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IT18-113 - Original - iText Software Corp. - iTextSharp (PDF creator for DEV Apps) - 03/13/2018
KENT Records Management Document CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to the City Clerk's, Office. All portions are to be completed. If you have questions, please contact the City Clerk's Office at 253-8,56-5725., El Blue/Motion Sheet Attached F-1 Pink Sheet Attached Vendor Name: iText Software Corp Vendor Number (]DE): 1731095 Contract Number (City Clerk): Category: License Agreement ------ Sub-Category (if applicable): Choose an itein. Project Name: _iTextSharp (PDF creator for DEV..AppsL ______ Contract Execution Date: 03/13/18 Termination Date: 03/12/19 Contract Manager: Somen Palit Department: IT Contract Amount: �940 Approval Authority: Z Director [:1 Mayor F-1 City Council Other Details: IText Software Corp. 265 Medford St,Suite 401 Sornerville,MA 02143 T:+1617 982 2646 F:+1617 982 2647 E:sales.isc@itex,,Pdf.com RD, W:www.itexedf.com End user address: Invoke address: City of Kent City of Kent To the att.of Lynnette Smith To the att.of Lynnette Smith 220 Fourth Ave. ;A 220 Fourth Ave. Pik 98032 Kent i-"'A 98032 Kent WA WA United States MAR 16 2018 United States INVOICE I/ISC/14227 1,ioi PT--t - Date Customer N' 3/1512018 t 26076 Description Quantity Unit price Total USD Commercial Production Server Lkense.NET 2.00 Serve r(s) $2,800.00 S5,600.DD ITS-P-SER-1 Perpetual License-Unlimited use in Tirre-Unlimited Users and PDrs I License per Server,Virtual machine or Node Updates and Support Commercial Production Server.NEr 1.00 Year(s) $1,120.00 $1,120.00 ITS-MAINr-P-SER-1 Technical Support and Updates durms 12 Mcnos. Renewed on an Annual basis. Commercial Non-Production Server License NET 1.00 Server(s) S1.400.0D $1,400.DD ITS-NP-SER-1 Perpetual License-Servers for Development-Testing-OA-Training- Disaster Recovery(Passive) I License per Server.Virtual machine or Node Updates and Support Commercial Non-Production Server NET 1.00 Yea r(s) $280-00 $280.00 ITS-MAINT-NP-SER-1 Technical Support and Updates during 12 Months Renewed on an Annual basis • Net S8A00.00 Total $8,400.00 Payment condition:Bank wire;Invoice+M days Always refer to the Document Number when executing payment. Any changes to the number of Servers,Nodes,Virtual Machines,or Desktops installed must be communicated to sale$.isc@itextpdf.com to avoid back charges and penalties. NM us A RE WRIP R 0 V E D W-nOVED BY*—%f DATE; D AT E: 0 8;�ciUiiikIti-o f�: vW'-w-.-1tqkf.PdfbfiV Ce �dcaeXclat' 7y12"i Mp! M IrgnrepmenidWC e„that Maybe assessed#iyetiyluifsdt ctEon sr� . 4.d .,`'T. 1 •s:,r• -w� s;•.;�' •p•��;.,:' 'y.}iQ•A( .� i•v i - i:x iText Software Corp. Q © � 265 Medford Somerville,MA 02143 T.+1 617 982 2646 F:+1 617 982 2647 E:sales.isc@itextpdf.com {N ltext cIf.com• ..t Payment by wire: Payment by credit card: Payment by courier or mail: Bank of the West Please email for a link to our CC Payable to Text Software Corp. 2287 2nd St,Livermore,CA 94550,USA payment portal:invoice.isc@itextpd[.com P.O.Box 620335 Routing Transit#121100782 Or Newton Lower falls,MA02462.0335 SWIFT Code:MT US66 Pay by phone:+1 627 982 26 46 Account Name:iText Software Corp. Account Number:026S47026 �n`eralaeriris'd'condnEoris www�.�extydt comJEegat •. 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J r 265 Medford St,Suite 401 {a Somerville, MA 02143 T:+1 617 982 2646 F:+1 617 982 2647 E:sales.isc@itextpdf.com W:www.itextpdf.com End user address; Invoice address: City of Kent city of Kent To the att.of Somen Palit To the att.of Somen Palit. 2,20 Fourth Ave. 220 Fourth Ave. 98032 Kent 98032 Kent WA WA United States United States QUOTE Qf 30890,/0 Crate Your fief Customer N' 2/26/2018 26076 Description Quantity Unit price Total USD USD Commercial Production Server Ucense.NET 2.00 Server(s) $2,800,00 $5,600.00 ITS-P-SER-1 Perpetual License-UnRirrited use in Time-Unlimited Users and PDFrs 1 License per Server,Virtual Machine or Node Updates and Support Commercial Production Server NET 1.00 Year(s) $1,120.00 $1,120.00 VTS-MAINT-P-SiER-1 Technical Support and Updates during 12 Months. Renewed on an Annual basis. Commercial Non-Production Server License,NET 1.00 Servers) $1,400.00 $1,400.00 ITS-N P-SER-1 Perpetual License-Servers for Development-Testing-0A-Tra¢ning-Disaster Recovery(Passive) 1 License per Server,Virtual Machine or Node Updates and'Support Commercial Non-Production Server.NET 1.00 Year(s) $280.00 $280.00 ITS-MA I NT-N P-SER-1 Technical Support and Updates during 12 Months Renewed on an Annual basis Net $9,400.00 Tax Saw This Qwote is valid until 3/26/2018 Tota) $8,400.00 Payment condition:Bank wire Invoice+30 days Always refer to the Document Number when executing payment. Any changes to the number of Servers,Nodes,Virtual Machines,or Desktops installed'must be communicated to sales.isc@)itextpdf.com to avoid' back charges and penalties. ,r; .r.... ✓... ,... rr r. I � �.. ,(,,,, r F a osr:.,> ,r,�.r/ rr i ., 29 v/,Y r r� „ti:"d ,, .., r ,�,1; r,n.;s r.I, ✓ f r. n ,,6,s r. ,r. I a /I. N...! r.t. 1.,/I. r' F A. ,,..., / r,,;.. ,k 1 ,., �.Gw, [ r,, ,, -sr. 1. r9 ,r .r.