HomeMy WebLinkAbout2008-177 Contract - Crandall Arambula
Contract for PERSONAL SERVICES Less than $25,000
CITY OF
ASHLAND
20 East Main Street
Ashland, Oregon 97520
Telephone: 541/488-6002
Fax: 541/488-5311
CONSULTANT: Crandall Arambula
CONTACT: Debra Ames
ADDRESS: 520 SW Yamhill, Roof Suite 4
Portland, OR 97204
TELEPHONE: 503.417.7879
DATE AGREEMENT PREPARED: 8/9/08
BEGINNING DATE: 9/1/08
COMPENSATION: $12,905
FAX: 503.417.7904
COMPLETION DATE: 10/1/08
SERVICES TO BE PROVIDED: See attached work plan
ADDITIONAL TERMS:
FINDINGS:
Pursuant to AMC 2.52.040E and AMC 2.52.060, after reasonable inquiry and evaluation, the undersigned Department
Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have
adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for
utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and
capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and
financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the
compensation negotiated herein is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings I Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service to which they will be
assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of
Oregon, are so registered, licensed and bonded.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified
above. Once work commences, invoices shall be prepared and submitted by the tenth of the month for work
completed in the prior month. Payments shall be made within 30 days of the date of the invoice. Should the contract
be prematurely terminated, payments will be made for work completed and accepted to date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $18,088 or more, Consultant is required to comply with
chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees
performing work under this contract and to any Subcontractor who performs 50% or more of the service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Consultant (including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations,
actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
Contract for Personal Services, Revised 07/01/2008, Page 1 of 11
10. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
c. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
written notice to Consultant, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Consultant to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Consultant may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written noUce of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice tc? Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obliaation/Liabilitv of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, cor d of this section, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business
on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or
delegate duties under, the Contract.
14. Insurance. Consultant shall at its own expense provide the following insurance:
a. Worker's Comoensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. Professional Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
c. General Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1.000.000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
Contract for Personal Services, Revised 07/01/2008, Page 2 of 11
d. Automobile Liabilitv insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1 ,000.000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
e. Notice of cancellation or chanae. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to
the City.
f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Consultant's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work
under this contract. The certificate will specify all of the parties who are Additional Insureds. Insuring companies
or entities are subject to the City's acceptance. If requested, complete copies of insurance policies; trust
agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent
deductibles, self-insured retentions and/or self-insurance.
15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further
liability to Consultant.
Certificati Consultant shall si
CONSU N
ertification attached hereto as Exhibit A and herein incorporated b reference.
CITY OF ASHLAND:
TITLE
DATE
!KJ~~
FederallD#
g~,. 12.~~5"
Contract for Personal Services, Revised 07/01/2008, Page 3 of 11
BY .t::JtJ(
er
DETERMINED BY:
Ci Department Head
Approved as to
form by Legal:
ACCOUNT #
/~?? t:P-1 ;;Z '1 ~ G t:J ~ r t9
(For City purposes only)
~ 6/tb~(c;
*Completed W9 form must be submitted with contract
PURCHASE ORDER #
Contract for Personal Services, Revised 07/01/2008, Page 4 of 11
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
~ (1) I carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
~ (2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
X (3) Telephone listing is used for the business separate from the personal residence listing.
)( (4) Labor or services are performed only pursuant to written contracts.
)( (5) Labor or services are performed for two or more different persons within a period of one
year.
X (6) I assume financial responsibility for defective workmanship or for service not provided
as evidenced by the ownership of performance bonds, warranties, errors and omission
insurance or liability insurance relating to the labor or services to be provided.
Contractor
(Date)
Contract for Personal Services, Revised 07/01/2008, Page 5 of 11
Contract for Personal Services, Revised 07/01/2008, Page 6 of 11
-'~-.~r'- "------.-.. '--'-'-'---, -.-'...-.-----.----.--
Form W-g
(Rw. 0Q0ber 2007)
Department of the Treasury
Internal Revet"lJe Service
Request for Taxpayer
Identification Number and Certification
GIN 'ann to the
ntquester. Do not
..nd to the IRS.
