HomeMy WebLinkAboutLT-2022-001 Jazz in the ValleyLI-2OZ2-OOL.JAZZ IN THE VALLEY
2022 LODGING TAX SERVICES AGREEMENT
BETWEEN KITTITAS COUNTY AND LAUGHING HORSE ARTS FOUNDATION
D.B.A. JAZZ IN THE VALLEV
This Contract, effective January 1,,2022 is made and entered into by and between KITTITAS
coUNTY ("County"), acting as agent for and on behalf of the City of Ellensburg, a Washington
municipal corporation ("City"), a subdivision of the State of Washington, AND LAUGHING HORSE
ARTS FOUNDATION D.B.A. JAZZ lN THE VALLEY ("Contractor") for the 2o22 Jazz in the Valley
("Event").
WHEREAS, the purpose of this Agreement is to provide for activities and expenditures
designed to increase tourism,
NOW THEREFORE, in consideration of the terms and conditions contained herein, or
attached and incorporated and made a part hereof, the County and the Contractor mutually agree
as follows:
ction 1 of Work
a' Contractor shall provide the services and staff described in its Application for Lodging Tax
Funds submitted to the Lodging Tax Advisory Committee, attached hereto as Exhibit '.A,,
which is attached hereto and incorporated herein by this reference.
b. Except as otherwise specifically provided in this Agreement, Contractor shall furnish the
following as required to perform the services, described in Paragraph (a)above, in accordance
with this Agreement: Personnel, labor and supervision; technical, professional and other
services. All such services, property and other items furnished or required to be furnished,
together with all other obligations performed, or required to be performed, by Contractor
under this Agreement are collectively referred to herein as "services."
c. Contractor shall commence, perform and complete such Services in accordance with Exhibit
"8" which is attached hereto and incorporated herein by this reference.
Section 2 . Pavment.
a' As full compensation for satisfactory performance of the Contractor's Services, the County
agrees to pay Contractor the sum of eight thousand five hundred forty five dollars and fifty
cents ($8,545.50) (City of Ellensburg funding).
b. Additional payment terms: The County will make payment to the Contractor only on a
reimbursement basis, as receipts/invoices for any items including marketing and/or
advertising are submitted to the County, not to exceed the sum of eight thousand five
hundred forty five dollars and fifty cents ($8,545.50) (City of Ellensburg funding).
c. Services/Expenses that are reimbursed must be dated during the current year and final date
to submit reimbursements requests is January 15,2023 after this date funds lapse.
_2022 County Lodging Tax Funding Agreement Page 7
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d. Requests for reimbursements must be submitted to:
Kittitas County Auditor
Attn: Auditor's Accounting
205 West 5th Ave - Suite 105
Ellensburg, WA 98926
a uditorsaccounting@co.kittitas.wa. us
Reporting requirements of your events will be required on prescribed forms from the County
Auditor.
f. Contractor is eligible to claim reimbursement for the following items and amounts only:
o Speaker and Performance fees
o Artist Expense (used to cover overnight lodging expenses)
o Rent canvas tents to cover the seating areas at the Downtown main venue
G Rent Porta-potties and wash stations for the Downtown to accommodate our attendees.
. Hire security to police the Downtown Venues Friday and Saturday nights from 8pm until L
pm
. Help defray the rentals costs of the sound equipment used in Music Production/Sound
Enhancement
r Rent cooling devices/fans for the venues if the temperatures during the festival require
them.
r Purchase radio Ads
o On-line and print advertising focused on our target audience.
o Social media advertising
o Use an on-line exit survey to get feedback from festival attendees
o Collaborate with other music festivals in our State - Sponsorships/advertising
. Send packets of festival brochures to all the Chambers of Commerce in the State.
g. Contractor is not eligible to claim reimbursement for any items not listed in Section 2 (f) and
is further expressly denied funding for the following items as requested in the application as
defined in Section 1(a): N/A
h. Contractors requesting reimbursement for event-specific expenses shall submit all claims as
no more than two reimbursement requests with supporting documentation at the conclusion
of the event.
Contractors must complete the Lodging Tax Reimbursement online training course provided
by the County Auditor's office prior to filing reimbursement claim. Requests for
reimbursement will not be accepted by the County Auditor prior to the training being
completed. The training may be found online at the Kittitas County Auditor's website at the
fo I lowing add ress: http ://www.co. kittitas.wa. us/a ud ito r/defa u lt.aspx
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Section 3. Perfo ce bv Contractor.
a Contractor shall not (by contract, operation of law or otherwise) delegate or subcontract
performance of any Services to any other person or entity without the prior written consent
of the County and City. Any such delegation or subcontracting without the County's or City's
prior written consent shall be voidable at the County's or City's option.
b. Contractor shall at all times be an independent contractor and not an agent or representative
of the County or City with regard to performing the Services. Contractor shall not represent
that it is, or hold itself out as, an agent or representative of the County or City. ln no event
shall Contractor be authorized to enter into any Agreement or undertaking for or on behalf
of the County or City. lt is understood that the Contractor and the Contractor's staff and
employees are not employees of the County or City and are not, therefore, entitled to any
benefits provided employees of the County or City.
c. Contractor shall comply with all applicable laws, ordinances, rules, regulations, orders,
licenses, permits, and other requirements, now or hereafter in effect, of any governmental
authority (including, but not limited to, such requirements as may be imposed upon the
County and applicable to Services). Contractor shall furnish such documents as may be
required to effect or evidence such compliance. All laws, ordinances, rules, and orders
required to be incorporated into agreements of this character are incorporated into this
Agreement by this reference. Contractor agrees to obtain all required licenses and permits,
and further agrees to keep them in full force and effect during the term of this Agreement.
d. The County and the Contractor agree that in fulfilling the terms and conditions of this
Agreement neither shall discriminate on the basis of race, creed, color, national origin, age,
sex, marital status, or the presence of a physical, sensory, mental disability or any other
protected status recognized under local, state or federal law.
e. The Services shall at all times be subject to inspection by and approval of the County or City,
but the County's or City's making (or failure or delay in making) such inspection or approval
shall not relieve Contractor of its responsibility to perform the Services in accord with this
Agreement, notwithstanding the County's or City's knowledge of defective or non-complying
performance, or the substantiality or ease of discovering the same. Contractor shall provide
the County or City with sufficient, safe, and proper facilities and equipment for such
inspection and free access to such facilities.
f. This contract is subject to review by any Federal or State auditor. Contractor shall promptly
furnish the County or City, or their designee, or such Federal or State auditor with such
information related to the Services as may be requested by the applicable governmental
entity. Contractor shall preserve and maintain all financial records and records relating to
performance of Services under this Agreement for six (6) years after contract termination.
For such duration after the County or City makes final payment of compensation due
hereunder, Contractor shall provide the County or City access to (and the County or City shall
have the right to examine, audit and copy, with or without notice) all of Contractor's books,
documents, papers and records related to the Services or this Agreement.
g. Contractor understands and acknowledges that Contractor is solely responsible for its own
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LT-2022-OOT-JAZZ IN THE VALLEY
reporting and accounting of all state, federal, social security, and local taxes, of every nature,
arising from Contractor's performance of this Agreement. All compensation received by the
Contractor will be reported to the lnternal Revenue Service at the end of the calendar year in
accord with the applicable IRS regulations.
Section 4. Release. lndemnitv, and Hold Harmless.
The County or City assumes no liability for the Contractor's actions under this Agreement. Contractor
releases and shall defend, indemnify, and hold harmless the County and the City, their officers and
employees, agents, representatives, attorneys and/or volunteers, from and against all claims, costs,
liabilities, damages, and expenses, (including, but not limited to, reasonable attorney fees) which
arise or may arise or be alleged to arise out of or by reason of this Agreement including:
Any fault, negligence, strict liability or product liability of Contractor in connection with the
Services for this Agreement;
Any lien asserted upon any property of the County or City in connection with the Services for
this Agreement;
a Any failure of Contractor, or of the Services, to comply with any applicable law, ordinance,
rule, regulation, order, license, permit and other requirement, now or hereafter in effect, of
any governmental authority; or
a Any breach of or default under this Agreement by Contractor
Section 5. Comoliance Public Records Law.
a ln compliance with Washington's public records law, the County will retain copies of any
documents associated with this Agreement, which may be required by law unless legally
exempt from such retention, for any applicable legally required retention period.
b. ln the event a public records request is made to the County or City for documents created in
relation to this Agreement, should legal uncertainty arise regarding the disclosability of any
documents under federal or state public records laws, the County or City shall provide notice
to Contractor pursuant to Washington's public records act, chapter 42.56 RCW, to allow
Contractor to seek a court injunction.
c. The County or City specifically shall not be liable to Contractor for the County's or City's
release under public records laws of any documents not otherwise exempt from disclosure
by trademark, copyright or other law.
Section 5-lnsurance Waiver.
With respect to performance of this Agreement and as to any claims against the County or City, their
Additional lnsureds, officers, agents and employees, the Contractor expressly waives its immunity under
Title 51 of the Revised Code of Washington, the lndustrial lnsurance Act, for injuries to Contractor's
employees and agrees that the obligations to indemnify, defend and hold harmless provided in this
a
a
t,County Lodging Tax Funding Agreement Poge 4
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Agreement extend to any claim brought by or on behalf of any employee of the Contractor. This waiver
is mutually negotiated by the parties to this Agreement.
Section 7. lnsura nce and Endorsements.
The County may require through a request in writing that the Contractor provide the County
with a certificate, binder, or policy of liability insurance, acceptable to the County in an
amount specified by the County.
b. Such liability insurance shall be such as will protect Contractor, its employees, agents and
representatives, from all claims, losses, harm, costs, liabilities, damages and expenses arising
out of personal injury (including death) or property damage that may result from performance
of the Services or this Agreement, whether such performance is by Contractor or any of its
employees, agents or representatives.
c. Should the County require such liability insurance, the Contractor agrees to provide proof of
insurance prior to commencing performance of this Agreement.
d. Copies of the County's written request and the insurance documents provided by Contractor
shall be attached to this Agreement and by this reference will be made part hereof.
Where insurance is requested by the County, all liability insurance policies shall be endorsed
to include the County and City as Additional lnsureds and shall stipulate that the insurance
afforded by the policies shall be primary insurance, and that any insurance, self-insured
retention, deductibles, or risk retention trusts maintained or participated in by the parties
shall be excess and not contributory to any other insurance or self-insurance maintained by
the County or City. Contractor shall furnish the County a certificate of insurance with
Endorsement as evidence that the required policies are in full force and effect.
Section 8.ermination.
The County may, by written notice thereof to Contractor, terminate this Agreement as to all or any
portion of the Services notyet performed, whetheror not Contractor is in breach ordefault. Upon
receiving such notice of termination, Contractor shall, except as otherwise directed by the County,
immediately stop performing the Services to the extent specified in the notice. ln the event the
County terminates the Contractor's Services, the Contractor is obligated and hereby agrees to refund
to the County all monies paid for Services not yet rendered by the Contractor, if any, as of the date
of the notice of termination.
Section 9. Miscellaneous.
The City is not a party to this Agreement but is an intended third-party beneficiary of this
Agreement and to the extent set forth herein certain of its provisions are for the benefit of
the City and are enforceable by City in its own name and capacity as a Washington municipal
corporation.
e
a
,nr?County Lodging Tdx Funding Agreement Page 5
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LT-2O22-OOL-JAZZ IN THE VALLEY
b. Contractor shall not (by contract, operation of law or otherwise) assign this Agreement or any
right or interest in this Agreement without the County's prior written consent.
