HomeMy WebLinkAbout150-18 RESOLUTION113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Resolution: 150-18
File Number: 2018-0330
MODERN EXTERIORS:
A RESOLUTION TO AUTHORIZE A CONTRACT WITH MODERN EXTERIORS OF SPRINGFIELD,
INC. IN THE AMOUNT OF $23,830.89 FOR THE PURCHASE AND INSTALLATION OF
SUNROOM GLAZING AT THE WALKER PARK SENIOR ACTIVITY AND WELLNESS CENTER
USING COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby authorizes Mayor Jordan
to sign a contract with Modern Exteriors of Springfield, Inc. in the amount of $23,830.89 for the purchase
and installation of sunroom glazing at the Walker Park Senior Activity and Wellness Center using
Community Development Block Grant funds.
PASSED and APPROVED on 7/3/2018
Page 1
Attest:
I �
Sondra E. Smith, City Clerk Treasurer
�����rrrrr►►►►'�i
t�•� I R EAS ►��
U
Printed on 715118
City of Fayetteville, Arkansas 113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Text File
File Number: 2018-0330
Agenda Date: 7/3/2018 Version: 1 Status: Passed
In Control: City Council Meeting File Type: Resolution
Agenda Number: A. 13
MODERN EXTERIORS:
A RESOLUTION TO AUTHORIZE A CONTRACT WITH MODERN EXTERIORS OF SPRINGFIELD,
INC. IN THE AMOUNT OF $23,830.89 FOR THE PURCHASE AND INSTALLATION OF
SUNROOM GLAZING AT THE WALKER PARK SENIOR ACTIVITY AND WELLNESS CENTER
USING COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby authorizes Mayor Jordan to sign a
contract with Modern Exteriors of Springfield, Inc. in the amount of $23,830.89 for the purchase and
installation of sunroom glazing at the Walker Park Senior Activity and Wellness Center using Community
Development Block Grant funds.
City of Fayetteville, Arkansas Page 1 Printed on 7/5/2018
Wade Aberanthy
Submitted By
City of Fayetteville Staff Review Form
2018-0330
Legistar File ID
7/3/2018
City Council Meeting Date - Agenda Item Only
N/A for Non -Agenda Item
6/14/2018 FACILITIES MANAGEMENT (140)
Submitted Date Division / Department
Action Recommendation:
Recommendation for approval the purchase and installtion of sunroom glazing for the Walker Park Senior Center
from Modern Exteriors in the amount of $23,830.89 with CDBG block grant funding.
2180.642.4990-5390.54
Account Number
N/A
Project Number
Budgeted Item? Yes
Does item have a cost? Yes
Budget Adjustment Attached? NA
Purchase Order Number:
Change Order Number:
Original Contract Number:
Comments:
Budget Impact:
CDBG-Public Facilities
Fund
N/A
^� Project Title
Current Budget $ 100,000.00
Funds Obligated $
Current Balance $ 100,000.00
Item Cost $ 23,830.89
Budget Adjustment
Remaining Budget
$ 76,169.11
Previous Ordinance or Resolution #
Approval Date:
V20180321
- CITY OF
FAYETTEVILLE
ARKANSAS
MEETING OF JULY 3, 2018
TO: Mayor and City Council
CITY COUNCIL MEMO
THRU: Don Mar, Chief of Staff
Paul Becker, Chief Financial Officer
Connie Edmonston, Parks & Recreation Sr. Director
FROM: Wade Abernathy, Facilities Management/ Building Construction Manager
DATE: June 14, 2018
SUBJECT: Approval Request for Sunroom Glazing
RECOMMENDATION:
Staff Recommends approval for the purchase and installation of sunroom glazing for the Walker
Senior Center from Modern Exteriors in the amount of $23,830.89 with CDBG Block Grant
Funds.
BACKGROUND:
CDBG has committed funding to enclose the porch with glazing, creating a sunroom. They are
also including all associated MEP along with finishes at the new and adjoining spaces as a part
of the project.
