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HomeMy WebLinkAboutKittitas County & Damman SchoolKITTITAS COUNTY AGREEMENT FOR SERVICES PHMH26-005 This Agreement for Services (hereinafter "Agreement") is entered into by and between Kittitas County (hereinafter "County"), a politicalsubdivision of the State of Washington, and Damman School District (hereinafter "Contracto/'). The purpose of this Agreement is as follows: L/LOth funding to Damman School district to provide mental health services and prevention strategies to the students in Damman School District. The term of this Agreement shall be from July t't,2026, through June 30th, 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 205 West 5th Ave, Suite 108 Ellensburg, WA 98926 Kasey Knutson Human Services Manager Kittitas County Public Health Department Kasev. knutson@co. kittitas.wa.us s09.962.7090 2681 Umptanum Road Ellensburg, WA 98925 Timothy Lawless Superintendent Damman Schooldistrict timothv. lawless@dam ma nschool.ore 509-952-9079 This Agreement includes the following, which are attached hereto and hereby incorporated by this reference: Attachment "A": Attachment "8": Attachment "C": Attachment "D": Attachment "E": Attachment "F": Kittitas County Agreement for Services (rev. 5/M/25l1 Page 1 of 21 Scope of Work Compensation lnsurance Requirements Reporting General Terms and Conditions W-9 (Contractor must complete and return to the County for payment) tN 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.5/M/251 Page2 of 2L *, ( a c t r".r-$-e,^-t \'.*tl- ritre 20z6 "ga'L7 CONTRACTOR Signature Printed Name Date !1 z4L6 Clerk rt KITTITAS COUNTY BOARD OF COUNW Commissioner g 0Date: Attest ATTACHMENT "A" SCOPE OF WORK ln addition to providing all material and labor, the Contractor shall perform the following activities: o Contract with a licensed mental health care provider to provide mental health services for the students of Damman School as described in the Damman School District Proposal. o Fifth grade camp attendance fees . lmplementation of a Visual Arts and Social-Emotional Wellness Program. Kittitas County Agreement for Services (rev.5/M/25) Page 3 of 21 ATTACHMENT "B,' COMPENSATION THE COUNTY WILL NOT PROCESS PAYMENT FOR SERVICES RENDERED UNDER THIS AGREEMENT UNTIL CONTRACTOR SUBMITS A COMPLETED W-9 (SEE ATTACHMENT "E"). As full compensation for satisfactory performance of the work described in Attachment"A", and within thirty (30) days of receiving Contractor's itemized invoice, the County shall pay Contractorthe following amount(s) plus any applicable taxes as detailed in Contractor's invoice: 59,900' Allowable direct expenses include, but are not limited to, salaries, wages, benefits, direct client services, promotion, outreach activities, necessary supplies, professionaldevclopment and training, travcl, cquipmcnt, and subcontracts. Purchases of clothing, incentives, video games and related items are not allowed. Food and gift card purchases require prior approval by Kittitas County. All expenses must be necessary and directly related to the scope of work as outlined in Exhibit A. Contractorwill 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. Any uses of these funds outside of the listed allowable uses must be approved by Kittitas County in advance of the expenditu re, in writing. Allfunding is based on localtax and fee revenue. lf local economic conditions result in insufficient funds to compensate at the stated levels, the County reserves the right to renegotiate funding amounts to remain within available revenue balances. The County will notifi7 the Contractor immediately if financial forecasting or actuals indicate such a circumstance. All funds must be spent by June 30, 2027. No extension of the funding period will be granted. Reim bu rsement Procedu res 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 tast day of the month fottowing the catendar month in which services were detivered. C. The Contactor must provide adequate backup documentation to support costs in each invoice. This includes a general ledger from the financial accounting system detailing transactions and expenditure dates for allowable activities within the period of performance. Payroll expenses must show employee names, hourly rate, number of hours, total pay, and project code. Benefits can be one line item but should include project code. Non-payroll expenses must include a copy of the receipt or payment invoice. Payments to subcontractors must be listed as a specific line item per subcontractor. D. All invoices must include invoice date and an invoice number. E. All invoices must also be accompanied by an updated Contractor Spending Form, as provided by Kittitas County, to ensure that billing record keeping matches County records. F. Failure to submit required monthly deliverable reports as outlined in Exhibit A: Scope of Work may result in delayed reimbursement payments or denial of invoices. G. Kittitas County is not liable for services provided unless the invoice is received on time or prior arrangements are agreed to in writing signed by the County. ln no event shall payments under this agreement total more than 59,900. Kittitas County Agreement for Services (rev. 5/t4/251 Page 4 of 21 Contractor will refer to their approved documents submitted through the funding request process for the I/t1th of 1% Mental Health and Chemical Dependency Tax Grant. Any changes or updates made to the activities or budget listed in those documents must be approved by Kittitas County through the appointed contract manager in advance, in writing. Kittitas County Agreement for Services (rev.5/La/251 Page 5 of 21 ATTACHMENT'C" I NSURANCE 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 Contracto/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 bytheCounty. lfaninsurerisnotadmitted,allinsurancepoliciesandproceduresforissuingtheinsurancepolicies 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 I Coverage limits not less than: e $1,000,000 per occurrence, for all covered losses o $2,000,000 general aggregate . S1,000,000 products & completed operations aggregate . S1.,OOO,000 personal and advertising injury, each offense r The policy must be endorsed to include the County and its officials, employees and agents as additional insureds. Commercial Automobile Liabilitv lnsurance r 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: o $1,000,000 combined single limit Excess or Umbrella Liabilitv r 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. r This requirement may alternatively be satisfied through Contractor's primary Commercial General and Automobile Liability coverage, or any combination thereof. r The policy