This Agreement embodies the entire Agreement between the County and Contractor, and
supersedes any and all prior oral or written communications, proposals, conditions, promises,
representations, or understandings regarding the Services. No change, amendment or
modification of any provision of this Agreement shall be valid unless set forth in a written
amendment to the Agreement signed by both parties.
d. Notice for any purpose under this Agreement, except service of process, shall be given by the
Contractor to the Kittitas County Commissioners and the Kittitas County Auditor, 205 W 5th Ave.
Ellensburg, WA 98926. For all purposes under this Agreement, any notice by the County to the
Contractor shall be given to the Contractor's address provided on the signature page. Notice
may be given by delivery or by depositing in the U.S. Mail, first class, postage prepaid, certified
mail, return receipt requested.
The section and paragraph headings of this Agreement are for reference convenience only
and are not intended to restrict, affect or be of any weight in interpreting or construing the
provisions of such sections or paragraphs.
f. This Agreement may be executed in one or more counterparts and by facsimile, each of which
will be deemed an original, but all of which together will constitute one and the same
instrument.
g. Contractor warrants to the County that the individual signing on Contractor's behalf has the
requisite power and authority to enter into and to perform Contractor's obligations under
this Agreement. Contractor further warrants to the County that Contractor has made no
misrepresentation or misleading statement in connection with this Agreement, and is not in
violation of any applicable law, ordinance, or regulation the consequence of which will or may
materially affect Contractor's ability to perform its obligations under this Agreement.
h. lf any term or condition of this Agreement or the application thereof to any person(s) or
circumstances is held invalid, such invalidity shall not affect the other terms, conditions or
applications which can be given effect without the invalid term, condition or application. To this
end, the terms and conditions of this Agreement are declared severable.
The exclusive venue for any action brought to enforce this Agreement or any of its terms shall
be in Kittitas County, State of Washington.
The performance of this Agreement is subject to termination without liability by either party
upon the occurrence, or upon the prediction by the National Oceanic and Atmospheric
Administration, any other agency of the United States Government, or any agency of the
Government of the State of Washington of the occurrence of any circumstance beyond the
control of either party-including, without limitation, acts of God, war, acts of terrorism
within a fifty (50) mile radius of Kittitas County, government regulations, disaster,
pandemic/epidemic illness, strikes or threat of strikes (except that neither party may
e
_2022 County Lodging Tax Funding Agreement Page 6
LT-2022-001.-JAZZ IN THE VALLEY
terminate this Agreement for situations involving that party's own employees), civil disorder,
or curtailment of transportation facilities-to the extent that such circumstance makes it
illegal , impossible or economically impracticable for the parties to complete the duties and
mutual obligations agreed upon and imposed upon them herein. The ability to terminate this
Agreement without liability pursuant to this paragraph is conditioned upon delivery of written
notice from one party to the other within 10 days of such occurrence or upon delivery of
written notice from one party to the other within 24 hours of the receipt of notice of the
prediction of any of the above occurrences. To the extent feasible within the constraints
imposed by any event of the type described above, the parties agree that if the triggering
event is of apparently or likely transitory effect, the parties may negotiate such amendments
to the agreement that are mutually satisfactory and not otherwise contrary to law, including
but not limited to a change in the dates for completion of any portion or the entirety of this
agreement.
KITTITAS COUNTY
MMISSIONERS
IPrint Name]
4'(ho=-.-
.:b /e<4"9,hair
t
rett ith, Commissioner
{Lr)fr.I},l .la.V<rb7--2- tl'1
ce Snr R-*, p r q
ll
,\\\\\\ I I I
sl, co.i .t\
-- (,) .'
_-- fJ .J
llllllrtttt [Address]
[Telephone]
* g zs"-'2
V,r-cah
4.
APPROVED AS TO FORM
Clerk of the Board
Deputy Prosecuting Attorney
_2022 County Lodging Tax Funding Agreement Page 7
Flnr br I "ftu
CLTAC: Application for Lodging Tax Grant Funding
Grant Application
Workshop - 2021*
Submittal lnstructions
& General
lnformation *
Organization Address * iir.f:l 'iioii'r't
PO.8ox 11.1
-\4a,. ,.:.; I 11, i
il r.t
f llerrsr::rg
r,.\t:,! , ,,1: 1,,,, .,
98926
l")id VnLr nlli:l1l ihc G'ort Applicalioil \rbrkf,hofr " 2il2 1 iroskrd f'y- Lire l(rtti{iis Corintr Onariher n. tlor}lil,e,c:')
r. Yes
,NO
I rlave r.)lLr iIt!.roil!lastanrl S!i.rn'rtlni it'tlru0aoll!.init aii,c,)dl l!rtc arall,ilo t_'!lra: :iir2l -:rrlqfr:l f:li Ll.aIt --, r\j1l1,J
You are strongly encouraged to compose your responses to the questions of lhis form with a desktop text editor
and save your work, then copy and pasle the infonnalion into ihe form. You may also save a craft by seleciing ihe butlon
at the bottom of this page. When you do this you will be logged out and must log back in to cont'nue. ln order io save a
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landing page ccntaining a iink to log bacK into the form We si.rggest you save this link as a bookrnaA. The link will also be
sentto you in an email. For your convenience we have provided a word document version otthe questions. Download it
here.
Organization I nformation
Name of Organization* Lauglring Horse Arts Founclation d.b a Jazz in the Valley
S!,{r' it'.)v,ri!: I il't,Jt,.rl
t rut rtr y
USA
Organization is a:*, Eusiness
o. Ncn-Profit
iNoie: Please subrnit W*3 for bL:siness or IRS Designation Letter for non-pi-ofit.)
Click here lo view sanrple documents (redtcied).
Upload Proof of
Organization Status*
First Name*
Last Name *
Phone Number*
- .,*Emalt
-.. a:ft'tti)lt ':it lt:. t.tt. I j, I :,i,j ' r, : rf t:i
W-'.1_JlV-r:cif
i:C icll.pi'
Don
Solberg
509-8S9-5347
Jazzintheva lley@ ch a rter. net
144.84K8
7BB,2BKB
Project Contact I nformation
Project or Event lnformation
ProjecUEvent Name * Jazz in the Valley
SefViCe Categofies {ll{x:! dll ( ni.ri.i}ie.i r'e! tri\)ll tt. rl -; rf,D r.ir .i
, Tourisrn p,cn)oiion.lrnarketing
r'. Operatron ot a spectal eve nt designed lo aitract tout'isls
. Operat:on of a rourism relateC tacility
Other
Event Dates
Please provtoe any specific dates, or range ot dates, cur whjch yoi-jr ever'tt or prolect wiil be held. You nray acld as ntany
dates or date rarrges as necessary,
Event Dates
Start Dates*
712912022
Prolect/Event
Location *
New or Ongoing
ProjecUEvent?*
Amount of Funding
Requested *
Response 1:
ProjecUEveni
Description *
s 8890.00
lf ytu seiecled - Cu!o{'q Prct.:cuf:,/orl" above ln!s amounl rilay .ol ex.eed i ti.L ol the tolal eyllenie bll{:qe! cf lht-s
proie{:r,
End Dates
7t31t2022
Downiown Ellensburg
. Ongoing Pro]ecllEverrl iMcre than io;r years rn exlslenc€)
Neu; Prcject/Eveni lFoi"lr ci fewer years n existenoe]
Jazz in lhe Valley ls a three-day music festival originally created lo celebrate ihe iazz
genre in all its varrous forms and lo entice visitors to spend time in our downtown
area during the Surrrmer Because our nunrbers have ciecreased in the past few
years, we have expanded our music repertoire beyond just Jazz (Blues, Funk.
Rhagae, Zadago. Gospel and even some Rock'n Roll) hoping to a{ract a larger and
more diverse audience, We have ever: apploached tlie icjea cf re-branding to reflect
that diversity. Our ccre audience rrembers are ,niJsic lovers of who are looking for a
weekend getaway at an affcrdable price. The primary atiendees wrll come lrom the
Pacific Nofthwesl. b'ul the festival draws from across the United States and Canada.
2501i .:lrir.acrer lirril
Funding Request Max
Tourism Seasons*aiarl lli,. tll l)elr)!r...;t rl:et,,r)il rr;l,/.i,ii l)rnt?J-i ?rl:.?rtr.) tr i.r,i? S,'iFrl 3ily,r;ilir;ir rllpl..
. \'ear-ri:rincl i..:anuary ' December';
Off Season lNovember - f:ehruary)
Shoulder Season (October cr lr,,larch - May]
I Fligh Season (Ju.e - Septemberl
Appllcation Questions. Parl 1
Please answer each question completely, in the order listed. Please include any supporting data within the
response narrative-
1 | ProjecUEvent Description
Please provlde a description of your projectieveni.
')<,i', q,,'a\t':. *'..t)rt r'lj.{,,.' rl r:rl: y !',r i1r r rr!
iitl:s ..llo.t,:.Le I lLl- l(41rr.is
Video Link
List pf lntended Use of Funds *
Speaker and Performance fees
Artist Expense (used to cover overnight lodging
expenses)
Rent canvas tents to cover the seating areas at the
Downtown main venue
Rent Porta-potties and wash stations for the
Downtown to accommodate our attendees.
Hire security to police the Downtown Venues Friday
and Saturday nights from 8pm until 1 pm
Help defray the rentals cosls of the sound equipment
used in Music Production/Sound Enhancement
Rent cooling devicesifans for the venues if the
temperatures during the festival require them.
Purchase radio Ads
Oniine and print advertjsing focused on our target
audience-
Social media advertising
Use an on-line exit survey to get feedback lrom
festival attendees
Collaborate with other music festivals in our State -
Sponsorshipsladvertisin g
Send packets of festival brochures to all the
Chambers of Commerce in the State.
2l Supporting Kittitas County as a tourism destinatiorr
i. Atvay from their plaoe of tesicience ot lrusiness and staylng overn:ght in paid accomnrodations.
2" To a Place liity nriles or n10,'e away {rcrr theit plaue of resilience cr brisirress {ot ihe cjay or stayinq ov*rr, jght;
3. or'ircmanolhelcountlyorstaleoulsrdeottheirplaceof resiiienceiirbusiness
You rrust provide the eviderrce utilized in deternrining ygur projections.
Response 2.'1 *
".',4ty ,,,"sn ti,r:irii:i:la!jf, l(, hrii:tl\ i-,rr,Ili, la ilii-,i.rl,),!1ir ,rgrJt,.t{i,lil./r'f:t,j!l:!rl
-- tfue rnderwrite raciic progrants lllai pronrote Jazz throughoi:t tha year anci
purcltase ads in lne nronths prrol to the Festival, targelinS our core airdieitce and
blankeirng mosi of tne slate
-- We procluce 70C0 brachures and 250 posters ihai. dislribirte througiroul the Staie
and nrajl information p3ckeis to ail olthe Chan.ibers olCcnrnrerce in lhe State.
-- Vv'e distribute at least 75 o{ our posters to lccaljcns lhroitqhoui the state. 30 cf
lvhich go to wineiies in Washrngton (many participate in the Wine lasiings provided
by Gallery One and the Clynrer lvluse unr dirring the feslival weekend).
