The URL can be used to link to this page

Signed Contract_Eastern Iowa Maintenance - Resurfacing Lots Copyrighted August 5, 2019 City of Dubuque Consent Items # 36. ITEM TITLE: Signed Contract(s) SUMMARY: Eastern IowaAsphalt Maintenance, Inc. forresurfacing and re-striping six surface parking lots; Blackstone Environmental for West Blum Site 1 Clean Up and conceptual Facilities Planning SUGGESTED DISPOSITION: Suggested Disposition: Receive and File ATTACHMENTS: Description Type Eastern lowa Asphalt and Maintenance Contract Supporting Documentation Blackstone Environmental Contract Supporting Documentation �� i � p �. All•Amer9��i�y � NyyAt K.kVALC]t Y'IFY�tiE: � ♦ � � . .... .. -.. �:. �. .. .. �. I � � k � ,.�� G�O��GV.L�'�G��J � � _,,. , ��t��.� - i TO: Michaei Van Milligen, City Manager � FROM: Renee Tyler, Director of Transportation Services ` ��'' ,rI ,� -- � SUBJECT: Resurfacing and Restriping 6 Surface Lots � DATE: July 19, 2019 � �� ,� a PURPOSE The purpose of this memo is to forward a request to proceed with resurfacing the City's surFace lots ', located at 9th Street and Bluff, Bluff Street and 5th, Bluff Street and 12tn 5t" and Main Street, 4th and '' Central Avenue and West 3rd and Locust. , i �,; �AC KGROU IV D I; The surface lots have suffered much wear and tear especially over the course of this past winter. '; Maintenance is necessary to provide a place for residents and visitors to park their cars without fear ; �. of damaging their vehicles due to potholes or uneven pavement area. Work needed includes the i;, asphalt maintenance of the parking areas and driveways, cleaning and sealing cracks with a hi rubberized sealant, power broom and cleaning of areas to be seal coated, and the application of ';I asphalt emulsion sealer with a latex additive and silica sand for durability. � I� Bids were solicited and three local companies submitted bids. � Eastern lowa Asphalt Maintenance Inc. $27,488 � Klue�ner Con�#ruction Inc. $29,446.76 Fahrner Asphalt Sealers $30,071.25 � i BUDGET IMPACT There remains $50,000 in the FY19 budget for maintenance for the municipal parking lots (7301380 73211). ACTION REQUESTED I recommend awarding the contract to Eastern lowa Asphalt Maintenance using funds allocated for the maintenance of the municipal parking lots. A copy of the contract and vendor's insurance ° documents are included with this memo. cc: Jenny Larson, Budget Director � � 6 � � D�buque f TF�TE�ITY C3F ....�,,,"' �^�°""'r �II�A�eHa�€�Y ,1'M1TM:PAd.iPl'M:'Lfr'e'd"A� �� ,f �� { 1Vl�ste�pi�e� vn t��.�issi�sipp� �'`Z°aZ . 2453>��?Y7 � v , COlVTRACT DOCU1111E�VTS NOTICE TO PROCEED "� �: ; �"O: Steve Kluesner ISSUE DATE: 7/15/2019 Eastern lowa Asphalt COMMENCEMENT DATE: Maintenance Inc. '" 105 Rose Cc�urt �'. Farley, IA 52045 '� I. PROJECT: I�; �Dear Mr. Kluesner: � You are hereby notified to commence with the work on the commencement date, in accordance with �� the accepted proposal for work. The contract time shall begin to run on the commencement date OR � working days will be charged beginning with the commencement date or the day work begins, � whichever is earlier.