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HomeMy WebLinkAboutKC & County JailKITTITAS COUNTY AGREEMENT FOR SERVICES PHMH26-OO7 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 Kittitas County Jail (hereinafter "Contractor"). Thc purpose of this AgreerrrerrI is as follows: Utilize the 2026 One-Time Opioid Abatement Strategies funding to provide medication for opioid use disorder program for individuals incarcerated in Kittitas County. The term of this Agreement shall be July L, 2026, through June 30, 2027, 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 CONTRACTOR This Agreement includes the following, which are attached hereto and hereby incorporated by this reference: Kittitas County Public Health 507 N Nanum Street Ste 102 Ellensburg, WA 98926 Kasey Knutson Human Services Manager Human Services Kasey.knutson@co. kittitas.wa. us s09-962-7515 Attachment "A" Attachment "B" Attachment "C" Attachment "D" Attachment "E" Kittitas County Agreement for Services (rev.5/!4/25) Page 1 of 19 Kittitas County Jail 205 W 5th Ave Ste 1 Ellensburg, WA 98926 Ed Buntin Jail Administrative Lieutenant Edward, buntin @co.kittitas.wa.us 509-962-7527 Scope of Work Compensation lnsura nce Requirements General Terms and Conditions W-9 (Contractor must complete and return to the County for payment) lN 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 Agreement for Services (rev.5lM/251 Page 2 of 19 BOARD OF COUNTY COMMISSIONERS KIfiITAS COUNTY Nu.a,vf Tha:lrw-Af) V *-+-(P41r.WLe)/\ Date neloq lau Attest: ' c B c of thee rd e Kjorsvik Buchholz CONTRACTOR Ua* Wat Printed ttrrE S\.!-+r S'+ Title Date: \J n Signatur/ t-\o"^ $N/rs{-\ e ?,r Lar a Kittitas County Agreement for Services (rev.5/t4/25) Page 3 of 19 a a ATTACHMENT "A" SCOPE OF WORK Subcontract with CompassDirect Healthcare o Medications for Opioid Use Disorder (MOUD) programming prescriber r Management and overhead of the MOUD programming staff o Nursing staff time Contractor will refer to their approved proposal documents submitted through the funding request process for additional scope of work detail. Any service provider offering transportation must ensure that drivers hold valid driver's licenses and have a background screerring completed to include a driving abstract in order to safely perform the services. ATTACHMENT'8" COMPENSATION THE COUNTY WILL NOT PROCESS PAYMENT FOR SERVICES RENDERED UNDER THIS AGREEMENT UNTIL CoNTRACTOR SUBMTTS 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 Contractor the following amount(s) plus any applicable taxes as detailed in Contractor's invoice: 5 98,635. Contractor will refer to their approved budget document submitted through the funding request process for line-item expenses. Any changes or updates to the budget must be approved by Kittitas County through the appointed contract manager in advance of the expenditure, in writing. 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, 2027 . No extension of the funding period will be granted. Reim bu rsement 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 katie.odiaga@co.kittitas.wa.us, B. Att invoices must be submitted by the last day of the month fottowing the catendar month in which services were detivered. C. The Contractor 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. ln no event shall payments under this agreement total more than $g4,53S, Kittitas County Agreement for Services (rev.5/14/25) Page 4 of 19 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 Vll or better in the most recently published edition of Best's Reports unless otherwise approved by the County. lf 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: Commercial General Liabilitv lnsurance . Coverage limits not less than: . S1,000,000 per occurrence, for all covered losses . $2,000,000 general aggregate . S1,000,000 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 Liabilitv lnsurance . 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: . S1,000,000 combined single limit Excess or Umbrella Liabilitv . Contractor shall provide Excess or Umbrella Liability coverage of 55,000,000. This Excess or Umbrella Liability coverage shall apply, at a minimum, to both the Commercial General and Automobile lnsurance policy coverages. lf 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. X Workers' Compensation & Emplover's Liabilitv 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.5/74/25) Page 5 of 19 Professional Liabilitv / Errors and Omissions Liabilitv. Coverage limits not less than: o $1,000,000 each claim. Contractor must provide evidence of this coverage on a policy form appropriate to Contractor's profession. Contractor shall furnish to the County a Certificate of lnsurance, 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 matprial alteration or non-renewal, of ony of thc above-required insurartce coverdges. 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 lnsurance with all required endorsements, properly completed and in the amounts required, and (2) where requested by the County, a copy of the required insurance policies, including all required endorsements. Kittitas County Agreement for Services (rev.5/M/25) Page 5 of 19 ATTACHMENT'D" GENERAL TERMS D 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 Pavment: 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 "8", the County will not reimburse Contractor for any costs or expenses irrcurred by Contractor ln 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 "8". ln 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 lnternal Revenue Service at the end of the calendar year in accordance with applicable IRS regulations. lt 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. lndependent 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. lf 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 Contractor to 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/M/25) Page 7 of 19 tomply 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. ln 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 Su bco ntractor's perfo rma nce of the su bco ntra ct. 6. Rieht 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 under this 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 availahle for review by any Fedcral or State auditor, the County, and/or any persons authorized by the County. 