HomeMy WebLinkAbout04.01.26-06.30.26 between KC and Wise0
Kittitas County Public Health Kittitas County
Public Health
Contract/Agreement Review Form 1. apartment
Today's Date:
06/25/26
Legal Request #:
E%��'
Fund/Department:
116-Public Health
Agenda Date:
Contract/Agreement Information
Contract/Agreement Agency: WISE
Contract/Agreement Title: AFS between Kittitas County and WISE
Begin Date: 04.01.26 1 f End Date: 06/30/26
Total $ Amount: NTE $10,000.00
Contract/Agreement Summary:
Contract/Agreement #: PHMH-006
Allow consultant to provide training and technical assistance specific to developmental
disabilities programs.
Kittitas County Prosecutor and Auditor Review and Comment:
APPROVED AS TO FORM:
Signature of P7se tor's Office Date
Signature of Auditor's
Budget Information
Revenue Code(s): 1105 - 334.04.68
Expense Code(s): HS2000-101/4101
❑✓ Agency is not suspended/disbarred �� Not Checked (reason)
Pass Through Information
Agency to Pass Through
Amount to Pass Through Expense Code:
Sub -Contract Approved Date:
Date
&. 3U•
ADMIN I Version: 0 .1 Supersedes: 0 1 Date Adopted: 12/01/2024 1 Modified By: Katie Odiaga I Approval By: Chelsey Loeffers
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KITTITAS COUNTY
AGREEMENT FOR SERVICES
PHMH26-006
This Agreement for Services (hereinafter "Agreement") is entered into by and between Kittitas County
(hereinafter "County"), a political subdivision of the State of Washington, and WISE (hereinafter "Contractor").
The purpose of this Agreement is as follows: provide training and technical assistance to Kittitas County
Developmental Disabilities program subcontractors and partners.
The term of this Agreement shall be April 1, 2026, through June 30, 2026, unless the Agreement is
terminated early or its term is extended as provided herein.
The parties' addresses and points of contact for the administration of this Agreement are as follows:
COUNTY
507 N Nanum Street Ste 102
Ellensburg, WA 98926
Kasey Knutson
Human Services Manager
Kittitas County Public Health
Kasey.knutson@co.kittitas.wa.is
509-962-7515
CONTRACTOR
16000 Christensen Road Ste 308
Tukwila, WA 98188
Charly Walters
Senior Technical Assistance and Training Manager
charly@gowise.org
509-217-4142
This Agreement includes the following, which are attached hereto and hereby incorporated by this
reference:
Attachment
"A":
Scope of Work
Attachment
"B":
Compensation
Attachment
"C":
Insurance Requirements
Attachment
"D":
General Terms and Conditions
Attachment
"E":
W-9 (Contractor must complete and return to the County for payment)
Attachment
"F":
Fee Schedule
Kittitas County Agreement for Services (rev. 5/14/25)
Page 1 of 20
IN WITNESS WHEREOF, this Agreement has been executed by and on behalf of the parties through their
authorized representatives, effective as of the latest date written below.
KITTITAS COUNTY
CONTRACTOR
BOARD OF COUNTY COMMISSIONERS
Cory Wright, Chair
Signature
Brett Wachsmith, Vice -Chair
Printed Name
Laura Osiadacz, Commissioner
Title
Date:
Date:
Attest:
Clerk of the Board
❑ Julie Kjorsvik
❑ Mandy Buchholz
KittitaiCounty Agreement for Services (rev. 5/14/25)
Page 2 of 20
ATTACHMENT "A"
SCOPE OF WORK
• WISE training and/or consultation services listed via gowise.org
• WISE consultation services for Kittitas County Public Health Department staff
■ Additional assistance related to the annual community summit
• Individualized Technical Assistance (ITA) for employment and day services providers via Developmental
Disabilities Administration (DDA) services.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 3 of 20
ATTACHMENT "B"
COMPENSATION
THE COUNTY WILL NOT PROCESS PAYMENT FOR SERVICES RENDERED UNDER THIS AGREEMENT UNTIL
CONTRACTOR SUBMITS A COMPLETED W-9 (SEE ATTACHMENT "E").
As full compensation for satisfactory performance of the work described in Attachment "A", and within
thirty (30) days of receiving Contractor's itemized invoice, the County shall pay Contractorthe following amount(s)
plus any applicable taxes as detailed in Contractor's invoice: $10,000
Unless otherwise provided herein, Contractor shall be solely responsible for Contractor's travel and
related expenses.
Any uses of these funds outside of the listed allowable uses must be approved by Kittitas County in advance of the
expenditure, in writing.
All funds must be spent by June 30, 2026. No extension of the funding period will be granted.
Reimbursement Procedures
A. The Contractor shall submit invoices for services due once a month, which shall be emailed to Katie
Odiaga, Kittitas County Public Health Department, at kat-te.odiaga@co.kittitas.wa.us.
B. All invoices must be submitted by the 20th day of the month following the calendar month in which
services were delivered.
C. The Contactor must provide adequate backup documentation to support costs in each invoice. This
includes a general ledger from the financial accounting system detailing transactions and expenditure
dates for allowable activities within the period of performance. Payroll expenses must show employee
names, hourly rate, number of hours, total pay, and project code. Benefits can be one line item but
should include project code. Non -payroll expenses must include a copy of the receipt or payment
invoice. Payments to subcontractors must be listed as a specific line item per subcontractor.
D. All invoices must include invoice date and an invoice number.
E. All invoices must also be accompanied by an updated Contractor Spending Form, as provided by Kittitas
County, to ensure that billing record keeping matches County records.
F. Failure to submit required monthly deliverable reports as outlined in Exhibit A: Scope of Work may
result in delayed reimbursement payments or denial of invoices.
G. Kittitas County is not liable for services provided unless the invoice is received on time or prior
arrangements are agreed to in writing signed by the County.
In no event shall payments under this agreement total more than $10,000.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 4 of 20
ATTACHMENT "C"
INSURANCE REQUIREMENTS
Contractor shall secure and maintain in effect at all times during performance of work under this
Agreement such insurance as will protect Contractor, its employees, and agents from all claims, losses, harm,
costs, liabilities, damages and expenses arising out of Contractor's performance under this Agreement, including
but not limited to personal injury (including death) or property damage.
All insurance shall be issued by companies admitted to do business in the State of Washington and have
a rating of A-, Class VII or better in the most recently published edition of Best's Reports unless otherwise approved
by the County. If an insurer is not admitted, all insurance policies and procedures for issuing the insurance policies
must comply with Chapter 48.15 RCW and 284-15 WAC.
At a minimum, Contractor shall maintain and provide proof of the following selected options:
M Commercial General Liability Insurance
■ Coverage limits not less than:
• $1,000,000 per occurrence, for all covered losses
• $2,000,000 general aggregate
• $1,000,000 products & completed operations aggregate
• $1,000,000 personal and advertising injury, each offense
■ The policy must be endorsed to include the County and its officials, employees and agents
as additional insureds.
Commercial Automobile Liability Insurance
• Automobile Liability for owned, non -owned, hired, and leased vehicles, with an MCS 90
endorsement and a CA 9948 endorsement attached if 'pollutants' are to be transported.