✓�, -., ! /. ,.. ,C rrs,f,..�//i„/1�/y�/ar✓cY�t�,�;f�rr��,,iYi��,.�lr����N���vJdr�wurar,d�l�f1/%ro��1r,!,�fgir�iJ�l�,/.+�r,rllli��i����✓,selr�/�urrl'(rrrr/,�rMl_��,Y?„/ur,,,�sC�ru,�r.,Nr✓ rr.r.r /.r.J�/✓//a,.r..„v`/nfl�nen,,.c��r<�arl.��, , d� "f„f9,Gli,rft far' iText Software Corp. 265 Medford St,Suite 401 Somerville, MA 02143 T:+1 617 982 2646 F:+1 61.7 982 2647 E:sa&es.isc@!textpdf.corn W:www.itextpdf.corn Payment by wire: payment by credit card: Payment by courier or mail: Bank of theWest Please email for a link to our CC Payable to iText Software Corp. 22,87 2nd St,Livermore,CA 94550,USA payment portal:invoice.isc@itextpdf.com P.Q.Box 620335 Routing Transit#121100782 Or Newton Lower Falls,MA 02462-0335 SWIFT Cade:BWST U566 Pay by phone:+1 617 982 26 46 Account Name:iText.Software Corp. Account Number:026547026 2/27/2018 End user license agreement I iText END USER LICENSE AGREEMENT (EULA) This End User License Agreement("EULA") is a legal agreement between you and one (and only one) of the following iText companies: • If you are a resident of US or Canada,then your counter-party, referred to in this EULA as"iText",will be iText Software Corp., having a principal place of business at 47 Third Street-Suite 301, Cambridge, MA 02141, United States. • If you are a resident of Asia or Oceania,then your counter-party, referred to in this EULA as"iText", will be iText Software Asia Pce., having its registered office at 15 Scotts Road#04-08,Thong Teck Building, 228218 Singapore. • If you are not a resident of the US or Canada, nor of Asia or Oceania,then your counter-party, referred to in this EULA as"iText",will be iText Software BVBA, Business Center De Punt, Kerkstraat 108, 9050 Gent, Belgium. If you are a group of companies,with subsidiaries residing in different countries,then you shall,for the purpose of this EULA, be considered to be a resident of the country in which the most of your users are located at the time of this EULA becoming effective. If you are agreeing to this EULA not as an individual but on behalf of your company,then "you" means your company, and you are binding your company to this EULA. This EULA governs the above-identified iText Software products, including any associated media, printed materials and electronic documentation (the"Software Products"). If you have entered into a separate and signed license agreement(SLA(http://itextpdf.com/legal)) or terms of use(TUO (http://itextpdf.com/AGPL) regarding the Software Products,which contains terms contradictory to this EULA,then the terms of such separate agreement shall prevail. The Software Products also includes any software updates,add-on components,stencils,templates, shapes,web services and/or supplements that iText Software may make available to you,or that you obtain from the use of features or functionality of the Software Products,to the extent that such items are not accompanied by a separate license agreement or terms of use. By installing, copying,downloading, accessing or otherwise using the Software Products,you agree to be bound by the terms of this EULA. If you should use any additional iText services or tools relating to the Software Products,including but not limited to the iText software development kit,you agree to be bound by the terms in force from time to time,which govern the said usage, and which can be found on iText's official website or at the place of download of the Software Products or the additional services or tools. The Software Products are protected by Intellectual Property laws and treaties (http://itextpdf.com/copyright-ip). The Software Products are licensed (http:Hitextpdf.com/Pricing), not sold. 1.GRANT OF LICENSE https:Hitextpdf.com/end-user-license-agreement 1/8 2/27/2018 End user license agreement I iText Subject to correct payment of the license fees displayed at iText's official website or at the place of download of the Software Products and the terms and conditions of this EULA,iTdxt hereby grants to you a limited, non-exclusive, non-transferable, non-sub-licensable, royalty based,worldwide license to install and make the Software Products available to the agreed number of resource accounts(authorized users). Authorized users may be your employees, representatives, consultants,contractors, agents,or other third parties who are acting for your benefit or on your behalf. Invoicing and payment of the license fee shall be made monthly, unless otherwise agreed.You may increase the number of users by placing a new order. In all cases,you must pay the applicable fee for the increased number of authorized users.You may at any time decrease the number of users from the first day of the next invoicing period by giving prior written notice to iText. 