� � � � �1 Yau are required to return an ackr�owledged copy ofi this Notice to Procesd to the City. � �I �; CfTY OF D OWA � � �r---� ,I ... R By: ` �, ( i ature '''i �,� � Renee Tvler � (Name) Director of Transportation Services (Titie) ACCEPTANCE �F IdOTICE Receipt of the abave notice to Proceed is hereby acknowledged this day ofi July, 2019 � THIS SERVICE AGREEMENT (the Cantract), made in triplicate, between the City of Dubuque, lowa (City), its City Manager, through authority conferred upon the City Manager by its City Council and Eastern lowa Asphalt (Contractor). Pro�ect Title: Clean, seal cracks and coat surFace lots for the City II � gt" Street and Bluff � 12t" Street and B1uff " 5t" Street and Bluff � 5th Street and Main 4t" Street and Central 7 W. 3rd Street and Locust Street ; For and in consideration of the mutual covenants herein contained, the arties hereto a ree as � p g (� follows: q �) CONTRACTO�AGREES: '� ,, i To clean and fill cracks with rubberized crack filler. Crack sealing will impede the intrusion of water , into the asphalt base. Remove loose debris and dirt from asphalt surface with broc�ms and power � blowers. Apply 2 coats of Sealmaster asphalt based sealer. Silica sand and top tuff will be added for ; durability. � � i) Lots will be restriped as currently exists with US DOT spec. paint. !! i The work described above shall be completed at the following locations: � 1 gt" Street and BIufF r 12t" Street and Bluff � 5t" Street and Bluff 5t" Street and Main 4t" Street and Central ; W. 3rd Street and Locust Street ,�I The project shall be completed in strict accordance with the terms as described in the accepted bid � (attached) and in strict accordance with the requirements of t�e laws of the State of lowa and the ordinances of t�e City of Dubuque. � � THE CITY AC3REES: 9 Upon the submission of monfihly invoices listing oniy the exact service perform�d specifying month, � start and completion date of the project as agreed upon through the acceptance of the contractor's bid. CITY OF DUBUQUE, IA CONTRACTOR By: �w�� Eastern lowa Asphalt Michael C. Van Milligen Company Name By: �.�6L�7,� '��-��`'' Signature .��(.�� 1 e?��- ��f'�'j��1ot� Printed Name & Title INSURANCE PROVISIONS AND REQUIREMENTS 1. Contractor shall furnish a signed certificate of insurance to the City of Dubuque, lowa for the coverage require in Exhibit I prior to commencing work and at the end of the project if the term of work is longer than 60 days. Contractors presenting annual certificates shall present a � certificate at the end of each project with the final billing. Each certificate shall be prepared on I the most current ACOFtD form approved by the lowa Department of Insurance or an � equivalent. Each certificate shall include a statement under Description of Operation as to why � issued. 