■ Coverage limits not less than:
• $1,000,000 combined single limit
❑ Excess or Umbrella Liability
■ Contractor shall provide Excess or Umbrella Liability coverage of $5,000,000. This Excess
or Umbrella Liability coverage shall apply, at a minimum, to both the Commercial General
and Automobile Insurance policy coverages. If used to meet limit requirements, coverage
must be at least as broad as specified for underlying coverages, and must cover those
insured in the underlying policies.
■ This requirement may alternatively be satisfied through Contractor's primary Commercial
General and Automobile Liability coverage, or any combination thereof.
■ The policy must be endorsed to include the County and its officials, employees and agents
as additional insureds.
• Coverage shall be "pay on behalf", with defense costs payable in addition to policy limits.
■ There shall be no cross liability exclusion precluding coverage for claims or suits by one
insured against another.
® Workers' Compensation & Employees Liability
• Contractor shall provide Workers Compensation and Employer's Liability insurance on a
state -approved policy form providing benefits as required by law with employer's liability
limits no less than $1,000,000 per accident or disease.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 5 of 20
❑ Professional Liability Errors and Omissions Liabillt
• Coverage limits not less than:
■ $1,000,000 each claim
• . Contractor must provide evidence of this coverage on a policy form appropriate to
Contractor's profession.
Contractorshall furnish to the County a Certificate of Insurance, with endorsement where required above,
as evidence that policies providing insurance required by this Agreement are in full force and effect. Contractor's
insurance policies required above must apply on a primary non-contributing basis in relation to any other
insurance or self-insurance available to the County.
Contractor agrees to provide notice to the County at least thirty (30) days prior to cancellation, or any
material alteration or non -renewal, of any of the above -required insurance coverages.
Contractor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools,
machinery, equipment, or motor vehicles owned or utilized by Contractor, or Contractor's agents, employees,
suppliers or contractors, as well as to any temporary structures, scaffolding and/or protective fences.
Contractor shall have sole responsibility for ensuring the insurance coverage and limits required herein
are also obtained by any subcontractors.
NOTE: Notwithstanding any other provision(s) of this Agreement, no contract shall form under this Agreement
until and unless the following are provided to the County: (1) a copy of the Certificate(s) of Insurance with all
required endorsements, properly completed and in the amounts required, and (2) where requested bythe County,
a copy of the required insurance policies, including all required endorsements.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 6 of 20
ATTACHMENT "D"
GENERAL TERMS AND CONDITIONS
1. Scope of Contractor's Services: Contractor agrees to provide to the County services as set forth in
Attachment "A". No materials, labor, or facilities will be furnished by the County, unless otherwise provided
herein. All work performed under this Agreement shall comply with applicable laws and regulations.
2. Accounting and Payment: Compensation to Contractor for services rendered under this Agreement
shall be as set forth in Attachment "B". Where Attachment "B" requires payment(s) by the County, payment shall
be based upon billings, supported unless provided otherwise in Attachment "B", by documentation of units of
work actually performed and amounts earned, including, where appropriate, the total number of hours for the
month and the total dollar payment requested. Unless specifically stated in Attachment "B", the County will not
reimburse Contractor for any costs or expenses incurred by Contractor in performance of this Agreement. Where
required, the County shall, upon receipt of appropriate documentation, compensate Contractor, no more often
than monthly, through the County voucher system, for Contractor's services pursuant to the fee schedule set forth
in Attachment "B". In the event Contractor fails to perform any of its obligations under this Agreement within the
time specified herein, then the County may withhold all monies due and payable to Contractor until such failure
to perform is cured or otherwise adjudicated. The County will not process payment for services rendered under
this Agreement until Contractor submits a completed W-9 (See Attachment "E").
3. Taxes: Contractor understands and acknowledges that the County will not withhold Federal or State
income taxes from payments made to Contractor. Where required by State or Federal law, Contractor authorizes
the County to make withholding for any taxes other than income taxes (e.g., Medicare). All compensation received
by Contractor will be reported to the Internal Revenue Service at the end of the calendar year in accordance with
applicable IRS regulations. It is the responsibility of Contractor to make its necessary estimated tax payments
throughout the year, if any, and Contractor is solely liable for any tax obligation arising from Contractor's
performance of this Agreement.
The County will pay sales and use taxes imposed on goods or services acquired hereunder as required by
law. Contractor must pay all other taxes, including but not limited to: business and occupation tax; or taxes based
on (1) Contractor's gross or net income, or (2) personal property to which the County does not hold title. The
County is exempt from federal excise tax.
4. Independent Contractor: Contractor's services shall be furnished by Contractor as an independent
contractor, and nothing stated herein shall be construed to create a relationship of employer -employee or a
guarantee of future employment. Contractor acknowledges that its entire compensation under this Agreement
is specified in Attachment "B", and that Contractor is not entitled to any County benefits, including but not limited
to: vacation pay, holiday pay, sick leave pay, medical, dental, or other insurance benefits, or any other rights or
privileges afforded to Kittitas County employees.
5. Assignment and Subcontracting: and Subcontracting: No portion of this Agreement may be assigned
or subcontracted to any other individual, firm or entity without the express and prior written approval of the
County. The Contractor may only subcontract work contemplated under this agreement if it obtains the prior
written approval of the County. If the County approves subcontracting, the Contractor shall maintain written
procedures related to subcontracting, as well as copies of all subcontracts and records related to subcontracts.
For cause, the County in writing may require the Contractorto amend its subcontracting procedures as they relate
to this agreement, prohibit the Contractor from subcontracting with a particular person or entity, or require the
Contractor to rescind or amend a subcontract. Every subcontract shall bind the Subcontractor to follow all
applicable terms of this agreement. The Contractor is responsible to the County if the Subcontractor fails to
Kittitas County Agreement for Services (rev. 5/14/25)
Page 7 of 20
comply with any applicable term or condition of this agreement. The Contractor shall appropriately monitor the
activities of the Subcontractor to assure fiscal conditions of this agreement. In no event shall the existence of a
subcontract operate to release or reduce the liability of the Contractor to the County for any breach in the
performance of the Subcontractor's duties.
Every subcontract shall include a term that County is not liable for claims or damages arising from a
Subcontractor's performance of the subcontract.
6. Right to Review; Maintenance of Records: This Agreement is subject to review by any Federal or State
auditor. The County or its designee shall have the right to review and monitor the financial and service
components of the work performed under this Agreement by whatever means are deemed expedient by the
County. Such review may occur with or without notice, and may include, without limitation, on -site inspection,
inspection of all records or other materials which the County deems pertinent, and any and all communications
with or evaluation by service recipients underthis Agreement. Contractor shall preserve and maintain all records
relating to this Agreement for six (6) years after termination or expiration of the Agreement, and upon request
shall make them available for review by any Federal or State auditor, the County, and/or any persons authorized
by the County.
7. Modification
7.1. This Agreement may be amended by mutual agreement of the parties. Any such amendment
shall be in writing and signed by both parties.
7.2 The County may unilaterally amend this Agreement at any time by written notice ("Change
Notice") to Contractor, to modify the work to be performed under this Agreement, within the general scope of
the Agreement. Such changes may include, but are not limited to, changes in the exact scope of work to be
performed (including modification, substitution, addition, or deletion of required tasks) and changes to the
schedule of performance. If any such Change Notice causes an increase or decrease to Contractor's cost of, or the
time required for, performance of the work, an equitable adjustment in the compensation to Contractor and/or
in the schedule for the performance of the work shall be made by the County to reflect such an increase or
decrease. Notwithstanding any dispute or delay in arriving at a mutually acceptable equitable adjustment,
Contractor shall proceed in accordance with all Change Notices. Within thirty (30) days after receipt of any Change
Notice which, in Contractor's opinion, lacks an adequate adjustment, Contractor must submit to the County a
written statement requesting a modified adjustment; otherwise, Contractor will forfeit its right to any such
modified adjustment. The County retains the final right to determine adjustments hereunder.
