreement or which would violate M.G.L. c.268A, as amended; (2) in the performance of this Contract, no person having any such interest shall be employed by the Contractor or engaged as a subcontractor by the contractor;

and (3) no partner or employee of the firm is related by blood or marriage to any Board Member or employee of the

Awarding Authority. https://malegislature.gov/Laws/GeneralLaws/PartIV/TitleI/Chapter268A

1.13 The LHA shall make awards in its best interest and as required by applicable law, regulation or policy, and to correct any award erroneously made as a result of a clerical error on the part of the LHA. Unless otherwise provided, basis of award shall be to the responsive and responsible supplier/vendor/contractor offering the lowest price.

Lowell Housing Authority, P.O. Box 60, 350 Moody Street, Lowell, Massachusetts

Tel. 978-937-3500 •Fax (888) 364-8835 •TDD 1-800-545-1833 ext. 178

If , the following HUD forms apply by reference to this procurement and may be downloaded from the hyperlink provided:

HUD Table 5.1 Mandatory Contract Terms for Small Purchases other than Construction http://portal.hud.gov/hudportal/documents/huddoc?id=74608c05PIHH.pdf https://malegislature.gov/Laws/GeneralLaws/PartI/TitleIX/Chapter64H/Section6 https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter121B http://www.dol.gov/whd/forms/wh347.pdf http://www.mass.gov/lwd/docs/dos/prevaling-wage/pw-payroll.pdf http://www.mass.gov/lwd/docs/dos/prevaling-wage/pw-payroll.pdf http://www.mass.gov/lwd/docs/dos/prevaling-wage/pw-compliance.pdf https://malegislature.gov/Laws/GeneralLaws/PartIV/TitleI/Chapter268A http://portal.hud.gov/hudportal/documents/huddoc?id=74608c05PIHH.pdf

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HUD-5370-EZ (Construction less than $100,000): http://portal.hud.gov/hudportal/documents/huddoc?id=5370-EZ.docx http://portal.hud.gov/huddoc/5370.docx >$100K

HUD-5370-C, §§1&2 supply/service/maintenance contracts $100K+ §C1 $100K+/no maintenance http://portal.hud.gov/hudportal/documents/huddoc?id=5370-C1.docx

§C2 <$100K supply/service & maintenance http://portal.hud.gov/hudportal/documents/huddoc?id=5370-C2.docx http://portal.hud.gov/hudportal/documents/huddoc?id=5370-EZ.docx http://portal.hud.gov/huddoc/5370.docx http://portal.hud.gov/hudportal/documents/huddoc?id=5370-C1.docx http://portal.hud.gov/hudportal/documents/huddoc?id=5370-C2.docx

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Form W9 follows this page.

Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

▶ Go to www.irs.gov/FormW9 for instructions and the latest information.

Give Form to the requester. Do not send to the IRS.

P ri nt o r ty p e.

S ee S p ec ifi c

In st ru ct io ns o n p ag e 3.

1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.

2 Business name/disregarded entity name, if different from above

3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes.

Individual/sole proprietor or single-member LLC

C Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ▶

Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner.

Other (see instructions) ▶

4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):

Exempt payee code (if any)

Exemption from FATCA reporting code (if any)

(Applies to accounts maintained outside the U.S.)

5 Address (number, street, and apt. or suite no.) See instructions.

6 City, state, and ZIP code

Requester’s name and address (optional)

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 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.

Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.

Social security number or Employer identification number

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); 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 Here

Signature of U.S. person ▶ Date ▶

General Instructions Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following.

• Form 1099-INT (interest earned or paid)

• Form 1099-DIV (dividends, including those from stocks or mutual funds)

• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)

• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)

• Form 1099-S (proceeds from real estate transactions)

• Form 1099-K (merchant card and third party network transactions)

• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)

• Form 1099-C (canceled debt)

• Form 1099-A (acquisition or abandonment of secured property)

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later.

Cat. No. 10231X Form W-9 (Rev. 10-2018)

Form W-9 (Rev. 10-2018) Page 2

By signing the filled-out form, you:

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, and

4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting, later, for further information.

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 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 organized in the United States or under the laws of the United States;

• 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 States are generally required to pay a withholding tax under section 1446 on any foreign partners’ share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and 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 United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income.

In the cases below, the following person must give 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.

• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity;

• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and

• 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.

Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. 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 treaties contain a provision known as a “saving clause.” Exceptions 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 relying on an 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 to claim an exemption 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, give the requester the appropriate completed Form W-8 or Form 8233.

Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 24% 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, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. 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 your TIN to the requester,

2. You do not certify your TIN when required (see the instructions for Part II 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 opened after 1983 only).

Certain payees and payments are exempt from backup withholding.

See Exempt payee code, later, and the separate Instructions for the Requester of Form W-9 for more information.

Also see Special rules for partnerships, earlier.

What is FATCA Reporting?

The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code, later, and the Instructions for the Requester of Form W-9 for more information.

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. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if 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 $500 penalty.

Form W-9 (Rev. 10-2018) Page 3

Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

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 Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return.

If this Form W-9 is for a joint account (other than an account maintained by a foreign financial institution (FFI)), list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. If you are providing Form W-9 to an FFI to document a joint account, each holder of the account that is a U.S. person must provide a Form W-9.

a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last 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 your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application.

b. Sole proprietor or single-member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or “doing business as” (DBA) name on line 2.

c. Partnership, LLC that is not a single-member LLC, C corporation, or S corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2.

d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. 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 line 2.

e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a “disregarded entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S.