-- UJe devaioperj arr on-ljne newsieiter targeted to past ailendees, lo (eep 0ur
pairons sngaged jn \,vhat this ysar's lestival will be offering as well as cther evenls in
oui" atea.
---l-hroitglt rrany of lhe on-irne arrC socialmeciia ads we placecj in past years.',nre
received vaiLral:le dernographic informatjon. Combining this with the emarl
adoresses ircm past tic'<et saies. v,re hope to direrd nrarket to ihis aucjience anc.l
reqliesl leedbaok on tiretr lestival experie nces. icurrenily ihe lisl niimirers E65 enrail
addresses)
2.11'ltl rit;it ectr)' l!,r:i
Response 2.2 t
Application Questions: Parl 2
3l lmpact
Response 3:
Measuring Results*
-,:",rr::, ille0t..t,r,..':,., )l\ t,a!t:.,,. l.ti\r,t.til,,:ldrti -,:!rij' t,t,.._,t:
The best record lci cJ. l'rdil;.Jn.il f*si,vai was rn 20't !t Foi irat y*ar
-We have a irrailinq list of over ,1750 members,36?4 (634) cf which ha,re add[esses
outsrde of our couniy and which span acloss the United slates and Britrsh Coiunrbia.
The out ofcountv addresses are ajl iror?) past attendees ofthe Festival who
requested i0 be on the list.
-- We have been a three-Cay fesiival with Friday and Saturdat- nights events goirrq
L.rntil miijnight. Mosl alleniees {rorn rnore thai: 5C rriles away choose to slay
cvernight. be it in local lodginq establislltlents or r,vith lriencs that iive in tire area
-- From our hest estirx3les. rn 2013 {ollr last ticketed event) 53,l/J or our lckets sold
lvere io out ol couniy resrdents. {See Exhibrt A l )
-- Of lbose wno cornpieled out sufvey ar lhe lesiirral: 5,/% were fronr out of courrly
iSee Exhli:it A2)
-- Cf those who completed our sLrrvey at ilre fesitval: 57!4 wer€ fronr or:l of county
{See E-xhibit A2}, Of lhs: nunrber.
-- 2% stayed in an RV Park in Kittltas County
-- 6'% stayed i rrrqhi rn patd acconrrrodations
* 24i,i slayed 2 niqirls in paid acccrrrlcdahons
-- 6% will: fiiends or {elatives in Kitlitas Crunly
-- 624,i didn't re Dort
-- We did an onl;ne sLirvey ir 2{119 lvith 77 responses anc C2% ol respor:ses were
fronr lri ci co;-inty.
* In 2019. ',.i/e ran a iic(et discount promotional or-r sociai ntedia. Oi:t of cor.rnty
residerrts accounteC for E5% of ihe ticl(ei sales.
-)iii.l i-t .rl,r,_1ii L[,it
l)'r).laiilihi!! fit::4tjptttr'tt,:: !,0.' a\.3rrl',tali1,lir1-ir ',,i, -ilt,,r,.tl,;r .Ji
-- As ouI surveys have showrr. ilasl aitendees icl our festrval have corne frcn: all
over the courtry and some flom olher parts of tne rarorld. We have establisheii a
database of erla;l contacts ior these people. 8i developing an c,n-line nevrslefter
targeiing these pasl attendees. vue hope to keep our patrons engage.J is happentng
wrth lhis yeafs festlral as well expose lirent othei everts i']appening in out area.
-- For tne past 1 7 years, JIV hos provided a sirrvey icr iestival attendees to fill out
arrd asked where lhey are frorn. lrow lrany niqlrls tbey lvere staying in lown, ancj
howthey heard about irs.. (see FxhrbitAl)This rs also lnclirded in cur oniine exil
survey. (Exirrbit 42).
-- We know th€re are sonie of oul-of-tcwners who atlend cL:r lestival Ltut speno theif
overnighls wlih rnerrbers cf our corrnrunity rather than in the nolels. This year our
online exii sutvey is des:grred to nreasure this lhis as well.
-- We are increasing our on-line promotions
-- Our nev;sletter to past attendees will also provide arr opportunity to share olher
e'ienls happening in cur area
-- lhis year we will again serrd a festival i:rochure to our rnailinC ltst iorvrh:ch 65c4
is cut ofKitiitas Caunty. The brochures also advertise otherevents happening tnat
weekend in E'lensbL[9.
jiiril cir ij,lal.'.1 l:rl,l
Application Questiorrs: Part 3
4l Gollaboration
lf your organiration collaborates or has created partnerships with other organizations, groups, or other events,
how is this accomplished?
4.1 Collaboration*1 CHAMBER OF COMMERCe:
* Setved as our sales outlet prior to the fesiival
- Provided staff support 3l the Bcx Office dLrrinq the Fesiival.
2, CITY OF ELLENSBURG
- Waived rroise ordinance for weekend
- Allowed our use of the Rotary Pavilion for oul main venue and tlre on-site --
bililding as our Box Offrce.
-- Provided fencing ior the Rotary Pavijion {main venue), no parking signs, handicap
signs, hung our banner across 4ih between Main and Pearl sireets.
3 CWU
.- Throi"rgh a contract arrangement provides: Pjsnos, Music stands. Plaiforlr']s, a4d
Cooling lans for the Rotary Pavilion.
-- We partnefed to provtde music clinjcs foi the County high school students.
-- We offered yearly scholarships for Jazz stud€nts attendinq CWU.
-- W€ offerec scholarshrps to High school students to attend J|V-CWU's suntmer
Jazz camp. Their canp T-shirts allowed lhem lo attend the festirral for free and their
families were also allowed to purchase festival |ckels a half price.
4. RODEO BOARD. Provides usage ot approximately 750 chatrs ior the fesiival
5. 509 FACILITIES donated $'i000 in-krnd services lo clearr and nrarntaifi the Rotary
Pavilion dur;ng ihe festival.
6. GALLERY ONE & CLYMER MUSEUM-
-- They serverj es rnus,c venues dtring the festival
- Provrded a tastir-1g oi premiunr Washington Stafe lvtnes on the S:1. afternoon of
the feslival.
7. FARMER'S MARKET Tan extended hours that'weekend
8. PUELIC LIBRARY:
-- Decoraied therr lobby with Festival memorabilia
- They also have an archrve of all our past feslivals.
9. KVH.
-- Displayed all 22 years ofpcsters in lheir lobby throughout July.
-- Was a Major Festival Sponsor in 2019 and provided a free Sunday concefl for our
comnrunily. We handed out468 wristbands to all those ihat didrr't have a festival
badge.
13. HOTEL WINDROW. We were in discussions this year about offering discounletj
tickets to pairons of the hotel: but this becante mute issue when lve decideci to go
with a non-licketed ifree) event.
11. Ellensburg Downtowrr Assocration. We have ongo,ng communications Ine,n for
our rllulual benefit,
25[]d ihsiacler lirnrl
4.2 Promoting Local
Business *-- Feedl:ack from partrcipating venues in 2021 suggested thai it was very beneficial
for their busrness to have alcohol. general beverages. and food sales al the venLtes.
3nd thus not lo have us compete lvith then at th'e Rol3ry PavilionlMain Stage area.
\A/e will be discussing th;s resull as a board and will integrale tlris information rnto
orrr ner,v festlval pl:n. and [itese chan!,es are rellected in cur proposed budget for
2022 Wtlh this clear benefit to the venrres ln mind, we would decrease some
income. bul also srgnificantly reduce our board and vclr:nteer eflort and expenses-
Our new collaboration v'rith the Dowtrtown association will benefit tl:is plannlnq and
discussion greatly.
-- We plan on usin3 social n]edra ntarketing, radio ads. sending brochures
thioughout Washirrglorr Staie, lourisnr ads.
'te\,vspaper
ads, online adveriis;nLj.
discounled ticket prornotions and crcss promotions wilh lodging estabiishntents.
--By developing our on-line netvslelterlargeting past attendees. we can keep our
palrcns engaged rn whai this year's festival will be offering as weli as conneclil]g
the,n with other €vents iri our area. The atlendee lisi is {,lerived froiri our POS sales
during the festival as well as whal the Chantber seils Showcllx sales ancl our
maiirng list thai rnclrJcles Email aodresses.
--ln20 19.\,vesenl 851 donatianlettersi536ot65-o.iowereot,tof KittitasCounlyand
35% were out of Washrngton Staie). The nrailing included our brochure adverlisin.o
oLrr {est;val and outltning other local events haspening that weekend.
- We will continue lo explore with lodging estabiishrrients the possib;lity ol creating
value packages far those who atlerd the fest,val. At least fcur-of them rndtcated
rnterest irr a potential partnership.
-- We are also con3idering offelng swag bags (in collaiJoration 'irith EDA) or other
inq6n11v.. tied tc a survey opportunity to the lodging establishnrenls fcr those
attending ihe festival. This should help us have a belte| counl on festival attendees
staying in town,
iJit)Ll ahar e.tler l;:lil
4.3 Host Hotel*r5 irlij',r I jtsi | 1.a|a1t /t: i .1 ; t.)r :tr:lt |: ?tac: .ii ,-:r; .ii ti!. 'j,.1{ l
Nc
e Yes- Hotel Windrow & EcorioLodge {for the artists)
5l Future Plans
Please explain what plans exist to allow this project to become self-sustaining. lnclude any plans for ticket sales,
event sponsors, and other cost-recovery models.
Future Plans*- From ils initial concepticn Jazzin the Valley was designed as an event to promote
and benefit dovlntowrl Ellensburg. Any profits fiom prevrous festrvals have l-reen
dedicaled to rmproving the festival experietlce the following year and helping supporl
the Jazz Studies progralr at CWU.
-- We recognize lhat festivais around the Uniled Slates a.e undergoing
transformational changes, due to both COVID and the shifting demographics and
financial practices in the music rndustry We have survtved fr:r 2D* years on
donatjons, granls. and volunteer labor to hold ticket prices to one of ihe rnost
affordable festrvals ;n the entire Pacific Northwest. We are focused on redesrgning
ourselves lo stay both viable and relevant.
--lf we are to stay a non-profil operation dedicated lo our communily's benefit,
continued ccmnrunity-based support is essentiai. This rnust extend to the previously
promised ibut so far not executed) changes i11 the downiown Majn Stage area (i.e.
Rotatl Pavilion area). Hopefirlly these changes will allow us to simplify our setup
and reduce opefat,cnal costs by prov;drng:
-- a new stage arca
-- torlels
-- shadirrg
* possible enlargement, to include usage ofsonre porttons of4th Ave andior
'rearlSlreet as parl of ihe festival grour-.ds.
'-We are erlgaged in discussions with the new City adnrinistrstton and cthers.
rncluding potential supporl oi a Creatrve Cenler Des'griatron by the State si
l^Jashing!on.
:5)il0 rJl] .r,Jef lirlrit
Application Questions: Parl 4
6l Additional lnformation
Provide any additional information which will assist the Lodging Tax Advisory Committee in evaluating your
project and its benefit to tourism.