8. Termination
8.1 This Agreement may be terminated at any time by mutual written agreement of the parties.
8.2 The County, by giving written notice, may terminate this Agreement at any time without cause
and without further obligation to Contractor except for payment due for deliverables provided and/or services
performed prior to the effective date of termination. An equitable adjustment in the contracted price for partially
completed tasks will be made by the County, but such adjustment shall not include compensation for loss of
anticipated profit on uncompleted work.
8.3 If Contractor defaults by failing to perform any of its obligations under this Agreement, or
becomes insolvent, is declared bankrupt or commits any act of bankruptcy or insolvency, or makes an assignment
for the benefit of creditors, the County may, by written notice to Contractor, terminate the Agreement, and at
the County's option, obtain performance of the work elsewhere. If the Agreement is terminated under this
paragraph, Contractor shall not be entitled to receive any further payments under this Agreement until all of its
obligations hereunder have been fully performed, and any extra cost or damage to the County shall be deducted
Kittitas County Agreement for Services (rev. 5/14/25)
Page 8 of 20
from any money due or coming due to Contractor. Furthermore, in the event of termination under this paragraph,
Contractor shall bear the costs of any extra expenses incurred by the County in completing the work, and all
damages sustained, or which may be sustained, by the County.
8.4 Termination of this Agreement by any means provided herein shall not excuse any party's
performance of its obligations hereunder through the effective date of termination, except that the County shall
not be obligated to pay for services that have not been performed or deliverables that have not been provided.
9. Indemnification
9.1 To the fullest extent permitted by law, Contractor agrees to indemnify, defend and hold the
County and its departments, elected and appointed officials, employees, agents and volunteers, harmless from
and against any and all claims, damages, losses and expenses, including but not limited to court costs, attorney's
fees and alternative dispute resolution costs, for any personal or bodily injury, sickness, disease or death, for any
damage to or destruction of any property (including the loss of use resulting therefrom), and for any other claims,
damages, losses, and expenses sustained by the County, which (1) are caused in whole or in part by any act or
omission, negligent or otherwise, of Contractor, its employees, agents or volunteers, or Contractor's
subcontractors, their employees, agents or volunteers; or (2) are directly or indirectly arising out of, resulting
from, or otherwise connected with the performance of this Agreement; or (3) are based upon Contractor's or its
subcontractors' use of, presence upon or proximity to the property of the County. This indemnification obligation
of Contractor shall not apply in the limited circumstance where the claim, damage, loss or expense is caused by
the sole negligence of the County. This indemnification obligation of Contractor shall not be limited in any way by
the Washington State Industrial Insurance Act, RCW Title 51, or by application of any other workmen's
compensation act, disability benefit act or other employee benefit act, and Contractor hereby expressly waives
any immunity afforded by such acts. The foregoing indemnification obligations of Contractor are a material
inducement to the County to enter into this Agreement, are reflected in Contractor's compensation, and have
been mutually negotiated by the parties.
9.2 The County reserves the right, but not the obligation, to participate in the defense of any claim
for damages, losses or expenses, and such participation shall not constitute a waiver of Contractor's indemnity
obligations contained in any section of this Agreement.
9.3 In the event Contractor enters into subcontracts to the extent allowed under this Agreement,
each such subcontractor shall indemnify the County on a basis equal to or exceeding Contractor's indemnity
obligations to the County.
10. Venue and Choice of Law: In the event that any litigation should arise concerning this Agreement,
the venue for such action shall be in the Superior Court of the State of Washington in and for the County of Kittitas.
This Agreement shall be governed by the laws of the State of Washington.
11. Non -Appropriation of Funds: if the County does not appropriate sufficient funding for this Agreement
for any future fiscal period, the County will not be obligated to make payments for services performed after the
end of the last fiscal period for which sufficient funding was appropriated. No penalty or expense shall accrue to
the County in the event this provision applies.
12. Contractor Commitments Warranties and Representations: Contractor represents and warrants as
follows:
Kittitas County Agreement for Services (rev. 5/14/25)
Page 9 of 20
12.1 Contractor is duly incorporated, validly existing and in good standing under the laws of the State
of Washington, and has all requisite corporate power and authority to enter into and to perform its obligations
under this Agreement.
12.2 Contractor has the authority to execute this Agreement, to make the representations and
warranties set forth herein, and to perform its obligations hereunder.
12.3 This Agreement has been validly executed by an authorized representative of Contractor and
constitutes a valid and legally binding and enforceable obligation of Contractor.
12.4 Contractor holds, or will obtain prior to commencing work under this Agreement, such licenses,
permits and other authorizations from federal, state and local governmental authorities, or from any applicable
industrial or professional certification or licensing bodies, as are necessary for the lawful performance of its
obligations under this Agreement, and will maintain such throughout the term of this Agreement.
12.5 Contractor 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. Contractor
is not subject to any order or judgment of any court, tribunal or governmental agency which materially and
adversely affects its operations or assets in the State of Washington, or its ability to perform its obligations under
this Agreement.
12.6 Contractor is not presently debarred, suspended, proposed for debarment, declared ineligible or
voluntarily excluded from covered transactions by any Federal or State department or agency.
12.7 None of the representations or warranties in this Agreement, and none of the documents,
statements, certificates or schedules furnished by Contractor in connection with the performance of the
obligations contemplated under this Agreement, contains or will contain any untrue statement of a material fact
or omits or will omit a material fact necessary to make the statements of fact contained therein not misleading.
13. Ownership of Items Produced: All writings, programs, data, reports, films, recordings, or other
materials prepared by Contractor and/or its consultants or subcontractors, in connection with the performance
of this Agreement, shall be the sole and absolute property of the County. The County will have all rights of
ownership therein, including but not limited to the right to use, copyright, trademark, and/or patent, and the
ability to transfer any or all ownership rights.
14. Intellectual Property Infringement: Contractor will defend and indemnify the County from any
claimed action, cause or demand brought against the County, to the extent such action is based on the claim that
information and/or materials supplied by Contractor infringe any intellectual property rights of any third
party(ies). Contractor will pay all costs and damages attributable to any such claims finally awarded against the
County in any action. Such defense and payments are conditioned upon the following: (1) Contractor shall be
notified promptly in writing by the County of any notice of such claim; and (2) Contractor shall have the right
hereunder, at its option and expense, to obtain for the County the right to continue using the information and/or
materials that are the subject of such claim, provided no reduction in performance or loss results to the County.
15. Use of County Name and Logo: Contractor may not use the County's name, logo(s), trademark(s), or
other identifying information, or identify the County as a current or former client, on its website or in any
marketing or promotional materials without the prior written consent of the County.