7. Modifi cation 7.I. 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. lf 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 lf 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. lf 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.5l7a/25) Page 8 of 19 '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. lndemnification 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 alternativp dispr-rte resolution costs, for any personal or bodily injury, slckness, 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 lndustrial lnsurance 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 ln 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: ln 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: lf 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 endofthelastfiscal periodforwhichsufficientfundingwasappropriated. Nopenaltyorexpenseshallaccrueto the County in the event this provision applies. 12. Contractor Commitments, Warranties, and Representations: Contractor follows: Kittitas County Agreement for Services (rev.5/t4/25\ Page 9 of 19 represents and warrants as ' 12'7 contractor is duly incorporated, validly existing and in good standing under the laws of the state :l#nil:t^:l#:"Tt all requiiite corporate power and authoritv to enter into and to perform its obrigations 12'2 contractor has the authority to execute this Agreement, to make the representations andwarranties set forth herein, and to perform iti obrigation, r,"r"rno"r. 12'3 This Agreement has been validly executed by an authorized representative of contractor andconstitutes a valid and legally binding and enforceaore ourigation of contractor. 12'4 contractor holds' or will obtain prior to commencing work under this Agreement, such ricenses,permits and other authorizations from federal, state and t."t gou"-mentar authorities, or from any appricableindustrial or professional certification or licensing bodies, as are necessary for the lawful performance of itsobligations under this Agreement, ancl will maintain such throughouI the term of this Agreement. 12'5 contractor is not in violation of any applicabre law, ordinance or regulation the consequence ofwhich will or may materially affect contractor's abiliiy to perform its obrigations under this Agreement. contractoris not subject to any order or judgment of any court, tribunal or governmental agency which materially andadversely affects its operations or assets in the state of washington, or its ability to perform its obligations underthis Agreement. 12'6 contractor is not presently debarred, suspended, proposed for debarment, declared ineligible orvoluntarily 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 oy contrr.tor in connection with the performance of theobligations contemplated under this Agreement, contains or wiil contain any untrue statement of a materiar factor omits or will omit a material fact neiessary to make the statements of fact contained therein not misreading. L3' ownership of ltems Produced: All writings, programs, data, reports, films, recordings, or othermaterials prepared by contracto' "nd/o' its consultants orsubcontractors, in connection with the performanceof this Agreement' shall be the sole and absolute propert;;f the county. The county wit have arr rights ofownership therein' including but not limited to the right to use, copyright, tradema rk, and/orpatent, and theability to transfer any or all ownership rights. 1.4.:ContractorwilldefendandindemnifytheCountyfromany claimed action' cause or o"ttno o['g-;-t.against the county, to the extent such action is based on the craim thatinformation and/or materials supplied by contract"; ';;;;" any inteilectuar property rights of any thirdparty(ies)' contractor will pay all costs and damages attributire to any such craims finaly awarded against thecounty in any action' such defense and payments are conditioned upon the following: (1) contractor shall benotified promptly in writing by the county of any notice of such craim; and (2) contractor shat have the righthereunder' at its option and expense, to obtain toitrre countf ine right to .oniinr. using the information and/ormaterials that are the subject of such claim, provided no reduction in performance or ross resurts to the county. L5' Use of countv Name and Loeo: contractor may not use the county,s name, logo(s), trademark(s), orother identifying informttion, o." idffi the county ,, , lrrr"nt or former crient, on its website or in anymarketing 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 beresolved informally if possible' However, in the event such a Jirpr," cannot be so reiorved, it shal be adjudicatedKittitas County Agreement for Services (rev.5/la/25) Page 10 of 19 .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. ln 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 (a)the arbitrator's decision or award shall be final and binding on both parties. t7. Confidentialitv: Contractor, its employees, agents and volunteers, and any of Contractor's subcontractors and their employees, agents and voluntccrs, shall nraintain 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. l-8. 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, Iegal 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 Waee: 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 lndustries. The schedule of prevailing wage rates for the applicable locality or localities is determined by the lndustrial Statistician of the Department of Labor and lndustries. lt is Contractor's responsibility to verify the applicable prevailing wage rate. lt 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 lndustries. 