COVID-19 lnformalion r;JL,rr')!j Ilatrr"lr\4illn2il:1J.1;zij'llr!l:i)itr:r':tir.,.irt.jrl'1.)lrrlarn.trjl:ta!..)l.tjirJi.)Jsi,t..,:c:tl,:t))..1
!ri:ii;:jsJ.:S:tr", .l tllitrill!-j Va,. a\r).]r .n i{,
We were forced to cancel iazz in lhe Valley in 2020 due to COVID. lr- planning for
2C21. we did extensive ''eseafch tnlo possibilities of a virllal event or a llve-
strearnecl everrt. Despile tent3t;ve agreemerlts frorn prodrrction companies t; ireip
p.oduce such ar event, ihe iollo\,ving iactors sicpped us.
-- Costs
-- Uncertain revenue strealns ircrl cnline Jltendrnce
-- Lack r)i hoard experlise in producrng sllch evenls
-- The M3y 2021 Cov:d Surge rvilh unced3tnty cf the governrrent a,lo1,a-ing in-person
attendees in i-rumhers Jdequaie to silpport lhe festival.
-- Uilccria:rr Safety rOr (),1 volrll]tdelS
lhe Board aluiost cancelled ihe festival again in 2031. but al tlie lasl mltuie. we
elected to try a simpier Rirailer lesttval. We cnose to Iimit it tr': thrse rrei:ues {all rn
existing restaur.iilis and a hotel: two ctt'rern ouldoorsj We onl_y advertised onlli.e
sold flo trckels and rnly perfcrrneci Frrday and :;alur.lay tt.e. ih's was a free" e'rent
\,vrth donahons accepled ai the event). Tilese changes reducerl crur volunteers lc a
fevr Board tlerltbefs, ;"eqLtrred no extens've setilp anci leariou/n crews. Th:s
rnirinrized prtentral COVID erposi;res anii greaily reduced our costs
Our g,:al irr 202 1 was to gii;e oack lo tlie contnrunil.l lot 2A+ years of suy:porl. Our
specifir.esults are coculnented els*where irr lhis 3Dpitcation. and a significan!
fitranciai lcss lvas prevented only by LTAC s accep:ance of .onliact rrodilicalions
allowrng reillbutsern€ni for perfornrer/aitist exocnses. 3llC an addational lurrcing
allocaticn fronr unused granis. We feel pr'odlct;on ci an ever':l in lhese conclilions
aecrrmptisheii out staied go.ql and gave no evit-Jence of lrrqgering a 'super-spleacier'
COVID evert iaccordtrg tc the K:lli'ras Cor]nly FHD)
\/Ve alsr: feel ii reaffirnrecj iha: lhe contnrunrly is ii'-rngry to atteno dow|iiow. ntustc
leslrv3l events *rore itr the fashron of previou-s years rahen tl:is beconles posslllle
2-'\rttj t.t..it , -it! ti- i
Additional lnformation Al the tinte o{ thrs subntissian. jazz in lhe Vailey ]s In lhe t?l:dil{e of ;ruliiple flrrd ard
significartt rnflLtence s, Tttsse jirolude unresol'.,ed Covid-19 issues, ehalg'1g Fesiivai
.jemtgfaphics anc financial suppcil both nalionaliy ani recronally a srlaller board
wilir feuvei rnternal volunleel resources. rew cpprlriirnitles far deeper but allered
pannersijlps witn iraditionaI collaboraiots llihe Eilensburg [Jowniown Assccralioir
The Crty of Fi[;nsbuig, C\.IJU wlth several new Bcards or Manaqers.]
Given the rapidly chang:ltg ,rslure cf lh;s envjronnrenl, riut reco!nrJing the statutory
and ilnlrnl; li,nit3tt3ns of the LIAC process. we cfferthis appllcatlon as ogiti'ue best
e{fod at plann:ng for a lestival ai tlre end of July. 2.}22.
',) !1i)i t )i\ a, : 1 :l ar ti, r,,l
Lxnrrrai A-2lll!.udf 2iS.illKlt
', .t,1,. ,r,r,ttt, ,ir)i.)i ,ji) 1 : ji! jir' 1 .,. , (\:.;t /i:.:i.:tt.:ii ta , 1,i., ..1 ij:i \,,',::,i
7l Previous Lodging Tax Grant Information
Previous Years
Awarded Lodging Tax
Grants*
I a: ytr.rr a',.'rll t/;a€,^i!l i .r1it :ttj tx !ri,t;j:i rr: irruv o,l,nti1>r
Nc. this eventlpio]e ct has not prev'ously receivecl LoC!linU .[ax Funding
Yes 1 year ptevious
Yes. 2 years prevlous
Yes. 3 or rnor{i ye3rs Drevious
Overall Attendnace
Number of people travelling more than 50 miles for your event?
Past Actual* Projected *
1 ,188 880
Number of people traveling from outside WA State for your event?
Past Actual* Projected *
49 47
The number of overnight guests who stay in paid accommodations in Kittitas County
for your event
Past Actual* projected*
444 S00
Number of paid lodging room nights resulting from you event/activityifacility?
Past Actual* Projected*
1,361 1,091
Past Actual*
2,241
Pasi Methodology*
Projected
Methodology*
Projected *
2,200
Prior Yeaf Paid | ,t'.: , t :tt: t. , 7,, ;,.i L.rii .,'i rL .... : :. !....:,!
overnight stay Data Loi1,rig.--,.:xi:'.,1; -_l{}t i.r;cif
I li i l:- '
.:;
',)
"., 'ti.i,\t .:
' 4 64trt]
i .. a nr j; r,J!! : ilr lt :.1? ,: .ri;...
t .a:.,;. ":': tl:; ri,, ,,rl:
1 t 'tt t.i 1i.: .:i ',i tt it :2 tlti: i \ . t
'ir . ir,: , t. .- .a:: .!: :: ,,at: a1 : t. ..tt
i:iitll,ua,b,nrti\it:\), ri{, yJLLi:i,l',r'al:r.llieaitp2{)1,-r;|,1t1 il.'r.ir,:r5'l
t Direci Couni iprefefred)
,r' lnclirecl Count
r Rep,esentative Suruey
lnfcrrnal Suive)/ apreferedi
. Structurerl Eslimale
Othet
!illijL iil.itj(Jijrlc{,r i!tll .J:t| |t+ i, i:jla!:iitlrj ir:c tJrijtiriilt( i\ttrlr:!\?
r, Direct Count (preierred)
, lndirect Count
Represenlative Survey
informal Survey iprelerreo)
' Structu{eC Esiima:e
, Other
Methodology
Narrative *
Funding Shortfalls*
Matching Funds
Percentage
Verification of ln-kind
Contributions
f_ii.j;i5:j erOla rl
-- We ha,re atternpied multiple lrr:res to have iocal hclels fiil ir sheel coirnis di
lodgers thal came to attend the festival. \ Je have found conrpliance \,vilh lhese
measrrres sootty at bEsl. ln 2019. we relied on coutlt estintates fionr lhe lrclel
establishnrents after tire feslrval.
-- ln ?C2't we did not have slaft or resources to com!riete either type of survey.
-- We aie exoloring provtrlrng swag bags io iire lodging eslablishmelts to ofier to
patro'rs who are attending ihe festlvai, as a r,\,ay to encourage fior-e accurale coilnts
z -UJ rfiir i.':r!ri I ia,t
Application Questions: Part 5
8l Funding
Does yot'r orgartrz:ticn har;e. ot nave yoii apnlied for, grant firnding from cll-rei- so,.rrlest lf not. why nol? lives please lis{
the iunt jng yoLr have for the prcject. inclLiding any voluilieer ald ir:-kinc.i soi.rces in Question gl project Budget
Overview
Fanding sourtes and amoLtnts whjch have not yet been seclirecj rvill he iisterj ;eparately, rI the field{s) drrectly below
Finally. wlrat cl:anges wouid occtir rt lhe projecr couidn't be funileci?
Other Funding *
'{t::, I i\t.l
Explanation *
Our prirr application anci glanl frorn €ller.isi:urg Alis Conl-t-tission was lo help put on
a i:and carr':p. $lith tlre fetitemeIt of Chr:s Bruya frorn CWU, lhis l]roject lias not yet
been prcked uD by ihe new darector crf Jazz Studres at CWU. We are in the orocess
of arrangrnq a nteelini: with tlre n-.w direator, but 'rrrrll no! be able lo accorrpl;sh this
;trior tc this applicalion needing sLrbmrssiolt.
li lll,:l::jt til.:! rir, l
:: \:. ii : , :,:. it,;:. , t .. .j t, , j. ... .- j
i;1lt t/i)iiiai ljrl tt.i3d lt i.J'.t!r {1C..,'*,r iJ- tit:ieav-c tni4liijd,:l ior ..;to;;ti: 'itnO,,,."ltr.-ir :.t,.C
il lS,:iiiiill : al :iXt,'U i V t-a! | i : a.-i :l rl y Sr r; tlia il.
9?'i i':
tit,::. ) :itl ,j
9l Project Budget Overview
Flease conrplete 0udget frrrthis orolectlproposal. lf your agency operates independenily oithis prcject applicaiior: it rnay
not be necessary to suht,nrt the ent;re agency l)udget. You nust subtnit a budgel whiclr specifically pertains to ihe
projectlevent for which you are requesting funding and adheres to the basic budget lorrnat shown below.
The br.tclget rrtusl include anticipaled revenues. expe nditLrres and any poiential profit or ioss For.projects,'everrts,which are
ongoitrg ior ntore than one il) year. olease also subinit actuals fiorr ihe previoUs lhree (3) years of oper3ttons (neecl not
be consecutive) for the projectlproposal ;f applicabie
For any clainted in-kind corrtribuiions valued at $500 or rnore arrd related to marketing/advertising. yor rnust
submit verilyirlg docutnentatiort which assures the contribution will be providad. For instance. rf yor; are clauulng rit-
kind ccnlributiorrs in lhe form of advertisrng ,]ratch. a binding contract iternizing the rnatciling vaiue and obil;;:ting1 each
pany musl be provided,
ATTENTIQN: ln an effort to allow an adequate level of flexibiljty for all applicants, not all lields in the budget portion are
required to be filled before this forrl Is subnritted. Providing all applicable data is your responsibility, failure to do so
will potentially jeopardize your application's chance for review.
