Dubuque Main Street Program Agreements Copyright 2014
City of Dubuque Consent Items # 19.
ITEM TITLE: Dubuque Main Street Program Agreements
SUMMARY: City Manager recommending approval of a resolution and
Program Agreement between Dubuque Main Street, the
City of Dubuque and the Iowa Department of Economic
Development.
RESOLUTION of Support and Financial Commitment for
the Main Street Program in Dubuque
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Adopt
Resolution(s)
ATTACHMENTS:
Description Type
MVM Memos City Manager Memo
Staff Memo Staff Memo
Resolution Resolutions
Main Street Iowa Agreement FY17 Supporting Documentation
Main Street Iowa Agreement FY18 Supporting Documentation
Main Street Board Resolution of Support Supporting Documentation
THE CITY OF Dubuque
UBE I
erica .i
Masterpiece on the Mississippi 2007-2012-2013
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Dubuque Main Street Ltd. Program Agreement
DATE: September 12, 2016
Dubuque Main Street Ltd. (DMSL) maintains an affiliation with the National Main Street
Center and the State of Iowa Main Street program through the Department of Economic
Development (IDED). In order to maintain this affiliation, IDED requires a Program
Agreement signed by DMSL, the City of Dubuque and IDED.
The Program Agreement provided by IDED includes a paragraph which states that
DMSL will do the following:
"Have a Resolution of Support passed by the city council. This resolution
must stipulate sources of funding for the program, (i.e., the city, downtown
association, development corporation, assessment district, private
donations or any combination thereof, etc.), who will be designated to
supervise the program director, (i.e., the Main Street Board, etc.), a
commitment to appoint a city official to represent the city on the local Main
Street governing board of directors"
Budget Jennifer Larson recommends City Council approval of a Program Agreement
between Dubuque Main Street Ltd., the City of Dubuque and the Iowa Department of
Economic Development, and resolution approval.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Michael C. Van Milligen
MCVM/JML
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Jenny Larson, Budget Director
THE CITY OF Dubuque
UBE I
erica .i
Masterpiece on the Mississippi 2007-2012-2013
TO: Michael C. Van Milligen, City Manager
FROM: Jennifer Larson, Budget Director
SUBJECT: Dubuque Main Street Ltd. Program Agreement
DATE: September 12, 2016
INTRODUCTION
The purpose of this memorandum is to approve the Program Agreement between
Dubuque Main Street Ltd., the City of Dubuque and the Iowa Department of Economic
Development.
DISCUSSION
Dubuque Main Street Ltd. (DMSL) is a downtown development organization developed
to promote the revitalization of downtown. Specifically the organization coordinates
downtown revitalization aimed at the creation and retention of jobs, prevention and
elimination of slum and blight, enhancement of the local tax base, and capturing of
private investment. Their mission includes the development of ongoing public
awareness and education programs designed to enhance appreciation of the district's
architecture and other assets. DMSL maintains an affiliation with the National Main
Street Center and the State of Iowa Main Street program through the Department of
Economic Development (IDED). In order to maintain this affiliation, IDED requires a
Program Agreement signed by DMSL, the City of Dubuque and IDED.
Attached is the Program Agreement provided by IDED. Included in the Agreement is a
paragraph which states that DMSL will do the following:
"Have a Resolution of Support passed by the City Council. This resolution must
stipulate sources of funding for the program, (i.e., the city, downtown association,
development corporation, assessment district, private donations or any combination
thereof, etc.), who will be designated to supervise the program director, (i.e., the Main
Street Board, etc.), a commitment to appoint a city official to represent the city on the
local Main Street governing board of directors"
This language is consistent with the annual Contracted Services Agreement between
the City of Dubuque and DMSL. The City is providing $66,848 in Fiscal Year 2017 and
has a City Council representative on the board of directors.
RECOMMENDATION
I respectfully recommend the approval of the attached Program Agreements and
resolution.
JML
Attachments
cc: Dan Lo Bianco, Dubuque Main Street
Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Prepared By: Jennifer Larson, Budget Director, City of Dubuque 50 W. 13th St. Dubuque, IA 52001 (563) 589-4110
RESOLUTION NO. 326-16
RESOLUTION OF SUPPORT AND FINANCIAL COMMITMENT FOR THE MAIN
STREET PROGRAM IN DUBUQUE
WHEREAS, an Agreement between the Iowa Economic Development
Authority, Dubuque Main Street, and the City of Dubuque for the purpose of
continuing the Main Street Iowa program in Dubuque; and
WHEREAS, this Agreement is pursuant to contractual agreements between the
National Trust for Historic Preservation and the Iowa Economic Development
Authority to assist in the revitalization of the designated Main Street project area of
Dubuque, Iowa; and
WHEREAS, the City Council of Dubuque endorses the goal of economic
revitalization of the historic commercial district within the context of preservation
and rehabilitation of its historic buildings and supports the continuation of the
Main Street Four Point Approach® as developed by the National Trust for
Historic Preservation and espoused by Main Street Iowa.