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.5l14/25) Page 11 of 19 2L.7 ln 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, 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; 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, 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. 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 suclr acl.iurr wlth respect to this Agreement as may be required to ensure full compliance with local, state and federal laws prohibiting discrimination in employment. 2L.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 lf 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,IO,13,1,4,15,L6,17,L9,20,22,24, 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. Severabilitv: 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 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/L4/2Sl Page 12 of 19 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/t4/25) Page 13 of 19 Fo,,n llUrg (Flev. M8rch 2024) Doparlmont of ths Troasury lntomat Rovonuo Soilico ATTACHMENT,,E,, Request for Taxpayer ldentification Number and Certification Go to www.irs.govlFo'm$lglot lnstrucllon8 and the lstest informston. Give form to the requestor. Do not eend to the lRS. Bofo16 For rolalGd to th€of Form W-9, see o/Fom, below. I Name ol ontity/indlvldusl. An entry ls required. (For o sole propr;etor or disregarded enlity, enter the owner's nsme on llno 1, and entor tho businass,/dlsrcgerdod ontity's nm6 on lans 2.) 2 Eusin8s nmo/disrogardod ontiiy namo, it diftoront trom abovo. 4 Exomptions (codos apply sty to certain enthles. not indivldual$; s€e lnstnictbns on page 3l: Exempt paym codo (il Rny) ExornDllon from For€l0n Account Tex Complianco Act (|:ATCA) roporlhg codo (if anyl (Applios lo acc&nts mainlainod ilts/da |to Uniled Stot€s.) Reqtr$l6r'B nffme Rnd rddross (optlonaD 7 t.,sl accounl oumbo(s) her6 (optiona0 o d)(tt 6o. o oc R.8 EE EK 4ortrI ,B Ea Enter your TtN ln th€ appropriate box. The TIN provided must match the nam€ given on line I to avoid backup wilhholding. For indlvlduals, this is gsn€rally your soclal securily numb€r (SSN). However, for a r6sident ali€n, sole proprietor. or disregardod entity, soo lh6 lnstructions for Part l, lalcr. For othor enlltios, it is your employer identilicauon nurnber (ElN). ll you do not hav€ a number, see How lo get a IlN. later. Notc: lf lhe account is in moro than ono namo, see the instruclions for line 1. seo also What Name and Numbor To GtVe lhe Roguoslar for guldolinos on whoso numb€r lo ontor. Slgnslurs ot U,S, parlon Dalo o7 Certiflcatlon Under penallles of perjury, I certify thal: 1 . The numbor shown on this form ls my corroct taxpayor idonlilioallon number {or I am waiting for a numbcr to be issued to mo): and 2. I am not subloct to backup wilhholding becnuso (a) I am oxompt lrom backup withholdlng, or (b) I havo not boen nollfiod by tho lntornnl Rovonuo Sorvice (lHS) thal I am sub.i6ct to backup withholdlng as a result of a lailure to r€port 8ll lnt€test or divldsnds, or (c) th€ IRS has nolified rne thRt I am no longer subioct to backup wlthholdhg; and 3. I am a U.S, cilizon or other U.S. person (definod below); nnd 4. Tho FATCA codo(s) ontorod on this lorm (lf any) lndicallng lhat I nm oxernpt lrom FATCA roporlhg is corroct. C.nmcstlon lnslructlona, You must croEs or,t itom 2 0bovo ll you hava bocn notlfiod by tho IRS that you oro cunonlly tubjocl lo backup wlthholding bocause you havs fa'lad to roport all lntorost and dlvidonds on your tax retunl. For roal sstato lransactlons, itam 2 does not apply. For lnorlgago irrlerost pald, ncqulsltlon or abondonmont ol securod proparty, cancollatlon ol dobt, conlrlbutions to an indlvlduRl other thnn lnterost and nro nol to tho cortiflcltion, but murt Slgn Here General lnstructions S€ction reJ€rences are lo lhe lntsmal Flevenuo Code unlgsg othorwlse notod. Fulurg devslopmontt. For tho latost lnformation Bboul dovolopmonts related lo Form W-9 and its lnslructions, such as leglslatlon enacted atler they were published, go to www.irs.govlFomwg. What's New Line 3a has be€n modilied to clarity how a disregarded entity compl€tes this line. An LLC lhat is a disregarded entlty should check lhe appropriato box lor th6 tax classificatlon of its owner. Olherwise, it should check lhe "LLC" box and enl6r i13 appropriate lax classllication. Now llno 3b has bg€n addod to lhi$ torm. A flow-through ontily is requlred to complot€ this llne to lndicate lhat it has di.ect or lndlract forelgn partrlerg, owners, or bensliclarios when it provides lho Form W'9 to anothor llow-lhrough cnlity in which il hfls an ownorshlp intotost Thls chango is intondod lo provido a flow-through 6nlity with ,nformntlon rogarding lh6 slatus ot it$ lndlroct forelgn partnsrs, ownors, or baneliciariss, so that lt can satisty any applicab16 roporling r€quirsments. For example, a partnership that has any indirect for€ign parlners may bo requlred to completo Schodules K'2 and K-3. S€o th€ Partnership lnstruclions for Schedulos K-2 and K-3 (Form 1065)' Purpose of Form An lndlvldual or entlty (Forrn W-9 roquestor) who is required to llle an inlormatlon r6tum wilh the lltS ls glving you this lorm bocause lhey 3a Check th€ sppropri€lo box ld federel lax classilicrtlion of tho sntity/indrvrduAl whosc nana is snlcred on ln€ 1. Check only on6 of lho followlng gov€n boxss. E lndlviduausolo propriotor ! C corpotatlon f] S corporation f] Parlnorsnlo n Trusyostato fl LLC. Eutorlhrtexcla6slllcallon{C = Ccorpotallon, S. $corFDtatlon, P - Patharship) Nolo: Check lh€ "LLC" box abova flnd, In th6 6nlry 8pflc€, €nl6r the approprlala code tC, S, or P) tor ttre tai-- cl0sslllcfflion ot lhe I I C, ilnlo$r lt ls