Loading...
HomeMy WebLinkAboutKittitas County & KCHNKITTITAS COUNTY AGREEMENT FOR SERVICES PHMH25.OO9 This Agreement for Services (hereinafter "Agreement") is entered into by and between Kittitas County (hereinafter "County"), a political subdivision of the .State r:f Washington, and Kittitas County Health Nctworl< ( herei nafter "Contractor" ). The purpose of this Agreement is as follows: Utilize the 2026 One-Time Opioid Abatement Strategies funding to address opioid use disorder through fourteen separate activities outlined in the opioid abatement MOU and aligns with the Kittitas County Health lmprovement Plan. The term of this Agreement shall be July 1, 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 509-962-75t5 Attachment "A" Attachment "B" Attachment "C" Attachment "D" Attachment "E" Kittitas County Agreement for Services (rev.5h4/25l1 Page 1 of 19 Kittitas County Health Network 110 W 6th Ave PMB 393 Ellensburg, WA 98926 Alicia Pierce Project Director a liciao@ hea lthierkittitas.org sog-925-5246 Scope of Work Compensation lnsurance Requirements General Terms and Conditions W-9 (Contractor must complete and return to the County for payment) Clerk of CONTRACTOR Signature Printed Name Title Date 1w ukl$/+ wolcJ Lttt,J fuo,t [l,nir 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 BOARD OF COIINTY COMMISSIONERS \lM-t)h'f Brett (hatv Lau 1.4"-AVLo\Lf rnL-t\ Date rd orsvik ndy Buchholz Kittitas County Agreement for Services (rev.5lIa/25) Page 2 of 19 ATTACHMENT'A,, SCOPE OF WORK . Pay for a Project Director and Project Specialist staff time. r Equipment and supplies o Resource Guide Website Hosting and Security o Event space rentals for events, trainings, and listening sessions o Training and training licenses o Printing expenses o Advertising and Outreach o 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 screening completed to include a driving abstract in order to safely perform the services. Kittitas County Agreement for Services (rev.5l!4/25) Page 3 of 19 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 Contractor the following amount(s) plus any applicable taxes as detailed in Contractor's invoice: S gg,gZZ.gt Contractor will refer to their approved budget document submitted through the funding request process for line-item expenses. Any changes or r.tpdates 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 bursement 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 subm itted by the tast day of the month f ol.towing 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 igg,gZ2.gt. Kittitas County Agreement for Services (rev.5lt4/25) 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: . $1,000,000 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: . $1,000,000 combined single limit n Excess or Umbrella Liabilitv 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 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. 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 Si.,000,000 per accident or disease. Kittitas County Agreement for Services (rev.5/t4/25) Page 5 of 19 n Professional Liabilitv / Errors and Omissions Liabilitv . Coverage limits not less than: o $L,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 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 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/U/25) Page 6 of 19 ATTACHMENT,,D,, GENERAL TERMS AND CONDITIONS t. 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, sr.rpported rrnless prrrvided otherwise in Attachment "8", 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 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 "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 (L) 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 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. 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 S u bco ntracto r's perfo rm a nce of the su bco ntract. 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 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 available for review by any Federal or State auditor, the County, and/or any persons authorized by the County. 7. Modification 7.L. 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.5/74/25) Page 8 of 19 fromanymoneydueorcomingduetoContractor. Furthermore,intheeventofterminationunderthisparagraph, 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 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 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 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: ln the event that a ny 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 end of the last fiscal period forwhich sufficient funding was appropriated. No penalty or expense shallaccrue to the County in the event this provision applies. l-2. Contractor Commitments, Warranties, and Representations: Contractor represents and warrants as follows Kittitas County Agreement for Services (rev.5/L4/25) Page 9 of 19 12.L Contractor is duly incorporated, validly existing and in good standing underthe 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. t2.2 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. L2.5 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. 1.2.6 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. 