r:': .-.lirit .t.: rtt,.t:ta,,\i il \,1.1\trt:1.,,.:lrtit:,),):t.ttt:.i ,t l
: tl/\. 't 1l t, : I
Budget Year
Edit if necessary 2A19 2020 2021
Revenues From Consolidated Lodging Tax Grant
Past Actual 2
$ 0.00
Past Actual 2
PastActual 1
$ 14,099,32
PastActual 1
$ 0.00
2422
Projected
$ 8,890.00
Projected
$ 22200.00
$ 57000.00
$ 10.00
$ 20.00
$ o.oo
$ 3200,00
Projected
$ 6000.00
Projected
1,896
Prolected
$ 141989.76
Projecled
$ 500.00
$ 16100.00
$ 6000.00
Past Actual 3
LTAC Grant Funding $ 10,000.00
All Other Revenues
Account Name PastActual 3
Total Contributions $ 27681.00
Event Sales $ 58071.00
lnterest earned $ 101.00
misc lncome $ 15.00
Concession Sales $ 5980.00
Souvenir Sales $ 5980,00
Account Name
lnkind Contributions
Past Actual 3
$ 6150.00
Evidence of Volunteer
Contributions*
Calculated Value of
Projected Volunteer
Time
Past Actual 3
RevenueTotals $ 113978.00
$ 0.00
$ 0.00
$ 10.00
$ 0.00
$ o.oo
$ 0.00
Past Actual '1
$ 4851,00
$ 0.00
$ 8.00
$ o.oo
$ 0.00
$ o.oo
ln-Kind Contributions {except volunteerism)
Past Actual 2
$ 0.00
Contributions of Volunteer Time
Past Actual 3 Past Actual 2
Number of Hours 2,748 940
Past Actual 2
$ 10,00
PastActual 1
1,195
Past Actual 1
$ 18958.32
lt:a':ilitra: l.if .liir:..)i\)t1)lfrr:a.\jrrr?{.ntt.a-i{ji:t:..t)(ir..r.:Clvrji:,r,{j:i,rr,:t
Bcarci-Vol-nteer Hr 2C2!,22.pdf 37.3K8
$ 44.6139.7S
Expenses
Account Name
Education Grants
Facilities
Fundraising
Past Actual 3
$ 5040,00
$ 17448.00
$ 4999.00
Past Actual 2
$ 0.00
$ 0.00
$ 0,00
PastActual 1
$ 0.00
$ 1416.00
$ 0.00
General
Musician/Ahist exp
Artist Lodging
Promotion:
Electronic
Promo: Print Ads
Promo:
Poster/Handbill/etc
Tickets/Sales
Volunteers
Cost of goods Sold
$ 8'160.00
$ 46757.00
$ 7749.00
$ 4297.00
$ 7605.00
$ 2744.00
$ 1632.00
$ 356.00
$ 4063.00
$ o.oo
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ o.oo
$ 0.00
$ 0.00
$ 0.00
Past Actual 2
$ 0.00
Past Actual 2
$ 10.00
$ 496.00
$ 11750.00
$ 944.00
$ 329.00
$ 8420.00
$ 36300.00
$ 6000.00
$ 4600.00
Past Actual 3
Expense Totals $ 110850.00
Profit & Loss
Psst Actual 3
$ 3128.00
Application Certification
$ 0.00
$ o.oo
$ o-oo
$ 0,00
$ 0.00
Past Actual 1
$ 14935.00
Past Actual 'l
$ 4023.32
$ 4500.00
$ 3250.00
$ 2050.00
$ 400.00
$ 850.00
Projected
$ 88970.00
Projected
$ 53019.76
The applicatlt here certifies and afflrms: 'l . Thal it does not now, nor will it during the perfcrmance of any contract ansing
fronr this application, unlawfully discrirninate against sny employee. applicant for ernployment. client, custorner, or other
person wl]o might benefit frotn said contracl, by reasorr of age, race. color. ethnicity. sex, religlon, rnilitary statLrs. sexual
,:rientation, creed. place cf birth, or disability: 2. That it will sbide by all relevant local, state and lederal laws and
regulations and: 3 Thal it has read the information contained ln the lnstructions on pages 1 and 2 and understands and
will comply with all provisions thereof.
Certified by:
Name*Don A. Solberg
Applicant's Title *Treasurer. Jazz in the Valleyllaughing Horse
Arts
Srgn
Form
(Rev. October 201 8)
Department ot the Treasury
lnternal Revenue Seruics
Here Signature ot
U.S. person )
General lnstructions
Seclion references are to the lnternal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its inskuctions, such as legislation enacted
afler they were published, go to wwulrs. gov/FormWg.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to fjle an
information return with the IRS must obtain your correct taxpayer
identification number fflN) which may be your social security number
(SSN), individuai taxpayer identification number (lTlN), adoption
taxpayer identilication number (ATIN), or employer identification number
(ElN), to report on an information return the amouni paid to you, or other
amount reportable on an information return. Examples of information
returns include, bui are not limited to, the following.
r Form 1 099-lNT (interest earned or paid)
Request for Taxpayer
ldentification Number and Certification
) Go to www.its.govlFormWg lor instructions and the latsst information.
Requester's name address
w-g
(f)
o
l!o.
co.o0rEo.o>E+b
o(
=tnr,o
:!(,ocIo
!).Ja
on your income tax relurn).on do not looee this line
Horse
2 Businose entity name, if different from above
7 List account numbe(s) here
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part l, later. For other
enlities, it is your employer identification number (ElN). lf you do not have a number, see Haw to get a
I/N, later.
Note: lf the account is in more than one name, see the instructions for line 1. Also see What Name and
Number To Give the Requester lor guidelines on whose number to enter.
Give Form to the
requester, Do not
send to the lRS.
4 Exemptions {codes apply oniy to
certain enlities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
--Exemplion from FATCA reporting
code {if any}
{/\ppti* loaccounls maintaind outsido ne U.S.}
Kittitas County Auditor
205 West sth Ave . Suite105
wA 98926
or
Certification
Under penallies of perjury, I certify that
l The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have noi been notified by the lnternal Revenue
Service (lRS) that I am subject to backup withholdjng as a result of a failure to repod all inleresi or dividends, or (c) the IRS iras notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S, person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certitication inslructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding becauseyou have failed to report all interest and dividends on your tax return. For real estate transactions, item2 does not apply. For modgage interest paid,
acquisition or abandonment of secured property, canceliation of debt, contributions io an individual retirement arrangement {lRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct Tlli, See the instructi|ns lor Fart li, later.
Sign
Date )
. Form 1099-DlV (dividends, including those from stocks or mutual
funds)
r Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
. Form 1099-8 (stock or mutual fund sales and certain other
transactlons by brokers)
o Form 1099-5 (proceeds from real estate transactions)
. Form 1 099-K (merchant card and third party network transactions)
r Form l09B (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
r Form 1099-C (canceled debt)
. Form 1099-A {acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S, person (including a resident
alien), to provide your correct TlN.
If you do not return Form W-9 to the rcquester with a TlN, you might
be subject to backup withholding. See What is backup withholding,
later.
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1 . Check only one o{ the
following seven boxes.
I lnoividual/sols proprietor or Z C Corporation n S Corporation ! Partnership f] TrusVestate
single-member LLC
fl t-imiteO liability cornpany. Enter the tax classilication (C=C corporation, S=S corpo.ation, P=padnership) >
Note: Check the appropriate box in the line above tor the tax classification of the single-member owner. Do not check
LLC if the LLC is classified as a single-member LLC lhat is disregarded from the owner unless the owner ol the LLC is
another LLC that is not disregarded from the owner for U,S. {ederal tax purposes. Otherwise, a single-member LLC that
is disregarded lrom the owner should check the appropriale box for the tax classification ol ils owner.
Other (see
street, and apt. or suite no.) See instruclions.
P.O. Box 214
5 Address (num
wA 98926
6 Cily, state, and
Ellensbu
Number
Social security number
Part I
identilication number
I 1 1 2 1 1 1 7 3
Part ll
Cat. No. 10231X rormW-91Rev. 10-201s)
Form W-9 (Rev. 10-2018)Pase2
By signing the filled-out form, you:
1, Certify that the TIN you are giving is correct (or you are waiting for a
number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee. lf applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership income from a U.S. trade or business
is not subject to the withholding tax on foreign partners, share of
effectiveiy connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating
that you are exempt from the FATCA reporting, is correct. See What is
FATCA reporting, later, for further information.
Note: lf you are a U.S. person and a requester gives you a form other
than Form W-9 to request your TlN, you must use the requester's form if
it is substantially similar to this Form W-9.
Definition of a U.S. person, For federal tax purposes, you are
considered a U.S. person if you are:
r An individual who is a U.S. citizen or U.S. resident alien;
. A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States;
. An estate (other than a foreign estate); or
. A domestic kust (as defined in Hegulations section 301 .7701-7),
Special rules for partnerships. Partnerships that conduct a trade or
business in the United States are generally required to pay a withholding
tax under section 1446 on any loreign partners' share of elfectively
connected taxable income from such business. Further, in certain cases
where a Form W-9 has not been received, the rules under section 1446
require a partnership to presume that a padner is a forelgn person, and
pay the section 1446 withholding tax. There{ore, if you are a U.S. person
that is a partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the parlnership to establish your
U.S. status and avoid section 1446 withholding on your share of
partnership income.
ln the cases below, the following person must give Form W-g to the
partnership for purposes of establishing its U.S. status and avoiding
withholding on its allocable share of net income from the partnership
conducting a trade or business in the United States.
I ln the case of a disregarded entity with a U.S. owner, the U.S. owner
of the disregarded entity and not the entity;
I ln the case of a grantor trust with a U.S. grantor or other U.S. owner,
generally, the U.S. grantor or other U.S. owner ol the grantor trust and
not the trust; and
. ln the case of a U.S. trust (other than a grantor trust), the U.S. trust
(other than a grantor trust) and not the beneficiaries of the trust.
Foreign person. lf you are a foreign person or the lJ.S. branch of a
foreign bank that has elected to be treated as a U.S. person, do not use
Form W-9, lnstead, use the appropriate Form W-B or Form 8233 (see
Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign
Eniities).
Nonresident alien who becomes a resident alien. Generally, only a
nonresident alien individual may use the terms of a tax ireaty to reduce
or eliminate U,S. tax on cedain types of income. However, most tax
treaties contain a provision known as a "saving clause.', Exceptions
specified in the saving clause may permit an exemption from tax to
continue for certain types of income even after the payee has otherwise
become a U.S. resident alien for tax purposes.
lf _you are a.U.$. residont alien who is relyrng on an exceplion
contained in lhe saving clause of a tax treaty [o claim an ei(emptionlrom U.S. tax on certain types of income, ydu must attach a stitementto Form W-9 thal specifie's the lollowlng liiie ltems.
.1. The treaty counlry. Generally, this must be the same treaty under
which you claimed exemption from tax as a nonresjdent ali6n. "
2. The treaty article addressing the income.
3. The arlicle number {or location) in the tax treatv that contains the
saving clause and its exceptions.
. 4. The type and amount of income that gualifies for the exemption
Jrom tax.
5. Suflicient facts to justify the exemption from tax under the terms ofthe treaty artlcle.
Example. Article 20 of the U.S.-China income tax treaty allows an
exemption from tax for scholarship income received by a Chinese
student temporarily present in the United States. Under U.S. law, this
student will become a resident alien for tax purposes if his or her stay in
the United States exceeds 5 calendar years. However, paragraph 2 of
the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows
the provisions of Article 20 to continue to apply even after the Chinese
student becomes a resident alien of the United States, A Chinese
student who qualifies for this exception (under paragraph 2 of the first
protocol) and is relying on this exception to claim an exemption from tax
on his or her scholarship or fellowship income would attach to Form
W-9 a siatement that includes the information described above to
support that exemption.
lf you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you
must under certain conditions withhold and pay to the IBS 24% of such
payments. This is called "backup withholding." Payments that may be
subject to backup withholding include interest, tax-exempt interest,
dividends, broker and barter exchange transactions, rents, royalties,
nonemployee pay, payments made in settlement of payment card and
third party network transactions, and certain payments from fishing boat
operators. Real estate transactions are not subject to backup
withholding.
You will not be subject to backup withholding on payments you
receive if you give the requester your correct TlN, make the proper
certifications, and report all your taxable interest and dividends on your
tax return.