2. All polices of insurance required hereunder shall be with an insurer authorized to do business � in lowa and all insurers shall have a rating of A or better in the current A.M Best's Rating � Guide. � 3. Each certificate shall be furnished to the Finance Department of the City of Dubuque. ' 4. Failure to provide minimum coverage shall not be deemed a waiver of these requirements by ', the City of Dubuque. Failure to obtain or mair�tain the required insurance shall be considered a material breach of this Agreement. � 5. Contractor sha91 require all subcontractors and sub-subcontractors to obtain and maintain �� during the performance of work insurance for coverages described in this Insurance Schedule � and shall obtain certificates of insurances from al! such subcontractors and sub-subcontractor !' i:. to obtain and maintain such coverages. The City may request a copy of such certificates from �i the Contractor. !I 6. Ail required endorsements to various policies shall be attached to Certificate of Insurance. ; 7. Contractor will be required to carry the minimum coverage/limi#s, or greater if required by law or other legal agreernent, in Exhibit I. If Contractor's limits of liability are higher than required minimum limits, then the Contractor's limits shall be this Agreement's required limits. �' 8. Contractor shali be responsible for all deductibles or retention. � i� � d � � � ��I�� f��.� , {��nt��t�} Ex�i��t 1 �} �c��n��ct��. ��r��a�.�.��ts��rY General Aggregate Lirnit $2,t300,Q00 Praducts-Gom�Eeted tJperatirns Aggregake Limit $2,000,(}QO Personal and Advertisir�g Injury Limit �fi,000,(}00 Each Occurrence �1,U0(},f�00 i Fire Qamage Limit(any one occurrence} � 50,OOQ 1�ledical Payments $5,(7{�Q 1} Coverage shall be written on an �ccurrence, not c(airns made, form. The general liabiEity u co�rerage shall be wwritten in accord with ISC� farm CG00{71 or �usiness owners fr�rm Br OQ02.. All � u�eviatians from the standard (Sd commerciai general liability form CG 0001 or �usiness owners G farm BP 0002 shall be clearfy identified. u 2} Include lSC} en�or�ement form CG 25 04 "Designa�ed Locatian{s} General �iggregate Limit" or � CG 25 Q3"C3esignated Construction Project(s}Genera!Ag�regate Limit"as appropriate. I� 3) lnclude endar��ment indicating that co��erage is primary and non-contributory. ') 4} Inclu�e Preservatior� of Gouernmentai Immunittes Endars�ment. {Sample attached}. � 5� Ir�clude ad�itional insured endorsement for: � The �ity caf Dubuque, inciu�ing aCi its elected and appoint�d officials, all its empioyees and ;� voEunteers, a11 its boards, cornmissions and/or au�horities and fiheir �oard members, II emplayees anc�vol�ant�ers, Use l�t�f�rm �� 2026. (�ngoing c�peratic�ns. � 6} Policy shall include t,�/aiver of Rir�ht to Recaver from Others �ndorserrent. I _. _. _ _ _ � �} At1T0iVl�JS1L� �i�8ti.�'T'f � `.1 �OCT1�}Itlf'.t� '��.