12J 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 ltems 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. L4. lntellectual Propertv Infrinsement: 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. L5. Use of Countv 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/M/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 (4)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 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 L 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 1of this Agreement. L9. Prevailing Wage: Where labor to be performed under this Agreement is considered "public work" as defined in RCW 39.04.0L0, 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.5/t4/25) Page 11 of 19 21,1 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 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 lf any assignment and/or subcontracting has been authorized by the County, said assignment or su bcontract shall i ncl ude a ppropriate safeguards aga inst d iscrimination, 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: Theprovisionsof paragraphs2,3,4,6,8,9,IO,13,14,15,16,17,19,20,22,24,and28of these GeneralTerms and Conditions shallsurvive 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.5l74/25) Page 12 of 19 27 . Tlme: 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.5h4/251 Page 13 of 19 ,",,n llll'9 ATTACHMENT'E" Request for Taxpayer ldentlfication Number and Gertificatlon Go to r,vww.td.govlFormlll9lor ln8tructlons and tha latcst lnformallon' Glve form to the requester, Do not send to lho lRS. (,16v. M6rch 20?4) Dopflrlmont ot lho Tr€&ury lntomol Rovonuo Soruico ri o Eo" 5 aEg'g OE =b O- tJEt Eoitt.A Botoro Enter your TIN ln th€ approprlate box. The TIN provlded must match tho name givon on lino 1 to avold backup wilhholding. For indlvlduals, thie is genernlly your socinl socurity numbor (SSN). l{owever, lor a rssldont allon, solo proprlotor, or dlsrogarded ontity, soo tho lnstructlon$ for Prrt I, laler. For olhot onlitlss, it lB your employer idenlilicatlon number (ElN). ll you do nol have a numb€r, s€e How lo 961a nN, later. Notc: ll the sccornrt is in moro than one namo, seo lho lnstruclions lor llno 1. Seo also What Namo and Numbor To Glva th6 Roquoslar for guldolinos on whoso number lo onlor, Slenalure ot U.g. pcrson Drto For rolalod to lh6 ol Form soo ol bolow. I Namo ol sntity/indlvlduol. An entry 18 requircd. {For a sole proprietor or disregarded ctrlity, ontor lhe owner's name on llno 1, and cntor lho businoss/dlsrogffdod entity's nams on lina 2.) 2 Buslnos8 nmoldbrogardod onliiy namo, il difloront trom 8bov6. 4 Exomptions (codos apply orly to cortnh enlltl€. nol indivlduals; sea lnslniclions on page 3): ExomDt paym codo (it Bny) €x€mptlon frorn Fo'oign Accounl Tax Complianco Act {rATCA) roportl4g codo (il try) (Appllss to accMnls mainlain$ Nlsido tha UniIod Statos.) Requ€ster'a nflme end add.oss {opllonaD 7 | ,sl nccq,nl nurnbe(El h€re (opliorat or Under ponaltles ot perjury, I certity that: 'L The numbor shown on this form ls my correct taxpayor idonlifioation numbor (or I am waiting tor a nttmbor to bs issued to mo): and 2. I Bm not subJect to backup wilhholding bocouso (o) I am oxompt from backup withholding, or (b) I havo nol b6on nolltiod by tho Intornnl Rovonuo Service (lRS) lhat I am subiect to backup withholding 6s a result ol a falluro to report all int€rest or dividends, or (c) tho IRS has nolilied tne that I am rro longer subi€cl to backup withholding; and 3. I am a U.S. ciliz€n or oth€r U,S. pe€on {dofinod balow); and 4. Th6 FATCA codo($) onto.6d on ihls form (if 6ny) lndicaling lhat I am oxampt from FATCA roporllng is correct. Corimcailon lnstruc-llons, You must cross out itom 2 abovo ll you havo boen nollliod by tho IRS that you aro curronlly 6ubje.l to backup withholdhg because you have tailed to roport all intorest and dividonds on your tax r6tum. For roal estate Itansaclions, itom 2 does nol apply. For mortgage interest paid, acquisition or abandonment of secured property, canc6llation of debt, contributions to an individual r6tir€menl anengsment (lRA), and, generally, psn€nts othsr than intorost and 8r€ not to lhe but mugt conoct TlN. Se€ lho instrucllons for Parl ll, later Sign Here General lnstructions Seclion relerences ar€ to lh€ lntenlal Rovenue Code unless othsrwlse notod. Futurg dov6lopmgnts. For lh6 lat€gt informalion about dovolopmonts 16latgd lo Form W-g and lls instructlons, such ae l€glslatlon enacted atter they woro published, go to www.irs.govlFomw9, What's New Lino 3a has boon rnodilied to clarity how a disrogarded ontlty completss this lino. An LLC lhat ls a disregarded ontlty should chock lhe spproprlato box lor tho tax classlflcation of its ownor. Olhorwlso, lt should chsck lhe "LLC" box and en16r its appropri6t€ lax classlficatlon. Now line 3b has boon addod to this form. A tlow-lhrough €ntily i3 requlred to compl€to this line lo indicale lhat il has direct or indiroct lorelgn partners, owners, or b€neliciarios when il provides lhe Fonn W-9 to anothor {low-through ontity in which il hfls an ownershlp intorest' This chonga ls lntondod lo provldo a llow-through onlity with informatlon rogarding tho status ol it$ lndlroct forslgn partner$, owners, or bsnoliciarios, so that it can salisly any appllcablo rsporting roqulrsmsrrts, For example, a partne6hlp that has any indirect {orelgn partners may be roqulrod to comploto Schodtllos K-2 and K'3. Sao lho Pdrtnorshlp lnsttuctions for Schedulos K-2 and K'3 (Form 