Check lIppI'opiate box: 0 lndividuellSole proprietor
o Limited l.ally oompeny. Em. the -. dllNiflcdon
o Other (Nt inttructionl) ...
Addreee ~, 8trMt, and
Corpordon 0 PartnereNp
Ieregarded entity, Cac:orporatian, P"'f*tnernp) ~ _ __ m _
o Exempt
ptiy..
Enter your TIN in the appropriate box. The TIN provided muat match the name given on Une 1 to avoid
backup withholding. For IncIvlduals, this i. your social secu1ty IU1lber (SSN). However, for a resident
allen, sole proprietor, or clsregarded entity, ... the Part I instructions on page 3. For other entities, It Is
yOU" employer identification nunber (EIN). If you do not have a nunber, see How to get a 71N on page 3.
Not.. If the KCOUnt Is in more than one name, see the chart on page 4 for guidelines on whose
mmber to enter.
Certification
Under penalties of perjury, I certify that:
1. The nunber shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be iS8Ued to me). and
2. I am not subject to backup withholding because: (8) I am eX8l11>t from backup withholclng, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withhddilg al a result of a failure to report all interest or civldend8, or (c) the IRS has
notified me that I am no longer 8lI;)ject to backup witIi101ding. and
3. I am 8 U.S. citizen or other U.S. person (cMfined below).
CertI1Icatlon InetructlOM. Y cu must cross out Item 2 above if you have been notified by the IRS that you are ClI'rently eubject to backup
withholding because ycu have failed to report allnterest and clvldends on YOU" tax retlr'n. For real estate transactions. Item 2 does not apply.
For mortgage interest paid, acquI8Ition or abandorment of lecured property, cancellation ~ debt, CaltributionS to an individual retirement
arrangement (IRA). and generally, payments other than interest and dividends. ycu are not reqlired to sign the Certification, but ycu must
provide ycur correct TIN. See th Itructions on e 4.
identification Number
Sign
H....
8ignn.n of
u.s. perean ...
General Instructions
Section references a-e to the Internal Revenue Code unless
otherwise noted.
Purpose of Form
A person who is required to file an infamatlon return with the
IRS nut obtain your correct taxpayer identification number (TIN)
to report, fa" exarY1>le, Income paid to you, real estate
transactions, matgage interest you paid, acquisition or
abandonment of S8ClI'ed property. cancellation of debt, or
contributions you made to an IRA
Use Form W-9 only if you .e a U.S. J*'son (Including a
restdent alten), to provide YOll' correct TIN to the person
requesting It (the requester) and, when applicable, to:
1. Certify that the llN you are giving Is correct (a" you are
waiting for a number to ~ Issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exefT1)tion from backup withholding if you are a U.S.
exefT1)t payee. If applicable, you a-e also certifying that as a
U.S. person, your allocable sha'e of any pa1nership 1nc0l'1le from
a U.S. trade a business Is not subject to the withholding tax on
foreign pa1ners' share of effectively connected incor1'll.
Note. If a requester gives you a form other than Form W-9 to
reqUHt your llN, you mJSt use the requester's fam if it is
substantially sirrita- to this Form W-9.
Requeet..... name and eddr.. (optional)
I SOd....~ !r
or
Dale ...
DdnIIIon of a U.s. person. For feder
considered a U.S. person if you are:
· An Individual who is a U.S. citizen or U.S. resident afien,
· A pa1nership, corporation, company, or association created or
aganized In the United States a 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 roles for ~ Partnerships that conduct a
trade a business In the United Stat.. a-e generally required to
pay a withholding tax on any faelgn partners' share of income
from such busi1ess. Fu1her, in certain cases where a Fam W-9
has not been receiv<<t, a partnership is required to presume that
a partner Is a faeign person, and pay the withholding tax.
lherefae, If you .e a U.S. person that Is a partner In a
partnership conctucting a trade a business in the United states.
provide Fam W-9 to the pa1nership to establish YOll' U.S.
status and avoid withholding on yolI' share of partnership
income.