n dinro0ord6d 6ntlly. A dl$ru$Hrd$d ontrty should lnsl€ad chock lho aDproprlAlo box tor ihs td clGslllcotion ot i$ ownot. E olh€r(soo lnslructions) 3b lf on lino 3fi you chock€d "Portnorchip- or "Trusv$lalo," or chockod "LLC" and eoterod "l'- os its tox clds6ificalion, snd you sr€ provlding thls lom lo a parln6rship, lrusl, or 63lal6 in which you hnvo en owm6hlp inl6r63t, chack thls bdx It you hsva any lorelon Fsrlnors, ownsrs. or bonaflciAri€s. Se€ inslrilcllons tr 5 Addrss$ (nufib€r, 8lr€el, sd apl. o. suito no.I, Sga ln$lnrclions. e City, stato, and ZIP codo numbar Part I numbar Part ll Cal- No. 10231X Kittitas County Agreement for Services (rev.5/74/25) Page 14 of 19 Form W-g (Rov. 3-2024) Form W-S (Rov.3-2024)Plr,e2 must obtain your correct taxpayer identification number fIlN), which may be your social eecurity number (SSN), individual taxpayer identifi cation number {lTlN}. adoption laxpayer identification number (ATIN), or employer identification number (ElN), to rsport on an information retum lhs amount paid to you, or oth€r amount reporlable on an information r€tum. Examples of infonnalion refumo include, btrt are nol limited to, fte following. r Form 1099-lNT {interest €amed or paid}. o Form 1090-DlV (dividends, including those from stocks or mutual funds). o Form 1099-MISC (various types of income, prizes, awards. or gross proceeds). . Form 1099-NEC (nonemployee compensation). r Form 1ff19-B {stock or mutual fund sales and certain other transactions by brokers!. r Form 109{l-S (proceeds from teal estate rransactiofls}. r Form 1099-K (merchant card and third-pany network transactions). i Form 1098 (ho.n€ mortgage inlerest|" 1098-E (student loan interFstl. aftl loga-T 0uhloh). o Form 10994 (canceled debt). . Form 1099-A {acquisition or abandonment ol secured property}. Use Form W-9 only if you are a U.S. person (ncluding a resident alien), to provide your con€cl TlN. Caution: lf you don't retum Fotm W-g to the requesterwith a TlN, you might be aubfecr to backup withholding. See What is hackup withholding,laler. By signing the filled-out form, you: 1 . Certity that tho TIN you are giving is conect (or you are waiting lor a numb€r to be issu€d); 2. Cartity lhalyou are not subioct to backup withholding; or 3. Claim exemplion from backup withholding if you are a U.S. exempt payee; and 4. Cer.tity to your non-foreign status for purposee of withholding under chaptor g or 4 of the Code (if applicable); and 5. Certify that FATCA code{s} entered on this form (if any) indicating that you are exsmpt from the FATCA reporting is con€ct. See Whal /s FATCA Heporting, later, for further information. Not€: 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 lhe requeste/s form if it is substantially similar to this Fom W-9. Definition of a U.S. person. Forlederal tar purposeq you are considered a U.S. person it you are: r An individual who is a U.S. cilizen or U.S. resilent alien; . A partnership, corporalion, cornpany. or association created or organized in the United States or underlh€ laws ol the United Staies; o An estate (other than a foreign estale); or . A dom€stic trust {as defined in Regulations seclion 301.7701-4. Establishing U.S, status lor purposes ot c*rapter 3 and chapter 4 wilhholding. Payments made lo forsign persons, including certain dislributions, allocations ol income, or transfers of sales proceeds, rnay be sut{ect to wilhholding under chapler 3 or chapter 4 ol the Code tseclions 1441-14741. Under those rules, if a Form W-9 or other certification of non-foreign slafus has not b€€n received, a withholding agent, lransferee, or partnerehip (payor) generally applies presumptiotr rules that may require th€ payor lo withhold applicaHe tax from the recipient, owner, hangferor, or parlner (payee). See Pub. 515, Withholding of Tax on Nonresident Aliarc ard For€ign Entities. The lollowing persons must provid€ Form W-9 to the payor for purposes of establishing its non-foreign status. o ln the case of a disregarded entity with a U.S. owner, the U.S. ownar of the dioregarded entity and not the disrogsrded entity, o ln the case of a grantor trust with a U.S. granlor or olher U.S. ovrner, generally, th€ U.S. grantor or other U.S. owner ol the grantor trust and not the granlor trusl. o ln the case of a U.S. trust (other than a granlortrust), the U.S. trust and not lhe beneficiaries of lhe bust. See Pub. 5't 5 for mor€ information on provkling a Form W-g or a certification of non-foreign stahls to avcid withholding. Kittitas County Agreement for Services (rev.5/1'4/251 Page 15 of 19 Foreign per*on , ll you are a foreign person or tha U.S. branch of a loreign bank lhat has elec{ed to be lreated as a U.S. p€raon {under Regulations seciion 1 .1aa1-1(b)(2[iv] or other applicable gection lor chapter 3 or 4 purposest do not use Form W-9. lnstead, u3s the appropriale Form W-8 or Form 8233 (eee Pub. 515). lf you are a qualilied foreign peruion fund under Regulations section 1.8S7(l)-1(d), or a partneraftip ihat ie wholly owned by qualified foreign peneion funds, that is tr€at€d as a non-toreign p€rson for purposes of section 1445 withholding, do not use Form W-9. lnstead, use Form W-8EXP (or other cedification of non-foreign status). Nonresident alien wfio becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax lreati€s contain a provision known as a saving clause. Exceptions specified in the saving clause may pe.rmil an exemption from tax to conlinu€ for certain types of income even after lhe payee has otherwise become a U.S. resirJent alien for tax purposes. lf you are a U.S. re€ident ali€n lvlto is relying on an exception containsd in the eaving clause ol a tax treaty to claim anexemplion from U.8. tax on c€rtalt typBs of lncom6, you must attach a 6tatement to Form W-9 lhat specifies the follaring five items. t. The trealy country. Generally, this musl be the same treaty urder which yorr claimed exemption fom tax as a nonresidenl alien. 