16. Disputes: Any dispute between the parties arising under or relating to this Agreement shall be
resolved informally if possible. However, in the event such a dispute cannot be so resolved, it shall be adjudicated
Kittitas County Agreement for Services (rev. 5/14/25)
Page 10 of 20
by a dispute board ("Dispute Board") in the following manner: Each party shall appoint one member to the Dispute
Board, the members so appointed shall jointly appoint an additional member to the Dispute Board, and the
Dispute Board will evaluate the facts, Agreement terms, and all applicable statutes and rules, and make a
determination as to the proper resolution of the dispute. Such determination shall be final and binding on both
parties. The cost of resolution will be borne as allocated by the Dispute Board. Alternatively, if agreed to in writing
by both parties, the parties may forego the option of establishing a Dispute Board to adjudicate the dispute, and
instead pursue arbitration, jointly selecting an arbitrator acceptable to both parties. In the event the parties
choose to pursue arbitration, the parties agree that: (1) the fees and expenses of the arbitrator shall be shared
equally by both parties to this Agreement, (2) each party shall bear its own costs and attorney fees, (3) arbitration
shall be conducted according to the commercial arbitration procedures of the American Arbitration Association,
and (4) the arbitrator's decision or award shall be final and binding on both parties.
17. Confidentiality: Contractor, its employees, agents and volunteers, and any of Contractor's
subcontractors and their employees, agents and volunteers, shall maintain the confidentiality of all information
provided by the County or acquired by Contractor in performance of this Agreement, except upon the prior
written consent of the Kittitas County Prosecuting Attorney or an order entered by a court after having acquired
jurisdiction over the County. Contractor shall immediately provide the County notice of any judicial proceedings
seeking disclosure of such information. Contractor agrees to indemnify, defend and hold harmless the County
and its departments, elected and appointed officials, employees, agents and volunteers from all loss or expense,
including but not limited to settlements, judgments, setoffs, attorneys' fees and costs resulting from Contractor's
breach of this provision. Notwithstanding the foregoing, and to the extent that any information obtained by the
Contractor hereunder is required to be shared with others by the explicit terms of the Scope of Work, this
provision shall not be construed as prohibiting such sharing, provided there are no applicable laws or regulations
prohibiting same.
18. Notices: Written notices required or permitted to be provided by one party to the other party under
this Agreement may be provided by personal delivery, legal courier service, or certified mail, postage prepaid and
return receipt requested. Notice may be provided by regular first class mail if simultaneous notice is provided by
email. Notices given by Contractor shall be provided to the County's point of contact listed on page 1 of this
Agreement, at the address there listed, and to the department head of the county department for which services
under this Agreement are rendered. Notices given by the County shall be provided to Contractor at Contractor's
address listed on page 1 of this Agreement.
19. Prevailing Wage: Where labor to be performed under this Agreement is considered "public work" as
defined in RCW 39.04.010, Contractor shall pay the prevailing rate of wages to all workers, laborers, or mechanics
employed in the performance of work under this Agreement in accordance with RCW 39.12 and the rules and
regulations of the Washington State Department of Labor and Industries. The schedule of prevailing wage rates
for the applicable locality or localities is determined by the Industrial Statistician of the Department of Labor and
Industries. It is Contractor's responsibility to verify the applicable prevailing wage rate. It is understood that
Contractor is responsible for obtaining and completing all required government forms relating to prevailing wage
and submitting same to the proper authorities. Disputes regarding prevailing wage rates shall be referred for
arbitration to the Director of the Department of Labor and Industries. The arbitration decision shall be final and
conclusive and binding on all parties involved in the dispute as provided for in RCW 39.12.060.
20. Standard of Care: Contractor shall perform its duties hereunder in a manner consistent with that
degree of care and skill ordinarily exercised by members of the same profession or industry as Contractor currently
practicing or working under similar circumstances. Contractor shall, without additional compensation, correct any
of its services not meeting such a standard.
21. Nondiscrimination
Kittitas County Agreement for Services (rev. 5/14/25)
Page 11 of 20
21.1 In the performance of this Agreement, Contractor will not discriminate against any employee or
applicant for employment on the grounds of age, race, creed, color, national origin, citizenship or immigration
status, sex, sexual orientation, marital status, honorably discharged veteran or military status, or the presence of
any sensory, mental or physical disability or the use of a trained dog guide or service animal by a person with a
disability; provided that the prohibition against discrimination because of such disability shall not apply if the
particular disability prevents the proper performance of the particular worker involved. Contractor shall ensure
that applicants are employed, and that employees are treated during employment, without discrimination
because of their age, race, creed, color, national origin, citizenship or immigration status, sex, sexual orientation,
marital status, honorably discharged veteran or military status, orthe presence of any sensory, mental or physical
disability or the use of a trained dog guide or service animal by a person with a disability. Such requirements
apply, without limitation, to the following: employment, promotion, demotion, transfer, recruitment or
recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and programs for
training, including apprenticeships. Contractor shall take such action with respect to this Agreement as may be
required to ensure full compliance with local, state and federal laws prohibiting discrimination in employment.
21.2 Contractor will not discriminate against any recipient of any services or benefits provided for
under this Agreement on the grounds of age, race, creed, color, national origin, citizenship or immigration status,
sex, sexual orientation, marital status, honorably discharged veteran or military status, or the presence of any
sensory, mental or physical disability or the use of a trained dog guide or service animal by a person with a
disability.
21.3 If any assignment and/or subcontracting has been authorized by the County, said assignment or
subcontract shall include appropriate safeguards against discrimination.
22. Waiver: The waiver of any default or breach of this Agreement, or the failure of a party to enforce
any provision hereof or to exercise any right or privilege hereunder, shall not be deemed to waive any prior or
subsequent default or breach, the enforcement of any provision hereof, or the exercise of any right or privilege
hereunder, unless otherwise stated in a writing, signed by the parties hereto.
23. Headings: The headings of sections and paragraphs of this Agreement are for convenience of
reference only and are not intended to restrict, affect, or be of any weight in the interpretation or construction of
the provisions of such sections or paragraphs.
24. Survival: The provisions of paragraphs 2, 3, 4, 6, 8, 9, 10, 13, 14, 15, 16, 17, 19, 20, 22, 24, and 28 of
these General Terms and Conditions shall survive the completion, expiration, termination or cancellation of this
Agreement for any reason.
25. Complete Agreement: This Agreement constitutes the entire agreement between the parties and
supersedes any and all other agreements, understandings, negotiations and discussions, oral or written, express
or implied, regarding the work to be performed hereunder. The parties agree that no other representations,
inducements, promises, agreements, or warranties relating to this Agreement, oral or otherwise, have been made
between the parties. Except as provided elsewhere in this Agreement, no modification or waiver of this
Agreement shall be valid or binding unless in writing and signed by the parties.
26. Severahility: If 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 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 to be severable.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 12 of 20
27. Time: Time is of the essence in the performance of this Agreement unless otherwise agreed between
the parties in a signed writing.
28. Construction: This Agreement has been mutually reviewed and negotiated by the parties, and should
not be construed against the drafter.
29. Agreement Not for Benefit of Third Parties: This Agreement is entered into solely for the benefit of
the parties hereto and vests no rights in, nor is it enforceable by, any third parties.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 13 of 20
ATTACHMENT "E"
Form W-9 Request for Taxpayer Give form to the
(Rev March 2024) Identification Number and Certification requester. Do not
Department Revenue Service of the Treasury Go to wimmirs.govfFormW9 for instructions and the latest information. Send to the IRS.
IntoRov
Before you begin. For guidance related to the pl qxM of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's rame on line 1, and enter :he business/disregarded
entity's name on line 2.)