NOW THEREFORE BE IT RESOLVED by the City Council of the City of
Dubuque, Iowa, meeting in regular session on September 19, 2016, that the City of
Dubuque hereby agrees to support both financially and philosophically the work
of Dubuque Main Street and designates the Main Street Board to• supervise the
Program Director.
Passed, approved, and adopted this 19th day of September 2016.
Kevin J. Lynch, Mayor Pro Tem
Attest:
Kevin S{ r Firnstahl, IAC, -City Clerk
Masterpiece on the Mississippi
Dan LoBianco, Executive Director
Dubuque Main Street
1069 Main Street
Dubuque, IA 52001
Dubuque
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AA -America City
11111F
2007 • 2012 • 2013
Re: Main Street Iowa Program Agreement
Dan,
City Clerk's Office
City Hall
50 W. 13th Street
Dubuque, IA 52001-4864
(563) 589-4100 office
(563) 589-0890 fax
ctyclerk@cityofdubuque.org
www.cityofdubuque.org
October 4, 2016
Enclosed is an original Main Street Iowa Program Agreement executed by the City of
Dubuque. Please secure signatures from the DMS Board and IEDA and return a copy
to me.
I have also enclosed a certified copy of our Resolution of Support No. 326-16.
Please contact me if you have any questions.
Thank you.
Kovin S. Firnstah ; C C
City Clerk
Enclosure
cc: Cindy Steinhauser, Assistant City Manager
Main Street Iowa Program Agreement
Agreement # PS2016-G300-20-A
Agreement between the Iowa Economic Development Authority, the City of Dubuque and Dubuque Main
Street Ltd. for the purpose of continuing the Main Street Program in Dubuque.
THIS AGREEMENT is entered into and executed by the Iowa Economic Development Authority herein
referred to as the "IEDA", the City of Dubuque and Dubuque Main Street Ltd. hereinafter referred to as the
"Community or Local Main Street Program".
WHEREAS, Dubuque Main Street Ltd. established a partnership with the Iowa Economic Development
Authority in 1985 and desires that the program continue; and
WHEREAS, the Iowa Economic Development Authority desires to continue the relationship which has been
established with Dubuque Main Street Ltd.;
NOW THEREFORE, in consideration of the foregoing and mutual covenants and agreements contained
herein, the parties have agreed to do as follows:
SECTION I. The Local Main Street Program agrees to:
1. Maintain the local program's focus on the revitalization of the historic commercial district utilizing
the Main Street Approach®. This should be reflected in the programs annual action plans, goals
and objectives, vision, and mission statement.
2. Employ a paid full-time Executive Director for the Local Main Street Program who will be
responsible for the day-to-day administration of the Main Street program in the Community. Full-
time employment is defined as 40 hours per week dedicated to the Local Main Street Program
work. Part time employment is 25 hours per week dedicated to the Local Main Street Program
work. In the event this position is vacated during the time of this agreement, the Local Main Street
Program agrees to fill this position in a reasonable time and provide a written timeline to fill this
position to the Main Street Iowa State Coordinator.
3. Develop an accurate position description, which includes the rate of compensation, describing the
administrative activities for which the program director is responsible. A copy of which is to be
provided to Main Street Iowa annually.
4. Maintain worker's compensation insurance for the Executive Director and staff.
5. Maintain an office within the designated boundaries of the local Main Street district.
6. Submit monthly performance reports to the IEDA by established deadlines. The reports will
document the progress of the Local Main Street Program's activities. Should a Local Main Street
Program become three months tardy on submission of monthly reports, program services available
through Main Street Iowa will be suspended until the Local Main Street Program has submitted all
late reports to become current.
7. Provide Main Street Iowa examples of local best practices and information demonstrating local
success stories (e.g. action plans, marketing materials, quality images, programmatic documents,
etc.)
8. Achieve National Main Street Center accreditation at a minimum once every three years. Not
achieving National Main Street Center accreditation at a minimum once every three years will result
in termination of this agreement and loss of recognition as a Main Street Program Community.
9. Participate, as required by the State Main Street Coordinator, in training sessions as scheduled
throughout the year. To remain in compliance and to be eligible for National Main Street
accreditation, the Local Main Street Program must have representation at both days, in their
entirety, of the three (3) training sessions held annually, indicated as mandatory on the program
calendar. In addition, any newly hired program director will be required to participate in Main Street
Orientation, as soon after the hire date as feasible. Registration and all related travel expenses for
training will be paid by the Community.