�'ICi��G'�.it'l}� �'�,{�{�{�,{}�}Q � �;} Wt3RK�RS' CC7�P�lVS;�TI��I t'3c E�1F�L�3YE�'i� I_l�$I�..l'T'( � Statutory benefi�s caverin� aII emplo�ees injured on th�job by acciden�r�r disease as prescribed by lo�va �I Code Chapfer 85 as amencied, u Goverage A Stafutory—State of lowa ° Coverage B Employers Lia�iEity Each Accid�nt �1UC�,aC�� Eacn Employee-Qisease $1�O,OQt} Poliey Lim�t-C�isease �aQt},fl�U Policy sha(I inciude b�laiver of Right to Recaver frarn tJthers endarsement. D} LIMBRELLAIEXGES s L1�81LtTY �1,QOO,C}{}0 X yes ____no Umbr�lla,excess Iiability coverage rnust be afi least fc�(lawing form with the underEying policies included �l�f�tCl PR�S��!'ATIC�1� t�� G�!/I�R�MENTAL �IU111�U�ITI�S E�II�Q��E1�EP�T 1. Nc�nwaiver of Gc��r�rnmental Irr�munit�l. The ins�r�r expressly agrees and state� that the purchase of this pvlicy and tf�c� including of the City of Dubu�u�, lowa as an Ad�ifiiartal Ins�red does nat waiVe any af the def�nses of gavernmental immurtifiy available tc� t�re Gity of Dubuqu�, Ic�wa under Gode of Iawa Sectic�n 67t},4� as it is r�ov�r exis#s and as it may be amencied from fiime to time. 2. Claims �overac�e. The insurer fcarfiher a�rees that this policy of ir�surance shall caver only � thas� clairns nofi subject ta the defense af governmerrtal immur�ity under the Code of lawa Section 670.4 as it nc�w exists and as ifi may be amended fir�rn time fio time. Those claims not � subject fa Gade of Ic�wa Section 670.4 sha11 be covered by the terms and condifiions c�f this � insurance pc�licy. � � 3. Assertian of �overnmenfi Immunity. The City t�f Dubuque, lowa shall be respat�sibl� for I'� �sserting any defer�se of gc�vernmental immunity, and may do so afi any time and shall d€� so i upan the timely writ�et� request of the insurer. � � ; 4�. NQr�-Denial of Coveraqe. The irtsurer shall nt�t deny coverage under fihis pc�licy and the insurer shall not deny any of the rights an� benefits accr�ing tfl the City c�f Dubuque, low� under this � policy f�r reas�ns rf �overnmental immunity unless and until a cour� of competent jurisdicfiian � has ru[ed in f�var of the c�efec7se�s} of governrr�er�ta[ immunity asserted by the Cifiy c�f �I a C}ubuque, lovva. 'I q _ _ __ _ ___ „ �. No C�ther Chanqe ir� Pal�c� The ab�ave preservatic�n c�f gaY�rr�menfial immunities s�a�f nc�t a othe�nrise chan�e �r alt�r the coverage available �nder the pc�licy. � � � ; � , % r� � � � � � Easte�n lowa Asp�alt � . ,� � IVla�ntenance lnc. �`� � � �� 105 Rose Ct ;+ P.O. Box 181 � (563) 744-3446 Name /Address P/'o�Osa� , City Of Dubuque Date Invoice# 830 Bluff Street Dubuque, IA 52001-4662 6/5/2019 1526 � '� � Work Description Total �a � � The work will be completed at 9th and BlufF. j� � Clean and fill cracks with rubberized crack filler. Crack sealing will impede the intrusion of water into the 1,075.00 � asphalt base, thus helping to prolong the life of the pavement. �� '� Remove loose debris and dirt from asphait surface with brooms and power blowers. This will promote 2,025.00 '� proper adhesion and pavement sealer. Apply two coats of Sealmaster asphait based sealer. Silica li sand and top tuff will be added for durability. !I ,� � ,i Restripe parking lot as currently exists with US DOT spec paint. 