The person who gives Form W-9 to the partnership for
ptJ'p0se8 of estabUshklg Its U.S. status and avoJdlng withholding
on Its allocable stw. c:I net Income from the partnership
conducting a trade a business In the United stat.. Is In the
following cases:
· The U.S. owner c:J a disreg.ded entity and not the entity.
Cat. No. 102S1X FClft'I'l W..I {Rev. 10..2007)
Contract for Personal Services, Revised 07/01/2008, Page 7 of 11
Form W-O (Rev, 10-2007)
· The U.S. grantor or other owner of a grantor trust and not the
trust, and
. The U.S. trust (other than a grantor trust) and not the
beneficiaries of the trust.
Foreign person. If you are a foreign person, do not use Form
W-9. Instead, use the appropriate Form W-8 (see Publication
515, Withholding of Tax on Nonresident Aliens and Foreign
Entities).
Nonresident alien who becomes a resident alien. Generally,
only a nonresident alien individual may use the terms of a tax
treaty to reduce or eliminate U.S. tax on certain types of income~
However, most tax 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 pll"poses.
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 protocoo 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 desaibed above to support that exemption.
If you are a nonresident alien or a foreign entity not subject to
backup withholding, give the requester the appropriate
completed Form W-8.
What Is backup withholding? Persons making certain payments
to you must under certain conditions withhold and pay to the
IRS 28% 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, 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 YOlJ' taxable interest and
dividends on your tax retll"n.
Payments you Neelve win be subject to backup
wlthhoIcIng If:
1. You do not furnish your TIN to the requester,
2. You do not certify your llN when required (see the Part II
instructions on page 3 for details),
3. The IRS tells the requester that you furnished an incared
TIN,
Contract for Personal Services, Revised 07/01/2008, Page 8 of 11
Page 2
4. The IRS tells you that you are subject to backup
withholding because you did not report all your interest and
dividends on YOll' tax retll'n (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 the instructions below and the separate
Instructions for the Requester of Form W-9.
Also see Special IUI9s for partnerships on page 1.
Penalties
Failure to furnish nN. 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 falllH'e is due to reasonable cause and not to
willful neglect.
Clvl penalty for false Informa1lon with respect to
wIIhholclng. If you make a false statement with no reasonable
basis that results in no backup withholding, you are subject to a
$500 penalty.
Criminal penally for falsifying Information. Willfully falsifying
certifications or affirmations may subject you to criminal
penalties including fines and/or imprisonment.
MIsuse of nNs. If the requester discloses or uses TINs in
violation of federal law, the requester may be subject to civil and
criminal penalties.
Specific Instructions
Name
If you are an Individual, you must generally enter the name
shown on your income tax return. However, if you have changed
your last name, for instance, due to marriage without informing
the Social Secll'ity Administration of the name change, enter
YOll' first name, the last name shown on YOll" social security
card, and your new last name.
If the account is in joint names, list first, and then circle, the
name of the person or entity whose number you entered in Part I
of the form.
Sole proprietor. Enter your individual name as shown on your
income tax return on the "Name" line. You may enter your
business, trade, or "doing business as (DBA)" name on the
"Business name" line.
Umltect lability company (LLq. Check the "Limited liability
company" box only and enter the appropriate COde for the tax
classification ("0" for disregarded entity, "C" for corporation, "P"
for partnership) in the space provided.
For a single-member LLC (including a foreign LLC with a
domestic owner) that is disregarded as an entity separate from
its owner under Regulations section 301.7701-3, enter the
owner's name on the "Name" line. Enter the LLC's name on the
"Business name" line.
For an LLC classified as a partnership or a corporation, enter
the LLC's name on the "Name" line and any business, trade, or
DBA name on the "Business name" line.