1065). Purpose of Form An lndlvldual or onllty (Fonn W-9 inlormation r€tum wilh lho IRS ls roquostor) who is roqulrod to lllo Bn glving you this torm b€cause lhey 3a Chack lh6 approprlalo box ttr tedoml lex classrflcation of lh6 entilylndivrduel vhose name is cnlered on Ine L Chack only on. ol the lollowing fovgn boxo0. f] lndlviduavsoloproDrlotor I Ccorporatlon f] Scorporallon I Pdrtncrchig f] Ttusvostalo n LLC. Eutnr th" tax classlllcollon (C = C mrFnnlion, S = S corporatlon, P.. Parlnorshlp) Nol.: Chek tho "LLC" box abovo aad, ln lhe snlry spac6, enl€r ths appropriate code (C, S, ot P) lor lhe tu- classlflcellon ot lho LLC, unl6ss ll ls I disrogerdad dltlly. A disr60ardod onlily should lnsl€ad chsk lhe atproftlslg box fot tho ld clas8ilication ot iB ownor. n Oth$(s6o inrlruclions) 3b ll on lino 3n you choched "Pdrtnorehip" or "Trusv8stat6," ot ctlockod "LLC" and sqteted "P'ss ils tu clossification, &nd you tr6 providlng this lom to R pa.tn€rship,1ru9t, or 6slnt€ in which you havo an ovJnership intersst, chtrk lhls box ll you have sny lorrlgn psrlnaF, own€'s, ot bonsticlarl€s, Ses inslruollons . 5 Addmss (numb€., $tresl, dnd apt. or sult6 no.l. S€e lnstnrcllons. 0 City, slat6, and ZIP coda ldenlificatlon NuPart I Part 1l Cal. No. 10231X Kittitas County Agreement for Services (rev.5/Ia/25) Page 14 of 19 rorm W-9 {nov. e-eotc} Form W-9 (Rev. 3-m24)Plg.e2 must obtain your corect laxpaye( identificatbn number ffiN), trfiich may be yow social security number (SSN), indivirhnl taxpayer idenlifcation number (mN), adoption laxpayer k entification number {ATlNf , or employer identification number (ElN), to r€port ofl an inlormatinn retum lhe amou'lt paid to you, or olher arnounl reporlable on an information relum. Examples of informalion r€furns include, but are not limited to, ihe following. . Fom 1O99JNT (interest eamed or paid). o Form lO99-DlV (dMdends, including those from slocks or mutual lunds). o Form 1 099-MISC (vadous types of income, pizes, awxds, or grose procaeds). . Form '1099-NEC {nonemployee compensation}. r Form 1O99-B (stock or mutual fund sales and certain oth€r Irar rsactlons by brok€rs). o Form 1O99-S (proceeds fom real estale trarca6{ions). r Form 1O99-K (merchanl card and third-party network transactions). o Form 1O98 (hotno mortgage interestl, 1098-E (student loan inter€stl, and 1098-T (tuition). . Form 1099€ (canceled debt|. . Form 1099-A (acquisition or abandonment of secured property). Use Form W-9 only if you are a U.S. person (lncluding a resident alien), to provide your con€ct TlN. Caution: lf you don't retum Fonn W-9 to the requesterwith a TlN, you might be subiect to backup withholding. See What rb bac&up witlrttolding,later. By signing the filled-out form, you: 1. Celtity that lhe TIN you are giving b con€ct (or )tou are waiting for a numb€r to ba issued); 2. Certify that you are not subiect to backup withholding; or 3. Claim exemptbn ftom backup withholdirq if pu are a U.S. exempt payee; and 4. Certify to your non-foreign slalus for purpoaes ol withholding under chapter 3 or 4 of the Code (rf applicable); and 5. Certify that FATCA code{s) entered on this form [f any) indicating lhat you are €x€mpt {rom the FATCA reporting is con€ct. See }Vhaf /s FATCA Heporting, later, for further information. Note: lf you are a U.S. person and a requester gives you a form other than Form W-9 to reque€t your TlN, you muat use the requ€€t€ds torm if it is substantially eimilar to this Form W-9. Delinition ol a U.S. pereon, For federal iax purposes, you ar€ considerod a U.S. person il you are: r An individual who is a U.S. cilizen or U.S. reskJenl alien; . A partne.ship, corporalion, company, or association creald ot organized in the United States or under the laws of the United States; . An sstate (other than a foreign estale); or o A domestic truet (as defined in Regulations secliongo1.77o1-7t. Establiohing U.S. atatu* lor purposec of chapter 3 and chapter 4 withholding, Payments made to foreign persons, including certain digtributions, allocations of income, or transfers of ralee proceeds, may be sublect to withholding under chapter 3 or chapler 4 of the Code (sections 1441-14741. Undar those rules, if a Form W-9 or olher certification of non-foreign status has not been received, a withholding ag€nt, transferee, or partnership (payor) generally applies presumption ndes that may require the payorto withhold applicable iax from the recipient, owner, transferor, or partner{payee}. See Pub. 5't5, Withholding of Tax on Nonresident Aliens and Foreign Entities. The following persons musl provide Form W-9 to the payor for purposes of establishing its non-loreign status. . ln the case of a disregarded entity with a U,S. ournet, the U.S. owner of the disregarded entity and not tha disregaded entity. . ln the case of a grantor trust with a U.S. granior or other U^S. owner, generally, the U.S. grantor or other U.S. oluner of the grantor trust and not the grantor trusl. . ln the case of a U.S. trusr {other than a grantor trusl}, the U,S. trust and not tfie beneficiaries of the tust. See Pub. 515 for mor€ information on providing a Form W-9 or a certification of non-foreign status to avcid whhholding. Kittitas County Agreement for Services (rev.5/].4/25]. Page 15 of 19 Foreign person. lf 1ou are a toreign person or the U.S. branch of a loreign bank thal hss elecled to be trealed as