must be endorsed to include the County and its officials, employees and agents as additional insureds. r Coverage shall be "pay on behalf", with defense costs payable in addition to policy limits. r There shall be no cross liability exclusion precluding coverage for claims or suits by one insured against another. Workers' Compensation & Emplove/s Liabilitv r Contractor shall provide Workers Compensation and Employe/s Liability insurance on a state-approved policy form providing benefits as required by law with employer's liability limits no less than S1,000,000 per accident or disease. Kittitas County Agreement for Services lrev.5/14/25) Page 6 of 21 x Professional Liabilitv / Errors and Omissions Liabilitv . Coverage limits not less than: . S1,000,000 each claim r 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/L4/25) PageT of 2l ATTACHMENT ''D.' REPORTING Contractor shall provide quarterly progress reports using the template provided. Please submit progress reports to the clerk at healthandhumanservices@co.kittitas.wa.us' o Quarter 1 (January-March) report due on the last day of April. r Quarter 2 (April-June) report due on the last day of July' r Quarter 3 (July-September) report due on the last day of October. o Quarter 4 (October-December) report due on the last day of January. The report shall include, at a minimum: o A narrative of project activities during the reporting period, including progress on the activities outlined in your Scope of Work (Attachment "A"). o A narrative of project successes during the reporting period. o A narrative of project challenges during the reporting period. The County retains the right to request clarification or additional information of the applicant as needed to assess project progress and/or appropriate use offunds. Failure to submit the required reports may result in delayed reimbursement payments, denial of invoices, or contract termination. Contracts, reporting, and invoicing documentation is subject to public disclosure. Please refrain from using individual names in these documents. These documents may be posted to the Kittitas County Public Department's Website at any time to provide transparency in the use of tax funding. Kittitas County Agreement for Services (rev. 5/L4/25) Page 8 of 21 ATTACHMENT "E,, GENERAT TERMS AND CONDITIONS 1. Scope of Contractor's Services: Contractor agrees to provide to the County services as set forth in Attachment "A". No materials, labor, or facilities will be furnished by the County, unless otherwise provided herein. All work performed under this Agreement shall comply with applicable laws and regulations. 2. Accounting and Pavment: Compensation to Contractor for services rendered under this Agreement shall be as set forth in Attachment "B". Where Attachment "8" requires payment(s) by the County, payment shall be based upon billings, supported unless provided 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 rcquested. Unless specifically stated in Attachment "8", the County will nut 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 tha n monthly, through the Cou nty voucher system, for Contractor's services pu rsua nt to the fee schedu le set forth in Attachment "B". 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 theCountytomakewithholdingforanytaxesotherthanincometaxes(e.g.,Medicare). Allcompensationreceived 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) Contracto/s gross or net income, or (2) personal property to which the County does not hold title. The County is exempt from federal excise tax. 4. Independent Contractor: Contracto/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 "8", 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. Assisnment 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.5/7a/251 Page 9 of 21 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 Su bcont racto r's pe rfo rm a nce of the su bcontract. 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 aftcr tcrmination or expiration of thc Agrccmcnt, 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 Contracto/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 adjustmenU 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.5/14/25l' Page 10 of 21 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 expelrses, ilrcluding but not llmlted 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 (21are directly or indirectly arising out of, resulting from, or othenarise 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 Contractol'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-Appropriationof Funds: lf theCountydoes notappropriatesufficientfundingforthisAgreement for any future fiscal period, the County will not be obligated to make payments for services performed after the end of the last fiscal period for which sufficient funding was appropriated. No penalty or expense shall accrue to the County in the event this provision applies. L2. Contractor Commitments, Warranties, and Representations: Contractor represents and warrants as follows: Kittitas County Agreement for Services (rev,5/7a/251 Page 11 of 21 t2.L Contractor is duly incorporated, validly existing and in good standing under the laws of the State of Washington, and has all requisite corporate power and authority to enter into and to perform its obligations under this Agreement. I2.2 Contractor has the authority to execute this Agreement, to make the representations and warranties set forth herein, and to perform its obligations hereunder. L2.3 This Agreement has been validly executed by an authorized representative of Contractor and constitutes a valid and legally binding and enforceable obligation of Contractor. LZ.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 certificaLiun or llcenshg bodies, as are necessary for the lawful performance of its obligations under this Agreement, and will maintain such throughout the term of this Agreement. lZ.S Contractor is not in violation of any applicable law, ordinance or regulation the consequence of which willor may materially affect Contractor's abilityto perform its obligations underthis Agreement. Contractor is not subject to any order or judgment of any court, tribunal or governmental agency which materially and adversely affects its operations or assets in the State of Washington, or its ability to perform its obligations under this Agreement. 