2. Th€ tr€aty article addressing the income. 3. The arlicle number (or localion) in the tax treaty that contains the saving clauae and ils exceptions, 4. The typs and amount of income that qualifies for the exemption from lax. 5. $rffcisnt facts to iustifo the exemption from tax under the terme of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exomption trorir tax for scholarship income received by a Chinese student tomporarily present in the United States. Under U.S. law, thie student will bocoms a resident alien tor tax purposes ff their etay in the Uniled States exceeds 5 calendar yeare. However, paragrcph 2 ol lhe first Protocol to th€ U.S.-China treaty {dated April 30, 1984) atlows the provisbns of Micle 20 to continue to apply w6fl aft€r the Chinese student beconreg a resident alien of the United Statss. A Chinese student who qualifiqs tor this exception {under paragraph 2 ot th€ first Prolocol) and is relying on this exception to claim an exemption from tax on their 6cholarghip oifellowship income would attach to Form W-9 a slatement that includes the informatbn described above to support that exemption. lI you are a nonresident alien or a foreign entity, give lhe requester the appropriate completed Form W-8 or Form 8233. Backup Withholding What is backup wirhholding? Persons making certain paymenls to you must under cerlain conditions withhold and pay to the IBS 24lo of such payrnents" This is called "backup withholding." Payments that may be sutrject to backup withholding include, but are not limited to, interest, tax-oxempt interest, dividends. broker and barter oxchang€ transaclions, rents, royalties, nonemployee pay, payments made in s€ttlem€nt of payment card and third-party network ttansactions. and certain paymenls from lishing boat operators. Real eslate transactions are not s.rbject to backup wilhholding. You will not be subject to backup withholding on payments you receive if you give the requester your conect TlN, make the proper cerlifcations, and report all your taxable int€rest and diviJends on your tax retum. Payments you receive will be subject to backup withholding if: 1. You do not fumish your TIN to the request€r; 2. You do nol cerlify your llN when required {see lhe inslruclions for Part ll for details); 3. The IBS tells the requester that you fumished an inconect TIN; 4. Ihe IRS tells you frat you are subiect to backup withholding because you did not reporl all your interest and dividends on your tax retum (for reportable interest and dividends only); or 5. You do not cerlify to ihe requester that you are not subject to backup withholding, as described in item 4 under "By signing the tilled- out lorm" abwe (for reportable interest and dividend accounts opened after 1983 only). Form W-9 {Rev.3-4f24)Pase 3 Certain payees and paynxrnts ara exenpt from backup whhholding. See Exempt payee code, laler, and the separate lnstructions lor the Requester of Form W-9 for more informalbn. See also Fslablishing U.S. status forpurposes of chapter 3 and chaptet 4 withholding, ea{ier. What ls FATCA Heporting? The Fore!;n Account Tax Compliance Act {FATCA} requires a participating foreign financial institution to report all U.S. accounl holders lhat are gpecified U.S. pentons. Certain payees are ex€mpl from FATCA reporting. See Exemption lrom FATCA reponing cde,later, and the lnetruclione for the Requesler of Form W-9 for more information. Updating Your lnformation You must provide updated information to any pe6on lo whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportabla payments in the future from thie pereon. For example, you may need to yovide updated information if you are a C corporation that elects to be an S corporalion , or il yau are no lonEcr tar erernpt. ln addfion, you must lumiah a new Form W-9 if the name or TIN changes for lhe account. for example, if lhe grantor ol a grantor trust dies. Penalties Failure to furnish TlN. lf you fuil to fumish your correct TIN to a r€quester, you are subiecl to a p€nalty ol $5o lor each such failure unless your failure is due to rcasonable cause and not to wififu] negl€ct. Civil penalty lor lalse information with respect lo withholding. lf you make a false slatement with no reasonable basis thal resuhs in no backup withholding, you are subriect lo a 95tXl penafty. Criminal penalty for falsilying inlormation. Willfully falsifyittg certifications or affirmations rnay subject you to criminal penafties including fi nes and/or imprisonmenl Misuse of TlNs. lf the requester discloses or uses TlNs in violation of federal law, lhe requ€ster may be sublecl to civil and criminal penallies. Specific lnstructions Line I You must ent€r one of the following on this lina; do not leave lhis line blank. The name should match the name on your tax retum. lf this Form W-9 is for a ioint account (othar than an account maintained by a foreign financial institution {FFl)}, liel firgt, and then circls, the name of the person or entity wlrose number you entered in Part I of Form W-9. lf you are providing Form W-9lo an FFI to docum€nt a ioint account, each holder of the accounl that is a U.S, peruon must provide a Form W-9. . lndividual. Generally, ent€r the nama shown on your tax return. lf you have changed your last name withotrt informing the Social Security Administration {SSA) of the name change, €nter your first nama, lhe last name as shown on your social security card, and your new last name. Note for lTlN applicant: Enter your individual nam€ as it was entered on your Form W-7 applbation, line 1a. This should also be the aame as the name you entered on the Form 104O you filed with your applicalion. o Sole proprielor, Enter your individual name as shown on yow Fonn 1 040 on line 1 . Enter your business, trade, or "doing businees as" {DBA} name on line 2. . Partnership, G