a U.S. person (under Regulations sectim 1.1441-1(bx2$v) or olher applicaHe seclion lor chapter 3 or 4 purpces), do not use Form W-9. lnstead, use the appropriate Form W-8 or Form 823:l (se€ Pub. 515). l{ pu are a qualified foreign pension fund under Regulations section 1.897{l)-1(d), or a partnerstrip that is wholly owned by qualified foreign penaion funds, that is treated as a non-{oreign person lor purposes ol section 1 445 wilhholding, do not use Fo.m W-9. lnstBad, use Form W-8D(P (or other cerlification of non-foreign status). Nonresident alien who becomes a resident alien, Generally, only a nonresident alien individual may use the terms ol a tax treaty to reduc€ 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 p€rmit an exemption from tax lo cirntlnue for cenaln types ol rncomb even atter lhe payee has otherwise become a U.S. resident alion for tax purposes. ll you are a U.S. rosident alien who is relying on an exc€ption contained in lhe aaving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statemEnt to Form W'9 that specifiee the following five items. 1. The treaty country. Ganerally, this must be the eame tr€aty unCer which you claimed exempiion fom tax as a nonresident ali€n. 2. The treaty article addressing the income. 3. The article number (or location) in the tax trealy thal contains the saving clause and its exceptions. 4. The type and amount of income that qualifies lor the exsmption from tax. 5. Sufficient facts to iustify the exemption trom tax under the lerms of lhe feary afiicle. Example. Articl€ 20 of the U.S.-China income tax teaty allows an exemplion from tax for scholarship incorne reccived by a Chinese student tempwarily prcssnt in th€ United States. Under U.S. law, thig student will become a resident alien for tax purposas if their stay in the United States exceeds 5 calendaryears. However, paragraph 2 of lhe first Protocol to th€ U.S.-China treafy {dated April 30. 1984} allows the provisions of Article 2o to continue to apply evsn aft€rthe Chinese stud€nt becomes a resideol alien of the United Stales. A Chinese student who qualifies for this exception {under paragraph 2 of lhe first Protocol) and is relying on thie exception to claim an exemption from lax on their echolarship orlellowship income would attach to Form W-9 a Btatement that includes the informalion described abov€ to suppott thal exemption. lf you are a nonreeident alien or a foreign entity, give th€ requ€slsr lhe appropriate completed Form W-8 or Form 8233. Backup Withholding What is backup wilhholding? Persons making cerlain paymsnts to you must und€r certain conditions withhold and pay to the IRS 24% of auch paymenls. Thie is call€d "backup withholding." Payrnents thal may be aubject to backup withholding include, but are not limited to, int€rsst, tax-sxempt interest, dividends, broker and barter exchange lransaclions, rente, royallies, nonemployee pay, paynents made in settlement of paym€nt card and third-party network lransactions, and cerlain paymsnts from lishing boat op€rators. Real €state transactions are not subiect to backup wilhholding. You will not be subiect to backup wilhholding on payments you receive il you give the requester your corecl TlN, make lhe proper cerlifications, and report all your taxable interest and divkJends on your tax retum. Payments you receive will be subject to backup withholding if: l. You do not fumish your TIN to the r€quester; 2. You do not certify your TIN when required {see the instnrctions for Part ll for details); 3. The IRS tells the requester that you fumished an inconect TIN; 4. The IRS tells pu that yan are suh{ecl to backup withholding because you did not report all your inlerest and dividends oo your tax rstum {lor reportable inlerest and dividends only); or 5. You do not certily to the requester that ydr are not subiect to backup withhdding, as described in item 4 under "By signing the filled- out form'above (lor reportable interest and dividend accounts opened after 1983 only). Form W-9 (Fev.3-2024)Pase 3 Cerlain paye€s and payments are exempt from backup withholding. See Exempt payee code, lalar, and the separate lnstructions lor the Requester of Form W-9 for more informalion. See also Esfab/ishrng U.S. status far purpses of chapter 3 and chaptet 4 withholding, eadier. What ls FATGA Reporting? The Fore[n Account Tax Compliance Act (FATGA] requires a participating forefgn financial institution to report all U.S. account holders lhat are specified U.S. pemons. Certain payees are exempt from FATCA reporting. See Frernption ftun FATCA rcprting code, later, and the lnsfuctions for the Requesler of Fom W-9lor rnore information. Updating Your lnformation You muct provido updatad informatiorl lu dfly lrefsurr to whom you chimed to be an ex€mpt pay€e il you are no longor an exempi payee and anticipate receiving reportaHa payments in the future lrom this person. For example, you may need to provide updated information if you are a C corporation that elects to b€ an S corporation, or if you are no longer lax exempt. ln addition, you musi fumish a new Form W-9 if lhe name or TIN changes for lhe account, for example, if lhe grantor ol a grantor trust dies. Penalties Failure to fumish TlN. ll you fail to lumish your conect TIN to a r€guester, you ar€ subiect to a penalty of $50 for each such failure unlese your failure is due to r€asonable cauee and not to willful neglect. Civil penalty lor lalge information with respoct to withholding. lf you make a fale€ siatement with no reasonable basis that results in no backup withholding, you are subject to a $500 penaliy. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including finee and/or imprisonment Misuse of TlNs. ll the requester discloses or uses TlNs in violalion of {ederal law, the requeater may be subject to civil and criminal penaltias. Specific lnstructions Line { You must enter ona of the following on this line: do not leavs lhis line blank. The name should match the name on yourt€x relum. lf lhis Form W-9 is for a ioint account {olh€. than an account maintained by a foreign financial inslitdion {FFl}}, list first, and then circle, the name of the person or entity whose number you entered in Part lol Form W-9. lf you are providing Form W-9 to an FFI to docurnent a ioint account, each holder of the accomt lhat is a U.S. person must provide a Form W-9. . lndividual. Generally, ent€r the nam€ shown on your tax return. lf you have changed your last name without inlorming the Social Security Administration (SSA) of the name change, enter your firot name, lhe laet nam€ a9 shown on your social security card, and your new last name. Nole lor lTlN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1a. This should also be the eame as the name you entered on the Form t O,tO you filed with your applicalion. . Sole proprietor. Enter your individual name as shown on your Form 1040 on line 1. Enter your business, trade, or "doing busineos as" (DBA) name on line 2. o Partnerehip, C corporation, S corporation, or LLC, other than a disregarded entity. Enter the enlity's name as shown on lhe €nlity's tax retum on line 1 and any business, trade, or DBA name on line 2. r 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 chader or other legal document creating the entity. Enter 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 ae an entity s€parate from its owner {a disregarded entiry). See Regulations section 301.7701 -2(c[2). A disregarded entity should check the appropriate box for the tax classification ol its owner. Enterthe owne/s name on line 1. The name of the owner entered on line 'l should never be a disregarded entity. The name on line I should be 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 15 of 19 example, if a foreign LLC that is tr€ated as a diaregarded entity lor U.S. federal tax purposes has a singh owner that is a U.S. person, the U.S. owner'g nama is required to Lre provided on lina 1. ll the direct owner of the entity is also a disregarded entity, enter the first ownet that is not dbregarded for federal tax purposes. Enter the disregarded enti$s narne on line 2. ll the owner of the disregarded entity is a foreign person, lhe own€r must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the loreign person has a U.S. TlN. Line 2 lf you have a business name, trade name, DBA name, or dbregarded entity name, enter it on line 2. Line 3a Check the appropriate box on lins 3a for the U.S. fuderal fax ula$silicatlon olthe pefsdn vuhose name is entered on line 1. Check only one box on line 3a^ Llne 3b Check this box il you are a partnership (including an LLC classified as a partrership for U.S. federal tax purpos€s), trust, or estate that has any foreign partners, owners, or beneficiaries, and you are providing this form to a parlnership, lrust, or €state, in which you have an ownership interest. You must ch€ck the box on line 3b il you receive a Form W-8 (or documentary evidence) lrom any partner, owner. or bene{iciary establishing foreign stalus or it you receive a Form W-9 from any partner, own€r, or beneficiary ttrat has checked the box on line 3b. Note: A parlnership that provides a Form W-9 and checks box 3b may be required to complete Schedules K-2 and K-3 {Form 1065). For more information, sse the Partnership lnstructions for Schedules K-2 and K-3 {Form 1065). lf you are required to complele line 3b but failto do so, you may not receive the information necessary to file a conect information refum with the IRS or fumish a correct payee statement lo your partner3 or beneficiaries. See, for example, sections 6698, 6722, and 6724 tor penalties that may apply. Line 4 Exemptions lf you are exempt from backup withholding and/or FATCA reporting, eriter in the appropriate space on line 4 any code(s) that may apply to you. Exempt payee code. ' Generally, individuals (including sole proprietors) are not exempt from backup withholding. o Excepl ae provided below, corporations are exempt from backup withholding for cerlain paymentre, including interest and dividends. . Corporations are not ex€mpt from backup wilhholding for payments made in settlement of payment card or third-party network transaclions. . Corporations are not sxempt from backup withholding with respect to attomeys' {ees or gross proc€eds paid to attomeys, and corporations that provide medical or health care seruices are not exempt with respect to payments reportable on Form 1099-M|SC. The following codes identify payees that are exempt from backup wilhholding. Enter lhe appropriate code in the space on line 4. 