2 Business name/disregarced entity name, if different from above.
3a Check the appropriate oax `or federal lax classification of the enlilyiind-dual whose name is entered on line 1. Check
only one of the following seven boxes.
❑ Individual/sole proorietor ❑ C corporation ❑ S corporation ❑ Partnershio ❑ Trust/estato
❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
Note: Check the "LLC" box above and, in the entry 5p,1CO, enter the appropriate code (C, S, or P) for the nut
classlllcation of the LLC, unless it is a disregarded artily. A disregaded artily should insload chock the fiWoprlato
box for the tax classification of its owner.
❑ Other (sae instructions)
31b If on line 3a you checked "Partnership" or'Trust✓estate," or checked "LLC" and entered "P- as its tax classification,
and you are providing Iris form to a partnership, trust, or estate in which you have an ownership interest, check
Ihls box it you have any foreign partners, owners, or beneficianes. See inslrucilons . . .
Address (number, street, and apt, or suite no.). See Instructions,
6 City, state, and ZIP code
7 L at account numbers) here (optional)
Number
4 Exemptions (codes apply only to
certain entries, not individuals.
see instructions on page 3):
Exempt payee code (if any)
Exemption from Foreign Account Tax
Compliance Act TATCA) reporting
code (if any)
(Applies to accounts maintained
outside the United States.)
Requester's name and address (opliona!)
Enter your TIN in the appropriate box. The TIN poolrlded must match the name given on line 1 to avoid JSoclat security number
backup withholding. For indivfduabs .this is generally your social security number (SSN). However, fora — m -
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or
TIN, later.
Employer Identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to Ire); and
2. 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Intemal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S, person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting ;s correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (.IRA), and, generally, payments
other than interest and dividends, you are not requirud to sign the certification, butyou must provide your correct TIN. See the instructions for Part 11, later.
Sign signature of
Here I U.S. person Date
General Instructions
Section references are to the Illtemal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9,
What's New
Line 3a has been Inodi ied to clarity how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
appropriate box for the tax classification of its owner. Othenvise, it
should check the "LLC" box and enter its appropriate tax classification.
New line 3b has been added to this form, A flow -through entity is
required to coinpiete this line to Indicate that it has direct or indlrecl
foreign partners, owners. or benefu:tarfes when it provides the Form W-9
to ttrmther'=low-tninl:gh entity in which d has an ownershlp interest. This
change is intended to provide a flow -through entity with information
rmyarding the status of its indirect foreign parivem. owners, or
t e .elicfanes, so that it can satisfy any applicable reporting
requirements. For example, a partnership that haS any indirect foreign
pariners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cal. No. 10231x Form W-9 (Rev. 3-2024)
Kittitas County Agreement for Services (rev. 5/14/25)
Page 14 of 20
F.— W-9 )Rev. 3-2024Y
must obtain your correct taxpayer identification numb er(TIN). which
may be your social security number PW,. individual taxpayer
identification number (IT1N). adoption taxpayer identi fi aWn number
(ATIN). or employer identification number (GIN). to report on an
information return the amount paid to you. or other amount reportable
on an information retum. Examples of information returns include, but
are not limited to. the following.
■ Form 1099-INT (interest earned or pad).
• Form 1099-DIV (dividends, including those from stocks or mutual
funds).
• Form 1099-MISC (vanous types of income. prizes. awards. or gross
proceeds).
• Form 1099-NEC Inonempfoyee compensation).
■ Form logg-B (stock or mutual lured sales and certain other
transactions by brokers).
• Forte IMS (proceeds from real estate transactions).
• Form im-K (merchant card and third -party network transactions).
• Form 1098 (home mortgage interest), 1 098-E (student loan interest),
and im-T(haitian).
• Form 1090—C (canceled dens!],
• Form 1099-A (acquisition or abandonment of secured fxaperty)•
Use Form W-9 only if you era a U.S. person (indudnng a resident
alien). to provide your correct TIN.
Caution: If you don't return Form W-9 to the requester with a TIN, you
might be subject to backup withholding. Sea What is backup
withholding. later.
By signing the filled-oul forrm 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 riot subject to backup withholding; or
3. Claim exemption from backup withholding if you are a U.S_ exempt
payee: and
A. Certify to your non -foreign status for purposes of withholding under
chapter 3 or 4 of the Code (f appticabler and
5. Certify that FATCA code(s) entered on this form (if any( indicating
that you are exempt from the FATCA reporting is correct. Sea What is
FATCA Repordng, later, for further information.
Note: If you are a U.S. person and a requester gives you a form other
than Form W-9 to request your T1N. 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:
• 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 taws of the United States.-
* An estate (other than a foreign estate): or
• A domestic trust (as defined in Regulations section 301.7701-7).
Establishing U.S. status for purposes of chapter 3 and chapter 4
withholding. payments made 10 foreign persons. including certain
distributions, allocations of income, or transfers of sales proceeds. may
be subject to vathhotding under chapter 3 or chapter 4 of the Code
(sections 1441-1474). Under those rules, if a Form W-9 or other
certification of non -foreign status has not been received. a withholding
agent, transferee, or partnership (payor) generally applies presumption
rules that may require the payor to withhold applicable lax from the
recipient, owner, transferor, or partner (payee). See Pub. 515,
Withholding of Tax on Nonresident Aliens and Foreign Entities.
The following persons must provide Form W-9 to the payor for
purposesof establishing its non -foreign status.
• In the case of a disregarded entity with a U.S. owner, the U.S. owner
of the disregarded entity and not the disregarded entity.
• In 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 of the grantor trust and
riot the grantor trust.
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust
and not the beneficiaries of the trust
see Pub. 5 15 for more information on providdirng a Form W-9 or a
certification of non -fans gn status to avoid withholding.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 15 of 20
Page 2
Foreign person. If you are a foreign person or the U.S. branch of a
foreign bank that has elected to be treated as a U.S. person (under
Regulations section 1.14-41-1(b)(2) iv) or other applicable section for
chapter 3 or 4 purposesl, do not use Form W-9. Instead. use the
appropriate Form W-8 or Form 8233 (see Pub. 515). If you are a
qualified foreign pension fund under Regulatw* section 1,897(1}4(d), or
a partnership that is wholly owned by qualified foreign pension funds.
that is treated as a non -foreign person for purposes of section 1445
withholding, do not use Form W-9. Instead. use Forte W-8EXP (or other
certification of non -foreign status).
Nonresident alien who becomes a resident alien. Gennerally. only a
nonresident alien individual may use the tenets of a tax treaty to reduce
or eliminate U.S. tax on certain types of income. However. most tax
treaties contain a provision known as a saving clause. Exceptions
specified in the saving clause may permit an exemption from tax to
continue for certain types of income even after the payee has otherwise
become a U.S_ resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an exemption
from U.S. tax on d:ertain types of income, you must attach a statement
to Form W-9 that specifies the following five items.
1. The treaty country. Generally, this must be the same treaty under
which you claimed exemption from tax as a nonresident alien_
2. The treaty article addressing the income.
3. The article number for location) in the tax treaty that contains the
saving clause, and Its exceptions,
4. The type and amount of income that qualifies for the, exemption
from lax.
5. Sufficient facts to justify the exemption from tax under the terms of
the treaty article.