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 owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, “Business name/disregarded entity name.” If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9.

This is the case even if the foreign person has a U.S. TIN.

Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2.

Line 3 Check the appropriate box on line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box on line 3.

IF the entity/person on line 1 is a(n) . . .

THEN check the box for . . .

• Corporation Corporation

• Individual

• Sole proprietorship, or

• Single-member limited liability company (LLC) owned by an individual and disregarded for U.S.

federal tax purposes.

Individual/sole proprietor or single-member LLC

• LLC treated as a partnership for U.S. federal tax purposes,

• LLC that has filed Form 8832 or 2553 to be taxed as a corporation, or

• LLC that is disregarded as an entity separate from its owner but the owner is another LLC that is not disregarded for U.S. federal tax purposes.

Limited liability company and enter the appropriate tax classification.

(P= Partnership; C= C corporation;

or S= S corporation)

• Partnership Partnership

• Trust/estate Trust/estate

Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space on line 4 any code(s) that may apply to you.

Exempt payee code.

• Generally, individuals (including sole proprietors) are not exempt from backup withholding.

• Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends.

• Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions.

• Corporations are not exempt from backup withholding with respect to attorneys’ fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC.

The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line 4.

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 U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities

4—A foreign government or any of its political subdivisions, agencies, or instrumentalities

5—A corporation

6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession

7—A futures commission merchant registered with the Commodity Futures Trading Commission

8—A real estate investment trust

9—An entity registered at all times during the tax year under the 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

Form W-9 (Rev. 10-2018) Page 4

The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13.

IF the payment is for . . . THEN the payment is exempt for . . .

Interest and dividend payments All exempt payees except for 7

Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations.

S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012.

Barter exchange transactions and patronage dividends

Exempt payees 1 through 4

Payments over $600 required to be reported and direct sales over $5,0001

Generally, exempt payees 1 through 52

Payments made in settlement of payment card or third party network transactions

Exempt payees 1 through 4

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 reportable under section 6045(f), and payments for services paid by a federal executive agency.

Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with “Not Applicable” (or any similar indication) written or printed on the line for a FATCA exemption code.

A—An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37)

B—The United States or any of its agencies or instrumentalities

C—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities

D—A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section 1.1472-1(c)(1)(i)

E—A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1(c)(1)(i)

F—A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state

G—A real estate investment trust

H—A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940

I—A common trust fund as defined in section 584(a)

J—A bank as defined in section 581

K—A broker

L—A trust exempt from tax under section 664 or described in section 4947(a)(1)

M—A tax exempt trust under a section 403(b) plan or section 457(g) plan

Note: You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed.

Line 5 Enter your address (number, street, and apartment or suite number).

This is where the requester of this Form W-9 will mail your information returns. If this address differs from the one the requester already has on file, write NEW at the top. If a new address is provided, there is still a chance the old address will be used until the payor changes your address in their records.

Line 6 Enter your city, state, and ZIP code.

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, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below.

If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN.

If you are a single-member LLC that is disregarded as an entity separate from its owner, 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.

Note: See What Name and Number To Give the Requester, later, 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 an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 1-800-772-1213.

Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification 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 Number (EIN) under Starting a Business. Go to www.irs.gov/Forms to view, download, or print Form W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to place an order and have Form W-7 and/or SS-4 mailed to you within 10 business days.

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 the form, and give it to the requester. For interest and 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 to 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.

Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.

Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, 4, or 5 below indicates otherwise.

For 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 line 1 must sign. Exempt payees, see Exempt payee code, earlier.

Signature requirements. Complete the certification as indicated in items 1 through 5 below.

Form W-9 (Rev. 10-2018) Page 5

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 or 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 certification before signing the form.

3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification.

4. Other payments. You must give your 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 care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, 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), ABLE accounts (under section 529A), IRA, 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 certification.

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) other than an account maintained by an FFI

The actual owner of the account or, if combined funds, the first individual on the account1

3. Two or more U.S. persons (joint account maintained by an FFI)

Each holder of the account

4. Custodial account of a minor (Uniform Gift to Minors Act)

The minor2

5. a. The usual revocable savings trust (grantor is also trustee)

b. So-called trust account that is not a legal or valid trust under state law

The grantor-trustee1

The actual owner1

6. Sole proprietorship or disregarded entity owned by an individual

The owner3

7. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulations section 1.671-4(b)(2)(i) (A))

The grantor*

For this type of account: Give name and EIN of:

8. Disregarded entity not owned by an individual The owner

9. A valid trust, estate, or pension trust Legal entity4

10. Corporation or LLC electing corporate status on Form 8832 or Form 2553

The corporation

11. Association, club, religious, charitable, educational, or other tax-exempt organization

The organization

12. Partnership or multi-member LLC The partnership

13. A broker or registered nominee The broker or nominee

For this type of account: Give name and EIN of:

14. Account with the Department of

Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments

The public entity

15. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section 1.671-4(b)(2)(i)(B))

The trust

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 SSN.

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, earlier.

*Note: The grantor also must provide a Form W-9 to trustee of trust.

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.

Secure Your Tax Records From Identity Theft Identity theft occurs when someone uses your personal information such as your name, 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 tax 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 Pub. 5027, Identity Theft Information for Taxpayers.

Victims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059.

Protect yourself from suspicious emails or phishing schemes.

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