215.00 � "*"**5th Street and Bluff Street. � Clean and fill cracks with rubberized crack filler. Crack sealing will impede the intrusion of water into the 1,840.00 � asphalt base,thus helping to prolong the life of the pavement � Remove loose debris and dirt from asphalt surface with brooms and power blowers. This will promote 5,719.00 proper adhesion and pavement sealer. Apply two coats of Sealmaster asphalt based sealer. Silica �� sand and top tuff will be added for durability. � Restripe parking lot as currently exists with US DOT spec paint. 365.00 ******12th street and Bluff St. Note- Payment due upon completion of project. This proposal may be withdrawn by Eastern lowa �Otas Asphalt Maintenance if not accepted within 14 days. Respectfully Submitted, � Steve Kluesner -Acceptance of Proposal � The above prices, specifications, and conditions are saisfactory and are hereby accepted. You are authorized � to do the work as specified. Date � r� � Signature Page 1 ' ` i Eastern la�va Asp�ialt 1l�air�t�r�ance lnc. � 105 Rose Ct �',� P.O. Box 181 � � (563) 744-3446 �I� ; � 9 I; Name /Address P/"Q�Q$a� 1 City Of Dubuque Date Invoice# 830 Bluff Street Dubuque, IA 52001-4662 6/5/2019 1526 { �� , Work Description Total Clean and fill cracks with rubberized crack filler. Crack sealing will impede the intrusion of water into the 798.00 �� asphalt base, thus helping to prolong the life of the pavement. '� � Remove loose debris and dirt from asphalt surFace with brooms and power blowers. This will promote 2,646.00 proper adhesion and pavement sealer. Apply two coats of Sealmaster asphait based sealer. Silica I� sand and top tuff will be added for durability. ;i '�i Restripe parking lot as currently exists with US DOT spec paint. 285.00 i N ***"*W 3rd Street and Locust Street. ,� Clean and fill cracks with rubberized crack filler. Crack sealing will impede the intrusion of water into the 1,265.00 '� asphalt base,thus helping to prolong the life of the pavement. i Remove loose debris and dirt from asphalt surface with brooms and power blowers. This will promote 2,588.00 proper adhesion and pavement sealer. Apply two coats of Sealmaster asphalt based sealer. Silica � sand and top tuff will be added for durability. Restripe parking lot as currently exists with US DOT spec paint. 312.00 � Note- Payment due upon completion of project. This proposal may be withdrawn by Eastern lowa TOta� $27>488.00 � Asphalt Maintenance if not accepted within 14 days. � Respectfully Submitted, Steve Kluesner - Acceptance of Proposa/ The above prices, specifications, and conditions are saisfactory and are hereby accepted. You are authorized to do the work as specified. Date t �' �! � Signature ''�� Page 3 � n �'��`� +��T�F1+��4TE t�F ��#BIL.