Example. Article 20 of the U. s.-China income tax treaty allows an
exemption from lax for scholarship income received by a Chinese
student temporarily present in the United Slates. Under U-S. law, this
student writ1 become a resident alien for tax purposes if their stay in the
United Slates exceeds 5 caler dar years. However. paragraph 2 of the
first Protocol 10 the U.S.-China treaty (dated Aptil 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 ctaun an exemption from tax
can their scholarship or fellowship income would attach to Form W9 a
statement that includes the information described above to support that
exemption.
if you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 a Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you
must under certain conditions withhold and pay to the IRS 24% of such
payments. This is called "backup withholding.* Payments that may be
subject to backup withholding include, but are not limited to, interest,
tax-exempt interest dividends, broker and barter exchange
transactions, rents, royalties. nonemployee pay. payments made in
settlement of payment card and third -parry network transactions, and
certain payments from fishing boat operators. Real estate transactions
are not subject to backup wilhholdir+g.
You will not be subject to backup withholding on Payments you receive
if you give the requester your correct TIN, make the proper certifications,
and report all your taxable interest and dividends on your tax return.
Payments you receive wiff be subject to backup wil hholdi ng if;
1. You do not furnish your TIN to file requester,
2. You do not certify your TiN vrhen required (see the instructions for
Pant I I for details):
3. The IRS tells the requester that you furnished an incorrect TIN:
s. 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 certify to the requester that you are not subject to
backup withholding, as described in item 4 under "By sigmV Me frli'ed-
out form" above (for reportable interest and dividend accounts opened
after 1803 only).
Form W-9 (Rev. 3-2024)
Cerlamn payees and payments are exempt from backup withholding.
See Exempt payee code, later, and the separate Instructions for the
Requester of Form W-9 for more information.
See also Establishing U S. status for purposes of chapter 3 and
chapterd wrlhhofding, earfier.
What Is FATCA Reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a
participating foreign financial institution to report all U.S, account
holders that are specified U.S. persons. Certain payees are exempt from
FATCA reporting. See Exemption from FATCA reporting code, later, and
the Instructions for the Requester of Form W-9 for more information.
Updating Your Information
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 ant eipate receiving reportable payments in the future from this
person. For example, you may need to provide updated information if
you are a C corporation that elects to be an S corporation. or if you are
no longer tax exempt In addition, you must famish a new Form W-9 if
the name or TIN changes for the account, for example, if the grantor of a
grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to fumish your correct TIN to a
requester, you are subject to a penalty of 550 for each such failure
unless your failure is due to reasonable cause and not to wilft neglect.
Civil penalty for false information with respect to withh old ing. If you
make a false statement with no reasonable basis that results in no
backup withholding, you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subject you to criminal penalties
including fines and/or imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Specific Instructions
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.
If this Form W-9 is for a joint account (other than an account
maintained by a foreign financial institution (FFO), list first, and then
circle, the name of the person or entity whose number you entered in
Part i of Form W-9. If you are providing Form W-9 to an F F I to document
a joint account, each holder of the account that is a U.S. person most
provide a Form W-9.
• Individual. Generally, enter the name shown on your tax return. If you
have changed your last name without informing the Social Security
Administration ISSA) of the name change, enter your first name, the last
name as shown on your social security card, and your new fast name.
Note for ITIN applicant: Ester your individual name as it was entered
on your Form W-7 application, line 1 a. This should also be the same as
the name you entered on the Farm 1040 you filed with your application.
• sole proprietor. Enter your individual name as shown on your Form
10.10 on line 1. Enter your business, trade, or -doing business as' NSA)
name on line 2.
• partnerships, C corporation. S corporation, or LLC, other than a
disregarded entity. Enter the entity's name as shown on the entity's tax
return on line 1 and any business, trade. or ❑SA name on line 2.
• Other entities. Enter your name as shown on required U.S. federal tax
documents on line 1. This name should match the name shown on the
charter or other legal document creating the entity. Enter any business,
trade, or DBA name on line 2.
• Disregarded entity. In general, a business entity that has a single
owner, including an LLC, and is not a corporation, is disregarded as an
entity separate from its owner (a disregarded entity). see Regulations
section 301.7701-2(c)(2). A disregarded entity should check the
appropriate box for the tax classification of its owner. Enter the owne is
name on line 1. The name of the owner entered on line 1 should never
be a disregarded entity. The name on tine t should be the name shown
on the income tax return on which the income should be reported. For
Kittitas County Agreement for Services (rev. 5/14/25)
Page 16 of 20
Page 3
exanrpfe, if a Foreign LLC that is treated as a disregarded entity for U.S.
federal 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. If the direct owner of
the entity is also a disregarded entity, enter five first owner that is not
disregarded for federal tax purpows. Enter the disregarded entity s
name on kne 2. If the owner of the disregarded entity is a foreign person.
the owner must complete an appropriate Fan W-8 instead of a Form
W-9. This is the case even if the foreign person has a U.S. TIN.
Line 2
If you have a business name, trade name, DBA name, or disregarded
entity name, enter it on line 2.
Line 3a
Check the appropriate box on line 3a for the U.S. federal tax
classification of the person whose name is entered on line 1. Check only
one box on line 3a.
IF the entityfindividual on lime 1
THEN check the box for.
is a(n) ...
• Corporation
Corporation.
• Individual or
Individual/sole proprietor.
• Sole proprietorship
• LLC classified as a partnership
Limited liability company and
for U.S. federal tax purposes or
enter the appropriate tax
• LLC that has filed Form M2 or
classification:
2553 electing to be taxed as a
P = Partnership,
corporation
C = C corporation, or
S = S corporation.
• Partnership
Partnership.
• Trust estate
T ustfestate.
Line 3b
Check this box if you are a partnership (including an LLC classified as a
partnership for U.S_ federal tax purposes), ttust. or estate that has any
foreign partners, owners. or beneficiaries, and you are providing this
form to a partnership. trust. or estate, in which you have an ownership
interest You must check the box on fine 3b if you receive a Form W-6
(or documentary evidence) from any partner. owner, or beneficiary
eslabiishi g foreign status or if you receive a Form W-9 from any
partner, owner, or beneficiary that has checked the box on line 3b.
Note: A partnership lftat provides a Form W-9 and cheeps box 3b may
be required to complete Schedules K-2 and K-3 {Form 1065). For more
information, see the Partnership Instructions for SchoWes K-2 and K-3
(Form 1065).
If you are required to complete line 3b butt fag to do so, you may not
reriumve the information necessary to file a correct information return with
the IRS or furnish a correct payee statement to your partners or
beneficiaries. See, for example, sections 6698, 6722, and 6724 for
penalties that may apply.
Line 4 Exemptions
If you are exempt from backup willhhol Ong and/or FATCA reporting,
outer in time appropriate spar:K r,1n line 4 arty (;vde(s) Hsat rimy apply to
you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from
backup withholding.
• Except as provided betow. corporations are exempt from backup
withholding for certain payments. krclud'tng interest and dividends—
. Corporations are not exempt from backup withholding for payments
made in settlement of payment card or third -party network tmrtsacWns.
• Corporations are not exempt from backup withholding with respect to
attorneys' fee_ or gross proceeds paid to attorneys, and corporations
Ihat provide medical or healffr carts services are not exempt with respect
to payments reportable on Form 1099-MISC.
The following codes identify payees that are exempt from backup
withholding. Enter the appropriate code in the space on line 4.
1—An organization exempt from tax under section 501(a). any IRA, or
a custodial account under section 403(bX71 if the account satisfies the
requirements of section 401(f (2).