12.6 Contractor is not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal or State department or agency. IZ7 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 orsubcontractors, 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. lntetlectuat Propertv lnfrinsement: Contractor will defend and indemnify the County from any claimed action, cause or demand brought against the County, to the extent such action is based on the claim that information and/or materials supplied by Contractor infringe any intellectual property rights of any third party(ies). Contractor will pay all costs and damages attributable to any such claims finally awarded against the County in any action. Such defense and payments are conditioned upon the following: (1) Contractor shall be notified promptly in writing by the County of any notice of such claim; and (2) Contractor shall have the right hereunder, at its option and expense, to obtain for the County the right to continue using the information and/or materials that are the subject of such claim, provided no reduction in performance or loss results to the County' 15. Use of County Name and Logo: Contractor may not use the County's name, logo(s), trademark(s), or other identifying information, or identify the County as a current or former client, on its website or in any marketing or promotional materials without the prior written consent of the County. i.6. Disputes: Any dispute between the parties arising under or relating to this Agreement shall be resolved informally if possible. However, in the event such a dispute cannot be so resolved, it shall be adjudicated Kittitas County Agreement for Services (rev.5/14/251 Page L2 of 2L by a dispute board ("Dispute Board") in the following manner: Each party shall appoint one memberto 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: (L) 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. L7. Confidentialitv: Corrl.lacl.or, lts 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 Contractot's address listed on page 1 of this Agreement. L9. Prevailins 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 orworking 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/M/25) Page 13 of 21 2t.t 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, maritalstatus, honorably discharged veteran or military status, orthe presence of any sensory mental or physical disability or the use of a trained dog guide or service animal by a person with a disability. Such requirements apply, without limitation, to the following: employment, promotion, demotion, transfer, recruitment or rccruitmcnt advertising, layoff or ternrinatiort, rates u[ 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. ZI.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. ZL.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 anyweight in the interpretation orconstruction of the provisions of such sections or paragraphs. 24. Survival: The provisions of paragraphs 2,3, 4, 6,8, g, LO, L3,14,75,16, t7 , 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 otheruvise, 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. 25. 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.5lt4/251 Page L4 of 2L 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.5h4/25l- Page 15 of 21 ,.*,,,,lllf-9 (Hev. March 20?4) Depanor€ni of lhe Tr€dsury lrltornal Rcvonuo Scryico AfiACHMENT "F" Request for TaxPaYer ldentification Number and Gertification Go lo www.irs.govl FormW9 lor instructions and the latest information. Give form to the requester, Do not send to the lRS. tri o6dd co tlEao>E oca6 OoE oav, do Befote Entsr your TIN in the appropriate box, The TIN provided milst rnatch the name givell on line I to avoid backup lvithholding. For individuals, ;hie is gonorally your social security number {SSN}. ljowovor, for a re$ident alien, $016 proprietor, or di$rcgard€d entity. see th{: in$trrotions for Ptri l, ialer. Fo. other entities, it is you. etnployer idenliiication nurntler (ElN). ll yoil do not have a rumber. see How to gel a I//V, later. Nots: lf the account is in moro thalt snc name, see the hrstrtictions lor line 1. Soe also yyial ilaffe and Number To Qiva the Rectuester latr quide lina$ on whoso number lo snler. For relalfrd to the of Forrr)$e6 of Foftn , balow . I Name ol entitylindivld.rsl. An eniry i3 tequjred. {For a 3ole p.opristqr or disregarded enti!/, entc.the o\vner'3 .ame on line 1. and euter lhe b!5i11€stdisreqsrded en:tiy's name on line 2.) 2 Susiooss narno/disr€Eardod cnlilv namo, it dilFcrollt trom abovG. 4 Exonptions {codcs apply only to cedain entilles, not indi\.iduals: see instrlclpn$ on page 3): Exempt oayoe code {i, nny} Ex.lnplknr froil Foreigl Atcolnt Tnx Compl'anc6 Act IFATCA} roporling cod8 lif ey} {Applias to acccutll$ maintaineci elside #Je Unilod Stafes.l Rerluesler's nAme xrxl address {optlonar} 7 1 $l accqrnl nlnlfler(s) here{opti.rilal ot Under penalties of perjllry, I certify that: 1 . The number shown on this form is my correct taxpayer tclentilicalion number (or I am lvaiting for a nilmber to bo issued to lne); and g. I am nol slbject to backrp wilhholcling bocausB (a) I arn exornpt tron backup wilhholding, or {b) I have nol been notifie<J by :he lnler.tl Revenue Se/vice {ln$i tha! I arn subject to backup vr'ithholding as a result of a tBilu.e to report all interest or dividends, ot {c} lhe lFlS il6s nolilied me tlral I ar}l Do longer silbiect to backup'.{ithholding; and 3- I am a U.S. otizen or other U.S. peBon {detined belol'r}: and 4. The FATCA code(s) entor€d on thi$ form (if any) incjicaling that I an] sxempt frorn FATCA reporling 's correct. Ceftmca{on insttuctions. You rfiust cross out iteln 2 above if you have been nolified by the IRS lhat you ar€ currcntly subject to backup withhokjing b€causa you have lailed to report all inter€st and dlvidends on your tax rstunl. For real estate lrar]saclions, iteln 2 doos not apply- For mortgage ilterast paici, acquisition or abalrdonment of secured propefry. cancallation of debt, cortttibutions io an individuai generally, payrnents 3d Ch$klheRppot)rialeollx'.rrledersllar(lassrlicdl;oilqflhesnirlylindrvidual$hqsenarnsis oiliy on6 ol tho lollowrrq 36{0r boxes, E Individuavsoleprogriotor ! Ocorporarion I Scorporatiorr ! radncrshio n Trusi,'c$tato n LLC, arrlai lln! l€r r.l.rssifir.altrt: (C = C lbrf{,rilloh, b - S coiPorsllon, P - Parlr.vshrp} lJole: Chsk lfre "LLO" l)ex above rrd, h lhe etlry sp!(e, enler lhe aplilopriate code {C' S, or P} lor the lu elasslflcation ot tho Lle, ui1066 it is a rlisto0ardod ontity. A {Ji6rcg6rriel entiiy should insl6ad chek lho aopropriald box for:ho tax tlassiiication ol its ownar n OtlBr {soe il3tructbr$) eolerd oil lrne I - Che.ik 3b ,f on lino 3a you checked "Partna.ship" or ''Trosusstate," o. cl'ccked "LLC' and ontered "P" as ,ts lox classiiicalion. $d you afa providing lFis forT lo i psrtne/shrp, lrust, o. eslal€ in which you have ao o\rnorseip lnl€.esl, check thislioxifyor;lravea;yloreignpart.reF,ov/[es,o.be.rcliciafie$.Sce;l]slrdollirns ' n 5 Address (nurrbe., 5lr4l, and spl or suite no.i. Sec lnslnlclions. 