Payments you receive will be subject to backup withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the instructions for
Part ll for details),
3. The IRS tells the requester that you furnished an incorrect TlN,
4. The IRS tells you that you are subject to backup withholding
because you did not report all your interest and dividends on your tax
return (for reportable interest and dividends only), or
5. You do not cerlify to the requester that you are not sub.ject to
backup withholding under 4 above (for reportable interest and dividend
accounts opened aftor 1983 only).
, Certain payees and payments are exempt from backup withholding.
See Exempt payee code, later, and the separale lnstructions for the
Requester of Form W-9 for more information.
Also see Specla/ rules for partnerships, earlier.
What is FATGA Reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a
participating foreign financial institution to report all United States
account holders that are specified United States persons. Certain
payees are exempt from FATCA reporting. See Exemption from FATCA
reporting code, later, and the lnstructions tor the Requester of Form
W-9 for more information.
Updating Your lnformation
You must provide updated information to any person to whom you
claimed to be an exempt payee if you are no longer an exempt payee
and anticipate receiving reportable payments in the iuture from this
person. For example, you may n€ed to provide updated information if
you are a C corporation that elects to be an S corporation, or if you no
longer are tax exempt. ln addition, you must furnish a new Form W-g if
the name or TIN changes for the account; for example, if the grantor of a
grantor trust dies.
Penalties
Failure to furnish TlN. lf you fail to furnish your correct TIN to a
reguester, you are subject to a penalty of $50 for each such failure
unless your failure is due to reasonable cause and not to willful neglect.
Givil penalty lor talse information with respect to withholding. lf you
make a false statement with no reasonable basis that results in no
backup withholding, you are subject to a $500 penalty.
Form W-g (Rev. 10-2018)Page 3
Griminal penalty for falsifying information. Wilfully falsifying
certifications or affirmations may subiect you to criminal penalties
including fines and/or imprisonment.
Misuse of TlNs. lf the requester discloses or uses TlNs in violation oi
lederal law, the requester may be subiect to civil and criminal penalties.
Specific lnstructions
Line 1
You must enter one of the following on this line; do not leave this line
blank. The name should match the name on your tax return.
lf this Form W-9 is for a joint account (other lhan an aocount
maintained by a foreign financial institution (FFl)), i'st first, and then
circle, the name of the person or entity whose number you entered in
Part I of Form W-9. lf you are providing Form W-9 to an FFI to document
a joint account, each holder of the account that is a U.S. person must
provide a Form W-9"
a. lndividual. Generally, enter the name shown on your tax return. lf
you have changed your last name without informing the Social Security
Administration (SSA) of the name change, enter your lirst name, the last
name as shown on your social security card, and your new last name.
Note: lTlN applicant: Enter your individual name as it was entered on
your Form W-7 application, ljne 1a. This should also be the same as the
name you entered on the Form 1040/1040A/i04OEZyou filed with your
application.
b, Sole proprietor or single-member LLC. Enter your individual
name as shown on your 1Q4O/104ON1A40EZ on line 1. you may enter
your business, trade, or "doing business as" (DBA) name on line 2.
c. Partnership, LLC that is not a single-member LLC, C
corporation, or S corporation, Enter the entity's name as shown on the
entity's tax return on ljne 1 and any business, trade, or DBA name on
line 2.
d. Otherentities. Enteryourname as shown on required U.S. federal
lax documents on line 1. This name should match the name shown on the
charter or other legal document creating the entity. you may enter any
business, trade, or DBA name on line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a
"disregarded entity." See Regulations section S01.7701-2(c)(2)(iii). Enter
the owner's name on line 1. The name of the entity entered on line .l
should never be a disregarded entity. The name on line 1 should be the
name shown on the income tax return on which the income should be
reported. For example, if a foreign LLC that is treated as a disregarded
entity for U.S. lederal tax purposes has a single owner that is a U.S.
person, the U.S. owner's name is required to be provided on line 1. lf
the direct owner of the entity is also a disregarded entity, enter the first
owner that is not disregarded for federal tax purposes, Enter the
disregarded entity's name on line 2, "Business name/disregarded entity
name." lf the owner of the disregarded entity is a foreign person, the
owner must complete an appropriate Form W-8 instead of a Form W-9.
This is the case even if the foreign person has a U.S. TlN.
Line 2
lf you have a business name, trade name, DBA name, or disregarded
entity name, you may enter it on line 2.
Line 3
Check the appropriate box on line 3 for the U.S. federal tax
classification of the person whose name is entered on line 1. Check only
one box on line 3.
Line 4, Exemptions
lf you are exempt from backup withholding and/or FATCA reporting,
enter in the appropriate space on line 4 any code(s) that may apply to
you.
Exempt payee code.
. Generally, individuals (including sole proprietors) are not exempt from
backup withholding.
r Except as provided below, corporations are exempt from backup
withholding for certain payments, including interest and dividends.. Corporalions are not exempt from backup withholding for payments
made in settlement of payment card or third party network transactions,
. Corporations are not exempt from backup withholding with respect to
attorneys' fees or gross proceeds paid to attorneys, and corporations
that provide medical or health care services are not exempt with respect
to payments reportable on Form 1099-M|SC.
The following codes identify payees that are exempt from backup
withholding. Enter the appropriate code in the space in line 4.
1 -An organization exempt trom tax under section 501(a), any lRA, or
a custodial account under section 403(bX7) if the account satislies the
requirements of section 401(D(2)
2-The United Stales or any of its agencies or instrumentalities
3-A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
4-A foreign government or any of its political subdivisions, agencles,
or instrumentalities
5-A corporation
6-4 dealer in securities or commodities required to register in the
United States, the Diskict oi Columbia, or a U.S. commonwealth or
possessjon
7-A futures commission merchant registered with the Commodity
Futures Trading Commission
8-A real estate investment trust
9-An eniity registered at all times during the tax year under the
lnvestment Company Act of 1 940
1 0 -A common trust fund operated by a bank under section SB4(a)
11 --A financial institution
12-A middleman known in the investment communily as a nominee or
custodian
1 3 - A trust exempt from tax under section 664 or described in section
4947
lF the entity/person on line 1 is
a(n)...
THEN check the box tor
. Corporation Corporation
. lndividual
. Sole proprietorship, or. Single-member limited liability
company (LLC) owned by an
individual and disregarded for U.S.
federal tax purposes.
lnd ividual/sole proprietor or singie-
member LLC
. LLC treated as a partnership for
U.S. federal tax purposes,
. LLC that has filed Form 8832 or
2553 to be taxed as a corporation,
or
. LLC that is disregarded as an
entity separate from its owner but
the owner is another LLC that is
not disregarded for U.S. federal tax
purposes.
Limited liabilily company and enter
the appropriate tax classification.
{P= Partnership; C= C corporation;
or S= S corporation)
r Partnership Partnership
. Trusyestate Trust/estate
Form W-9 (Rev. 10-2016)Paoe 4
The following chart shows types of payments that may be exempt
from backup withholding. The chad applies to the exempt payees listed
above, 1 through 13.
Payments made in settlement of Exempt payees 1 through 4
payment card or third party
transactions
1 See Form 1099-lVlSC, Miscellaneous lncome, and its instructions.
' However, the following payments made to a corpotation andreportable on Form 1099-MISC are not exempt fiom backup
withholding: medical and health care payments, attorneys'fees, gross
proceeds paid to an attorney reportable under section 6045(f), and
payments for services paid by a federal executive agency.
Exemption from FATCA reporting code, The following codes identify
payees that are exempt from reporting under FATCA. These codes
apply to persons submitting this form for accounts maintained outside
of the United States by certain foreign financial institutions. Therefore, if
you are only submitting this form for an account you hold in the United
States, you may leave this field blank. Consult with the person
requesting this form if you are uncertain if the financial institution js
subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with "Not Applicable" (or
any similar indication) written or printed on the line for a FATCA
exemption code.
A-An organization exempt from tax under section 50.1(a) or any
individual retirement plan as defined in section 7701(a\(37\
B -The United States or any of its agencies or instrumentalities
C-A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
D-A corporation the stock of which is regularly traded on one or
more established securities markets, as described in Regulations
section 1.1 472-1 (cXlXi)
E-A corporation that is a member of the same expanded affiliated
group as a corporation described in Fegulations section .1.1472-1(c)(1)(i)
F-A dealer in securities, commodities, or derivative financial
instruments {including notional principal contracis, futures, forwards,
and options) that is registered as such under the laws of the United
States or any state
G-A real estate investment trust
H-A regulated investment company as defined in section 851 or an
entity registered at all times during the tax year under the lnvestment
Company Act of 1940
l-A common trust fund as defined in section 584(a)
J-A bank as defined in section 581
K-A broker
L-A trust exempt from tax under section 664 or described in section
asaz(a)(1 )
M-A tax exempt trusi under a section 4tl3(b) plan or section 457(9)
plan
Note: You may wish to consult with the financial institution requesting
this form to determine whether the FATCA code and/or exempt payee
code should be completed.
Line 5
Enter your address (number, street, and apartment or suite number).
This is where ihe requester of this Form W-9 will mail your information
returns. lf this address differs from the one the requester already has on
file, wriie NEW at the top. lf a new address is provided, there is still a
chance the old address will be used until the payor changes your
address in their records.
Line 6
Enter your city, state, and ZIP code.
Part l. Taxpayer ldentification Number (TtN)
Enter your TIN in the appropriate box. lf 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 identitication number (lTlN). Enter it in the social
securiiy number box. lf you do not have an lTlN, see How to get a TIN
below.
lf you are a sole proprietor and you have an ElN, you may enter either
your SSN or ElN.
l{ you are a single-member LLC that is disregarded as an entity
separate from its owner, enter the owner's SSN (or ElN, if the owner has
one), Do not enter the disregarded entity's ElN. lf the LLC is classified as
a corporation or partnership, enter the entity's ElN.
Note: See What Name and Number To Give the Requester,later, for
further claritication of name and TIN combinations,
How to get a TlN. If you do not have a TlN, apply for one immediately,
To apply for an SSN, get Form SS-5, Application for a Social Security
Card, from your local SSA office or get this form online at
www.SSA.gov. You rnay also get this form by calling 1-BOO-772-1219.
Use Form W-7, Application for IRS lndividual Taxpayer ldentification
Number, to apply for an lTlN, or Form SS-4, Application for Employer
ldentification Number, to apply for an ElN. You can apply for an Ef N
online by accessing the IRS website al www.irs.govl9uslnesses and
clicking on Employer ldentification Number (ElN) under Starting a
Business. Go lo www.irs.govlForms to view, download, or print Form
W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to
place an order and have Form W-7 and/or SS-4 mailed to you within 10
business days.
lf you are asked to complete Form W-9 but do not have a TlN, apply
for a TIN and write "Applied For" in the space for the TlN, sign and date
the form, and give it to the requester. For interest and dividend
payments, and certain payments made with respect to readily tradable
instruments, generally you will have 60 days to get a TIN and give it to
the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments.
You will be subject to backup withholding on all such payments until
you provide your TIN to the requester.
Note: Entering "Applied For" means that you have already applied for a
TIN or that you intend to apply for one soon.
Caution: A disregarded U.S, entity that has a foreign owner must use
the appropriate Form W-8.
Part ll. Certification
To establish to the withholding agent that you are a U.S. person, or
resident alien, sign Form W-9. You may be requested to sign by the
withholding agent even if item 1, 4, or 5 below indicates otherwise.