�'"�'1�1SU�A�ICE °°��''�' 7�liS ��Tl��A7£ i;� iB�-tB� AS R �iATTER CAF I�^1F4t2du1AT1�'at1 {31#LY A#� �OI��RS #�S3 Rirts}tT5 #1PC`N Tii� �ffR7��it`ATE HCTi33�R. THIS ��7iF��"CE t7d��3S0'i Tc4�t87MA�"d1�LY OA�3A7l�l.X bR ALTER Tk�C�5f�R1w<3E AFF �Y TF�A�LNC9ES�L95�W.T�S CER3"fl��A�E COF iHSUl�Ai�� t�G'i"f �N�TfT+�7E A � �'11+�EN ?!� �sSCI�NC� INStS�R(�p, A�'CH�9Fttt8.1 itEP�:�ITATf1�E t>li �'+ tt,ANL3 7'T'�116 C�RT�C:�TE fiULI'�R. �PC/fd'Ta�di7. IF thB t�'ifliC�tt i5 8t4�11"iC�liAt 1liSitlR�p:�t9�dde5�ttil�0�8U�tr a4Gi�i"tO7�4�L[NSIi#�EU}MI'trii�0#�tM"i,§b#�Ser[x. �1 " :ii�[ik�Ci�"TiC�lt tS YYAt1tEU. scd�}e�ta the tetic�6� �5 a�tha pW4cy,t+�fl#wilcies may re�Fra att an�rs�rstrt.A 3tACest�E t�n�i� r�a°t�lit:�+c�a��eK'rP tu� lwdckn'in 1lett t�sa�Z s. f��'fl"G�:41AE3TU+'�f.aNSURANCE Ct.�1PANY ��r � �eT C CT C i�97_,.;� �iC'A�dE�3FF3C'£:P.t"3..8f7X:3� t�.�ext��S-;i�•�iJ49 �tao{5ID7 ._ CxdtiA"CC�tdA,FJEt� �n'��s�:CiS�P1T_„�tN fiC7CEt+t �R EdAitVS.!"' — �+�w:�Et�RA7�$�i€11TUAL��5C9r.crv�x,nr� . _..,. .____��._ I _,_._ �_. CE Ct7MPANY 7� ;I st�� 172-ff3.9-1 �s��s: _._ � k �A�T(EttN tt�PA ASPHALT AAATNT�9VF#N�C,lt3C. pnsees�a� � �TM��.._ u �ti3'7TH R&t��i� �AR1.�Y,t1L - 57'32 °` � �zt�t��: �E� ��t�` "!� •Q S#Cd�! �t2:t p� n�t� s��rra c:��si�v 'r°�a�rrr� a�.tc:r��z��r�st�a�c� a:rsr�n �sa..ca�ruv��s c�su�>rts m� m�asc�c��t�a��;s� r�tsc sa�� cw° s+��rc�a f r�a�a�a°r�; �'sw��t��r;�rm�n�c n�v �e�rt��r��sr. r�tt�s zxc a�rac� t� �� rs�aca� �t Q��t t�;u��r w�r;� ��s��ct r� ur�er� r�tts I �Tih"�GR"tE�Y @�lSSAJE}�C�R MAcY�E6tTh#tQ.Ti�fNStiRrsN�E �f�Y"��1�5 i9ESGRS$Eb tt�l't�fN!S*�UBJECC TC)AI:L Tk�TEtE�.�.YASiC7�5 [�tT C�'St��t��aUG3�.�,9t�t"P5 S4YS.�iN ANA�H�� R 8�FAtD�L#iA�. I �a' rw��tr�5uataa+�e ' '� �R�V sa a�.rcY�F �aaa�v�a� x.sau'r� I '� ��aa.a��.cu�xrcv ��a�urerz�nc� �t�ta�;� �. s� ��a�z z+��s-�°�r��"�� i� ti ' ��acr tw�� .+ �i � >....,.....�_._._.. _.�w �r � �sra �� a�r�.,,�w ` S�„ � �r��Y ..„��r �,.,.,�„m�I.GC�� , PR�CdLX9C'F`��L'97A�.Pi4N a3CXb Y � ��r .�� li � � _ �e � !°RiP- €a�: il =�a��s�rt.�e.sasumc�r � �aaa�csa�rar�t��twssv ��g � ;;C a�a°a�arto �s�:asatt�rs 1i � � � `1f�i �"183"d�i�Y� g C�"28 8�x$�:�°i"�+�g___ .�_._...____,.._.____ � g� .�s�a�a�ssc5 at�`r � i �s�c�u �r �wsra»s�aav v rr �c� �II 1 i I �! �u u:�e ;x o�wi ��a�ua�a�t�c� �, '; A i d�c�cu� � �;ura� Ft td t�3. "d9 � sa��caz� ��; �, ;p� a�r�n�rcsi� .�-._.�_� __________ _..._ ��as�uaaau� �� x �tt a�r�,rure °��` _____ ,'r+�x a�ao�s�*ra�,n�ar�r��ar�sv� �.��u:sa��r � ; �tz�awa�.�v �_._.�ra r a hG � Q3P2 ��49 �,�ss�s��-��r�a.rr�r� � ; ��► i ��' ratr��ar�ttas �.�.a�s��•r�v�srnrr II � ! � iC�$M`s K}P�gk:ATKS9t6 k 1,i1C31Y10.321C&d 4'E�SAiS"att.8 ��. Sb9.F�at3!�Y',�3 �� a awx�A�.`. . . . §T e,rep'!spea iS � �y` � 5 ��ss c�� xs �s� � �� c+ �a� s ,� � �� . b � �G � h � �� ,�� a �r��-aa�� °r�t�?ac�s ca�v� �tt�r�� wsa�a r� � f �aarzs. �t t�, �x �senrz�t��r � � +�# t� F�CRAT#�+t1.A�t� ��►�kt; "fl� nara�:�d lo�o�rec�"sl��d�ts�mks a[A��Ct 8 � ��..