6 City. stat€..rrd ZIF codo ldentification NumberPart I Employe. identmcation numbat Part ll oiher than intorsst and dividonds,are not roquired lo sign lhe Sign Here but nust ions for Part ll, later. Dalo New line 3tr has beon adcied to lhis form. A flow-lhrough sntily is requi/ed to conlplste this line to indicate lhat it has direct or indirecl foreign paillers, owners, ot beneliciaries vJhelr i1 provides lhe Fonn W-9 to another tlow-through sntily in which ii has an ownership rnterost. 'l'his chang{r is intsndad to providc n ilow-thtough entity !vith informalion rogardiog lho status ol its inditect foroign pa/tners, ownors, ol beneliciati6s, s6 that it can 6atjsfy any applicable tsporting requirements. For exarnple, a partllership lhat has atry hrdirect loreign partners may be required to complete Schedrles K-2 and K-3. See the Parlnership lnstructions for Schoclules K-2 lrnd K 3 {Form 1065}. Purpose of Form An indivlc.lual or oiltity (Form w-9 reqileste4 who is rcquired to lile all inforination ret(nr with the IRS is giviug you this loiln becarlse thoy Signaturo of U.S. psrson General lnstructions Section relerences are to the Intenlal Bevelrue Code ulless olhenvise noted, Futuro dovslopm€nts. For the lal8si intormation about devoloprnents relaied 10 Form W-9 and its instruclions, such as legislation enacted atter they were published, go lo w.irs.gov/FonnlJtlg, What's New Llno 3a has be€n rnodilied to clarily hovr a disregarded entity complstes lhrs lin€. An LLC lhat is a drsregarded entity should check the appropriate box lor:h€ lax classification of its owner. Olhe^T i50, it should check the ''Ll-C" box :rnd enler its appropriate tax classiticalioil. Cal. ND, 102:tlX Kittitas County Agreement for Services (rev. 5/74/25l' Page 15 of 21 Forn W-9 (Rcv 3 2024, Form W-8 (Rev. 3-?0241 Past 2 must oblain your correct l.xpayer identification number OIN), which may be your social s€curity number (SSNI. indiuidual taxpayer ide;tificaiion number {lTlN), adoption taxpayer identification number (ATIN), or employer identilicstion rumber {ElN}. to report on an informalion relum ths arnount paid to you, or other amounl repoatable on an infonnalion reium, Exarnples of information relums include, bul are not limited to, fte following. . Form losglNT (interesl eamed or paidl, o Form 1099-DlV (dividends, including those bom stocks or mutual funds). ' Form 1099-MISC {vaJious types of income, prizes, awards, or gross proceeds). r Form 1099-NEC {nonernployee comp€flsation}. r Form 1099-9 (stock or mulual fund sales and certain other transactions by brokersJ. . Form 1099-S (proceeds ftom real eslate tnansactions). . Foffii lu99-K tmerchant card and third-party network transactions). . Form 1098 {home mortgage interest), 1098-E (student loan interest}, and 109s-T (tuition)- . Form 1099-C (canceled debt|. r Form 1099-4 (acquisition or abandonrnent ol secured propedy). Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TlN. Caution: lf you don't retum Form 1/t/-9 lo the requester with a TlN, you might be subject to backup withholding. See Whatis bac&up withholding,laler. By signing lhe lilled-out {orrn, you: 1. Certily that lhe TIN you are giving is conect {or you are waiting tor a number to be issued); 2. Certify that you are not subiecl to backup wilhholding; or 3. Claim exemption lrom backup wiftholding il you are a U.S- exempt payee; and 4. Certify to yout non-foreign stalus for purposes o{ rvithholding under chapter 3 or 4 bf the Code (i{ applicable): and 5. Certifo that FATCA code(s) enlered on this form {if any) indicating that you are exempt from the FATCA reporting is corect. See what /s FATCA Reporting, later, for further information. Note: lf you are a U.S. person and a requester gives you a form other than Fomr W-9 to request yourTlN, you must use lhe requester's lonn if it is substantially similat to this Form W-9- Definition ol a U,S. person. For fedeml tax putposes, you are considered a U.$. person il you are: . An individual who is a U.S. citrzen or U.S. resident alien; . A partnership, corporalion, company, or association created 9r orginized in the United States or under lhe laws of the United States; . An estate (otherthan a foreign estaie): or . A domestic trust {as defined in Begulations section 301'7701-7). Establishing U.S. status for purposes of chapter 3 and chapter 4 withholding. Payments made to foreign persons, including certain distributioni, all6calions ol income, or ttansfers ot sales proceads, may be subject to wilhholding under chsPtet 3 or chapter 4 of the Code (sections 1 441 -147 4). Under those rules, il a Fsrm W-9 or other iertification of non-foreiqn stattts has not been received, a withholding agent, transferee, or pa16rership {payor} g+nerally applies presumption rules that may require lhe payor lo lrithhold applicable lax trom the recipient, owner. Fansferor, or parlner {payee). See Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities. The following persons must provide Form W-9 to the payor for purposes of establishing its non-foreign stalus. r ln the case of a disregarded entity $ith a U.S. orvner, the U.S. owner of the disregarded entity and not the disregarded enlity. . ln the case of a grantor trugi with a U.S. granlor or other U.S. owner, generally, lhe U.slgrantor or other U.S. owner o{ the grantor trust and not the granlor trust. r ln the case of a U-S. trust (olher than a grantor trust), lhe U.S' trust and not the beneficiaries of the trust. See Pub. 515 for more information on providing a Form W-g or a certification of non-foreign status to avoid I'rithholding- Foreign person, lf you are a foreign person or the U.S. branch of a foreigi b'ank that hds elecied lo b,e treated as a U.S person {under Regulations seclion 1.1441-1p){2}{iv) Dr olhet applicable section tor chtpter 3 or 4 purposes), do not us€ Fo.m W-9- lnstead. use the appropriate Form W-8 or Form 8293 {see Pub. 515). ll you sre a oualrliid foreiqn pension fund under Regulations section 1 .897(l)-l (d)' orj parrnership inat is wholly owned by qualified foreign penson funds, that is treated as a non-toreign perscn {or puryoses of s€clion 1445 withholding, do nol use Form W-9. lnslead, use Form W-8D(P {or other certifi cation of non-foreign status). Nonresident alien who becomes a resident alien. Geneally. only a nonresident alien individual may use the terms of a tsx treaty to reduce or eliminate U.S. 1ax on certain tyPes of income. However, most tax lrealieg contain a provision known as a saving clause. lxceplions specified in the saving clause may p€rm( an exemplion from lax lo cbntinue for certain ryles of incomb even afler the payee has otfrerwise become a U.S. resident alien for tax purposes. ll you arc a U.3" tesidcrrl alittr wlro i$ i€lylng on gn exdeptmn cont-ained in the saving clause ol a lax treaty lo claim an exemplion from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following {ive ilems. 