Form W-9 (Rev. 3-2024)
2—The United States or any of its agencies or instrumentalities.
3—A state, the District of Columbia, a U.S. commonwealth or territory,
or any of their political subdivisions or instrumentalities.
4—A foreign government or any of its political subdivisions, agencies,
or instrumentalities.
5—A corporation.
6—A dealer in securities or commodities required to register in the
United States, the District of Columbia, or a U.S. commonwealth or
territory.
7—A futures commission merchant registered with the Commodity
Futures Trading Commission.
8—A real estate investment trust.
9—An entity registered at all times during the tax year under the
Investment Company Art of 1940,
10—A common trust fund operated by a bank under section 584(a).
11—A financial institution as defined under section 581.
12—A middleman known in the investment community as a nominee or
custodian.
13—A trust exempt from tax under section 664 or described in section
4947.
The following chart shows types of payments that may be exempt
from backup withholding. The chart applies to the exempt payees listed
above, 1 through 13.
IF the payment is for ...
THEN the payment is exempt
for...
• Interest and dividend payments
All exempt payees except
for 7.
• Broker transactions
Exempt payees 1 through 4 and 6
through 11 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.
• Barterexchange transactions
Exempt payees 1 through 4.
and patronage dividends
• Payments over $600 required to
Generally, exempt payees
be reported and direct sales over
1 through 5.2
$5,000'
• Payments made in settlement of
Exempt payees 1 through 4.
payment card or third -party
network transactions
'See Form 1099-MISC, Miscellaneous Information, and its instructions.
7 However, the following paymerrts made to a corporation and
reportable on Form 1099-MW are not exempt from 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 autside
of the United States by certain foreign financial institutions. Therefore, if
you are only submitting this farm for an account you hold in the United
States, you may leave this field blank. Consult with the person
requesting this form H you are uncertain if the financial institution is
subject to these requirements. A requester may irdrrate that a code is
not required by providing you with a Form W-9 with "Not Applicable" (or
any similar indication) entered on the line for a FATCA exemption code.
A — Anorganization exempt from tax under section 501(a) or any
individual retirement plan as defined in section 7701OX37).
B—The United States or any of its agencies or instrumentalities.
C—A state, the District of Columbia, a U.S. commonwealth or
territory, or any of their political subdivisions or instrumentalities.
D—A corporation the stools of which is regularly traded on one ar
more established securities markets, as described in Regulations
section 1. 1472-1 (c)(1)(i).
E—A corporation that is a member of the same expanded affitialed
group as a corporation described in Regulations section 1.1472-1(cK1xi).
Kittitas County Agreement for Services (rev. 5/14/25)
Page 17 of 20
Page 4
F—A dealer in securities, commodities. or derivative financial
instruments (including notional principal contracts. futures, forwards,
and options),hat 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 investment
Company Act of 1940.
1—A common trust fund as defined in section 584(a).
J—A bank as defined in section 581.
K—A broker.
L—Atrust exempt from tax under section 664 or described in section
4947(a)(1).
M—A tax-exempt trust under a section 4M(b) plan or section 457(g)
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 numbed.
This is where the requester of this Form W-9 will mail your information
raturns, If this address differs from the one the requester already has on
file, enter 'NEW' at the top. If 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 I. Taxpayer Identification Number (TIN)
Fitter your TIN in the appropriate box. If you are a resident alien and
you do not have, and are not eligible to get, an SSN. your TIN is your
IRS ITIN. Enter it in the entry space for the Social security number. It you
do not have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an FIN, you may enter either
your SSN or EIN.
If you are a single -member LLC itlal is disregarded as an entity
separate from its owner. enter the owner's SSN (or EiN, 0 the owner has
one). If the LLC is classified as a corporation or partnership, enter the
entity's EIN.
Note: See What Name and Number To Give fire Requester. later, for
further clarification of name and TIN combinations.
Now to get a TIN. if you do not have a TIN, apply for one immediately.
To apply for an SSN, get Farm SS-5. Application for a Social Security
Card, from your local SSA office or get this farm online at
www.SSAgov_ You may also get this form by calling 800-772-1213. Use
Form W-7, Application for IRS Individual Taxpayer Identification
Number, to apply for an RIN, or Form SS-1. Application for Employer
Identification Number, to apply far an EIN. You can apply for an EIN
online by accessing the IRS wabsite at www.irs.90VON. Go to
www.irs_gov1F6rms to view, download. or print Form W-7 andfor Farm
SS-4. Cr. yuu con gu to to plater xu wdtts and
have Form W-7 andler Form SS-4 mailed to you within 15 business
days.
If you are asked to complete Form W-9 but do not have a TIN, apply
for a T)K and enter "Applied Far' in the space for the TIN, sign and date
the form, and give it to the requester. For interest and dividend
payments, and certain payments made with respect to readily tradable
instruments, you will generaily have 60 days to get a TIN and give it to
the requester before you are subject to backup withhdding on
payms+nis. The 60-day rule does not apply to other types of payments.
You will be subject to backup withholding an 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. See also EstabfisWng Ut S.
stars forpurposes of chaptev 3 and chapter-! withholding, earlier, for
when you may instead be subject to withholdng under chapter 3 or 4 of
the Code.
Caution: A disregarded U.S. entity that has a foreign owner must use
the appropriate Form W-8.
Form W-9 (Rev. 3-2024)
Part II. Certification
To establish W 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, of 5 below indicates otherwise.
For a joint account, only the person whose TIN is shown to Part I
should sign (when required), In the cage of a disregarded entity. the
person identified on line 1 must sign. Fxempt payees, see Fxempf payee
code, earlier.
Signature requirements. Complete the cerification as indicated in
items 1 through 5 below.
1. Interest, dividend, and barter exchange accounts opened
before 1994 and broker accounts considered active during 1983.
You must give your correct TIN, but you do not have to sign the
certification.
2. Interest, dividend, broker, and barter exchange accounts
opened after t983 and broker accounts considered inactive during
1983. You must sign the certification or backup withholding will apply. If
you are subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2 in the
certification before signing the form.
3. Real estate transactions. You must sign the certification. You may
cross out item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not
have to sign the certification unless you have been notified that you
have previously given an incorrect TfN. "Other payments" include
payments made in the course of the requesters trade or business for
rents, royalties, goods (other than bilts for merchandise). medical and
health care services [ncluding 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 property, cancellation of debt, qualified tuition program
payments (under section 5291, ABLE accounts (under section 529A),
IRA. Cove rdelI ESA, Archer MSA or NSA contributions or
distributions, and pension distributions. You must give your correct
TIN, but you do not have to sign the certification_
What Name and Number To Give the Requester
For this type of account:
Give name and SSN of:
1. individual
The individual
2. Two or mare individuals (joint aceo untl
The actual owner of the account or.
other than an aepwnt maintained by
if combined funds, the first individual
an FFI
on the account'
3. Two of more U.S. persons
Each holder of the account
(joins account maintained by an FF1)
4. Custodial account of a meter
The minor2
g,lnitorm GM to Minors Act
5. A. The usual revocable ravings lrus!
The grantor -trustee-,
(grantor is also trustee)
b. So-called trust account that to not
The actual owner'
a begat or ward trust under state law
F. Sate proprietorship or disregarded
The owner'
entity owned by an individual
7. Grantor trust filing under Optional
The grantor
Firing Method 1 (sea Aegulatiom5
section 1.671-4(b)l2)(1(A))"
Kittitas County Agreement for Services (rev. 5/14/25)
Page 18 of 20
Page 5
For this type of account:
Give name and EIN of_
a. Disregarded entity not neared by an
The owner
individual
9. A valid trust estate. or pension trust
Legal entity-1
10, Corporabon or LLC electing corporate
The corporafion
status on Form e832 or Fwm 250
11. Association. dub, mNious. rlaritable.
The efgan:mtion
ddUC9hPnal, or other tax-exempt
grown ttior!