Page 1 of 3
Main Street Iowa Program Agreement
Agreement # PS2016-G300-20-A
10. Have a Resolution of Support passed by the City Council. This resolution must stipulate sources of
funding for the program, a commitment to appoint a city official to represent the City on the local
Main Street governing board of directors, and that the Local Main Street Program will continue to
follow the Main Street Approach® as developed by the National Main Street Center, Inc. and
espoused by Main Street Iowa.
11. Have a Resolution of Support passed by the Local Main Street Program Board of Directors. This
resolution must stipulate a commitment to continue to follow the Main Street Approach® as
developed by the National Main Street Center, Inc.
12. Maintain a "Designated Main Street Network" membership with the National Main Street Center.
13. Use the words "Main Street" when referring to and marketing the local program, either as an official
part of the organization's name or as a tagline such as... "A Main Street Iowa Program". As a
designated Main Street Iowa community, the Local Main Street Program is required to include the
National Main Street Center/Main Street America and the Main Street Iowa logos on local program
websites.
14. Not assign this agreement to another organization without obtaining prior written approval of the
IEDA.
15. Remain in compliance with the requirements of this program as outlined in this agreement. If the
IEDA finds that the Local Main Street Program is not in compliance with the requirements of this
program agreement, the Local Main Street Program will be notified of non-compliance and given a
90 -day probationary period in which to return to compliance. Continued non-compliance will result
in termination of this agreement and loss of recognition as a Main Street Program Community.
16. Submit with this signed Program Agreement, one (1) copy the City's Resolution of Support, one (1)
copy of the Local Main Street Program Board of Director's Resolution of Support, and one (1)
completed W-9 of the Local Main Street Program.
SECTION II. The IEDA agrees to:
1. Designate a Main Street State Coordinator to handle communication between the Community, the
Main Street Iowa Program, and state government agencies.
2. Coordinate up to three (3) statewide training sessions annually for program directors and local Main
Street volunteers based on the combined needs of all Iowa Main Street Communities.
3. Conduct three one -day (1) Main Street orientations for all new program directors, board members
and volunteers. The Orientation will introduce the Executive Director to the Main Street Program
and to their immediate responsibilities. Orientation meetings will be held in a central Iowa location.
4. Conduct an on-site program visit annually.
5. Provide continuing advice and information to the Local Main Street Program.
6. Include the Community in the Main Street Iowa network.
7. Provide, as requested and can be scheduled, on-site technical assistance visits to the Local Main
Street Program with Main Street Iowa personnel in the areas of design, economic vitality,
promotion, organization, committee training, board planning retreat facilitation, action planning.
8. Offer additional optional, regionally hosted trainings throughout the year.
Page 2 of 3
Main Street Iowa Program Agreement
Agreement # PS2016-G300-20-A
SECTION III. The PARTIES hereto otherwise agree as follows:
1. The term of this agreement shall be for a period of one year, beginning July 1, 2016, and ending
June 30, 2017. It may be extended or revised by a written amendment signed by both parties.
2. This agreement shall be binding upon and shall insure to the benefit of the parties and their
successors.
3. Not to discriminate against any employee or applicant for employment because of race, color, sex,
age, disability, creed, religion, sexual orientation, marital status, or national origin. The parties
further agree to take affirmative action to assure that employees are treated without regard to their
race, color, region, sex, age, disability, creed, religion, sexual orientation, marital status, or national
origin during employment.
4. Either party may terminate this agreement without cause after 30 days written notice to the other
party.
5. This document memorializes all elements of this agreement, and both incorporates and supersedes
any previous agreements or negotiations, whether oral or written.
6. The IEDA is limited to furnishing its technical services to the Community and thus nothing contained
herein shall create any employer-employee relationship.
IN WITNESS WHEREOF, the parties have executed this agreement.
BY:
BY:
BY:
(Mayor Signature) v
Kevin J. Lunch. Mayor Pro -Tem
(Mayor Printed Name)
(Board President /gnature)
September 19. 2016
(Date)
Dubuque, Iowa
(City)
--1 q f ;
(Date)
CC/4J IA`,e Dubuaue Main Street Ltd.
(Board President rinted Name) (Local Main Street Program)
Deborah V. Durham, Director
Iowa Economic Development Authority
(Date)
Page 3 of 3
Form 11117 Request for Taxpayer Give Form to the
(Rev.December .Identification Number and Certification requester. Do not
Treasury
Department of the Treasury Send to the IRS.
Internal Revenue Service
1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
Dubuque Main Street Ltd.