1. The treaiy country. Generally, this must be lhe sa$e treaty unde)- which you claimed exemption ftom tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the lax ttealy that conta;ns the saving clause and its exceptions. 4. The type and amount of incorn€ that qualifles for tfie exemption from tax. 5. Sufficient facts 1o juslify the exemption from tax under the lerms of the treaty article. Exanple. Article 20 of the U.S.-China income tax teaiy allows an exemptibn lrom tax for scholarship income received by a Chinese studeht temporarily present in the United States. Urder U.S. law, this student will become a rcsident alien for lax putposes if their stay in the United States exceeds 5 calendar years. However, paragraph 2 of the firsl Protocol to the U.S.-China lreaty (dated April 30, 1984) allows the provisions of Article 20 to continu€ to apply even after the_Chineae student becomes a rcsident alien of lhe Unhed Siates. A Chinese student who qualifies lor this exc€ption {under Paragraph 2 of the first Protocol) and is relvinq on this exception to clatm an exemption from tax on their icholarshif oifellowship in6ome would attach to Form W-9 a statemenl that inciudes the in{ormation described above to support that exemption. lf you are a nonresident alien or a foreign entity, gite the tequester the appropriate completed Form W-8 or Form 8233- Backup Withholding What is backup withhokling? Persons making cerlain payments to you must under ce*ain conditions withhold and pay to the NF$ 24% of such payments. This is called "backup withholding." Paymenls that may be subject to backup witfrholding include, but are not limiled to, inierest, tar-exempt interest, dividends, broker and barter exchange transactions, rents, royalties. nonemployee pay, paymenls made in settlement of paymeni card and third-patty net'iJork transaclions, and certain paymdnti from fishing boat operalors. Real estate tranaactians are nol srbject to backup wilhholding. You will not be subject to backup withholding on Payrnente you receive if you give the requester your conect TtH, make lfle proper carlificalions' and report all your taxable inlerest and dividends on your tax retum- Paymenls you receive will be subject to backup withlrolding il: 1- You do not fumish your TIN to lhe requester 2. You do not certify your TIN when required {see the inslnrclions Jor Parl ll for details); 3. The IRS lells the requesterthat you furnished an incorrect TIN; 4. The IRS tells you tfiat you are subiect to b.ackup wilhholding because you did not report all your interest and dividends on your tax retum {tor reportable interest and dividends only}: or 5. You do not certify to the requester that yoil a(e not subiect to backup rvithholding, ds described rn item 4 under "By signing lhe filled- out foim'' above for reporlable interesl and dividend accounts oPened after 1 983 only). Kittitas County Agreement for Services (rev. 5/7a/251 Page L7 of 2L Fom W-9 lRev.3-2024)Page 3 Cerlain payees and payments are exempt from backup withholding. See Fxem!l layee code,'later, and the separate lnsttuctions for the Requester of Form W-9 for more infomtation, See also Fstab/lshing U.S. status for purposes of ehapter 3 and chepter 4 withhdding, eaflier. What ls FATCA Reporting? The Foreign Account Tax Compliance Ac1{FATCA} requires a parlicipating foreign financial institution to r€port all U.S. account holders thai are specified U.S. persons. Certain payees are exempt from FATCA reporting.'See Evemptiirn from FATCA repofting code,later, and the lnstruclions for the Requesler of Form W-9 for more information. Updating Your lnformation You musl provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable pavments in the future from thin peeon. F6r example, ybu may need to provide updated information if you are a C corporalion that elects to be an S corporation, or if you are ho longer tax exempt. ln addition, you musl fumish a new Form W-g if the naire or TIN chinges for lhe account, for example, if lhe grantor ol a grantor lrust dies. Penalties Failure to firmish TlN. lf you fail to fumish your correct TIN to a requester, you are subiect to a penalty of $50 for each such failure unl-ess youi failure is due to reasonable cause and nol to will{ul neglect. Civil penalty lor false information wilh respect to withholding' lf you make a false statement with no reasonable basis that results ln no backup withholding, you are subject to a $500 p€nalty- Criminal penalty for falsifying inforrnation. Willfully falsifying certifications or affirmatians may subject you to criminal penalties including fi nes and/or imprisonment. Misuse of TlNs. ll the requester discloses or uses TlNs in violation of {ederal law, lhe requester may be subiect to civil arrd criminal penalties- Specific lnstructions Line I You must enter one of the following on this line; do not leave this line blank. The name sftotlld match the name on your tax letum. lf this Form W-9 is for a ioint account (other than an account maintained by a foreign financial institution (FFl)), list firsl, and then circle, the name of the person or entity whose nutnber you entered in Part I cf Form W-9. lf you are providing Form W-9 1o an FFI lo document a ioint account, each holder of the account that is a U.S. person must provide a Form W-9, . hrdividual. Generally, enter the name shown on your tax retum. lf you have changed your last name without informing lhe Social Security Administrition (SSA) ol the name change, enter your first name, the lasl name as showd on your social security card. and your new last name. Note for lTlN applicant Enter your individual name as it was entered on your Form W-7 application, tine 1a. This should also be the same as lhe name you entered on the Form .1040 you filed with your application. . Sole proprietor, Enter your individual name as shown otr your Form 'l 04o on line 1. Enter your business, trade, or "doing business as" (DBA) name on line 2, . Partnership. C corporation, S corporatiolr, or LLC, otherthan a disregarded'entity. Enter ths entily's name as shown on the entity's tax retunion line 1 and any business, trade, or DBA name on line 2. o Other entities, Enler your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or olher legal document creating the entity. Enter any business, trade, or DBA nam6 on line 2. . Disregarded entity. ln general, a business entity that has a single