2.DESCRIPTION OF OTHER RIGHTS AND LIMITATIONS License Key: Is a unique numbering code used for accessing the Software Products,which will be distributed to you automatically or by e-mail. Limitations on Reverse Engineering, Decompilation, and Disassembly;You may not reverse engineer, decompile,or disassemble the Software Products,except and only to the extent that such activity is expressly permitted by applicable mandatory law. No rental, leasing or commercial hosting;You may not rent, lease, lend or provide commercial hosting services to third parties with the Software Products. 3.FEES License fees and other remunerations are displayed at iText's official website and may be changed by iText by giving at least 6 months prior notice on the website. Each party shall be responsible for its own taxes. 4.INTELLECTUAL PROPERTY RIGHTS All ownership and intellectual property rights in the Software Products and any copies and derivative works thereof(regardless of form or media in or on which the original or other copies may exist),including but not limited to patents,design rights,copyrights,trademarks,trade-secrets and proprietary know-how, shall be owned by and vested in iText,or iText's licensors,and nothing in this EULA shall constitute or be interpreted as a transfer of such rights from iText to you.You are solely entitled to the limited license to the Software Products specifically granted under this EULA. 51IMITED WARRANTY, LIMITATION OF WARRANTIES iText warrants that the Software Products will perform substantially in accordance with the specifications of the Software Products for a period of ninety(90) days from the date of initial purchase.Any supplements or updates to the Software Products, including without limitation, any (if any)service packs or hot fixes provided to you after the expiration of the ninety(90) day limited warranty period are not covered by any warranty or condition,express, implied or statutory.Your exclusive remedy for any breach of this Limited Warranty is as set forth below. Except for any refund elected by iText,you are not entitled to https://itextpdf.com/end-user-license-agreement 218 2/2 7120 1 8 End user license agreement I Mext any damages, including but not limited to consequential damages,if the Software Products does not meet iText's Limited Warranty, and,to the maximum extent allowed by applicable law,even if any remedy fails of its essential purpose. iText's and its retailers or suppliers'entire liability and your exclusive remedy shall be, at iText's option, (a) return of license fees paid during the preceding three months,or(b) repair or replacement of the Software Products,that does not meet this Limited Warranty.This Limited Warranty is void if failure of the Software Products has resulted from accident,abuse, misapplication,abnormal use or a virus.Any replacement Software Products will be warranted for the remainder of the original warranty period or thirty(30) days,whichever is longer. The Limited Warranty that appears above is the only warranty made to you. Except for the Limited Warranty, iText and its retailers/suppliers provide the SOFTWARE Products and support services(if any) "as is"and hereby disclaim all other warranties and representations of any kind, including any warranty of non-infringement,title,fitness for a particular purpose,functionality or merchantability,whether express, implied or statutory. In no event shall iText or its suppliers/retailers be liable for any special, incidental, indirect,or consequential damages whatsoever arising out of or in any way related to the use of or inability to use the Software Products. UP INFRINGEMENT iText will,at its own expense,defend you against any claim brought against you by a third party alleging that your authorized use of the Software Products under this EULA infringes a third party's intellectual property rights(a "Claim"), provided that iText have received from you: (a) prompt written notice of the Claim; (b) reasonable assistance in the defense and investigation of the claim,including providing us a copy of the claim and all relevant evidence in your possession,custody or control; and (c)the exclusive right to control and direct the investigation,defense, and settlement(if applicable) of the claim. If the Software Products are found to infringe a third party's intellectual property