N 2 Business name/disregarded entity name,if different from above
Dubuque Main Street
m
°- 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to
° ❑Individual/sole proprietor or C Corporation ElS Corporation ❑ Partnership ❑ Trust/estate certain entities,not individuals;see
»
single-member LLC instructions on page 3):
n o
0 E]Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► Exempt payee code(A any)
0 2 Note.For a single-member LLC that is disregarded,do not check LLC;check the appropriate box in the line above for
Exemption from FATCA reporting
m the tax classification of the single-member owner. code(if any)
— e
a �
El Other(see instructions)11- (aapb+mtn•US.f
5 Address(number,street,and apt,or suite no.) Requester's name and address(optional)
n 1069 Main Street Main Street Iowa-IEDA
6 City,state,and ZIP code
200 East Grand Avenue
Dubuque, IA 52001 Des Moines, IA 50309
7 List account numbers)here(optional)
IMM Taxpayer Identification Number(rIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,fora -m -
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 number,see How to get a FM
TIN on page 3. or
Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for I Employer identification number
guidelines on whose number to enter.
4 2 -11121610131015
JjCM Certification
Under penalties of perjury,1 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. 1 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. 1 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 on page 3.
Sign signature of
Here U.S.Person 11- Date►
General Instructions •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T
(tuition)
Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-C(canceled debt)
Future developments.Information about developments affecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release it)is at www.irs.gov/Iw9.
Use Form W-9 only if you are a U.S.person(including a resident alien),to
Purpose of Form provide your correct TIN.
An individual or entity(Form W-9 requester)who is required to file an information If you do not return Form W-9 to the requester with a 71N,you might be subject
return with the IRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2.
which may be your social security number(SSN),individual taxpayer identification By signing the filled-out form,you:
number(ITIN),adoption taxpayer identification number(ATIN),or employer 1.Certify that the TIN you are giving is correct(or you are waiting for a number
identification number(EIN),to report on an information return the amount paid to to be issued),
you,or other amount reportable on an Information return.Examples of information
returns include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or
•Form 1099-INT(interest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If
•Form 1099-DIV(dividends,including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of
•Form 1099-MISC various any partnership income from a U.S.trade or business is not subject to the
( types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-B(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA coastal entered on this form(if any)indicating that you are
brokers) exempt from the FATCA reporting,is correct.See What is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further information.
•Form 1099-K(merchant card and third party network transactions)
Cat.No.10231X Form W-9(Rev.12-2014)
Form W-9(Rev.12-2014) Page 2
Note.If you are a U.S.person and a requester gives you a form other than Form 3.The IRS tells the requester that you furnished an incorrect TIN,
W-9 to request your TIN,you must use the requester's form if it is substantially 4.The IRS tells you that you are subject to backup withholding because you did
similar to this Form W-9. not report all your interest and dividends on your tax return(for reportable interest
Definffion of a U.S.person.For federal tax purposes,you are considered a U.S. and dividends only),or
person if you are: 5.You do not certify to the requester that you are not subject to backup
•An individual who is a U.S.citizen or U.S.resident alien; withholding under 4 above(for reportable interest and dividend accounts opened
•A partnership,corporation,company,or association created or organized in the after 1983 only).
United States or under the laws of the United States; Certain payees and payments are exempt from backup withholding.See Exempt
•An estate(other than a foreign estate);or payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
•A domestic trust(as defined in Regulations section 301.7701-7). Also see Special rules forpartnerships above.
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 What is FATCA reporting?
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 Foreign Account Tax Compliance Act(FATCA)requires a participating foreign
the rules under section 1446 require a partnership to presume that a partner is a financial institution to report all United States account holders that are specified
foreign person,and pay the section 1446 withholding tax.Therefore,if you are a United States persons.Certain payees are exempt from FATCA reporting.See
U.S.person that is a partner in a partnership conducting a trade or business in the Exemption from FATCA reporting code on page 3 and the Instructions for the
United States,provide Form W-9 to the partnership to establish your U.S.status Requester of Form W-9 for more information.
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 Updating Your Information
for purposes of establishing its U.S.status and avoiding withholding on its You must provide updated information to any person to whom you claimed to be
allocable share of net Income from the partnership conducting a trade or business an exempt payee if you are no longer an exempt payee and anticipate receiving
in the United States: reportable payments in the future from this person.For example,you may need to
•In the one of a disregarded entity with a U.S.owner,the U.S.owner of the provide updated information if you are a C corporation that elects to be an S
disregarded entity and not the entity; corporation,or 8 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
•In the case of a grantor trust with a U.S.grantor or other U.S.owner,generally, of a grantor trust dies.