DISCUSSION:
Facilities Management staff solicited 3 bids from sunroom contractors. The low bid was Modern
exteriors in Bentonville. Their total bid was 23,830.89. The glazing system is 3 5/8" thermally
broken frames with solar low a glass.
BUDGET/STAFF IMPACT:
CDBG Block Grant Fund 2180.642.4990-5390.54 will be used for this project, and a B/A is not
required.
Attachments:
Modern exteriors estimate/acceptance
Proof of Insurance
W-9
Modern Exterior Bid
Four Seasons Bid
Florian Greenhouses Bid
Mailing Address:
113 W. Mountain Street www.fayetteville-ar.gov
Fayetteville, AR 72701
N
AngieQs listrc rr. _,-e`-..R
Preferred Contrnetor n NARI I NARI 11
V of Springfield, Itu.. ,�,I_J► ; ��.;,.'s::.::
SINCE 2 973, SERVING SOUTNWEST MISSOURI AND NORTHWEST ARKANSAS
Corporate Once 800.773.3166 Satellite Office
8101V, NORTON RD 609 SW 8th STREET, 6th FLOOR
SPRINGFIELD, MO 65803 "'Where Quafity and Price Became Friends" 13ENTONYILLE, R 727
417 -882 -SIDE A 12
47, A R 71715
INSULATED SUNROOMS • PATIO STRUCTURES
SEAMLESS POLYMER SIDINC s SOFFIT& FASCIA
PERMANENT CUSTOM TRIMS* WINDOWAND
DOOR REPLACEMENT • CUSTOM DECKS
DATE June 11, 2018
NAME= Waylon Abernathy, Facilities & Building Projects Manager, City of Fayetteville PHONE 479-575-8361
ADDRESS Re: Sunroom Project at Senior Center
❑ Accomplish all work with skilled tradesmen
❑ All Technicians fully insured:
Workers compensation insurance
Public liability insurance
Property damage insurance
❑ Includes all labor
❑ Tighten & secure all weatherboards as needed
❑ All matching accessories as specified
❑ Caulk & seal all windows & doors
❑ All debris removed from premises
❑ Includes city permits when required
Install TEMO insulated walls stl
1 section approx. 10' wide x 9' hi
high. i front wall seclion approx.
Product description: 3-5/8" walls
includes deadbolt and key locks,
❑ Manufacturers warranty _
❑ Over43 years experience
❑ Absolute attention to detail given on every job
❑ References furnished
❑ Financing arranged
❑ Insurance appraisals & inspections given
❑ Licensed by the City of Springfield
❑ Member of local & national association of the
remodeling industry
❑ Includes lien waivers on completion
Ask about Our "PRICE MATCH GUARANTEE"
under existing
1 section with
•1O tNlde x 8-9
Color cations: white. sandstnne nr hrnn7a
IPTION
roof as follows:
door (includes deadbolt and key lock) 6' wide x 9'
broken and insulated with T6 aircraft grade aluminum. Dual
PLUS SALES TAX ON MATERIALS
Total Project
A
Incl, in total
$23,830.89
1DATE (MMIDDYYYY)
AC I?U CERTIFICATE OF LIABILITY INSURANCE
002018THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATNE OR PRODUCER, AHD THE CERTIFICATE HOLDER.