�,�� ,� �� . � ' ,'�". � �J��l..��l�� '� • G�u�Form to the �n �'�� t�ti4'S'� �!'�c�X��+�!' requester.Do nat �.��,�> Identific�tion Number �nd Ce�it�fication �„��,tr��s. - . �� # tdame(as stwwn a�yYaur lncome#ayc rtstum).�+kar�as ia rec�uired on this(irie;cics rua#Meave Ehis iine biank, �:.td.�#-�.rw .�c>c,�,�- V�s�_ t�"'-�.� �C..a� c _._______ . 2 9u�r�s clameldisr�Zded en�ty rs�une,rf suiferent fram abcav� ca � � � ste bcrx for federai ta�c�las�siricallon�c�k y ane of Yhe lo�w"srig sevsrs bc>xes: 4 �ions(c�las�riy c�nly to 3 L'tae�k�s�rn�ri Tn�sUestate °ert�n e�atif��s,z�ot ir�froidt.�als;s�e ill � rr�truatiaTrs on 3 �tt��kh�si�scaEe prapr�efor or [� C Gz,r�wr�tion Carp�a�sc+n � Parie�ershlP T� )� � �irgls-memtaer L�C F�emy�i pays�s�ade�f any� �;� �,]L'arn)ked 9tab3ttty GompBny+.�rYt�rr tho'ka�c�!&.S�ifir.�rllCatt{G �tafaon,S��'+S�raliCen,P=�at�lnsrship)► �$ny�kar�from�ATCA t'e�rt}ng _ �i �� ti�s t�ae�r�iass'�tian��s&'sg3�-m�er�aiaar ownt�t, 'da rrot ct�ec3c LLG;ctaack tta�appr��box Ir�che iit�:�ve#�+r cradM�lK�Y? �„ . � � (�es W sct� • � �tlaa it.s,7 � �� ]C7�s�{see�aatructie+rrs}� er's narr�e�nd adziress C�spttc� � � A��ss(vaucr�b�^y stra�t,s�rrd apt.rar r�ike nua.) �.�.°��1� � �,�'�� I`�'��a`"`.�` �+ ��.�c��.�,a z��,� � � ��1t� _,.�. �--- �� ,��>r,��t�,:�� i - "t'a�cp er lcferttit5catio�1Vu�zrtb�r 1 : �nd�r yt�ur T!!�in the apprc��riatg taesa�.The Td9�pc�,vided must match the name c�ivan on tine 1 to auc�"sd ��sgcur�ty r�um� �i �rack�p�t�t�a9�alding.For 9ndivtdua3� t�rs is ganeral�y your szacial secur�}r r�umb€�r(��hP�.#�#owevar.,for a ;; r�s�ierrt a#I�s.�oie prcrprlet�,or c![ arcl�d entity see the Pa�4 insiru�tions an page 3.Fc�r othar" ; sn"` ,it i��+aur ernptayer identifi�ai�crn rrumber{��N).tf ycar�da n��hays a nu�ber„se�N�rrw fa gef� �r , TIlN s�"�p�e 3. �mP�eaYer'ident�tic�trota nun�r�� I�� ata.lf it�e�u�#i�in mcsre th�rs tane name,see th�instruc�titrns ftar tin�1 at�d the char�can page d fcrr ��yY,R�F,1..�- ; guide[a��t wh�ase riu�sber tct erstsr. li ,; �, °'s ' �.'iBC�t�l�8�10t1 �I �s��r��ts��s o��y.t��+�y�,��. W �t. "i`�s�s�mber shc�wn cars this fcrrrrr is rray s;c�rreci t�acp�+er idsntificatian nt€mb�(�r 1�m w�iting far a numi��rr La be issued ica mej,and , 2. 6 arn nrrt scsbject to backup wi#hhotdin�b�r.�use:(a�t ars��x�rra�a#fraam b�sckup avi�hh+aiding>ar{ka��ts�ve nc�2 b�n�stifiec�#sy the Interne!�ievenus I �etva�{t�>j t�tat#a�'s sut�f�sct to backup�vdthhald�ng as a r�sult�sf�fiaiture 3o repc�-t�CC intarest or diwidends,or(a�the 1R>he�natifiieri rrse that!am ra�langer sarbjcact t�s backup wi#hhcsiding;�rad � �. 4�m a L3.S.cit'szer�c�r�th�s'U.S.p�rson(de�sned b�3ow)r and i 4.The�ATCA�d�s}er�ter�ci�s thi�4�rm jif a�ay�inddc�ting#hat!�rra axem�rt#r�m FAT�A repas#irs��cc�r��k� I �ms�t�s.'Cazts mus#crr,�ss aut iter��crus i�yr�u hays be��s n�ti#i�d by the ERS tt�k you�re cur'r�nt�+sub#e�t ta backup withhca}ding a�e ycw t�eve faliae3 ia�repork a31 interest and div+dereds an ytrs�r t�rsiurrc.Fcsr rsa[�ta3e 4ransectians,�tem 2 d�s ntai�pPh°.