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 Penalties
grantor trust)and not the beneficiaries of the trust. Failure to furnish TIN.If you fail to furnish your correct TIN to a requester,you are
Foreign person.If you are a foreign person or the U.S.branch of a foreign bank subject to a penalty of$50 for each such failure unless your failure is due to
that has elected to be treated as a U.S.person,do not use Form W-9.Instead,use reasonable cause and not to willful neglect.
the appropriate Form W-8 or Form 8233(see Publication 515,Withholding of Tax Civil penalty for false information with respect to withholding.If you make a
on Nonresident Aliens and Foreign Entities). false statement with no reasonable basis that results in no backup withholding,
Nonresident alien who becomes a resident alien.Generally,only a nonresident you are subject to a$500 penalty.
alien individual may use the terms of a tax treaty to reduce or eliminate U.S.tax on Criminal penalty for falsifying information.Willfully falsifying certifications or
certain types of income.However,most tax treaties contain a provision known as affirmations may subject you to criminal penalties Including fines and/or
a"saving clause."Exceptions specified in the saving clause may permit an imprisonment.
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. Misuse of TINs.If the requester discloses or uses TINS in violation of federal law,
If you are a U.S.resident alien who is relying on an exception contained in the the requester may be subject to civil and criminal penalties.
saving clause of a tax treaty to claim an exemption from U.S.tax on certain types Specific Instructions
of income,you must attach a statement to Form W-9 that specifies the following p
five items:
1.The treaty country.Generally,this must be the same treaty under which you Line 1
claimed exemption from tax as a nonresident alien. You must enter one of the following on this line;do not leave this line blank.The
2.The treaty article addressing the income. name should match the name on your tax return.
3.The article number(or location)in the tax treaty that contains the saving If this Form W-9 is for a joint account,list first,and then circle,the name of the
clause and its exceptions. person or entity whose number you entered in Part I of Form W-9.
4.The type and amount of income that qualifies for the exemption from tax. a. Individual.Generally,enter the name shown on your tax return.If you have
5.Sufficient facts to justify the exemption from tax under the terms of the treat changed your last name without informing the Social Security Administration(SSA)
1 fY P y of the name change,enter your first name,the last name as shown on your social
article. security card,and your new last name.
Example.Article 20 of the U.S.-China income tax treaty allows an exemption Note.ITIN applicant:Enter your individual name as it was entered on your Form
from tax for scholarship income received by a Chinese student temporarily present W-7 application,line Ia.This should also be the same as the name you entered on
in the United States.Under U.S.law,this student will become a resident alien for the Form 1040/1040AI1040EZ you filed with your application.
tax purposes if his or her stay in the United States exceeds 5 calendar years. b. Sole proprietor or single-member I.I.C.Enter your individual name as
However,paragraph 2 of the first Protocol to the U.S.-China treaty(dated Aprtl 30, shown of your proprietor
0r singl -me b line 1.You may enter your business,trade,
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 or"doing business as"(DBA)name on line 2.
who qualifies for this exception(under paragraph 2 of the first protocol)and is c. Partnership,LLC that is not a single-member LLC,C Corporation,or S
relying on this exception to claim an exemption from tax on his or her scholarship Corporation.Enter the entity's name as shown on the entity's tax return on line 1
or fellowship income would attach to Form W-9 a statement that includes the and any business,trade,or DBA name on line 2.
information described above to support that exemption. d. Other entities.Enter your name as shown on required U.S.federal tax
If you are a nonresident alien or a foreign entity,give the requester the documents on line 1.This name should match the name shown on the charter or
appropriate completed Form W-8 or Form 8233. other legal document creating the entity.You may enter any business,trade,or
DBA name on line 2.
Backup Withholding e. Disregarded entity.For U.S.federal tax purposes,an entity that is
What is backup withholding?Persons making certain payments to you must disregarded as an entity separate from Its owner is treated as a"disregarded
under certain conditions withhold and pay to the IRS 28%of such payments.This entity." See Regulations section 301.7701-2(c)(2)(iii).Enter the owner's name on
is called"backup withholding." Payments that may be subject to backup line 1.The name of the entity entered on line 1 should never be a disregarded
withholding include interest,tax-exempt interest,dividends,broker and barter entity.The name on line 1 should be the name shown on the Income tax return on
exchange transactions,rents,royalties,nonemployee pay,payments made in which the income should be reported.For example,if a foreign LLC that is treated
settlement of payment card and third parry network transactions,and certain as a disregarded entity for U.S.federal tax purposes has a single owner that is a
payments from fishing boat operators.Real estate transactions are not subject to U.S.person,the U.S.owner's name is required to be provided on line 1.If the
backup withholding. direct owner of the entity is also a disregarded entity,enter the first owner that is
You will not be subject to backup withholding on payments you receive if you not disregarded for federal tax purposes.Enter the disregarded entity's name on
give the requester your correct TIN,make the proper certifications,and report all line 2,"Business name/disregarded entity name."If the owner of the disregarded
your taxable interest and dividends on your tax return. 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.