For a joint account, only the person whose TIN is shown in part I
should sign (when required). ln the case of a disregarded entig, the
person idenlified on line 1 must sign. Exempt payees, see Exempt payee
code, earliet-
Signature requirements. Compleie the certification as indicated in
itemsl through5below.
lF the payment is for
lnterest and dividend payments
Broker transactions
Barter exchange transactions and
patronage dividends
Payments over $600 required to be
reported and direct sales over
$5,0001
THEN the payment is exemptfor,,.
All exempt payees except
lor 7
Exempt payees 1 through 4 and 6
through 1 1 and all C corporations.
S corporations must not enter an
exempt payee code because they
are exempt only for sales of
noncovered securities acquired
prior to 2012.
Exempt payees 1 through 4
Generally, exempt payees
1 through 52
Form W-9 (Rev. 10-201 8)Page 5
1. lnterest, dividend, and barter oxchonge accounts opgned
before 1984 and broker accounls considered activo during 198:t.
You must give your correcl TlN. but you do not have to sign the
certification.
2. lnterest, dividend, broker, and barler exchange accounts
op€ned after 1983 and broker accounts considered inactive during
1983. You must sign the certification or backup withholding wlll apply. lf
you are subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2 in the
certification before signing the form.
3. Real estate transactions. You musi sign the certification. you may
cross out item 2 of the certification.
4. Other payments. You must give your correct TlN, but you do not
have to sign the certification unless you have been notified that you
have previously given an incorrect TlN. "Other payments" include
payments made in the course of the reguester's trade or business for
rents, royalties, goods (other than bills for merchandise), medical and
health care services (including payments to corporations), payments to
a nonemployee for services, payments made in settlement of payment
card and third party network transactions, payments to certain fishing
boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5, Mortgage interest paid by you, acquisition or abandonment of
secured propery, cancellation of debt, qualitied tuition program
payments (under section 5291, ABLE accounts (under section 529A),
lRA, Goverdell ESA, Archer MSA or HSA contributions or
distribuiions, and pension distributions. You musi give your corect
TlN, but you do not have to sign the certification.
What Name and Number To Give the Requester
For this of account:Give name and SSN of:
For this type of account:Give name and EIN of:
1,1. Accoutl with the entity
Agriculture in the name ol a public
ontity {such as a staie or local
government, school district, or
prison) that recejves agricultural
program payments
15. Grantor tlust filing under the Form
1041 Filing lvlethod or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1 .671 -4(b)(2)(iXB))
The trust
1 List first and circle the name of the person whose number you furnish.
lf only one person on a joint account has an SSN, that person's number
must be furnished,
2 Circle the minor's name and furnish the minor's SSN.
3 You must show your individual name and you may also enler your
business or DBA name on the "Business name/disregarded entity"
name line. You may use either your SSN or EIN {if you have one), but the
IRS encourages you to use your SSN.
4 List first and circle the name of the trust, estate, or pension trust. (Do
not furnish the TIN of the personal representative or trustee unless the
legal entiiy itselt is not designated in the account title.) Also see Special
rules for paftnershps, earlier.
*Note: The grantor also must provide a Form W-9 to trustee of trust.
Note: lf no name is circled when more than one name is listed, the
number will be considered to be that of the first name listed.
Secure Your Tax Records From ldentity Theft
ldentity theft occurs when someone uses your personal information
such as your name, SSN, or other identifying information, without your
permission, to commit fraud or other crimes. An identity thief may use
your SSN to get a job or may file a tax return using your SSN to receive
a refund.
To reduce your risk:
. Protect your SSN,
. Ensure your employer rs protecting your SSN, and
. Be careful when choosing a tax preparer.
lf your tax records are affected by identity theft and you receive a
notice from the lRS, respond right away to the name and phone number
printed on the IRS notice or letter.
lf your tax records are not currently affected by identity iheft but you
think you ar€ at risk due to a lost or stolen purse or wallet, questionable
credit card activity or credit report, contact the IRS ldentity Theft Hotline
at 1 800-908-4490 orsubmit Form 14039.
For more information, see Pub. 5027, ldentity Theft lnformation for
Taxpayers.
Viclims of identity theft who are experiencing economic harm or a
systemic problem, or are seeking help in resolving tax problems that
have not been resolved through normal channels, may be eligible for
TaxpayerAdvocate Service (lAS) assistance. You can reach TAS by
calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD
1 -800-829-4059.
Proteet yourself from suspicious emails or phishing schemes.
Phishing is the creation and use of email 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 surrendering
private information that will be used for identity theft.
'1. lndivldual
2 Two or more individuals (oint
account) other than an account
maintained by an FFI
3. Two or more U.S. persons
toint account maintained by an FFI)
4. Custodial account ol a minor
{Uniform Gift to Minors Act)
5. a. Ths usual revocabl€ savings tlust
(grantor is also t,ustee)
b. So-called irust account that is not
a legal or valid trust under siate Iaw
6- Sole p/oprietorship or disregarded
entity owned by an individual
7. Grantor trust tiling under Optional
Form 1099 Filing Method 1 {see
Regulations seclion 1.671 4(b)(2)(i)
(A))
The individual
The actual owner ol the account or, if
combined funds, lhe tirst individual on
the accountl
Each holder of the account
l-he minor2
The grantor-irusteel
The actual ownerl
I ne owner
The grantor'
Give name and EIN of:
Legal entitya
The co,'poration
The organizalion
The par-tnership
The broker or nominee
8.
For this type of account:
not owned by an The owner
individual
9- A valid trust, es'tato, or pension lrust
10. Corporation or LLC elBcting
corporate status on Form 8832 or
Form 2553
1 1. Association, club, religious,
charitable, educational, or other tax,
exempt organization
12. Partnership or mulli-member LLC
'13. A broker or registered nominee
Form W-9 (Rev. 10-20181 Page 6
The IRS does not initiate contacts with taxpayers via emails. Also, the
IRS does noi request personal detailed information through email or ask
taxpayors for the PIN numbers, passwords, or similar secret access
information for their credit card, bank, or other financial accounts.
lf you recelve an unsolicited email claiming to be from the lRS,
fonruard this message to phishing@irs.gov. You may also report misuse
of the IRS name, logo, or other IRS property to the Treasury lnspector
General for Tax Administration OIGTA) at 1-800-366-4484. You can
forward suspicious emails to the Federal Trade Commission at
spam@uce.gov or report them al www.ftc.govlcomplaint. You can
contact the FTC at www. ft c. gov / idtheft or 877-l DTHEFT (877-498-4998).
lf you have been the victim of identity theft, see www.ldentityTheft.gov
and Pub. 5027.
Visit www.rrs.govlldentiwheftto learn more about identity theft and
how to reduce your risk.
Privacy Act Notice
Section 6109 ofthe lnternal Revenue Code requires you to provide your
correct TIN to persons (includlng federal agencies) who are required to
file information returns with the IRS to report interest, dividends, or
certain other income paid to you; mortgage interest you paid; the
acquisition or abandonment of secured properiy; the cancellation of
debt; or contributions you made to an lRA, Archer MSA, or HSA. The
person collecting this form uses the information on the form to file
information returns with the lRS, reporting the above information.
Routine uses of this information include giving it to the Department of
Justice for civil and $iminal litigation and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions for use in
administering their laws, The information also may be disclosed to other
countries under a lreaty, to federal and state agencies to enforce civil
and criminal laws, or to federal law enforcement and intelligence
agencios to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers
must generally withhold a percentage of laxable interest, dividend, and
certain other payments to a payee who does not give a TIN to the payer,
Certain penalties may also apply for providing false or fraudulent
information.
lntemal Revenue Service
Date: Aprit 12,2003
Laughing Horse Arts Foundation
P.O. Box 214
Ellensburg, WA 98926-0214
Departrnent of the Treasury
P.0. Box 25O8
Cincinnati, OH 45?01
Person to Contact:
Ronnie Clemons
Customer Service Representative
Toll Free Telephone Number:
8:00 a,rn to 6:30 pm. EST
877-82s-5540
Fax Number:
513-263-3756
Federal ldentification Nunaber:
91-1211173
Dear Sir:
This is in response to your Certificate Of Amendment, filed Juty 6, 1999, in the State of Washington,
changing the organization's name from Ellensburg Summer Theater Foundation, to the above as listed
Our records indicate that a determination letter issued in July 1984, granted your organization exemption
from federal income tax under section 501(cX3) of the lntemal Revenue Code. That letter is still in effect.
Based on information subsequently submitted, we classified your organization as one that is not a private
foundation within the meaning of section 509(a) of the Code because it is an organization described in
sectlons 5o9(a)(1) and 1 7o(b){1 )(A)(vi),
This classification was based on the assumption that your organization's operations would continue as stated
in the application. lf your organization's sources of support, or its character, method of operations, or
purposes have changed, please let us know so we can consider the effect of the change on the exempt
status and foundation status of your oganization.
Your organization is reguired to file Form gg0, Retum of Organization Exempttrom lncome Ta:c, only if its
gross receipts each year are normally more lhan $25,000. lf a retum is required, it must be filed by the 15th
day of the fifttt rnonth after the end of the organization's annual accounting period, The lEw imposes a
Penalty of S20 a day, up to a maximum of 910.000, when a r€tum is filed late, unless there is reasonable
cause for the delay,
All exempt organizatlons (unless specifically excluded) are liable for taxes under the Fecteral lnsurance
Conftibutions Act (social security taxes) on remuneration of $100 or more paid to each employee during a
calendar year, Your organizalion is not liable for the tax imposed under the Federal Unemployment Tax Act
(FUrA).
Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the
Code. However, these organizations are not automatically exempt from olher fedenal excise taxes.
Donors may deduct contributions to your organization as provided in section 170 of the Code. Bequests,
legacies, devises, transferg, or gifts to your organization or for its use are deductible for federal estate and
gift tax purposes if they meet the applicable pmvisions of sections 2055, 2106, and 2522 of tho Code.
,2
Laughing Horse Arts Foundation
91-1211173
Your organization is not required to file federal income tax returns unless it is subject to the tax on unrelated
business income under section 511 of the Code. If your organization is subject to this tax, it must file an
income tax retum on the Form 99S-T, Exempt Organization Elusiness lncorne Tax Retum. ln this letter, we
are not determining whether any of your organization's present or proposed activities are unrelated trade or
business as defined in section 513 of the Code.
The law requires you to make your organization's annual retum availahle fcr public inspection without charge
for three years after lhe due date of the refum. lf your organization had a copy of its application for
recognition of exemption on July 15. '1987, it is also required to make available for public inspection a copy of
the exemption application, any supporting documents and the exemption letter to any individual who requests
such documents in person or in writing. You can charge only a reasonable fee for reproduction and actual
postage costs for the copied materials. The law does not require you to provide copies of public inspeclion
documents that are widely available, such as by posting them on the lnternet (Wortd Wde Web), You may
be liable for a penalty of $20 a day for each day you do not make these documents available for public
inspee*ion {up-to a maxirnum sf $1{3,OCI*-in the case of ar"l aRnuai retu:nl
Because this letter could help resolve any questions about your organization's exempt status and foundation
status, you should keep it with lhe organization's permanent records.
lf you have any questions, please call us at the telephone number shown in the heading of this letter.
-I'his letter affirms your organization's exempt stiatus.