rights, iText, at its own expense, may either(i) obtain rights for you to continue using the Software Products,or(ii) modify the Software Products while maintaining substantially similar functionality,or(iii)terminate your right to continue using the Software Products and refund the license fee paid by you as reduced to reflect a three year straight-line depreciation from the license purchase date.THIS SECTION STATES iText'S SOLE LIABILITYAND YOUR EXCLUSIVE REMEDY FOR ANY INFRINGEMENT OF INTELLECTUAL PROPERTY RIGHTS IN CONNECTION WITH ANY PRODUCT OR OTHER ITEMS PROVIDED BY iText UNDER THIS EULA. 7.US GOVERNMENT RIGHTS The Software Products are to be considered a"commercial item"as that term is defined at FAR 2.101. If you are the US Federal Government(Government) Executive Agency(as defined in FAR 2.101), iText provides the Software Products, including any related software,technology,technical data, and/or professional services in accordance with the following: If acquired by or on behalf of any Executive Agency other than an agency within the Department of Defense (DoD),the Government acquires, in accordance with FAR 12.211 (Technical Data) and FAR 12.212 (Computer Software), only those rights in technical data and software customarily provided to the public as defined in this Agreement. If acquired by or on behalf of any Executive Agency within the DoD,the Government acquires, in accordance with DFARS 227.7202-3 https://itextpdf.com/end-user-license-agreement 3/8 2/27/2018 End user license agreement I iText (Rights in commercial computer software or commercial computer software documentation),only those rights in technical data and software customarily provided in this Agreement. In addition, DFARS 252.227- 7015 (Technical Data- Commercial Items) applies to technical data acquired by DoD agencies.Any Federal Legislative or Judicial Agency shall obtain only those rights in technical data and software customarily provided to the public as defined in this Agreement. If any Federal Executive, Legislative,or Judicial Agency has a need for rights not conveyed under the terms described in this section,it must negotiate with iText to determine if there are acceptable terms for transferring such rights, and a mutually acceptable written addendum specifically conveying such rights must be included in any applicable contract or agreement to be effective.This U.S. Government Rights clause in this section is in lieu of,and supersedes, any other FAR, DFARS,or other clause, provision,or supplemental regulation that addresses Government rights in computer software or technical data under this Agreement. 8.TERM AND TERMINATION The term of this EULA commences on the day you download or in any other way gain access to the Software Products and is valid until terminated by either party. iText may terminate this EULA without reason and by giving written notice in advance. Such termination shall be effective as from the first day of the calendar month following no less than 30 days after the notice of termination was given.Such notice may be given by notification to you by email or regular mail using the addresses provided by you to iText. Without prejudice to any other rights, iText may terminate this EULA immediately if you fail to comply with the terms and conditions of this EULA.You may terminate this EULA without reason and by giving written notice in advance.Such termination shall be effective as from the first day of the calendar month following no less than 30 days after the notice of termination was given. In the event of termination of this EULA by either party,you must destroy all copies of the Software Products and confirm to iText in writing that the destruction has been fulfilled. In the event of termination of this EULA,you are aware that any license fees paid by you are non-refundable. 9.MISCELLANEOUS This EULA contains the entire agreement between the parties on the subject matter of this EULA,and supersedes all representations, undertakings and agreements previously made between the parties with respect to the subject matter of this EULA. Consequently, any and all pre-printed standard terms(e.g. on a purchase order,order acknowledgement, pop-up license or invoice)shall not have any applicability unless the other party has expressly accepted the relevant term in writing. The failure by either party to enforce any provisions of this EULA or to exercise any right in respect thereto shall not be construed as constituting a waiver of its rights thereof. If any provision of this EULA would at any time be in conflict with any law or regulation compulsorily applicable to this EULA,the parties shall endeavor to amend such provision,so that the intent of this EULA may be carried