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 Part II instructions on page
3 for details),
Form W-9(Rev.12-2014) Page 3
Line 2 'However,the following payments made to a corporation and reportable on Form
If you have a business name,trade name,DBA name,or disregarded entity name, 1099-MISC are not exempt from backup withholding:medical and health care
you may enter it on line 2. payments,attorneys'fees,gross proceeds paid to an attorney reportable under
section 6045(f),and payments for services paid by a federal executive agency.
Line 3 Exemption from FATCA reporting code.The following codes identify payees
Check the appropriate box in line 3 for the U.S.federal tax classification of the that are exempt from reporting under FATCA.These codes apply to persons
person whose name is entered on line 1.Check only one box in line 3. submitting this form for accounts maintained outside of the United States by
Limited Liability Company(LLC).If the name on line 1 is an LLC treated as a certain foreign financial institutions.Therefore,if you are only submitting this form
partnership for U.S.federal tax purposes,check the"Limited Liability Company" for an account you hold in the United States,you may leave this field blank.
box and enter"P"in the space provided.If the LLC has filed Form 8832 or 2553 to 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 n code is
be taxed as a corporation,check the"Umited Liability Company"box and in the not required by providing you with a Form W-9 with"Not Applicable"(or an
space provided enter"C"for C corporation or"S"for S corporation.If it Is a y
single-member LLC that is a disregarded entity,do not check the"United Liability similar indication)written or printed on the line for a FATCA exemption code.
Company"box:instead check the first box In line 3"Individuallsole proprietor or A—An organization exempt from tax under section 501(a)or any individual
single-member LLC." retirement plan as defined in section 7701(a)(37)
Line 4, Exemptions B—The United States or any of its agencies or Instrumentalities
If you are exempt from backup withholding and/or FATCA reporting,enter in the C—A state,the District of Columbia,a U.S.commonwealth or possession,orany of their political subdivisions or instrumentalities
appropriate space in line 4 any code(s)that may apply to you.
Exempt payee code. D—A corporation the stock of which is regularly traded on one or more
established securities markets,as described in Regulations section
• Generally,individuals(including sole proprietors)are not exempt from backup 1.1472-1(c)(1)(1)
withholding. E—A corporation that is a member of the same expanded affiliated group as a
• Except as provided below,corporations are exempt from backup withholding corporation described in Regulations section 1.1472-1(c)(1)(1)
for certain payments,including Interest and dividends. F—A dealer in securities,commodities,or derivative financial instruments
• Corporations are not exempt from backup withholding for payments made in (including notional principal contracts,futures,forwards,and options)that is
settlement of payment card or third party network transactions. registered as such under the laws of the United States or any state
• Corporations are not exempt from backup withholding with respect to attorneys' G—A real estate investment trust
fees or gross proceeds paid to attorneys,and corporations that provide medical or H—A regulated investment company as defined in section 851 or an entity
health care services are not exempt with respect to payments reportable on Form registered at all times during the tax year under the Investment Company Act of
1099-MISC. 1940
The following codes identity payees that are exempt from backup withholding.
Enter the appropriate code in the space in line 4. —A common trust fund as defined in section 584(x)
1—An organization exempt from tax under section 501(a),any IRA,or a J—A bank as defined in section 581
custodial account under section 403(b)(7)if the account satisfies the requirements K—A broker
of section 401(p(2) L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
2—The United States or any of Its agencies or instrumentalities M—A tax exempt trust under a section 403(b)plan or section 457(8)plan
3—A state,the District of Columbia,a U.S.commonwealth or possession,or Note.You may wish to consult with the financial institution requesting this form to
any of their political subdivisions or instrumentalities determine whether the FATCA code and/or exempt payee code should be
4—A foreign government or any of its political subdivisions,agencies,or completed.
instrumentalities
5—A corporation Line 5
6—A dealer in securities or commodities required to register In the United Enter your address(number,street,and apartment or suite number).This is where
States,the District of Columbia,or a U.S.commonwealth or possession the requester of this Form W-9 will mail your information returns.
7—A futures commission merchant registered with the Commodity Futures Line 6
Trading Commission Enter your city,state,and ZIP code.
8—A real estate investment trust
9—An entity registered at all times during the tax year under the Investment Part I.Taxpayer Identification Number(TIN)
Company Act of 1940 Enter your TIN in the appropriate box.If you are a resident alien and you do not
10—A common trust fund operated by a bank under section 584(a) have and are not eligible to get an SSN,your TIN is your IRS individual taxpayer
11—A financial institution 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.
12—A middleman known in the investment community as a nominee or If you are a sole proprietor and you have an EIN,you may enter either your SSN
custodian or EIN.However,the IRS prefers that you use your SEN.
13—A trust exempt from tax under section 664 or described in section 4947 If you are a single-member LLC that is disregarded as an entity separate from its
The following chart shows types of payments that may be exempt from backup owner(see Limited Liability Company(LLC)on this page),enter the owner's SSN
withholding.The chart applies to the exempt payees listed above,1 through 13. (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.