0Iher .nIftIes. Enter yoU" business name as shown on required
federal tax documents on the "Name" line. This name should
match the name shown on the charter or other legal document
creating the entity, You may enter any business, trade, or DBA
name on the "Business name" line.
No.. You are requested to check the appropriate box for your
status (individuaVsole proprietor, corporation, etc.).
Exempt Payee
If you are exempt from backup withholding, enter your name as
described above and check the appropriate box for your status,
then check the "Exempt payee" box In the line following the
business name, sign and date the form.
Form W-Q (Rev. 10-2007)
Page 3
Generally, individuals (including sole proprietors) are not exempt
from backup withholding, Corporations are exempt from backup
withholding for certain payments, such as interest and dividends.
Note. If you are exempt from backup withholding, you should
still complete this form to avoid possible erroneous backup
withholding.
The following payees are exempt from backup withholding:
1. An organization exempt from tax under section 501(a), any
IRA, or a custodial account under section 403(b)(7) if the account
satisfies the requirements of section 401 (1)(2),
2. The United States or any of its agencies or
Instrumentalities,
3. A state, the District of Columbia, a possession of the United
states, or any of their political subdivisions or instrumentalities.
4. A foreign government or any of its political subdivisions,
agencies, or instrumentalities, or
5. An international organization or any of its agencies or
instrumentalities.
Other payees that may be exempt from backup withholding
include:
6. A corporation,
7, A foreign central bank of issue,
8. A dealer in securities or commodities required to register in
the United States, the District of Columbia, or a possesSion of
the United States,
9. A futures commission merchant registered with the
Commodity Futures Trading Commission,
1 O. A real estate investment trust,
11. An entity registered at all times during the tax year under
the Investment Company Act of 1940,
12. A common trust fund operated by a bank under section
584(a),
13. A financial institution,
14. A middleman known in the investment community as a
nominee or custodian, or
15. A trust exempt from tax under section 664 or described in
section 4947.
The chart below shows types of payments that may be
exempt from backup withholding. The chart applies to the
exempt payees listed above, 1 through 15.
IF the payment Is for . . .
THEN the payment Is exempt
for .. .
All exempt payees except
for 9
Exempt payees 1 through 13.
Also, a person registered under
the Investment Advisers Act of
1940 who regularty acts as a
broker
Exempt payees 1 through 5
Interest and clvidend payments
Broker transactions
Barter exchange transactioos
and patronage dividends
Payments over $600 required
to be reported and direct
sales over $5,000 '
Generally, exempt payees
1 through 72
'Se. Form 1090-MISC, M.c:el1eneous Income, and its irwtructione.
2However, the following payments made to a corporatia'l (Including grOlS
proceed. paid to an attorney under MCtion eo45(f), even If the attaney i8 a
corporation) m'ld repCll1llbl. on Form 1099-MSC ... not exempt from
backup withholding: medical and heeIth care payments, attorn~.' f8M, and
peyments for aervicee paid bJ a fed...1 executive agency.
Contract for Personal Services, Revised 07/01/2008, Page 9 of 11
r-- ..~._-_.. -.-..-..----.....-..-.-
Part I. Taxpayer Identification
Number (TIN)
Enter your TIN In the approprtale 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 seclM'ity number box. If you do not
have an ITlN, 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. However, the IRS prefers that you
use your SSN.
If you are a single-member LLC that is disregarded as an
entity separate from its owner (see Umited liability company
(llC) on page 2), enter the owner's SSN (or EIN, if the owner
has one). Do not enter the disregarded entity's EIN. If the LLC Is
classified as a corporation or partnership, enter the entity's EIN.
Note. See the chart on page 4 for further clarification of name
and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one
immediately. To apply for an SSN, get Form SS-5, Application
for a Social SeclM'lty Card, from your local Social Security
Administration offICe or get this form online at www.ssagov. 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 ITlN, 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.ilS.govlbusinesses and clicking on Employer Identification
Number (EIN) under starting a Business. You can get Forms W-7
and SS-4 from the IRS by visiting wmv.llS.gov or by calling
1-800- TAX-FORM (1-800-829-3676).