owner, including an LLC, and is not a corporation, is disregarded as an entity separate ftom its owner {a disregarded entity)' See Regulations section io1.zzo1-2{cJ(2). A disregarded entity should check the appropriate box Jor the lax class;fication of its owner. Enter the owner's nime on line .l - The name of lhe owner entered on lir.re 1 should never be a disregarded entity. The narne on line 1 should be the name shown on the incime tax retrim on rvhich the income should be reported. For THEN check the box lcrlF the entity/individual on line I isa{n)... . Corparation Corporation. . lndividuat or . Sole proprietorship lndividual/sole proprietor . LLC classilied as a pannership for U.S. federal tax purpo3es o{ . LLC that has iled Fo,m 4832 or 2553 electing to be taxed as a corporalion Limiled liability company and enler the eppropriate tax classification: P = Partnership, C=Ccorpcralion,or S = S corporation. . Par-brership Partnership. Trusuestate TrusUestale, examole. if a foreiqn LLC that is lreated as a divegarded entity lor U'S. federal tax purpos-es has a singt€ owner that is a U.S person, the U.S. owner's narne is raquired to be provided on line 1' ll the direct owner oi the entiiy is a,so a disregarded enthy, enter lhe first ownet that is not disregaried for federal tax pul'poses. Enler the disregarded entity's name on fine 2. lf the owner cJ the disregarded entily is a foreign person, lhe owner must complete an appropriate Form W-a instead of a Form W-9. This is the case even if the foreign person has a U.S- TlN. Line 2 lf you have a business narne, lJade nane. DBA name, or disregaded entity name, enter it on line 2" Line 3a Check the appropriate bcx on line 3a for lhe U.S. federal tax classification bf lhe pe{Eon who$e flame is enlered on line 1. Check only one box on line 3a. Line 3b Check this box if you are a partnersh:p {including an LLC classified as a partnership for U.S- federal tax pu.poses). Itust, or eslate that has any ioreign partners, ownem, or beneficiaries, and you are providing this formlo b partnership, trust, or eslale, in which you have an ownership interest. You musl iheck th€ box on line 3b if you receive a Form W-8 (or documentary evidence) lrom any partner, owner, or beneliciary istablishing foreign slalus or if you rcceiue a Farm W'9 from any parher, owner, or beneficiary tfiat has chesked the box on line 3b. Note: A parln€rship that Prolides a Form W-9 and checks box 3b may be required to complete Schedul* K-2 and K-3 {Form 1065}. For more information, see lhe Parlnersftip lnstructions for Schedules K-2 and K-3 (Form 1065). l{ you are required to complele lineSb but {ail to d-o so, you may nol",. receive lhe information nece'ssary to file a ccrrect information refum wilh the IRS or fumish a corect payee statement to your parhers or beneficiaries. See. for example, seclions 6699, 6722' and 6724 lor penalties that may apply. Line 4 Exemptions lf you are exempt lrom backup whhholding and/or FATCA reporting, eril.er irr tlre appiupriate spaue $rt l;t!e 4 arry co<Jds] lllai tllay apply lo you- Exempt payee code. o Generally, individuals {including sole proptietors) are not exempt lrom backup withholding. . Except as provided belcq'" co{pclations are exempl f(om backup withholiiing for ceriain payments, including interest and dividends- . Corporations are not €xempt frsm backup whhholding for payments made in settlement of paymeilt card or third-pa$y nelwotk transaclions. r Corporalions are not exernpt {rom backup withholding wilh respecl io attomeys' fees or gross proceeds paid to attorneys, and corporations that provide rned;cal or health care services are noi exempt with respect to payment6 reportatlle on Form .1S99-MISG' The following codes idenli{y payees that are exempi from backup withholding" Enter tha appropriate code in the space on line 4. 1 -An organization exempl from tar unde{ section 501[a], any IRA' or a custodiai account unde{ seclion 403tb){4 il the actount satisfies the requirements of section 4S1 {t){2}. Kittitas County Agreement for Services (rev. 5/7a/25) Page 18 of 21 Form W-9 (Bev.3-2024)Poqe 4 2-The United Slales or any of ils agencies or instrunrentalilies. 3-A state, lhe District of Columbia, a U.S. commonwealth or terntory, or any ot their political subdivisions or instrumentalities. 4-A foreign govemment or any of its political subdivisions, agencies, rr instrumentalities. 5-A corporation. 6-A dealer in securities or commodities.equired to register in the United $iates, the District of Columbia, or a U.S. commonweallh or tenitory- 7-A futures commission merchant registered with lhe Commodity Fulures Trading C6mmission. 8-A real estate investment trust. g-An entity rcgistered at all times during the tax year under the lnvestment Company Act of 1940. -lo-A common trust fund operated by a bank under section 584(al. 1 1 -A fin.ncid institution ao dcfined undef secliur r 581. "12-A middleman known in the investment community as a nominee or custodian. 1 3-A trust exempt from tax under sectiotr 664 or described in section 4947. The following chart shows types of payments lhat may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through I3. lF the payment is {ar THEN the paynreilt is excmpt for, - - ' lnterest and dividend paynlents All exsmpt payees except for 7 . Broker Exenrpt payees I through 4 and 6 through I 1 and all C corporations. S corporations must nol enter an exempt payee code because they are exempt only for sales ol noncovered securities acquired to 2012 r Barter transactions Exempt payees 1 through 4. and F-A dealer in securilies, commodities, or derivative financial ;nstruments {including notional principal conlracts, fu tures, forwards, and optlonsl lhat is registered as such under the laws of lhe United Slateg or any stale, G-A real estate investment tsusl. H-A regulated investrnent company as defined in section 851 or an entitlr r€gbtered at all times during the tax year under the lnvestrnent comFany Act of 1940. | -A common trusi fund as defined in section 584{a}. J-A bank as defined in section 581. K-A broker. L-A trust exenrpt lrom tax under section 664 or d€'scribed in section aeaT{a}{'l). M-A lax-exempt trust under a section rlt)3{b) plan or section 457{9} plan. Nota: You nray wish tu wrrsull. wilh the financial inslrtutlon requesting this farm to delermine whether the FATCA code and/or exempl payee code should be compl€ted. Line 5 Enter your address (number, stseet, and apartment or suite number), This is where the requesler ol this Fomt W-9 will nrail your information retums. lf this address differs lrom th€ one the requester already has on {ile, enter "NEW'at lhe top. ll a new address is provided, there is stilla