IF the payment is for... THEN the payment is exempt for... Note.See the chart on page 4 for further clarification of name and TIN
combinations.
Interest and dividend payments All exempt payees except How to get a TIN.If you do not have a TIN,apply for one immediately.To apply
for 7 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
Broker transactions Exempt payees 1 through 4 and 6 calling 1-800-772-1213.Use Form W-7,Application for IRS Individual Taxpayer
through 11 and all C corporations.S Identification Number,to apply for an ITIN,or Form SS-4,Application for Employer
corporations must not enter an exempt Identification Number,to apply for an EIN.You can appy for an EIN online by
payee code because they are exempt accessing the IRS website at www.irs.gov/businesses and clicking on Employer
only for sales of noncovered securities Identification Number(EIN)under Starting a Business.You can get Forms W-7 and
acquired prior to 2012. SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM
(1-800-829-3676).
Barter exchange transactions and Exempt payees 1 through 4 If you are asked to complete Form W-9 but do not have a TIN,apply for a TIN
patronage dividends and write"Applied For"in the space for the TIN,sign and date the form,and give it
Payments over$600 required to be Generally,exempt payees to the requester.For interest and dividend payments,and certain payments made
reported and direct sales over$5,000' 1 through 5� with respect to readily tradable instruments,generally you will have 60 days to get
9 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
Payments made in settlement of Exempt payees 1 through 4 subject to backup withholding on all such payments until you provide your TIN to
payment card or third party network the requester.
transactions Note.Entering"Applied For"means that you have already applied for a TIN or that
'See Form 1099-MISC,Miscellaneous Income,and its instructions. you intend to apply for one soon.
Caution:A disregarded U.S.entity that has a foreign ownermust use the
appropriate Form W-8.
Form W-9(Rev.12-2014) Page 4
Part II. Certification 'You must show your individual name and you may also enter your business or DSAname on
To establish to the withholding agent that you are a U.S. arson,or resident alien, the"Business name/disregarded entity"name line.You may use either your SSN or EIN(e you
9 9 Y P have one),but the IRS encourages you to use your SSN.
sign Form W-9.You may be requested to sign by the withholding agent even If a List first and circle the name of the trust,estate,or pension trust.(Do not furnish the TIN of the
items 1,4,or 5 below indicate otherwise. personal representative or trustee unless the legal entity itself is not designated In the account
For a joint account,only the person whose TIN is shown in Part I should sign title.)Also we Special rules/orparmersMps on page 2.
(when required).In the case of a disregarded entity,the person identified on line 1 'Note.Grantor also must provide a Farm W-9 to trustee of trust.
must sign.Exempt payees,see Exempt payee code earlier. Note.If no name is circled when more than one name is listed,the number will be
Signature requirements.Complete the certification as indicated in items 1 considered to be that of the first name listed.
through 5 below. Secure Your Tax Records from Identity Theft
1.Interest,dividend,and barter exchange accounts opened before 1984
and broker accounts considered active during 1983.You must give your Identity theft occurs when someone uses your personal Information such as your
correct TIN,but you do not have to sign the certification. name,SSN,or other identifying Information,without your permission,to commit
2.Interest,dividend,broker,and barter exchange accounts opened after fraud or other crimes.An identity thief may use your SSN to get a job or may file a
1983 and broker accounts considered inactive during 1983.You must sign the tau return using your SSN to receive a refund.
certification or backup withholding will apply.If you are subject to backup To reduce your risk:
withholding and you are merely providing your correct TIN to the requester,you .Protect your SSN,
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 •Ensure your employer is protecting your SSN,and
item 2 of the certification. •Be careful when choosing a tax preparer.
4.Other payments.You must give your correct TIN,but you do not have to sign If your tax records are affected by identity theft and you receive a notice from
the certification unless you have been notified that you have previously given an the IRS,respond right away to the name and phone number printed on the IRS
Incorrect TIN."Other payments"include payments made in the course of the notice or letter.
requester's trade or business for rents,royalties,goods(other than bills for If your tax records are not currently affected by identity theft but you think you
merchandke),medical and health care services(including payments to are at risk due to a lost or stolen purse or wallet,questionable credit card activity
corporations),payments to a nonemployee for services,payments made in or credit report,contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit
settlement of payment card and third party network transactions,payments to Form 14039.
certain fishing boat crew members and fishermen,and gross proceeds paid to For more information,we Publication 4535,Identity Theft Prevention and Victim
attorneys(including payments to corporations). Assistance.
