My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
Fully Executed Agreement
>
Meetings
>
2026
>
05. May
>
2026-05-19 10:00 AM - Commissioners' Agenda
>
Fully Executed Agreement
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
6/25/2026 12:27:26 PM
Creation date
6/25/2026 12:27:11 PM
Metadata
Fields
Template:
Meeting
Date
5/19/2026
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Item
Request to Approve an Agreement for Services between Kittitas County and Comprehensive Healthcare
Order
5
Placement
Consent Agenda
Row ID
144485
Type
Agreement
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
22
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Fornr !V-9 {Rer- 3-2024)P*ge 4 <br />2-The United States or any of its agencies or instnlmentalities. <br />3-A state, the District of Columbia, a U.S. commonr'/ealth otterrilory, <br />or any of th€lir political subdivisions or instrumenlalities. <br />4-A {oreign govenlment or any of its political suMivisions, agencies' <br />or instrunrentalities. <br />5-A corporation. <br />6-A dealer in securilies or commodilies required to register in the <br />Uniled Slates, the Districl of Columbia, or a U.S. commorlwealth or <br />territory. <br />7-A lutures commisgion merchant registered with the Cornmodity <br />Futures Trading Commission. <br />8-A real estate investm€nt trust. <br />9-An entity registered at all limes during the ta,r year urrder the <br />lnvestment Cornpany Act of 1 940. <br />10 -A common trust fund operated by a bank under s€ction 584{a}. <br />1 1 -A financial institution as de{ined under seclion 581. <br />12-A middlernan knov;n in the inveslment community as n nomirtee or <br />custodian. <br />13-A trust exonrpt from tax under seclion 664 or described in section <br />.1947. <br />The follouring chart shows typ€s of paymenls that may be exempt <br />from backup withholding. Tlre chart applies to the exempt pal"ees listed <br />above, I through 13. <br />lF the paynterrt is for THEN the paynrent is exenlpi <br />for... <br />. lnterest and di'zidend payments All exempt paye€s except <br />tor 7. <br />. Broker transactions payees I through 4 and 6 <br />through 11 and all C corporations. <br />S corporations must nol ent€t an <br />exempt payee code because they <br />are exempt only for saies of <br />noncovered securilies acquired <br />lo 2012. <br />. Barter exch transactiorrs Exempt payees I lhrough 4. <br />and <br />. Paymente over $600 required to Generally, exempt payees <br />be reported ancl djrect sales over 1 ihrough 5.2 <br />. Payments made in settlement of <br />payment card or third-party <br />network transactions <br />l See Form 1099-MlSC, Miscellaneous lnformation. and its instructions- <br />2However, the follouring paymenls made to a corporalion and <br />reportable on Form 1Oss-fullSC are not exempt from backup <br />r,.'ithholding: medical and health care payments. attomeys'fees, gross <br />proceeds paid to an attorney reportable under section 6045{fi. and <br />payments ior sewices paid by a federal executive agency. <br />Exernption from FATCA reportirrg code. The following codes identify <br />payees that are exempt from reporting under FATGA. These codes <br />apply 1o persons submitting this Iorm for accounts maintained outside <br />of the United States by certain foreign financial institutions. Therefore. if <br />yor-r are only submitting this form for an account you hold in the United <br />States. you may leave this field blank. Consult wiih the p€rson <br />requesling this form if you are uncertain if the financial instifution is <br />subject to these requirernents. A requester may indicate that a code is <br />not required by providing you with a Form W-9 rvith "Not Applicable" (or <br />any siririlar indicationi enlered on the line for a FATCA exemption code. <br />A-An organization exempt from tax under section 501{a) or any <br />individual retirement plan as de{ined in section 7701{a){37i. <br />B-The United States or any of its agencies or ;nstrumentalities. <br />C-A state. the District of Colurnbia, a U.S. comnronrvealth or <br />tenitory. or any of lheir polilical subdivisions or instrunrentalities. <br />D-A corporation the stock of i'vhich is regtrlarly traded on one cr <br />more established securilieg markets. as described in Regulations <br />section 1.1472-1 (cX1){i). <br />E-A corporation that is a nrernber of the same expanded afliliated <br />group as a corporalion descril>ed in Regulations section 1. 