chance the old address will be used until the payor changes your address in their records. Line 6 Enter your crty. slate, and ZIP code. Part l. Taxpayer ldentification Number {TlN) Enier your TIN in the appropriate box, l{ you are a resident alien and you do not have, and are not eligible to get, an SSN, your TIN is your aRS lTlN. Enter it in :he entry space for lhe Social security number. If you do nol have an lTlN, see Hovl to get a IJI\I below. l{ you are a sole proprietor and you have an ElN, you may enter either ynur SSN or ElN. lf you are a single-member LLC thai is disregarded as an entity separale from its owner, enter the owner's SSN {or ElN, il the owner has one1. If rhe LLC is classified as a corporalion or partnership, ent€r the entity's EiN" l,,f ote: See !ilhat fiIanr e and Number To Give ffte Feguesler, laler, for further clarification oi name and TIN combinations. Hovlr to get a TlN. lf you do not have a TlN. apply Ior one inrmediately. To apply lor an SSN, get Form SS-5, Application {or a Social Securi\ Card, frorn your local SSA offrce or get this form online at wwr,v.SSA.goy. You may also get this farm by calling 800-77?- 1213. Use Fonn W-7, Application for IRS lndividualTaxpayer ldentiflcation Number, to apply for an lTlN, or Form SS-4, Applicaticn for Employer ldentific€tion Number, to apply {or an ElN, You can apply for an EiN onllne by accessing the IRS websile al wrvwlrs.govlElN. Go to vvww.irs4ovlForms to view, download, or prinl Fomr W-7 andlor Form SS-^1. Or. ycru uan go to www.irs.govfQrderFr-rttts lo place att ordel and have Form W-7 ancUor Form SS-4 mailed to you wilhin 15 business days. l{ you ate asked to complete Form W-9 but do not have a Tll{, apply {or a TtrN and ente-r "Applied For" in the space lor tfre TlN, sign and dale lhe f6nn, and give it io tfte requester. For inlerest and dividend paymenls, and certain payments made vrith respect to readily tradable instruments, you will generally have 60 days lo get a TIN and give il 1o the requester b€fore you are subject to backup withholding on payments. The 60-day rule does not apply to olher types of payments, You will be subject to backup withholding on all such paymenls until you provide your TIN to the requester. Note: Enlering "Applied For'' means thal you have already applied lor a TIN or that you intend to apply for one soon. See also Estabfishing U-S. status forpirrposes ol chapter 3 and chapter 4 withholding. exlier.fot when you may instead be subject to lvilhholding under chapter 3 or 4 of the Code. Caution: A disregarded U-S. enlity that has a foreign cwner must use the appropriale Form W-4. ' Payments over$600 required to be reported and direct sales over $s.ooo' Generally, exempt payees 1 through 5.? Exempt payees .l through 4.I Payments made in settlemeltt of payment cald or third-party netlvork lransaclions 1 See Form 1osg-MlSC, Miscellaneous lnformation. and its instructions. 2 However, the following payments made lo a cotporation and reporlable on Form 1 099-MISC are not exempt from backuP wilhholding: medical and health care paymenls, atlomeys' fees, gross proceeds paid to an attorney reportable under section 6045fi), and payments for services paid by a federal exectrtive agency. Exemption from FATCA reporting code. The following codes ldenlify payees that are exempt fronr reporting under FATCA. These codes apply lo persons submitting this form for accounts maintained outside of lhe United Stales by cedain {oreign financial institutions. ThereJore, il you are only submitting lhis lorm for an account you hold in ihe United States, you may leave this lield blank. Consult with the person requesling this form if you are uncedain if the financial institution is subiect to these requiremenls. A requester may indicate lhat a code is not required by providing you with a Form W-9 with "Not Applicable" (or any siririlar indichtion) enlered on the line for a FATCA exemption code. A-An organization exempt from lax under seclion 501(a) or any individual retirement plan as deiined in section 7701(a)(37). B-The United States or any of its agencies or instrumentalilies. C-A state, lhe District of Columbia, a U.S- commonwealth or lenitory, or any of their political subdivisions or instrumentalities, D-A corporation the stock of which is regulady traded on one or more established securities nrarkets, as described in Regulations section .l .1 47?-1 {c)(.1 Xi). E-A corporation lhat is a member of the same expanded affiliated group ae a corporation described in Regulations section 1.1 472-1{cX1}{i). Kittitas County Agreement for Services (rev. 5/7a/251 Page 19 of 21 Form W-9 (Rev. 3-2024)Pss* 5 Part ll. Certification TD establish to the wilhholding agent lhat you are a U.S. person. or resident alien, sign Form W-9. You may be requesled to sign by the withholding agent even ff item 1, 4, or 5 below indicales othen'{ise- For a joint account, only the person whose TIN is shown in Pari I shculd iign {when required). ln the case of a disregarded enlity, the person idbntified on line 1 must sign. Exempt payees, see Fxempl payee code, eadier. Signature requirements. Complete the cefiilication as indicaled in itemsl through5below. 1. hrterest, dividend, and barter exchange accounls opened before 1984 and broker accounls considered aclive during l98il' You must give your correct TlN, but you do not have lo sign the certification. 2, lnterest, dividend, broker, and barter exchange accounts orured afler l98il and broker accounts considered inactive during 1b83. Yuu rrrust sign the cenlfication or backup wi$rholding rvill apply. If you are subiect to backup withholding and you are merely providing your conect TIN to the requester, you must cross out item 2 in the certification before signing the fomr. 3. Real estate transactions. You must sign lhe ceiliflcalion. You rnay cross out item 2 of the cerlification. 4. Other paynrerrts. You must give your conect TlN, but you dc nol have to sign the certification unless you have been nolifed lhal you have previously given an inconect TlN. "Otherpayments" include paym'ents mad-er-n the course of the requester's trade or busines for ients, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporalions), payrnents to a nonemployee for selices. payments made in setdement of paym€nt card andthiid-party network trdnsactions. paynrenls to certarn frshing boat crew members and fishermen, and gross proceeds paid to attomeys (including payments to corporatioflsl. 