5.Mortgage interest paid by you,acquisition or abandonment of secured Victims of identity theft who are experiencing economic harm or a system
property,cancellation of debt,qualified tuition program payments(under
problem,or are seeking help y resolving tax problems that have not been resolved
section 529),IRA,Coverdell ESA,Archer MSA or HSA contributions or through normal channels,may
distributions,and pension distributions.You must give your correct TIN,but you be eligible for Taxpayer Advocate Service(TAS)
do not have to sign the certification. assistance.You can reach TAS by calling the TAS toll-free case intake line at
1-877-777-4778 arTTY?DD 1-800-829-4059.
What Name and Number To Give the Requester Protect yourself from suspicious smalls or phishing schemes. Phishing is the
creation and use of email and webshes designed to mimic legitimate business
For this type of amount: Give name and SSN of: entails and websites.The most common act is sending an email to a user falsely
1.Individual The individual 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.
2.Two or more Individuals(joint The actual owner of the account or, The IRS does not initiate contacts with taxpayers via entails.Also,the IRS does
account) if combined funds,the first not request personal detailed information through email or ask taxpayers forthe
individual on the account' PIN numbers,passwords,or similar secret access information for their credit card,
3.Custodian account of a minor The minor' bank,or other financial accounts.
(Uniform Gift to Minors Act) If you receive an unsolicited email claiming to be from the IRS,forward this
4.a.The usual revocable savings The grantor-trustee' message to phishing@im.gov.You may also report misuse of the IRS name,logo,
trust(grantor is also trustee) or other IRS property to the Treasury Inspector General for Tax Administration
b.So-called trust account that is The actual owner' (TIGTA)at 1-800-366-4484.You can forward suspicious emalls to the Federal
not a legal or valid trust under Trade Commission at:spam®uce.gov or contact them at www.ftc.gov/idtheft or
state law 1-877-IDTHEFT(1-877-438-4338).
5.Sole proprietorship or disregarded The owner' Visit IRS.gov to learn more about identity theft and how to reduce your risk.
entity owned by an individual
6.Grantor trust filing under Optional The grantor' Privacy Act Notice
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i) Section 6109 of the Internal Revenue Code requires you to provide your correct
(A)) 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
For this type of account Give name and EIN of: you;mortgage interest you paid;the acquisition or abandonment of secured
7.Disregarded entity not owned by an The owner property;the cancellation of debt;or contributions you made to an IRA,Archer
individual MSA,or HSA.The person collecting this form uses the information on the form to
8.A valid trust,estate,or pension trust Legal entity° 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
9.Corporation or LLC electing The corporation criminal litigation and to cities,states,the District of Columbia,and U.S.
corporate status on Form 8832 or commonwealths and possessions for use in administering their laws.The
Form 2553 information also may be disclosed to other countries under a treaty,to federal and
10.Association,club,religious, The organization state agencies to enforce civil and criminal laws,or to federal law enforcement and
charitable,educational,or other tax- intelligence agencies to combat terrorism.You must provide your TIN whether or
exempt organization not you are required to file a tax return.Under section 3406,payers must generally
11.Partnership or mufti-member LLC The partnership 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
12.A broker or registered nominee The broker or nominee providing false or fraudulent information.
13.Account with the Department of The public entity
Agriculture in the name of a public
entity(such as a state or local
government,school district,or
prison)that receives agricultural
program payments
14.Grantor trust filing under the Form The trust
1041 Filing Method or the Optional
Form 1099 Filing Method 2(see
Regulations section 1.671-4(b)(2)(1)
(B))
'List first and circle the name of the person whose number you furnish.If only ane person on a
joint account has an SSN,that person's number must be furnished.
'Circle the minor's name and furnish the minor's SSN.
RESOLUTION OF SUPPORT
(Dubuque Main Street Board of Directors)
Resolution of Support and Commitment for the Main Street Program in Dubuque
WHEREAS, an Agreement between the Iowa Economic Development Authority,
Dubuque Main Street and the City of Dubuque for the purpose of continuing the Main
Street Iowa program in Dubuque and,
WHEREAS, this Agreement is pursuant to contractual agreements between the
National Trust for Historic Preservation and the Iowa Economic Development Authority
to assist in the revitalization of the designated Main Street project area of Dubuque,
Iowa and,
WHEREAS, the local Board of Directors for the Main Street Program in
Dubuque is committed to the goal of economic revitalization of the Downtown within the
context of preservation and rehabilitation of its historic buildings and supports the
continuation of the Main Street Four Point Approach® as developed by the National
Trust for Historic Preservation and espoused by Main Street Iowa.
NOW THEREFORE BE IT RESOLVED by the local Board of Directors for the Main
Street Program in Dubuque, Iowa, meeting in regular session on July 20, 2016, that the
Board of Directors hereby agrees to support philosophically the work of Dubuque Main
Street and to supervise the Program Director.
PASSED, APPROVED, AND ADOPTED THIS 20th day off July, 2016.
2.x'0
Chad VVAgener
Board President