1-An organization exempt from tax under section 501{a), any lRA, or a custodial account under seclion 403{bX7) if the account satisfies lhe requirements of section a01 (f){2). lF the entityfindividual on line I is a{n} ... THEN check the box lor . Corooralion Corporation. o lndividual or . Sole proprietorship lndividual/sole poprietor . LLC classified as a partnership for U.S. federal tax purpoees or r LLCthathas filsd Form8832 or 2553 €lecting to be taxed as a corporation Limited liability company enter the appropriate tax classilication: P - Partnership, C=Ccorporation,or S = S corporation. and . Partnership Parlnership. r TrusVeetate TruByestale. Form W-9 {Rev.3-m24}Pgge4 z-The United States or any of its agencies or instrumenlalilies. 3-A state, the District of Columtria, a U.S. oommonweallh or territory. or any of thdr political subdivisions or instumentalities. 4-A foreign govemment or any of its political suMMsions, agencies, or instrumsnialities. 5-A corporation. 6 -A dealar in securities or commodilies required to regieter in the United Stales, the District of ColumLria, or a U.S. oommonwealth or tenitory. 7-A futures commission merchant registered wilh ihe Comrnodity Futures Trading Commission. 8-A real estate inveslmenl tu$t. 9-An entity registered at all times dudng the iax year under the lnvAslmenl rhmFany Act ot 1040, 1O-A comrnon trust fund operated by a bank under section 584(a). 1 1 -A financial institutiofl as defined under section 581. 12-A middleman known in the investment community as a nominee or custodian. 13-A lrust exempt t om tax under seclion 664 or descriH in section 4947. The following chart shorrs typ€ of payrn€nts that may be exempt from backup withholding. The chart applies lo the exempt paye€s list€d above. 1 13. lF the payment is for THEN the pryment i$ exempt for. . . . lnter€st and dMdend paynents All exempt payees excepl tor 7. Exempt payees-l lhrough 4 and 6 through 11 and all C corporalions. S corporations must noi enter an exempt paye€ code because lhey are exempt only for sales of noncovered securities acquired lo 2012. . Barter trangaclionB Exempt payees 1 through 4. and F-A dealer in securities, commodities, or derivative financial inslruments (including notional pdncipal conlracts, futures, fonvards, and options) that is registered as such under the laws of the United States or any state. G-A real estate investment trusl. H-A regulated investmenl company as defined in section 851 or an €ntity r€gietsred at alltimes during the tax year under the lnvestment Company Act ol 1940. l-A common trugt lund ag defined in section 584(a). J-A bank as delined in s€ction 581. K-A broker. L-A trust exempt from tax under section 864 or described in section aecT(a){1). M-A tax-exempt trust under a secrion am(b) plan or section 457(9) plan. Note: You may wish to consult wilh lhe financial institution requesting lhis torm to d€termine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address {number, sbeet and apartm€nt or suite nurnber}. This is where the requester ol this Form W-9 will mail your information retums. lf this address dillers fmm the one the requester already has on file" enter "NEW" at lhe top. lf a new addrees is pmvided, there is still a charrce the old address will be us€d until the payor changes your address in their r€cords. Line 6 Enter your city, stale, and ZIP code. Part l. Taxpayer ldentification Number tTlNl Enter your TIN in lhe appropriate box. lf you are a resident alien and you do not have, and are not eligible to get, an SSN, your TIN is your IRS lTlN. Enter it in the entry space for the Social security number. lf you do not have an fflN, sea How lo get a I/N below. lf you are a aole proprietor and you have an ElN, you may enter either your SSN or ElN. lf you are a singl€-member LLC that ie disregarded as an €ntity separale from ite owner, €nter the own€/e SSN (or ElN, if thE owner has one). lf the LLC ig classitied as a corporalion or partnership, enter the entity'a ElN. Note: See What Name and Number To Give the Requestdr,later, for further clarification of name and TIN combinalions. How to get a TlN. lf you do not have a TlN, apply for one immediately. To apply for an SSN, get Form SS-5, Apy'ication for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by callinggB-772-1213. U* Form W-7, Application for IRS lndividual Taxpayer ldentificalion Number, to apply for an lTlN, or Form SS-4, Application lor Employer ldentificalion Number, to apply for an ElN. You can apply for an EIN online by accessing the IRS website at www.irs.govlElN. Go to www.irs.pvlForns to view. download, or prinl Form W-7 and/or Form SS-4. Or, you can go to www.r'i6.govlOrde$orms to placa an order and have Form W-7 and/or Form S94 mailed to you within 15 business days. ll lou are asked to complete Form W-9 but do not have a TlN, apply for a TIN and enier "Apdied For' in the spaca lor the TlN, sign and date ihe form, and give it to the requester. Fof interest and dividend paymenls, and certain paym€nts made with respect to readily tradable inslruments, you will generally have 60 days lo get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other typ€s o{ payments. You will be subiect to backup withholding on all such payments until you provide your TIN to the requ€ster. Note: Entering "Applied Fol means that you have already applied for a TIN or that you intend to apply for one soon. See also Fslab/lshing U.S. status for purposes ot chapter 3 and chapter 4 withholding, earlier, lor when you may instead be subiect to withholding und€r chapler 3 or 4 of the Code. Caution: A disregarded U.S. enlity that has a loreign owner musl use lhe appropriate Form W-8. e Paymenls over $600 required to be reported and dir€ct sales over Generally, exempl payees 1 through 5.? . Paym€nts made in eettlement of Exempt pay€es 1 through 4. paymsnt card or third-party network iransactions r See Form 1099-M|SC, Miscellaneous lnformation, and ib instructions. 