corporation, S corporation, or LLC, other than a disregarded entity. Enterthe entity's name as shown on the entity's tax retum on line 1 and any business, irade. or DBA name on line 2. o Otlrer entities. Enter your name as shown on reguired U.S. federal tax documenls on line l. This name should match tfie name shown on the charter or other legal document creating the entity. Enler any business, trade. or DBA name on line 2. . Disregarded entity. ln general, a business entity lhat has a single owner, including an LLC, and is not a corporation, is disregarded as an entity s€parate from its owner {a dieregarded entity}. Sae Regulations section 3Ol .7701-2lcl(21. A disregarded entity should check the appropriate box for the tax classification ol its owner. Entet the owne/s name on line 1. The name of lhe owner €nterd on line 1 should never be a disregarded entity. The name on line 1 should b€ the name shown on the income tax retum on which lhe income should be reported. For Kittitas County Agreement for Services (rev.5/14125) Page 16 of 19 example, if a foreign [fG lhat is lroated as a disregarded entity for U.S. federal tax purposes has a singh ownerlhat is a U.S. person, the U.S. orvnels narne is required to be provided on line 1. lf the direct owner of the €ntity is aho a disregarded entity, €nter the first owner that is not dbregarded for fede{al tax purpos€s. Enter the disregarded entitt's name on line 2. lf the owner ol the disregarded entity is a foreign person, the orrrner must complate an appropriate Form W-8 instead of a Form W-9. This is lhe cas€ even il the foreign person has a U.S. TlN. Line 2 lf you have a business name, trade name, DBA name, or dbregarded entity nam€, entff 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. Line 3b Check thb box il you are a partn€rship (including an LLC classified as a parhership for U.S. federel lax purposesl, trust, or estate that has any foreign parlnes, owners, or beneficiaries, and you are providing this {orm to a partnership, trust, or estiale, in which you have an ownership interest. You mtlst check lhe box on line 3b if you receive a Form W-8 (or documentary evidence) from any partner, owner, or beneficiary establishing foreign stalus or if you receive a Form ltV-O from any partner, own€r, or beneficiary that has checked the box on line 3b. Note: A parlnership lhat providea a Form W-g and checks box 3b may be reguired lo complels Schedulee K-2 and K-3 (Form 1065), For more information, s€e the Partn€rehip lnstructions for Schedulee K-2 and K-3 (Form 1065), ll you are requked to complete line 3b but failto do so, you may not . rec€ive lhe information n€c€ssary to file a conect information retum with th€ IRS or fumish a conect payeo gtatement to your panners or beneficiaries. See, for example. sections 8698, 6722, and 8724 lot penalti€s that may apply. Lina 4 Exemptions lf you are exempt from backup withholding andlor FATCA reporting, eriter in the appropriate space on lin€ 4 any code(s) lhat may apply to you. Exempt payee code, o Generally, individuals (including sole proprietors) are not exempt from backup withholding. . Excepl as provided below, corporations are exempt tom backup withholding for certain payments, including interest and dividends. . Corporalions are not axempi from backtp wilhholdng for payments made in settlement ol payrnent card orthird-pafi network transactions. . Corporalions are not exempt lrom backup withholding wilh respect to attomeys' fees or gross proceeds paid to attomeys, and corporations that provide medical or health care services are not exempt with respect to payments r€portable on Form 1099-M|SC. The lollowing codes identfu payees that are exempt from backup withholding. Enter lhe appopriate code in the space on line 4. 1-An organization exempt lrom tax under section 501(a), any lRA, or a cuslodial account und€r section 403{bX7} if the account gatisfies the requirementa of section 401(fX2). lF the entity/individual on line { is a(n) ., , THEN check the bor lor. . . Corporation Corooration. o lndividual or r Sole proprielorship lndividual/sole proprietor . LLC classilied as a partnership for U.S. lederal tax purposes ot . LLC that has filed Form 8832 or 2553 electing to be taxed as a corporation Limited liability company and enter ihe appropriate tax classification: P = Partnership. C=Ccorporation,or S = S corporation. ' Partership Partnership. . TrusVestate Trust/estate. Form W-B {Flev.3-2O24) The chart 13. lF lhe payment is for r lnteresl and dividend paymentB transactions . Barter and 55,oo0r T}IEN Ior.,. Exempt payees'll andthrough all C the payment is exempt Pwe42-The Uniled States or any of its agencies or instrumentalilies.3*A state, the District of Columbil g U:S. "o.rnon*"J* or terrilory,or any of thdr political subdivisions or lnstumentatifies,-* "l;jri,?l?fllfl,?llmmenr or any of irs potiticat subdivisions, asencies, 5-A corporation. 6-A dealer in securilies oru"it;.;i;;,'ih;;;#i"i;;ailHff i:::ffiy.H#s:lili'l: tenitory. ol;f "t*ffd'#*'f; ior.romerchant resislered wilh ttre comrnodirv 8-A real estate investment frrst. 'J";"fr"T,t3"ffi11i'fl$if*[: o"n"g the tax vear under rhe 10-A common trust fund operated by a bank under section s8rt{a}. 1 1 -A financial institution as defined under section 581.12-A middleman known in tlcustodion, lg tnvestment communily as a nominee or l3;1 ,*" exempt from tax under section 664 or describ€d in s€ction F-A dealer in securitie.s, cornmodities, or derivative financialrnsrrum.ents.