5. Mortgage interest 1:aid lry you, acquisition or abandotlment of secured Dror)ertv. cancellation of debt, qualified trtition program pavmentb (uirdei section 529), ABLE accounts (under section 529A), lRA, Coverdell ESA, Archer MSA or HSA contributions or distribulions, atrtl pension distributions. You must give your corect TlN, but you do not have to sign the certification. What Name and Number To Give the Requester For this of account: B. Disregilded ffitity not ovrned by m individml g. A valid trust, esiate, or peNi6 t.ust 1o- Corpoation or LLC electing csrpsate status on Fom 883? or Form 25,53 l1 . Assmialim, club. religirus, ch*itable, educational, or other til-exffiPt 0rqaniataon .12. Parln€Ehip or muhimmber LLC 13- A kokBr or registered nomin* 1+. Acount with the Departmmt of Agriculture in lhe name ol a Public*lity (such m a state or laal govemmtrl, school dbkict, or pdson) ihat reeives agricultuml program pnymenls 15. Gmtor trust filing Fm l04l or uoder lhe Optional Filing Method 2, requirinq Fom 10€9 (sR Fl€gulations sstion 1.671 -4ib)(2XiXB))" Give name and €lN of: The owrer Legil entiqd The csp€ralisn The +rganiatim The partrrership The brolts or nominee The public mlity The minor: The grstor-trusleer The actuai omerl The ovrneF The gmtor' Kittitas County Agreement for Services (rev.5/14/251l Page20 of 2I The trust 'List lirst and circle the name of the person whfs€ number you fumish' lf only one penion on a ioint account has an SSN, that person's numb€r musl be fumished. zCircle the minor's name and fumish the minor's SSN" 3You must show vour individual name on line 1. and enter your business or DBA name, if ahy, on line 2. You may use eilher your SSN or EIN df you have one), but the IRS encourages you to use your SSN- l List {ilBt and circle the name of lhe arust, estate, or pension lrust. {Do not fumish the TIN of the personat representalive or trustee unless tfie legal entity itself is rrot designated in the account litle.) 'Note: The grantor musi also provide a Fo(m W-9 1o the truslee of lhe trust. '. For more infonnation on oplional ftling methods lor Eranlor Susts' see the lnstructions for Form 1941. Note: lf no name is circled when more than one name is lisled' the number lvill be considered to be that of the tirsi name listed' Secure Your Tax Hecords From ldentity Theft ldentitv theft occurs when someone uses ytur persona! informatiolr' such as your name, SSN, or other identifi;ing information, '.'rithoul your permission lo commit fraud or other crimes. An idenliiy thie{.may use your SSN to get a job or may file a tax retum using your SSN lo receive a refund" To reduce your risk: . Protecl your gSN, . Ensure your employer is ptotecfing your SSN, and . Be careful when choosing a lax retum paeparer- lf your lax records are afiected by identity lheft and yotl recei're a nolice from the lRS, respond right away to the narne and phone nurnber printed on the IRS notice or letter. lf vour tax records are not cunenlly affected by rdenldy theft but you thin( you are at risk due to a losl or itolen purse or wallet' questionable credifcard activity, or a queslionable credit report, conlact the lBS ldentity Theft Hotline al 800-908-4490 or subrnil Foffn .l 4,039- For more information, see Pub. 5o2?, ldentily Theft lnlormstion for Taxpayers- For tlris of account: 2. Two or more individuals fioint account) other than an accsunt maintained by an FFI 3 Two or more U.S. peruons floant account maintained by m FFI) 4, Custodiql account oI I minq {Unifom Gift to Minors Act) 5. a. The usual revomble uvings trust (grmtor is al* frustee) b. So-called trust accmni lhat is not a legal or vali<J lrct under state law 6. Sole proprietorrhip o disregrded atity owned by an individual 7- Grantor lrust filing under Optional Filing Method 1 (see Flegulations strtion 1.671 -aibXzXiXA)" Give narne and SSN of: The The actual orer of the rccwnt or. il mmbined funds. the fist individual on ihe accounll Each holder ofthe rccounl Form W-9 {Rev.3-2O24)Paqe 6 Viclims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, nray be eligible for TaxpayerAdvocaie Service flAS) assistance. You can reach TAS by calling the TAS tolFfiee case intake line at 877-777-4778 orIfYffDD 800-829-4059. Protecl yoursell from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to rnimic legitimale business emails and websites. The moEt common act is sending an email to a user lalsely claiming 1o be an established legitimate enterprise in an ettempl to scam the user inlo sunendering private infonnation that will be used for identity theft. The IHS does nol initiate contacts with taxpayers via emails. Also, lhe IRS does not request personal detaibd information through email or ask taxpayers for the PIN numbers, passwords, or similar s€cret access information for lheir credit card, bank, or other financial sccounts. lf you receive an unsolicited email claiming to he from thc lR$, forward thia message tophr3hrhgr@irs.gov. Yau may also report misuse of the IRS name, logo, or other IHS property to the Treasury lnspeotor General forTax Administration (IIGTA) at 800-366-4484. You can lorward suspicious emails 1o the Federal Trade Commission at spam@uee,gov or report lhem el|rir#w.fic,govlcomplaina. You can contact the FTC al www.ftc.govlidffieft or 877-IDTHEFT (877-438-4338). lf you have been the viclim of idenlity theft, see www.tdentityTheft.gov and Pub. 5027. Go to r4wlv.i/s.govlldentityTheftla leam more aboul identity theft and how to rcduce your risk. Kittitas County Agreement for Services (rev. 5/7a/25) Page2L of 2L Privacy Act Notice Section 610s of the lnternal Revenue Code requires you to provide your coneot TIN lo persons {including federal agenciesJ uuFo are required lo file information relums wllh lhe IRS ta report inte{e€t dividends, or certain other income paid to you; mortgage lsd€rest you paid; the acquisition or abandonmenl sf se€ured propert$ the cancellation ol debt; or contributions you made to an lHA. fucher MSA. or HSA" The person collecting this form uses the inlormation on the brm to fle information retums with the lRS, repottirg the sbove infomation. Routine uses of this infarmation include girring il to lhe Department of Justice for civil and criminai litigation ard to cities, stales. the District ol Columbia, and U.S. comrnanweahhs and tenitories for use in administering their laws. The information may a$so be disclosed to other counlries under a treaty, to federa! and state agencies to enforce civil and criminal laws, or to lederal law enforcernent and intelligence agenci€s to combat tenorism, You mtst provide yeur TIN wtrether or not you are requited lo lila a lax tehrn. I lnrlet qtr:litn 3406. pryon muEt generally withhold a percentage ol taxable interest. dividends, and certain other paymente lo a payee r'{ho does noi give a TIN to the payor. Certain penalties may also apply for providing false or fraudulent infurmation.