rIVNAL. I st t3p elifforsomStTFSFti1Cn`7TC1tT75WA7V �`F!{SjLCi TU
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
NAM -
DAN V
PRODUCER !LAME:
Allied Insurance Agency PHONE (417) 887-4456 IAC (d17) 99? -5302
1722 S. Glenstone, Suite 22 EMAIL
u,esleeelnl nccnuroNn r:nvsaAr:w HAIC M
Springfield MO 65804 _ INSURERA CAMERON MUTUAL
INSURED INSURER 8 MTSSOLTRI EMPLOYERS MUTUAL
MODERN EXTERIORS OF SPRINGFIELD, INC INSURE11C:
810 W NORTON INSURER D:
INSURER E :
SPRINGFIELD MO 65803- INSURER F:
COVERAGES CERTIFICATE NUMBER: IttvIblum rvumacrc:
THIS IS TO CER'TTFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS-
114,11
LAIMS-
ffSR I - ADOL POLICY EFF POLICY ERP LIMITS
LTR TYPE OF INSURANCE _ IN4R POLICY NUMBER 1MMIDDIYYYYI pfd NYYY!_
A GENERAL LIABILITY 3L14737 1/04/201B 01/04/2019 ZACH OVCtMRENCF s 1, 000,00
T1AWC(,"F_Tb IMIN -U 50,00
X (;QMMS RCIAL GENERAL LIABILITY
I CLAWS -MADE L^ ! OCCUR / / / / MEDEXP (Any Olin P"IM) S 5,00
PERSONAL BADV INJURY $ 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
^ALIHCI 1 ATI^kl
HOLDER( ) _ ( ) _
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
GENERAL AGGREOA7E
S 2,000,00
GEN'L AGGREGATE LIMITgPPLIES PER
PRODUCTS• COMPIOP AGG
3 2,000,00
-
_X
Pyr T 11 LOC
AUTOMOBILE LIABILITY
BODILY INJURY (Per person)
S
ANY AUTO
ALL OWNED SCHEDULED
/ /
/ /
BODILY INJURY Oler aocldef,l)
$
AUTOS
AUTOS"' A TOS
NON -OWNED
HIRED AUTOS AUTOS
/ /
/ /
PPROPERT+'f7AMAG4:
,i,
I g
UMBRELLA LIAR OCCUR
EXCESS LIAR GLAIM5�IAOE
/ /
/ /
/ /
/ /
EACH OCCURRENCE
S
AGtiREGATE
S
B
WORKERS COMPENSATION
M 2015408
1/05/2019
01/05/2014
W ST TU- onf -
AND EMPLOYERS' LIABILITY Y r N
ANY PROP RIE TORIPARTNERIEXECUTIVE
OFFIC£RIM£MBER EXCLUDED?
(Mandalory In NHI
If yyes, dewbe under
pESCRIPTiON OF OPERATIONS low
NIA
/ /
/ /
Et EACH ACGIUEN7
S 1,000,0
' I
FL. DISEASE EA EMPLOYE¢
S 1,00o.0
F- I, MSF.ASE - POLICY LIMIT S 1.000.0(
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
^ALIHCI 1 ATI^kl
HOLDER( ) _ ( ) _
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2070/05) v I vov-cv Iv ra�wnu _w,"-7 , , ,_. �-., ..y„•� -�.
INS025 (201005) 01 The ACORD name and logo are registered marks of ACORD
Form W-9 Request for Taxpayer
(Rev,December 2
Department of the Treasury Identification Number and Certification
internal Ravenue Service
N
N
0)
N
OL
c
0
CL
0
`o 13
C N
•` c
a o
U
Ul
CL
ar
m
I Name (as shown on your income tax retum). Nrune Is required on this line; do not leave this line blank.
Modern Exterteriors of Spfd, Inc.
narnelrfi9rr.YjvrWKl entity name, V deferent Irom above
Give Form to the
requester. Do not
send to the IRS.
3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to
✓❑ Individual/sole proprietor or ❑ C Corporation ❑ 5 Corporation ❑ Partnership ❑Trust/estate certain entities, not individuals; see
instructions on page 3):
single -member LLC Exempt payee code (if any)
❑ Limited liability company. Enter the tax classilication (C=C corporation, S=S corporation, P=partnership) ►
MA9. For a single -member LLC that is dis do not check LLC; check the appropriate box in the line above for Exemption from FATCA reporting
the tax classification of the single=meistberok"ar. code (if any)
❑ Other (see instructions) 0-
5
5 Address (number, street, and apt. or suite no.) Requester's name and odditis fonlionaU
810 West Norton Rd.
6 City, state, and ZIP code
Springfield, MO 65803
7 List account number(s) here (optional)
NUM. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 110 avoid social security number ��
backup withholding. For individuals, this is generally your social security number ( However, for
page _m ^ �_i . I
resident ellen, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3. or _
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for Empfoyar Werrtlifeation »ulrtber T]
guidelines on whose number to enter.