If you are asked to complete Form W-9 but do not have a TIN,
write "Applied ForN 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 6O-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 domestic 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 items 1 , 4, and 5 below indicate
otherwise.
For a joint account, only the person whose TIN is shown in
Part I should sign (when required). Exempt payees, see Exempt
Payee on page 2.
SIgnature requirements. Complete the certification as indicated
in 1 through 5 below.
1. Interest, dividend, and barter exc:hange accounts
opened before 1884 and broUr accounts considered acUVe
durlna 1983. You must give your correct TIN, but you do not
have to sign the certification.
2. In......, dividend, broker, and barter exc:hange
accounts opened after 1SMS3 and broker accounts consIdenKI
InacIIve durtng 1883. You rrust 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.
, I
Form W-O (Rw. 10-2007)
3. Real estate transactions. You must sign the certification.
You may cross out item 2 of the certification,
4. OIher ~nts. You must give your correet TIN, but you
do not have to sign the certification unless you have been
notified that you have previously given an incareet TIN. "other
payments" Include payments made In the COll'S9 of the
requester's trade a business for rents, royalties, goods (other
than bills for merchandise), medical and health care services
(including payments to caporations), payments to a
nonemployee fa services, payments to certain fishing boat crew
members and fishermen, and gross proceeds paid to attorneys
(including payments to caporations).
5. Mortgage Interest paid by you, acqulslUon or
abandonment of secured property, cancellation of debt,
qualified tuition program ~nts (under seellon 5-' IRA,
CCMH'deII ESA, Archer MSA or HSA con1rlbutlons or
distributions, and pension distributions. You must give your
careet TIN, but you do not have to sign the certification.
What Name and Number To Give the Requester
For thie type of account:
1. Individual
2. Two or more individuals Ooint
account)
Give name 8nd SSN of:
The individual
The actual owner of the account or,
if eanbined Mda. the first
individual on the account'
The minor ·
3. Custodian acco~t of a minor
(Uniform Gift to Minora Act)
4. a. The ~ revocable aavings
trust (gr8l'ltor ia also truatee)
b, So-called tr-.t accoU'rt that ia The actual owner 1
not a legal or valid trust under
atate law
5. Sole proprietcnhip or elisregarded The owner ·
entity owned by an individual
For thie type of account:
6. Disregarded entity not owned by an The owner
individual
7. A valid truat, eaeabt, or penaion tru&t Legal entity ·
8. Corporate or LLC electing The corporation
corporate status on Form 8832
9. Aeaociation, club, religious,
charitable, educational, or other
tax-exempt organization
10. Partnership or multi-member liC The pertnerahip
11. A broker or regiatered nominee The broker or nominee
12. Account with the DeJ*1ment of The public entity
Agricultl... in the name of a plbHc
entity (such 88 a state or local
government, achool diatrict, or
priaon) that receives agricultural
program payments
1 Ust first ald circle the nam e of the persCl'l whose number you furnish. If Cl'lly one persCl'l
Cl'l a joint account has an SSN, that perSCl1's number must be furnished.
2Circle the minor's name and furnish the minor's SSN.
3you must show yoor individual name lMld yoo may also enter your business or "DBA"
name Cl'l the second name ~ne. You may use either your SSN or EIN (if yoo have one).
rut the IRS encoorages you to use ywr SSN.
4 Ust 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 accoont title.) Also see Special rules for peJtnerships on page 1.
Note. If no name is circled when mae than one name is listed,
the number will be considered to be that of the first name listed.
The grentor-truatee '
Give name end ElN of:
The organization
Page 4
Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your personal
information such as your name, social security number (SSN), a
other identifying infamation, without your permission, to commit
fraud a other crimes. An identity thief may use your SSN to get
a job a may file a tax return using YOll' 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.
Call the IRS at 1-800-829-1040 if you think your identity has
been used inappropriately for tax purposes.