1 472-1 (c)(1)(i). <br />F-A dealer in securities. commodities, or derivalive {inancial <br />instruments {including notional principal contracts, futures, fomrards, <br />and options) that is registered as such under the laws of the United <br />$tales or any state. <br />G-A real estate investment trust. <br />H-A regulated investment company as defined in section 851 or an <br />entity registered at all times during the tax year under the lnvestment <br />Company Act of 1940. <br />l-A common trust fund as defined in s€ction 584(a). <br />J-A bank as defined in section 581. <br />K-A broker- <br />L-A trust exempt from tax under section 664 or described in s€ction <br />ae.17{a)fl). <br />ful -A tax-exempl trust under a section 403(b) plan or seciion 457(9) <br />plan. <br />Note: You may wish to consult wilh the financial institulion requesting <br />this lorm to delermine v/hether the FATCA code and/or exenlpl pay€€ <br />code shculd be completed. <br />Line 5 <br />€nter your address {number, street, and apartment or suite. nuilber}' <br />This is vrhere the requester of this Form W-9 will mail your information <br />retums. lf this address dit{ers from lhe one the requesler already lras on <br />file. enter "NE!1f'at lhe top. lf a new address is provided, there is 6fill a <br />chance the old address lvill be used until the payor chang€s your <br />address in their records. <br />Line 6 <br />Enter 1'aur city. slate, and ZIP code. <br />Part l. Taxpayer ldentification Number (TlN) <br />€nter your TIN in the appropriate box. lf you are a resident alietr and <br />you do not have. and are not eligible to get, an SSN, your TIN is your <br />iRS mru. Enter it in the entry space for the Social security number. lf you <br />do not ha're an lTlN, see Hov' to get a I/N below. <br />lf you are a sole proprielor and you have an EIN' you may enter €ither <br />your SSFI or ElN. <br />It yott are a single-member LLC that is disregarded as an entity <br />separale from its ovrner. enter the owrrer's SSN (or ElN, if the otl'ner has <br />one). lf tne LLC is classilied as a corporation or parlnership, ent€r lhs <br />entity's ElN. <br />tlote: See What Name and Number To Give the Requester,later, for <br />further clarification of name and TIN combinations' <br />How lo get a TlN, lf you do not have a TlN, apply for one immediately. <br />Ta apply lor an SSN, get Form SS-5, Application lor a Social Security <br />Card. from your local SSA otlice or get this form online at <br />vrsnv.SSAgov. You may also get this form by calling 800-772-1213. Use <br />FormtrV-7. Application for IRS tndividual Taxpayer ldenti{ication <br />Number. ro a'fply for an lTlN, or Form SS-a, Applicalion for Employer <br />ldentific.ation Nuntber. lo apply for an ElN. You can appty for an EIN <br />online by accessing the IRS website atuaaw.irs.govlE|N. Go lo <br />u*,wt.its'.govlFomts to'rievl, dorvnload, or print Form W-7 and/or Form <br />SS-4. Oriyou can go Io www.irs.govlOrdeForms to place an order and <br />have Form !4/-7 and/or Form SS-4 nrailed to you within 1 5 business <br />days. <br />l{ ycu are asked to complete Form W-9 but do not have a TlN, apply <br />ior a TtN and enter "Applied Fo/' in the space for the TlN, sign.and date <br />the form, and give it t6 ihe requester. Foi interest and dividend <br />payments. and certain payments made rvith respect to.readily tradable <br />insiruments, you rvill generally have 6o days to get a TIN and give it to <br />the requester before you are subject to backup rvithholding,on <br />paymehts. The 6o-day rule does not apply lo olher types of payments. <br />Vou will be subrjecl to backup vrithholding on all such payments until <br />yaupro'irJe your TIN to the requester. <br />Note: Enlering "Applied Fo/' means that you have already appti"d !gt-" <br />flN or that vou intend to applv for one soon. See also Esfab/lshing U.S <br />status for piurposes of cha'piei 3 and chapter 4 withholding, earliei' for <br />when you may instead be subject to rvithholding under chapter 3 ot 4 ot <br />the Code. <br />Caution: A disregarded U.S. entity that has a foreign ownar must use <br />the appropriate Form W-8. <br />Exempt payees 1 through 4 <br />Kittitas County Agreement for Services (rev.5/L4/25) <br />Page L9 of 22
The URL can be used to link to this page
Your browser does not support the video tag.