2However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt fiom backup withholding: medical and heahh care paymenta, attomeys'fees, gross proceeds paid to an attorn€y reportable under section 6045{4, and paynents for ser,uices paid by a federal executive agency. Exemption from FATCA reporting code. The following codes fuJentify pay€€s that are exempt fiom reporting under FATCA These codes apply to persons submitting this form for accounb maintained outside of the Uniled States by certain foreign financial instihrtions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Corsult with the p€Gon requesting this form il you are uncertain il lhe financial institution is subiect to these requiremenls. A r€quester may indicate that a code is not required by providing 1lou with a Form W-9 with "Not Applicable" (or any similar indication) entered on the line for a FATCA exemption code. A-An organization ex€mpt ftom tax under seclion 501{a} or any individual retirement plan as defined in section 7701(al(371. B-The United States or any of its agencies or instrumentalities. C-A state, the District of Columbia, a U.S. commonwealth or t€nitory, or any of their political subdivisions or instrumentalities. D-A corporation the stock of which is regularly trad€d on one or more ertablishsd securitiee ma*els, as dsscrib€d in Fegulalions saction 1 .1 47 2-l (cX1 )0. E-A corporation that is a member of the sama expanded affiliated group as a corporalion described in Regulations section 1.1472-1{c}{l}(i). Kittitas County Agreement for Services (rev. 5/14125) Page 17 of 19 Form W-9 (Hav. 3-2024|Pase 5 Part ll. Certification To establish to the wilhholding agent lhat you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sbn by the withholding agent even if item 1, 4, or 5 below indicates olherurise. For a joint account. only the pecon whose TIN is shown in Part I should sign (when required). ln the case of a disregarded entfu, the penon idenlified on line 1 must sign. Exempt payees, see Exernptpaye,e code, ea'J.;ier. Signature requirements. Complete the certification as indicated in ilemsl throughSbelow. J. lnteresi, dividend, and barter erchange accounts opened belore l9B4 and broker accounts considered active during 1983. You must give your correct TlN. but you do not hav6 to sign the certification. 2, lnterest, dividend, broker, and barter exchange accounts opened afler 1983 and broker accounts congidered inactive during l9&1. You muet sign the cedification or backup withholding will apply. lf you are subiect to backup withholding and you are merely p'roviding your conect TIN lo ths requester, you must cross out item 2 in lhe certification before signing the form. 3, Raal estate transactions. You musl aign the certification. You may cross out item 2 of the cerlification. 4. Olher paymente. You must give your conect TlN, but you do not have to sign the certification unless you have been notified lhat you hava previously given an inconect TlN. "Other paymenls" include payments made In the cours€ ol lhe requesler'g trada or business for renls, royalties, goods (other than bills for merchandiae), medical and health care services (including payments to corpo€tiofls), payments to a nonemployee for services, payments made in setdement of paymenl card and third-party n€twod( transactions, payments to c€rtain fishing boat crew members and fishermen, and gross proceeds paid to aftomeys (including payments to coporations). 5. Mortgage interest paid by you, acquisition or abandonmett of secured property, cancellation of debt, qualified tuition program payntents (uhder section 529), ABLE accounts (under seaion 520A), lRA, Coverdell ESA, fucher MSA or HSA contributions or distributions, and pension distributions. You must give your correcl TlN, but you do not have to sign the c-ertification. What Name and Number To Give the For this of accounl:Give name and SSN of: 1. lndividual 2.Two or moro individuals (ioint accounl) other than an account mahtained by an FFI 3. Two or mora U.S. penons (oint accouni maintained by an FFI) 4. Cuilodial account of a minor (Uniform Gift lo Minors Act) 5, a, The usual rcvocable savings buel (grontor is aleo lrusleo) b. Secalled trusl account lhal is not o legal or valid trusl under slate law 6. Solo propdaorship or dis.egatded entity owned by m indMdual 7- Grantor trusl filing under Optioml Filing Mcthod 1 (soo Regulations section 1.671 -a{bX2XiXA)i" Kittitas County Agreement for Services (rev.5/1'4125) Page 18 of 19 For ttris of accounl: $" Disregorded enlity not ovined by m irdividud 9- A valid trust, estaio, or pension trust '!Q- Corpomlion or LLC electing corporate 3tltus on Fo.m 8832 or Form 2553 't 1 . Association. club, rellgious, charitablo, eduealioml. or other tax€xmpt orgonization 12, Partmhip or multi-mernber ll0 13, A koker or regietered norrinee '14- Accounl witlr the Depatmmt of Agricufturc for the name ol a public entity {ruch a! e 3loto or loool governrnenl, school diskici, or prisonl that recaives agricuhunl program payrnents 15. Grantorlrustfilhg Form 1041 or under lhe Optional Filing Method 2, requiring Form l00g {se€ Regulatbru section 1.671 -4(b){2XilF))" Give name and EIN oll The owner Laqal entibd The corporation The orgoni:ation The partrership The broker or nominee Tbe public entity The actual drvn€r of lhe account or, if combined funds. the first individml on the accountl Eacfi holder of ihc aceount Thc minorz The grdnior-truoteet The actual olwrerl The owneP The grantor' The trusl ? List firgt and circle the name of th6 pe€on whose number you fumish. lf only one person on a joint account has an SSN, that person'g number must be fumished. 