�or mcrr�gage 1 inie�rsst�aid,a�q�is'stiara or abandnnmsnt caf��ured prop ,caz�cs#lati�n�i debt,can�ribuisaras tv an in�lividuai r�t"srement arranc�ament{IR{�),and � ar gen�s�tiy.pa�'ments cothor tt�an iraterest anr�di��idends,yssu�re not r�yuirsd tra�ign the ceriific�tiesn,but yazz mus�t prvvide ycsur cc3rre�t TIN.5�aa t � ins�aa ' s san page�. ' I �� ;��„�wre� � ��M-�._.�--,._ r�te r �°�+�� r�,? � �e� �.�.�n► � �'��'"�� C1�1"t1C�It�C1S •F�r�vn 1A�8 tl�me marigage ir�ter�sf).1tt96-E t�ur3errt 9aan tntsrest},1098-i" 4 (tuitivn� � . reter �ta 4he krat�mai Ree��rsue Gseie un4sss�stl�eruvis�nated. .Fc}ms 1�9�C(cencaled deGat� � 1Futsua d�r+�rpntsnts.ktzicammxatic�rs about�it�veSoprr�snts af€�tiaag�cu�m Yt�-9{such .Faarm 1 p99-A�scquBsS�ian or r�bandanrrserrt af�cetred pre�party} � ��i�t�tic�n er�acted aiter w�relc�e it}is at wvrw.lrs.gcavlfw9. Lfss�s�rm W 9 aniy'tf ycau are a U.S.��ersco�r(i a t�iderat�1ien�,io � �it�'1�p58+C3��Yidl ��a�Yaur cors`�ci 7!P!. � !9 y�t da nc�t relum Fnrrrs W-91a� wPiPa e T1AJ,Yrw ml�tat be�ub}ect Rn#+divldual crr arrtity(�arm W-9 ractr�e�ea�whcs is r�u{ra�l io�de�n lssfarrraedttcu^s ta baa:kup r�thhc�tc�{6r�.Sse iNhet ts trachup w7�hoPding?an g��gs 2. rs3aurt with the f�i a rrwsi cabtal»yascar taac�aayer i�Mitdcation numtusr(T#5+� A �rssa�r 8�yczur�aci�t numb+�r d�,aNj,�ndi�ldual taxp�yer k3ent°afice#iz�n 6y sign�#he fitlecf-oui form,You: � n�ntatier#(T#t�>�dc�p2lon i�sc}�yer ldenYt��c.aticm twtni�(A7#N},or esnp6uyer 1.Cert4Sy that ttr�TIN you ars�ivi�rg Ss cprract(or you�w�king ior a numkrer � � rwrn@aer(�fNj,to repr,at ran�h�farrreatian return the�rr+aa�t pald to ta ks�issued}, you.cs�atharr er�icut�t�{x+rtab�an ara trfi�srmatiesn reium. i�s oi in€sxrvset�ra �,��afy that ysw are r+at sukrj+�ct tc�backup vrithf�sal�iir�g,or � retustta irsclude,bui ars rxat Gmltad to.2F�a#tslkawlr+g; ��arm'�099-t�ifi#Entarast sarr�ed a paid} 3.Ckaim sxsmptian frcam backup vnthtrsiding if ycw sre a U.S.szempt payeaa.3f ��a^irrn� (cRvider�ds,3r�luding tt+osa fram sksacks or rs�utua]iuncls) �icable.Yau are alsa c��tf��a U.S.�erson,Your alkacabie st3ars of unc �3'Partraeashup inccame frzam a U.�.teac3e�sr k�uainess as rac,t su�ec!to ths +Fcanac 1£�9-MlSG(variews tg�pes vf u�come,prizet�,awards�or grssss prrsc+�eds} arlthhotdir�taae on 3araigra parkr+ers'share af sffecUve4y s;eannected in�ome,and �For�+`i 7�9-8(�ts�ck ar mutual fuad s�s�nd certain cstt�r traneactiocas by 4..Gartity th�ct EATGA cadg(s)enYered�sn tt+is forrn{it any}imiicat'a�t ihet ycw s�re $3T0$LBCS� 8X83Yi�t$'�l'Q[41��1��'�.+A FB�?4fCfY0�y�8 CQtlBC�.n.r°S9��'t8f 9S�.��'A l�.?G�YY#�fl�%QiZ �8:c�8 c"�0['fl.it'�18f�7YfC7YYh8'�3�1. •Fom31 U99-S(preaceads fram reaf estate trar�ssactiorts) 0 •Fertm 9�-K{mers:h�nt c�rci end third party network#Pansact�ans} R �at,No.lcs��tx Fon„1N-9{��v.a2-2tt��} � � �