(incruding norionar pri""ipJ lJ,irllii!l;;r*, forwards,and optons) that is reoistered as "u"'t unJ"i'tn-" i"*-r-tt tn" Unit"aStates or any gtate. G-A realestate investment t ust. H-A regulat€d investrnent company as defined in s€ction gS1 or anentiry resistered at ail rimes durint-the,#;;;;#rie tnvestrnentCompany Act ot 1940. l-A common trust fund as defined in section Sa4(a).J-A bank as defined in section S8,1. K-A broker. L-A lrust exemDt from tax under section 664 or described in sectionasaT{a}{1). f\4-A tax-exempt trust under a section a03{b} plan or section 4S7{g} ilirt!;;L1?"Hf]ffi f r, yr,r'_the nnanciar insrilurion requesrins code should o" "ornpl"t"ilh"r the FATCA err4fs 1n6l/e7 sxempt payei Line 5 Enter your address fnumber, stre€t, and apartm€nt or suite number).This is tlhere the requester of rhis r"^ fr_s;iii;a"it iJur informarionretums. lf this address differs from th" on; th;,"d;sii', "treaay fras onfite, enrer ,,NEW at the roo._.tf a new adl;;;;r';ffi;;, rhere is srill a :3eff"",,1;fi f ,igfi :"irro"**i,"rir'ir,?p""i"i"Jifr g""vo,, Line 6 Enter your city, state, and Zlp code. Part l. Taxpayer ldentification Number (TlN) 11._l-V:y:JtH in rhe appropriate. box. tf you are a resident atien andyou do not have, and are not'eligible to g"t, "n SGN, v;; TIN is youi-tRS tIN. Enter it in the entry spjce foi_rf," i;.Jd'ilJiiii) number. tf youdo not have an tTtN, see uow'to get i iiN fiii. -**'" r.ljrt3$tffirtffile proprielor and vou have an ElN, vou mav enter eitfier lf you are a single-member LLC that is.dbregarded as an enlilysepamte from its owner. enter the owner,; SSfrl.. AN, fithe owner hasonef. tf the LLG is ctassified ," " "orpor"rioi-r, iiirillilip, enter theentity's ElN. Note: See lrtr?al Arame end Numbe-r,To Give lhe Beguesler, later, forfurther clarification of name and fff.f co.Ui^aiior;sYrco'E llow to get a TlN. lf you do To appry-ror an ssN. i;i ;;fri3:l.TrllLiffJ#:gXl:i$:1ff , card, from your tocar bsR oree ord"iif,'"-ri#'riii,i#"ffig#*"t " g{X:&t?,"y:":#n!rit?#,*7,-".*vrcaetormstopraceanorderand have Form W-7 andtor Form ssj ;rt"l[;;r"rtinf,i'ii ou"in*r,days. ll you are agked to comblete Form W-9 but do not have a TlN, apply [:hHti!iJ::itrri:t{:,1",e#;nr[*:tnix*.,j,"?;;?i5:1"liflTl"t and cerrain paymenrs made *irt;;;pdiJ;aliry tradabternsrruments, you will oeneraily E*.ry OaVs to 6er-a fff.f-ind give it rothe requesrer b€fore lou are lubject to batrup"*ir,r,oioi,ia onpayments. The 6o-dav rute doeshor appty t;;mdiivp.J'lir payments.You wil be subjed to'backup withh;ffi;;;;i';l#f,ili"nr, unriryou provide your TIN to the iequesrer. Note: Entering "Applied For" means that you have already applied for a i,ffi iir{fr #$i:ffi ryiT.?t"ff !,:*;#,5t8:g#tfr tflfll#tr may instead be subiect to withhotOint unU".-ir,'Jprer 3 or 4 of t?:$??;3rXiffi#fr-'".*' *t"t *at has a foreisn owner must use Ail for exempt payees except 4and6 S coporations must corporalions. not enter an €xempt paye€ code because are exempt only for sales of lhey noncovered securilies acquired to 2012. transaclions Exempt paye€s 1 through 4. required to Generally, exempt payees sales over 1 thmugh S.2 of Exempt pay€es'! through 4. E-A corporation that is a membelof the same expanded affiliatedgroup as a corporation described in negurafi;si;[#ii+za_t1"1r61. Kittitas County Agreement for Services (rev. 5/1,4/25) Page 17 of 19 ' Form W-9 {Rev.3-2024)Pasc 5 Part ll. Certification To establieh lo the withholding agent lhat you are a U.S. person, or resident alien, sign Form W-9. You may be requested to Bign by the wilhholding agent ev€n if item 1, 4, ot 3 below indicates otherwise. For a ioint account, only ths person whose TIN is shown in Part I should eign (when required). ln the cage of a disregarded entily, the person identified on line t must sign. Exempt payaos, see Exempt payea code. earlier. Signatura requirements, Complete the certification ae indicated in itemsl through5below. 1. lnteresl, dividend, and barler exchango accounts opened before l9&{ and broker accounts considered active during 1983. You must give your correct TlN, but you do not have to sign the certification. 2. lnterest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considerad inaclive during l98il. You must sign the certification or backup withholding will apply. lf you are subjecl to backup withholding and you are merely providing your concct TIN lu lhe roqu€€ter, you must cross out item 2 in the certification belore signing the form. 3. Real estate transactions. You must sign the certaficaiion. You may cro€s out item 2 of the certifrcation. 4. Other payrnents. You must giva your conect TlN, but you do not have to sign lhe certification unless you have been notified that you have previously given an inconect TlN. "Other payrnenls" include payments made in lhe course of ihe requester's trade or business lor renls, royallies, goods (other lhan Lrills for merchandiae), rnedical and health care services {ncluding payrents to corporations), paFneflts to a nonemployee lor services, payments made in setdement of paymenl card and third-party network transactions. payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attom€ys (including paym€nb to corporalion8). 5. Morrtgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualilied tuition program paymonts (under eection 529), ASLE accounts (under eection 529A). lBA, Coverdell ESA, Archer MSA or HSA contribstiong or dielributions, and peneion dietributions. You must give yaur conecl TlN, bul you do not have to sign the certification. What Name and Number To Give the For this ol account:Give name and SSN of: The individual The s€tual owner of the accounl or. il eombined funds, the first individual on tt|c accountr Each holder of the aconl The mhorz The grantor-lrusl*i The sctual ownerl Theowners The granlor' Kittitas County Agreement for Services (rev.5/14|25) Page 18 of 19 For this of accounl: 8. Disregarded enlity not owned by a individual 9. A valid trust, estato, or psnsion lrusl 10. Corporation or LLC elccling corporale status on Form 8832 ar Form 2653 1 1, Association, c{ub, rcligio:g, charitable. educalional, or othsr lax-exrynpl organizalion 't2. Par&Ership or multi-member LLC 13. A broker or regislered nominee 14. Accounl with lhe Daparlmenl ol