5 o
-- 2 1 6 8 3 0 1 7
110 _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 code(s) entered on this form (if any) indicating that 1 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 and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.
bign Signature of
Here I U.S. person)-
General
erson►
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.gov/fw9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (TIN)
which may be your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), or employer
identification number PIN), to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns include, but are not limited to, the following:
• Form 1099 -INT (interest earned or paid)
• Form 1099 -DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
Date► 02/04/2015
• Form 1096 (home mortgage interest), 1098-E (student loan interest), 1098-T
(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured properly)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
If you do not return Form W-9 to the requester with a 77V, you might be subject
to backup withholding. See What is backup withholding? on page 2.
By signing the filled -out form, you:
1. Certify that the TIN you are giving Is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding If you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. See What is FATCA reporting? on
page 2 for further information.
Cat. No. 10231X Form W-•9 (Rev. 12-2014)
Form W-9 (Rev. 12-2014)
Note. 11 you are a U.S. person and a requester gives you a form other than Form
W-9 to request your TIN, you must use the requester's form if it is substantially
similar to this Form W-9.
Definition of a U.S, person. For federal tax purposes, you are considered a U.S.
person if you are:
• An individual who is a U.S. citizen or U.S. resident alien;
• A partnership, corporation, company, or association created or organized in the
United States or under the laws of the United States;
• An estate (other than a foreign estate); or
• A domestic trust (as defined in Regulations section 301.7701-7).
Speeiol rules for partnarshfps. Pas'tnrxships th it conduct a trade or business in
The United States are genitally required to pay a withholding tax under section
1446 on any foreign partners' share of atieetivety connected taxable incoma from
such business. Further, in certain cases where a Farm Vv -9 has not been received,
the rules under section 1446 require a partnership to presume that a partner is a
foreign person, and pay the section 1446 withholding lax. Therefore, If you are a
U.S. person that is a partner Tit a partnership conducting a trade or business in the
United Slates, provide Form W-9 to the partnership to establish your U.S, slatus
and avoid section 1446 withholding on your share of partnership income.
In the cases below, the following person must give Form W-9 to the partnership
tar purposes of eslabllalrlhg its U.S. status and avoiding withholding on its
Wo4able share of net income from the partnership conducting a trade or business
in the United States:
• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the
disregarded entity and not the entity;
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a
grantor trust) and not the beneficiaries of the trust.
Fdre(grr person. If you ate a foreign person or the U.S. branch of a foreign bank
that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use
the appropriate Form W-8 or Form 8233 (see Publlcznlan 515, Withholding of tax
on Nonresident Aliens and Foreign Entities).
Nonresident alien who becomes a resident alien. Generally, only a nonresident
alien individual may use the terms o1 a tax treaty to redrrrae or eliminate U.S. tax on
carWLn types of Income. However, most tax Iredlfas contain a provision known as
a "saving clause." Exceptions specilled in the saving clause may permit an
exemption from tax to continue for certain lypes.of Income evon after The payee
has otherwise become a U.S. resident alien for lax purposes.
If you are a U.S, resWeril alien who is relying on an exception contained in the
saving clause of a lax treaty to claim an exemption from U.S, tax on certain types
of Incomic you must attach a statement to Fotm W9 that specifies the following
five items:
1. The treaty country. Generally, this must be the same treaty under which you
claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the saving
clause and its exceptions.
4. The type and amount of income that qualifies for the exemption from tax.
5. Sufficient facts to justify the exemption from tax under the terms of the treaty
article.