Sincerbly,
{au
John E. Ricketts, Director, TEIGE
Customer Account Servlces
925-7037
933-1 500
925-9844
933-1 600
925-9800
962-6888
925-931 9
925-4734
933-1 500
9254244
962-9400
962-5585
Exhibit C
Lodging Worksheet - 201I
Online su rvey
Air B&B / Vacation homes z 2 4
Total - Short Term Vacation Rentals (STVR)4
Stayed - Friends / Relatives 12
KOA 31 3'l 62
Lodging Friday Saturday Totals
Comfort lnn - Amanda *52 52 104
Days lnn 25 25 50
Econolodoe 38 39 77
Hampton lnn - Christine 3 3 6
Red Lion lnn '15 30 45
Super I 4A 40 80
Total H/M 362
Yakima River RV Park 0 0 0
Total Camp/RV 62
Total Lodging 440
No Discrimination
E&JRV Park 13 13 26
Motel 6 full both davs 72
Holiday lnn Express d nb
Lincoln Suites full both 110
274
Exhibit ,A1
Tickets 20t9
Ticket Sales with recorded zipcodes Kittias
Gountv
Out of
Countv Totals Unknown
U nrestricted Contribution Tickets 142 142
Chamber Ticket Sales 43 43 5
ShowClix 284 383 667 23
Recorded during the Festival 48 42 90 374
Totals 517 425 942 402
55o/o 45o/o 100Yo
Comp Tickets
Band Member Tickets 74 1 I 1 25s
JazzCamp Friday Night 14 94 108
Donated Tickets to non-profits I 16 24
Sunday - Free Sponsored Concert 468
Volunteers 10+ hrs
Totals
34
130
I
299
42
429
30o/o 70o/o 100%-T
Total Tickets 647 724 1371 870
47olo 53o/o 100%
Total tickets 2018 Festival 2241
Jazzin the Valley Festival Survey Results
Of the surveys that reported resident locations:
Kittitas County:43o/o
Out of County 57o/a
Exhibit A2
77o/o raported staying at least one night
59% reported two or more nights
Jazzin the Valley On-Line Survey Results
Of the surveys that reported resident locations:
Kittitas County:38o/o
Out of County 620h
Exhibit 43
Volunteer Hours - 2018
2021Volunteer Hours
Board Members Board Meetings Committee
Meetings
lndividual
Reponsibilites Festival Total
Brunner Micah 16 30 54 8 108
Burke Amv 16 12 50 12 90
Joel 10 0 0 36 46
Marie 10 15 16 10 51
Solberq Jov 12 b 240 '10 268
Solberq Don 20 30 110 30 190
Stanley Laura 18 15 37 19 89
Swartz Tonv 25 30 100 35 '190
Warren Linda 20 20 25
Wallen Norm 10 I 10 28
Estimated 2020 Hours
with no Festival 157 166 617
1060
total prefestival hours 940
Committees
Music 50
Facitlities 50
Volunteers 20
Promotions 15
135 Total Volunteer Hourc 1 195
Volunteer Hours - 2018
2019 Volunteer Hours
Past Board
M€mbers
Board Members Board Meetings Committee
Meetinqs
Individual
Reoonsibilites Festival Total
tseck Dan 6 2 27 35
Brotherton John 16 8 51 60 135
Brunner Micah '16 30 54 50 150
Bruya Chris 8 20 60 10 98
Burke Amv 16 12 70 12 110
Fraser Rob 12 15 52 15 94
Korte Virqinia 16 30 160 206
Smith Joel 10 16 110 36 172
Smith Marie 10 8 100 10 128
Solbero Jov 12 6 240 10 268
Solberg Don 20 30 110 20 '180
Solberq Ona 18 12 25 32 87
Stanlev Laura 18 28 37 19 102
Swartz Tony 25 30 100 35 190
Wallen Norm 10 8 10 28
Wineoar Kori 16 30 100 146
Brunner Debbie 28 28
lloe Svdnev 50 50
Sharpe Larrv 20 12 32
2129
Committees
Music 203
Facitlities 121
Volunteers 200
Promotions 95
619
Volunteer Hours - 2018
Projected Volunteers 2022:
Based on the last 3 years of calculated hours, and the alterations in this years planned festival
specifically designed to reduce dependence on a large board and many volunteers, we estimate
that similar will fall between 2019 and the limited 2021 Festivals.
Board Members Board Meetings Committee
Meetinqs
lndividual
Reponsibilites Festival Total
Brunner Micah 16 30 54 20 120
Burke Amv 16 12 50 12 90
Smith Marle 10 't0 16 10 46
Solbero JoV 12 6 200 10 228
Solberq Don 20 30 240 30 320
Stanley Laura 18 15 37 19 89
Swartz Tonv 25 30 240 35 330
Warren Linda 20 20 20 25 85
Wallen Norm 10 8 10 20 48
1 356
Music 204
Facitlities 100
Volunteers 150
Promotions 90
540 Total Volunteer Hours 1896
Exhibit ,,B,,
Guidelines and Requirements for
Expenditure Reimbursements from Lodging Tax
Section 1. Brandine
Contractors who have been approved to utilize grant awards for advertising expenditures must
incorporate Kittitas County and the appropriate City of Cle Elum, Ellensburg, or Roslyn tourism
information as follows;
A. Websites and Social Media Sites must include the County's and appropriate City's tourism
website logo or URL with an operational link to the site(s). The URL landing page must use the
correct logos and have a link to centralwashingtonoutdoor.com. Contractors must either keep
the landing page active until time of reimbursement or use a screen capture for full
reimbursement. (lf you are using a live logo as the link to CWO, please ensure the hyperlink is
shown in the screen capture). The logo must be displayed on the contractor's home page, it
must be sized no smaller than% inch in height and must be surrounded by appropriate white
space to allow easy recognition and legibility. Contractors shall not change the logo(s) in color or
appearance.
B. Print Advertising and Online Display Advertising of all types (including but not limited to
newspaper, periodicals, flyers, posters, billboards, direct mail, e-newsletters, third-party
websites, streaming displays, social media etc.) must include the County's and appropriate
City's tourism website logo (or URL with a one-click away operational hyperlink). The URL
landing page must use the correct logos and have a link to centralwashingtonoutdoor.com.
Contractors must either keep the landing page active until time of reimbursement or use a
screen capture for full reimbursement. (lf you are using a live logo as the link to CWO, please
ensure the hyperlink is shown in the screen capture). The logo must be sized no smaller than]1.-
inch in height and must be surrounded by appropriate white space to allow easy recognition and
legibility. contractors shall not change the logo(s) in color or appearance.
C' Video Advertisine of all types (including but not limited to television, online, electronic kiosks,
motion billboards, etc.) must include the County's and appropriate City's tourism website logo.
The logo must be sized no smaller lhan%inch in height, and must be surrounded by appropriate
white space to allow easy recognition and legibility. Contractors shall not change the logo(s) in
color or appearance.
All logos and website information may be obtained by contacting the Director of Tourism, Kittitas
County Chamber of Commerce.
Section 2. Advertisins Reimbursements
Contractors seeking reimbursement from Lodging Tax Funds for advertising expenditures must adhere
to the following guidelines and requirements for each type of advertising media utilized.
A..Print Advertising:
1. Print advertising placed with any media provider which operates exclusively outside of
Kittitas County may be reimbursed at LO}% of the cost, including any production costs. To
operate exclusively outside of Kittitas County, the provider must not be physically located in
the County and/or not distribute any media within the County.
2' Print advertising placed with any media provider which operates inside Kittitas County may
be reimbursed as follows:
a, For date-specific events, advertising the day ofthe event and up to L0 days prior to
the event may be reimbursed atIOO% of the cost, including any production costs.
b. For seasonal or year-round events, or for date-specific events outside of the time-
frame in Section 2 A, (2)(a) above, advertising reimbursement requests must include a
statement from the media provider specifying the percentage distribution to areas
outside of Kittitas County. Reimbursements will be allowed for the amount distributed
outside of Kittitas County, including any production costs.
B. Television Advertising:
1. Television advertising placed with any media provider outside the Yakima/Kittitas DMA will
be reimbursed at 100% of the cost, including any production cost.
2' Television advertising placed with any media provider inside the Yakima /Kittitas DMA will
be reimbursed as follows:
a. For date-specific events, advertising the day ofthe event and up to 7 days prior to
the event may be reimbursed at 100% of the cost, including any production costs.
b. For seasonal or year-round events, or for date-specific events outside of the time-
frame in section 2 8,2(al above, advertising may be reimbursed at the rate of 70% of
the total cost, including any production costs.
e. Online Advertisins:
1. Online advertising and promotion may be reimbursed at 100% of the cost, including any
production cost.
2. Streamed media (radio, television, other) requests for reimbursement must include a
statement from the media provider specifuing the percentage of recipients which are
outside of Kittitas County. Reimbursements will be allowed for the percentage distributed
outside of Kittitas County, including any production costs.
D. Direct Mail:
1', Direct mail advertising may be reimbursed at 1-00% of the cost, including any production
cost, for each item mailed or shipped to a destination outside of Kittitas County. ln order to
receive reimbursement, a list of the addresses and a signed statement from the contractor
that the list is accurate, or other proof of delivery, must be provided along with other
required documentation.
t" Flv-ers/Postg_rc:
1' Flyers or posters which are placed outside of Kittitas county may be reimbursed al LOO% of
thecost,includinganyproductioncost. lnordertoreceivereimbursement,alistofthe
locations where flyers or posters were posted outside of Kittitas County, a signed statement
from the contractor that the list is accurate and a copy of the poster/flyer must be provided
along with other required documentation.
2. Banners which are placed inside of Kittitas County may be reimbursed at LOO%of the cost,
including any production costs. ln order to receive reimbursement, the banner cannot list a
specified date or location. Request can only be made one time.3. Signage (site layout use only) which are placed inside of the venue/facility of the event may
be reimbursed at 100% of the cost, including any production costs. ln order to receive
reimbursement, the signage cannot list specified date or location. Request can only be
made one time. (i.e. ADA Parking/Parking, Loading Zone, Evacuation Route, Bathrooms, and
Stage locations)
F. Rad io. A€hrgtUsi ne:
7. Radio advertising placed with any media provider located outside of Kittitas County may be
reimbursed at LOO% of the cost, including any production cost.
2. Radio advertising placed with any media provider located inside of Kittitas County may be
reimbursed as follows:
a. For date-specific events, advertising the day ofthe event and up to 7 days prior to
the event may be reimbursed at 100% of the cost, including any production cost.
b. For seasonal or year-round events, or for date-specific events outside of the time-
frame in Section 2 F,2(a) above, advertising may be reimbursed at the rate of 30% of
the total cost, including any production costs.
G. Qpgration Reirnbursement:
'l'- operation costs may be reimbursed lo}% of the paid invoice cost. ln order to receive
reimbursement operations invoice must an approved cost from the Consolidated Lodging
Tax committee members list. lnvoice provided must include notation of payment with proof
of payment.
2' Mileage reimbursements that are outside of 50 miles of Kittitas County may be reimbursed
atIO0% of cost. ln order to receive reimbursement, a signed statement from the receiver
along with other required documentation. Mileage reimbursement subject to IRS mileage
reimbursement rates which may change annually.3. ltems not eligible for reimbursement:
a. Salaries of employees
b. Capitol purchases- any item with 3+ years life and over S5,0OO.c. Licenses, permits, insurance, or credit card fees