Agricuhure h the name of a public erdity (such & a state or loeal goverwnenl, school diskict, or prisonl that receives agricuhunl program payments 15. &antor tru3t filbg Forrn 1041 or rmder lhe Optional Filing Method 2, requiring Fom 1#19 {w Eegulatiore se€lion !.c71 -4{b){2xi}tB})" Give name and EIN of: Themer Lagal entity! The caporation The organization The partrerafiip The broker or nominca The public entity 2. Two or more individuals 0oint accountl olher than an account mahtained by an FFI 3. Two or more U.S. persons $oint account msinlained by m FFI) 4. Cuslodial account ol a minq flJnilorm Gift to Minors Acl) 5. a. The usul revocable savin€s bust {grmtor is also truslee} b. So.called tn:st account that is not a legal or vdil trust rnder state lav 6. Sole proprietorship or disregarded entity ovrned by an individual 7. Grantor hwt nling mder Oplional Filhg Method 1 (see Regulalions section r.671 -a{bX2XiXAD" The trutl ? List lirst and circle the name of the person whose number you fumish. lf only one person on a joint account has an SSN, that person's number must be fumished. ?Circle the minols name and fumish the minor's SSN. 3You must show vour individual n:une on line 1. and enter vour business or DBA name. if ahy, on line 2. You may use ehher your SSN or EIN [f you have one), bur the IHS encouftrg€s you to use your SSN. {List firsl and circle the name of the trust, estale, or pension trust. (Do not fumish the TIN of the personal representative or trustes unless the legal entity itself is not designated in the account title.) 'Note: The granlor must also provide a Form W-9 to the trustee of th6 trust. " For moro information on oplional filing methods for granlor 8usts, 9e€ the lnstructions lor Form 1041. Note: lf no name is circled when more lhan one name is listed, lhe number will be considered lo be that of lhe firgt name lieted. Secure Your Tax Records From ldentity Theft ldeniity theft occurs when someon€ uses your psnx,nal information, such as your name, SSN, or other identifring information, without your permission to commit fraud or other crimes. An identity thief may use your SSN to get a iob or may file a tax rsturn 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 retum preparer. lf your tax records are affected by identity lheft and you receive a notice lrom the lRS, respond right away to the name and phone number printed on the IRS notice or letter. lf your tax records are not cunenlly affected by iJentity theft bur you think you are at risk due to a lost or stolen purse or wallet, questionable credit card aclivity, or a queslionable credit report, contact the IRS ldentity Theft Holline al 800-90&4490 or submil Form 14t)39. For more information, see Pub. 5027, ldentity Theft lnlormation for Taxpayers. ' Form ltr-g {Rev. 3-?024}Poga 6 Viclims of id€ntity theft who arc exp€riencir€ economic harm or a syslemic problem, or are seeking hdp in resolving tax goHems that harre not been resolved througrh normal channeb, may be eligibls for TaxpayerAdvocate Service (IAS) a$istance. You can reach TAS by calling the TAS toll-free case intake lin€ at 877-?f-4778 orTTY/TDD 800-829-zl(Fg. Protect yoursell lrom suspicious emails or phishing schemes. Phishing is the crestion and use of email and websites deeigned to mimic legitimate business emails qnd websitee. The most common act is eending an email lo a user fubely claiming to be an established legitimate enterprise in an attempt to 6cam the user into sunendering private information that will be used lor idenlity lheft. The IRS does not initiale contacts $rilh taxpayers via emails. Aso, the IHS does nol request personal detailed information lhrough email or ask taxpayers for the PIN numbers, passwords, or eimilar gecret access information for their credit card, bank, or other linancial acc,ounts. lf you receive an unsolicit€d email claiming to be from the lBS, fonvard lhig mossage to pfiishing@irs.gov. You may also report misuse of the IRS name, log9. or olher IRS propofty to thc Tlua*ury krspec{or General forTax Administration fIIGTA) at 800-386-44f'4. You can loruard suspicious emails to the Federal Trade Commission at spam@uce.gov ar report them at www.ftc.gwlcomplainf. You can conlact the FT C at www.ftc.govlidtheft or 877-IDTHEFT {877-ili}8-4it38). lf you have been the victim ol identity theft, see www.ldentityTheft.gov and Pub. 5027. Go to www.irs.govlldentityTheftlo leam more aboui identity theft and how to reduce lour risk. Kittitas County Agreement for Services (rev.5/74/25) Page 19 of 19 Privacy Act Notice S€ction 6109 ol the lntemal Revenue Code requires 1pu to provide your conect TIN to persons (including fuderal agencies) who are required to file inlormation retums with the IRS to report interest, dividends, or certain other income paid to you; mortgags interest you paid; the acquisition or abandonment of secwed prop€rty; the cancellation of debt; o. contribdions yolr made to an lFliA. Archer MSA, or HSA. The person collecting thie form uses the information on the form io file informalion retums with the lRS, reporting the above information. Routine uses of this informalion irrclude giving it to lhe Department of Justic,e for civil and criminal litigation and to cities, states, the Disttict ol Columbia, and U.S. commonweahhs and lenitories for use in administering their laws. Th€ in{ormation may also be disclosed to other couniri€s under a tr€aty, to federal and state agencies to enforce civil and criminal laws. or lo lederal law enlorcement and intelligence agencies to combat tenorism. You must provide your TIN whether or not you are required to fil€ a lax return. Under seclion 3406, payors must generally withhold a percentage of taxable interest, dividends, ond uertaln other payrnents to a payee who does not give a TIN to lhe payor. Gertain penallies may also apply for providing false or lraudulent information.