Exampfe. Article 24 of tha U.S.-China Income lax treaty allows an exemption
from tax For scholarship Income received by a Chinese student temporarily present
In the United States. Under U.S. law, this student will become a resident alien far
tax purposes if his or her stay in the United States exceeds 5 cafendar years,
I lowover, paragraph 2 of the first Protocol to tile U.S.-China treuiy (dated April 30,
1984) allows The prov%lons of Article 20 to continue to apply even alter the
Chinese 5tudimt Fxxomes a resident alien of the United StaW%. A Ghinese student
who qualifies for this exception (under paragraph 2 -of the first protocol) and is
relying on this exe;eplfon to claim an exemption from lax on his or her scholarship
or fsifowship income would attach to Form W-9 a statement that includes The
information described above to support that exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W -e or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you most
under certain conditions withhold and pay to the IRS 28% of such payments. This
is called "backup withholding." Payments that may be subject to backup
withholding include interest, tax-exempt interest, dividends, broker and trader
exchange transactions, rents, royalties, nonemployee pay, payments made In
settlement of payment card and third party nalwork transactions, and certain
payments from fishing boat operators. Real estate transactions are not subject to
backup withholding.
You will not be subject to backup withholding on payments you recr�ve 0 you
give the requestery= correct TIN, make the proper certifications, and report all
your taxable interest and dividends on your tax return:
Payments you receive will be subject to backup withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructions on page
3 for details),
3. rhe IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are sub[ect to backup withholding because you did
not report all your interest and dividends on your tax return (tor reportable interest
and dividends only), or
5. You do not cerhly to the requester that you aro not subject to backup
withholding under 4 above For reportable inttresi and dividend accounts opened
after 1963 only).
Certain payees and paymends are exempt from backup withholding. See Exempt
payee costo on page 3 and the separate Instructions for the. Plaquester of Form
W-9 for more information.
Also see Special rules for partnerships above.
What is FATCA reporting?
The Foreign Account Tax Compliance Act (FATCAI requires a participating foreign
financial institution to report all United States account holders that are spnclfied
United States persons. Certain peyma are exempt from FATCA reporting. See
Exempflon from FATCA reAG*W code on pans 3 and the Instruct Ons or The
Requester of Form W-9 for more information.
Updating Your Information
You must provide updated Infomialion to arty person to whom you clatmod to be
an exempt payee If you are no longer an oxampl payee and anlicipale receiving
reportable payments in the future from th}s person, For exampte, you may need to
provide updated [niwmallan 9 you are a G corporation that etects to be an S
corporation, or if you no tenger ate tax axempi. In addilirul, you must ftnnish a new
Form W9 If the name or TIN changes for the account; for exaunple. If the grantor
of a grantor trust dies.
Penalties
Fallum to furnish TIN. If you fail to furnish your correct TIN to a requester, you are
subjaci to a penalty of $50 for each such failure unless your failure is due to
reasonable cause and not to willful neglect.
Civil penalty for false information wlth respect to withholding. If you make a
false sialernent with no reasonable basis that results in no backup withholding,
you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying rerliifcatlons or
affirmations may subject you to criminal penalties including fines andlor
imprisonment.
Misuse of TINS. If the requester discloses or uses TTNB in violation of federal law,
the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line blank. The
name should match the name on your tax return.
If this Form W-9 is for a joint account, list first, and then circle, the name of the
person or entity whose number you entered in Part I of Form W-9.
a. Individual. Generally, enter the name shown onour tax relurn. If you have
Changed your last name wilhout Informing Iho Social Security Adminislrafidn (SSA)
of the name change, enter your first name, tine last nartta as shown on your social
security card, and your new last name.