2Circle lhe minor's name and fumish the minor's SSN. 3You must show vour individual name on line 1. and enter vour business or DBA name, if ahy, on line 2. You may use either your SSN or EIN (f you have one), but the IRS encourages you to use your SSN. {List first and circle the name of lhe trust, eslate, or pension trust. (Do not fumish the IIN of the personal representativ€ or trustee unless the legal entity itself is not designated in lhe account litle.) 'Note: The grantor must also provide a Form W-9 to the truslee of the trust. " For more information on oplional filing methods lor grantor trusts, see the lnstructions lor Form 1041. Note: lf no name is circled when more lhan one name is listed, the number will be considered to be that of lhe first name listed. Secure Your Tax Records From ldentity Theft ldentity theft occurs when someons uses your personal in{ormation, such a-s your name, SSN. or other identihTing information, without your permission to commit fraud or other crimes. An identity thief may use your SSN to gel a iob or may file a tax r€tum using your SSN to receive a refund. To reduce your risk: o Protect your SSN, . Ensure your employer is protecting your SSN, and . Be careful when choooing a tax relum prcparct. ll your tax records are affected by identity theft 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 identity theft but you think you are at risk due to a loet or stolen purse or wallet, questionable credit card activity, or a questionable credit report, contact lhe IRS ldentity Theft Hotline at 800-90&4490 or submit Form 14O39. For more information, see Pub. 5027, ldentity Theft lnlormalion for Taxpayers. 'I Form W-9 (Rev.3-2024)Poga 6 Victims of ideniity thslt who are exp€riencing economic hann or a syEternio probl€m, or are seeking help in resolving tax problems that have not been resolved through normal chann€ls, may be eligible for TaxpayerAdvocate Service (fAS) assistance. You can reach TAS by calling the TAS toll-fee case intake line at 877-777-4778 orfTYffDD 800-829-4059. Prolect yourself from suspicioue emails or phishing schenres, Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. Th€ moat common act is sending an email to a user lalsely claiming to be an established legitimate enterprise in an attempt to scam lhe user into surrendering private information that will be used lor identitytheft. The IRS does not initiate contacts wilh taxpayers via emails. Aso, the IRS does not regu€st personal detailed information lhrough ernail or ask texpayom for tho PIN numbcrs. patlswords, ol silrrildr seursl ascess information for their credit card, bank or other financial accounls. lf 1tou receive an unsolicited email claiming to be ftom lhe lBS, fonvard thb message to phsftl4g€irs.gov. You may also report misusa of the IRS name, logo, or other IRS property to the Treasury lnspector General for Tax Administration IIIGTA] at 800-366-4484. You can lonvard suspicious emails to tha Federal Trade Cornrnission at spam@uce.gov orreport them at wwvr.ftc.gwlcomfiainf. You can contact the FTC at www,ftc.gavlidthef or 877-IDTHEFT {877-4i}8-4338). lf you have been the viclim ol identity theft, s* www.ldentityTheft.gov and Pub. 5027. Go lo www,irs.govlldentityTheft lo leam more about identity theft and how to reduce your risk. Kittitas County Agreement for Services (rev.5/14/25l, Page 19 of 19 Privacy Act Notice Section 6109 ol the lntemal Revenue Code requires you lo provide your conect TIN to persons (including federal agencies) who are required lo file information ratums whh lhe IRS to report interest, dividends, ot certain other income paid to you; mortgage interest you paid; the acquisition or abandonmeni of sscured property; the cancellation of debt; or contribdions you made to an lRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information retums with the lRS, reporting the above information. Routine uses of thb information irrclude giving it to the Department ol Justice for civil and criminal litigation and to cti€s, stale6. the District of Columbia, and U.S. commonwealths and tenitories for use in administering their laws. The information may also be disclosed to other counlries under a treaty. to {ederal and state agencies to enforce civil and cnmrnal laws, or to federal law enforcement and intelligence agencies to combat tenorism. You must provide yourTlN whether or not you are required to lile a tax retum. Under s€clion 3406, payors must generally wirhhold a percentage ol taxable interest, dividerds, and certain other payments to a payee rrho does not give a TIN to the payor. Certain penalties may also apply for providing false or fraudulent infrcrmalion.