12. Pw%wship or muitr-membar LLC
The partnership
1a. A brother or registered nominee
The broker or norninee
14. A DWM with the Department of
The public entity
Agriculture it the noun- of a public
entity (such as a state or local
government school district, or prison)
that receives ypicultural program
payments
is. Grantor trot fifing Form 1D41 or
The trust
under the Optional Filing Method 2.
requiting Form 1099 (see Regulations
section 1.8T1-4JbX2XPW)1"
List first and circle the name of the person whose number you furnish.
It only one person on a joint account has an SSN, that person's number
must be furnished,
2Circle the minor's name and famish the minor's SSN.
'You must show your individual name on line 1, and enter your business
or DBA name. it any, on line 2. You may use either your S a EIN fif
you have one), but the IRS encourages you to use your SSN.
`List first and circle the name of the Irust. estate, or pension trust. (Do
not fumish the TIN of the personal representative of trustee unless the
legal entity itself is not designated in the account tile.)
Note: The grantor must also provide a Form W-9 to the trustee of the
tmr9t.
"For mare information an optional filing methods for grantor trusts. see
the Instructions for Form 1041.
Note: If no name is circled when more than ore name is listed, the
number will be considered to be that of the first narne listed.
Secure Your Tax Records From Identity Theft
Identity theft occurs when someone uses your personal information,
such as your name, SSN. or other idea l fy rig information, without your
permission to commit fraud or other crimes. An identity thief may use
your SSN to gat a job or may fit at tax return using your SSN to receive
a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax return preparer_
If your tax records are affected by identity theft and you receive a
notice from the IRS, r3spond right away to the name and phone number
printed on the IRS notice or letter.
If your tax records are rot currently affected by identity t1hiett but you
Ihink you are at risk due I a lost or stolen purse or wallet questionable
credit card activity. or a questionable credit report. contact the IRS
Identity Theft Hog ine at Boo-908.4490 or submit Form 1 :D39.
For more information, see Pub_ 5027, Identity TYteft Information for
Taxpayers.
Farm W-9 (Rev. 3-2024)
Victims of identity theft who are experiencing economic harm or a
systemic problem. of are seeking help in resolving tax problems that
have not been resolved through normal channels. may be eligible for
Taxpayer Advocate Service (TAS) assistance. You can reach TAS by
calling the TAS toff -free case intake line at 877-777-4778 orTfY/MD
800-829-4059.
Protect yourself from suspicious emails or phishing schemes.
Phishing is the creation and use of email and wabsites 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.
The IRS does not initiate contacts with taxpayers via emails. Also, the
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers. passwords. er similar secret access
information for their credit card, bank, or other financial accounts.
If you receive an unsolicited ernd claiming to be from the IRS.
forward this message to pftishingQirs.gov. You may also report misuse
of the IRS nerve, logo, or other IRS property to the Treasury Inspector
General for Tax Administration (TIGTA) at 600-366-448d. You can
forward suspicious emails io the Federal Trade Commission at
spafrmduce.yov or report Them at www.fftc.govicompfar'nt. You can
contact the FTC at wvnv.Rc.gov/idthek or 877-1 DTHEFT (877 -438-4338).
If you have been the victim of identity theft, see www.tdantity7,hef.gov
and Pub. 5027.
Go to www.irs.goy!ldentityThaft to learn more about identity theft and
how to reduce your risk.
Kittitas County Agreement for Services (rev. 5/14/25)
Page 19 of 20
Page 6
Privacy Act Notice
Section 6109 of the IMArnal Revenue Code requires you to provide your
correct TIN to persons (nciuding federal agencies) v tmo are required to
file information returns with the IRS to report interest. dividends. or
certain other income paid to you: mortgage omerest you paid: the
acquisition or abandonment of secured property, the carwellation of
debt: or contributions you made to an IRA. Archer WSW or HSA. The
person collecting this form uses the information on the form to file
information returns with the IRS, reporting the above information.
Routine uses of this information include giving it to the Department of
Justice far civil and criminal l ligation and to cities. stales. the district of
Columbia, and U,S. commonwealths and territories for use in
administering their laws. The information may also be disclosed to other
countries under a treaty. to federal and state agencies to enforce civil
and criminal laves, or m federal law enforcemesit and intelligence
agencies to combat terrorism. You must provide your TIN whether a not
you are required to file a tax return Under section 3405, payors must
generally withhold a percentage of taxable interest. dividends. and
certain other payments to a payee who does not give a TIN to the payor.
Certain panaltles may also apply for providing false or fraudulent
information.
ATTACHMENT "F"
FEE SCHEDULE
Kittitas County Agreement for Services (rev. 5/14/25)
Page 20 of 20
%.
Wise Fee Schedule July 1, 2025 — June 30, 2026
Welcome to the Wise Fee Schedule for 2025-2026. Our goal is to provide transparent and competitive pricing to
ensure the highest quality of service for our clients. We have categorized our rates into different tiers to
accommodate various needs and project requirements. Additionally, we offer specialized services and training
programs to support professional development and customized employment certifications.
Hourly Consulting Rates for Professional Services are as follows:
Tier 1 - $140 per hour (Program Support)
Tier 2 - $165 per hour (Professional Services)
Tier 3 - $175 per hour (Directors)
Special - Individual Technical Assistance (ITA) services in WA State — $165
Specialty Offers — Fees are determined based on project requirements.
Training Programs—Trainine i Wise Nowise.o[S)
Customized Employment ACRE Certificate (WOA 100): $600
Customized Employment ACRE certification prepares students for sitting for the APSE CESP exam.
For more information and to enroll: https://www.gowise.org/training/woalOO
Customized Employment ACRE Professional Certificate (WOA 200): $1750
Customized Employment Professional Level ACRE certification attendees must have either the ACRE Basic or
Customized Employment certificate to attend. https://www.gowise.org/training/woa200/`
Expenses: Per State, Federal or International travel regulations on reimbursable basis. Mileage billed at the
current IRS rate. Hourly rates do not include travel expenses.
Special Considerations: The above rates and registration fees do not include the cost of venues, interpreters,
alternative formats for documents or other accommodation costs, the cost of supplying food, refreshments or
supplies to participants in a training or technical assistance service/event. These expenses will be negotiated and
proposed in addition to training and technical assistance rates.
Third Party Brokering Services: A 15% Brokering Fee will be charged on any third -party invoice brokered
through Wise. Brokered contracts exceeding $35,000 in a fiscal year will have a reduced Brokering Fee of 10%.
The Brokering Fee includes development of the subcontract, contract compliance monitoring, insurance, fiscal
oversight, auditing services, fiscal reporting to the contractor and IRS, Third party consultants may be brokered
within the Wise rate range per hour unless otherwise approved by the Executive Director, and/or the funder.
International Projects: Each engagement will be negotiated in accordance with this fee schedule in US dollars.
Final 6.30.2025