out to the extent legally possible.The invalidity, because of any such law or regulation,of provisions of this EULA which are not fundamental to its performance shall not relieve any party from its obligations under the other provisions of this EULA, nor deprive any party of the benefits of such other provisions. https://itextpdf.com/end-user-license-agreement 4/8 2/27/2018 End user license agreement i iText 10 APPLICABLE LAW, DISPUTES This EULA is governed by the laws of Belgium.Any dispute,controversy or claim arising out of or in connection with this contract,or the breach,termination or invalidity thereof,shall be finally settled by arbitration administered by the Belgian Chamber of Commerce (BCC).The Rules for Expedited Arbitrations shall apply, unless the BCC in its discretion determines, taking into account the complexity of the case,the amount in dispute and other circumstances,that the Arbitration Rules shall apply. In the latter case,the BCC shall also decide whether the Arbitral Tribunal shall be composed of one or three arbitrators.The language to be used in the arbitral proceedings shall be English, unless the parties otherwise agree. Notwithstanding the foregoing, iText shall be entitled to bring action before a competent court of law in Belgium,the United States or Singapora,with regard to payment of license fees and with regard to other claims the capital amount of which is less than EUR 50,000. (/#facebook) (/#google_plus) (/#twitter) (/#reddit) (/#Iinkedin) (/#email) (/#print) GET PRODUCTS Product Overview(https:Hitextpdf.com/itext7suite) Downloads (https://developers.itextpd[com/downloads) Uninstall iText(https://developers.itextpdf.com/question/how-can-i-uninstall-itext) HOW TO BUY Explore Pricing(https://itextpdf.com/Pricing) Request a Quote (https:Hitextpdf.com/Request-A-Quote) Find a Partner(https://itextpdf.com/partner) CUSTOMERS Customer Portal (https:Hitextpdf.com) https://itextpdf.com/end-user-license-agreement 5/8 2/27/2018 End user license agreement I iText Customer Support(httPs:Hitextpdf.com/support) FAQ (httPs:Hitextpdf.com/customer-faq) DEVELOPERS Developer Portal (https://developers.itextpdf.com) Q&A (https://developers.itextpdf.com/frequently-asked-developer-questions-7) Release Notes (httPs:Hitextpdf.com/posts/release-note-and-changelogs) API Docs (https://developers.itextpdfcom/apis) COMPANY About us (https:Hitextpdf.com/about) Blog(https:Hitextpdf.com/posts/general) Press Releases(httPs:Hitextpdf.com/posts/press-and-news) Events (https:Hitextpdf.com/posts/events) Awards (https:Hitextpdf.com/awards) Legal (https:Hitextpdf.com/legal) Contact Us (https://itextpdf.com/contact) Jobs (https://itextpdf.com/jobs) Newsletters(https://itextpdf.com/itext-newsletters) Asia, Oceania 3 Fraser Street Duo Tower#08-21 Singapore 189352 sales.isa@itextpdf.com (mailto:sales.isa@itextpdf.com) https://itextpdf.com/end-user-license-agreement 6/8 2/27/2018 End user license agreement 1 iText Tel: +65 68281430 (tel:+6568281430) Fax:+65 68281401 201510495G Europe, Middle East,Africa Business Center"De Punt" Kerkstraat 108 9050 Gentbrugge (Ghent) Belgium sales.isb@itextpdf.com (mailto:sales.isb@itextpdf.com) Tel:+32 9 298 02 31 (te1:+3292980231) Fax:+32 9 270 33 75 0838.649.627 North America,South America 265 Medford St,Suite 401 Somerville, MA02143 USA sales.isc@itextpdf.com (mailto:sales.isc@itextpdf.com) Tel:+1 617 982 2646 (tel:+16479822646) Fax:+1 617 982 2647 26-4352833 @ 2018, iText Group NV Privacy&Cookies Policy(http://itextpd[co m/privacy-and-cookies-policy) Terms of Use (http://itextpdf.com/end-user-license-agreement) (https://www.flickr.com/photos/itextinaction/) "U7 (httPS://www.Youtube.com/channel/UC6kLI—Vm7l2V3XDMI—RSY8w) (httPS://www.pinterest.com/itext/) (https://www.facebook.com/iTextPDF/) https:Uitextpdf.com/end-user-license-agreement 7/8 2/27/2018 End user license agreement i iText (https://plus.google.com/+itext) (httP://www.slideshare.net/iTextPDF) (https://www.linkedin.com/company-beta/281131/) (httPs:Htwitter.com/iText) https:Hitextpdf.com/end-user-license-agreement 8/8 New Vendor ' Vendor Set-up Form �06 Reactivate Vendor K E N T p ❑ Address Ch M To be filled out by Vendor ONLY Vendor Number0 E'S FINANCE AS 220 Fourth Avenue South 4- Kent,WA 98032-5895•Phone: (253) 856-5235 4- Fax: (253) 856-6200 x - 10111 An incomplete form will create a delay in our payment(s)to you and your payment(s) could be subject to the IRS required back-up withholding. 