Victims of identity theft who are experiencing economic harm
a a system problem, a are seeking help in resolving tax
problems that have not been resolved through namal channels,
may be eligible fa Taxpayer Advocate Service (TAS) assistance.
You can reach TAS by calling the TAS toll-free case Intake line
at 1-877-777-4778 or TTYrrDD 1-800-829-4059.
Protect yourself from suspicious .mans or phlshlng
schemes. Phishing is the creation and use of emall and
websites designed to mimic legitimate business emails and
websites. The most common act is sending an email to a user
falsely claiming to be an established legitimate enterprise in an
attempt to scam the user into SU'rendering private infamation
that will be used for identity theft.
The I RS does not Initiate contacts with taxpayers via emalls.
Also, the IRS does not request personal detailed infamation
through email or ask taxpayers for the PIN numbers, passwads,
a similar secret access information for their credit card, bank, or
other financial accounts.
If you receive an unsolicited email claiming to be from the IRS,
forward this message to phishingOirs.gov. You may also report
misuse of the IRS name, logo, or other IRS personal property to
the Treasury Inspecta General fa Tax Administration at
1-800-366-4484. You can forward suspicious emails to the
Federal Trade Commission at: spamOuce.gova contact them at
www.consumBr.govlidtheft a 1-877 -IDTHEFT(438-4338),
Visit the IRS website at www.irs.gov to learn more about
identity theft and how to reduce your risk.
Privacy Act Notice
Section 6109 of the krternal Rev... Code requiree you to provide your carect TIN to pensona who must file information returns wi1h 1he IRS to report intweet,
dividende, and certllin other ineane paid to you, mortgage inter.. you peId, the acquieitian or abandonment of secured property, cenc:eIIetion of debt, or
contributiona you made to an IRA, or Neher MSA or HSA. The IRS .... the nunber. for identification JX6POM8 and to help verify the aCCU'acy of yotI tex return.
The RS may a1eo pt'O\'ide 1hI8 information to the Dep.-tment of .luetice tor civil and criminal litigation, and to cities, etates, the Di8trict of Columbia, and U.S.
poea8NioM to Cllrry out their tllX law.. We may aI.o di8doee thie information to ather counlriu under a tax treaty, to federal and etate agenclee to enforce federal
nontax. crirninallaW8, or to fed4rallaw enforcement and inleligence agenc:i.. to cornbet terroriem.
You must prCNide Y04lTlN whether 01 not you are reqlired to file a tex relurn. Pay.... must ger'lerally wi1hhold 28% of taxable int.....t. dividend, and certain other
payments to a pay.. who doee not give a TIN to a payer. Certain peneltiee may also apply.
Contract for Personal Services, Revised 07/01/2008, Page 10 of 11
T-----.-.--....--.-
r.,
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY RECORDER
Page 1 / 1
VENDOR: 010738
CRANDALL ARAMBULA PC
520 SW YAMHILL ROOF SUITE 4
PORTLAND, OR 97204
SHIP TO: Ashland Planning Department
(541) 488-5305
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Tenns: Net
Req. Del. Date:
Special Inst:
Req. No.:
Oepl: COMMUNITY DEVELOPMENT
Contact: Adam Hanks
Confirming? No
THIS IS A REVISED PURCHASE ORDER
Croman Mill Redevelopment Plan
Consultant to conduct a two-part, '
three-hour workshop with the City
Council and Plannina Commission. This
task will be paid by the City.
12,905.00
J
Part I - Presentation & Discussion
Part II - Consultant Led Sketch of a
Preferred Option
Part III - Provide summary memorandum
of preferred plan
Part IV - Schedulelfacilitate
teleconference to discuss results,
identify next steps, and determine
final revisions.
Contract for Personal Services
Date of aareement: 08/09/2008
Beainnina date: 09/01/2008
Completion date: 1 0/01/2008
Insurance reQuired/On File
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
12
~~ ~
A~tho~d Si~~re
VENDOR COPY