'Teo 5c)P iwarf- Cc Pula-}I or, Name,as it will appear on check (NoABBREVfATrONS) Doing Business As(If different than name on check) a65 Ailed&(d Si Payment Address Business Address Some,Kv,Ile M A DOA I y_� City State Zip City State Zip Phone Number Accounts Receivable Contact U - •• •- check the appropriate box F Wcorporation ❑ Government Agency ❑ Individual/Sole Proprietor ❑ Non-Profit ❑ Partnership • This business is ❑ Minority Owned ❑ Women Owned ❑ Both Minority and Women Owned t(Neither Will you provide medical services to the City of Kent? ................................................................Yes Will you provide legal services to the City of Kent? ....................................................................Yes No Will you provide services other than medical or legal to the City of Kent?....................................Yes Will you provide parts, supplies or materials to the City of Kent?.."...............................................Yes o Do you pay sales tax to the State of Washington?........................................................................Yes No If exem t from Form 1099 reporting, and check your qualifying exemption reason below: ❑ 1. Corporation,except there is no exemption for medical and healthcare payments or payments for legal services ❑ 2. Tax Exempt Charity under 501(a),or IRA ❑ 3. The United States or any of its agencies or instrumentalities ❑ 4. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions ❑ 5. A foreign government or any of its political subdivisions Name (Owner of the Tax Payer Identification Number(EIN or SSN)as name appears on IRS or Social Security Administration Records): JeX Sot+�J uAx(f ror po1'GA_ I j3 Social Security#: or Federal TIN: a(o- y 3518 3 3 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me)and, fl 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends, or(c)the IRS has notified me that I am no longer subject to backup withholding. r. E-Signature Date dI frs2727 Irtau•2/04 Form W-9 Request for Taxpayer Give Form to the (Rev.November zol7) Identification Number and Certification requester.Do not tMemaal Reve ue Srvicc Treasury ►Go to wwwJmgov/FormW9 for instructions and the latest information. send to the IRS. 1 Name(as shown on your income lax return).Name is required on this line:do not leave this line blank. 2 Business name/disregarded entity name,d different from above 3 Check appropriate box for lederal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to t following seven boxes. certain entities,not individuals;see Cd instructions on page 3): p ❑ Individual sole proprietor or Il-I C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate 0 single-member LLC W C Exempt payee code lit any) Q.o .?,,'� ❑ Limited liability company.Enter the tax classification(C=C corporation.S=S corporation.P-Parinership)► p Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting t a LLC it the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is C a another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that code(if any) is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other(see Instructions)► Uy+paur+o•x:w,+s msMrnvoe a,Rairb rn.U.S+ y 6 Address(number,street,and apt.or suite no.)See instructions. Requesters name and address(optional) Poi .2tsL Ave_ Z3q, 6 City,state.and ZIP code CA Q455 7 List account numbers)here(optional) Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number backup withholding.For individuals,this is generally your social security number(SSN.However,for a resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other -Il entities,it is your employer Identification number(EIN).If you do not have a number,see Now to get a FM TIN,later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and I Employer Identification number Number To Give the Requester for guidelines on whose number to enter. M16 - `t35 � $ 33 • Certification Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA codes)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest an div ends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secur p perty,cancellation of debt,contributions to an individual rettrement arrangement(IRA),and generally,payments other than interest and dividends,Vio aP�not required to sign the certification,but you must provide your correct TIN.See the instructions for Part It,later. Sign signature of Here U.S.person► Date P. General Instru tfons •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the internal Revenue Code unless otherwise .Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments .Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/ForrnW9. .Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number Use Form W-9 only it you are a U.S.person(including a resident (EIN),to report on an information return the amount paid to you,or other alien),to provide your correct TIN. amount reportable on an information return.Examples of information returns include,but are not limited to.the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.11-2017)