}late. MN applicant: Enter your individual name as it was entered on your Form
W 7 applicalion, line la. This should also be The same as the name you entered on
the Fomt 104011040MI040EZyou flied With your appllc Von.
b. Sole proprietor or single -member LLC. Enter your individual name as
shown on your ID4011040A11040EZ an line 1. You may enter your business, trade,
or "doing business as" (DBA) name on line 2.
c. Partnership, LLC that is not a singlo-memb,ar LLC, C corporation, or S
Corporation. Enter the entity's name as shown on the entity's tax return on line 1
and any business, trade, or DBA name on line 2.
d. Other entities. Enter your name as shown on required U.S. federal lax
documents on line 1. This name should match the name shown on the charter or
other legal document creating the entity. You may enter any business, trade, or
DBA name on line 2.
o. Disregarded entity. For U.S, federal tax purposes, an entity that is
disregarded as an entity separate From its owner is treated as a 'disregarded
entily." See Regulations section 301.7701.2{a)j7)(li], Enter the owner's name on
fine 1. The name of the entity entered on line 1 should never be a disregarded
entity. The name on lino 1 should be the name shown on the income tax return on
which the income should be reported. For example, if a foreign LLC Ihat is treated
as a disregarded entity for U.S. federal' lax purposes has a single owner f hat is a
U.S. person, lha U.S. owner's name is raquhed to be provided on line 1. If the
direct owner of the enlily Is also a disregarded entity, enter I h a first onmut that is
nut disregard ad for federal tax purposes. Enter the disregarded entity's narne on
fine 2, "Business nameJdlsregarded erility name." If tho owner or the disregarded
entity is a foreign person, the owner must complete an appropriate Farm W -B
instead of a Form W-9. this is the caro even if the foreign rrersan has a U.S. TIN.
Form W-9 (Rev, 12-2014)
Line 2
If you have a business name, trade name, DBA name, or disregarded entity name,
you may enter it on line 2.
Line 3
Check the appropriate box in line 3 for the U.S. federal lax classification of the
person whose name is entered on line 1. Check only one box in line 3.
Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a
partnership for U.S. federal tax purposes, check the "Limited Liability Company"
box and enter "P" in the space provided. If the LLC has filed Form 8832 or 2553 to
be taxed as a corporation, check the "Limited Liability Company" box and in the
space provided enter "C" for C corporation or "S" for 3 corporation. If it is a
single -member LLC that is a disregarded entity, do not check the "Limited Liability
Company" box; instead check the first box in line 3 "Individual/sole proprietor or
single -member LLC."
Line 4, Exemptions
II you are exempt from backup withholding and/or FATCA reporting, enter in the
appropriate space in line 4 any code(s) that may apply to you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from backup
withholding-
- Except as provided below, corporations are exempt from backup withholding
for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments made In
settlement of payment card or third party network transactions.
• Corporations are not exempt from backup withholding with respect to attorneys'
fees or gross proceeds paid to attorneys, and corporations that provide medical or
health care services are not exempt with respect to payments reportable on Form
1099-MISC.
The following codes identify payees that are exempt from backup withholding.
Enter the appropriate code in the space in line 4.
1—An organization exempt from tax under section 501(a), any IRA, or a
custodial account under section 403(b)(7) if the account satisfies the requirements
of section 401(f)(2)
2—The United Stales or any of its agencies or instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or possession, or
any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies, or
instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the United
Stales, the District of Columbia, or a U.S. commonwealth or possession
7—A futures commission merchant registered with the Commodity Futures
Trading Commission
8—A real estate investment trust
9—An entity registered at all limes during the tax year under the Investment
Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section 4947
The following chart shows types of payments that may be exempt from backup
withholding. The chart applies to the exempt payees listed above, 1 through 13,
IF the payment is for.. ,
THEN the payment is exempt for. ,
Interest and dividend payments
All exempt payees except
for 7
Broker transactions
Exempt payees 1 through 4 and 6
through i 1 and all C corporations. S
corporations must not enter an exempt
payee code because they are exempt
only for sales of noncovered securities
acquired prior to 2012.
Barter exchange transactions and
Exempt payees 1 through 4
patronage dividends
Payments over $600 required to be
Generally, exempt payees
Mporfed and direct sales over $5,000'
1 through 52
Payments made in settlement of
Exempt payees 1 through 4
payment card or third party network
transactions
I See Form 1099-MISC, Miscellaneous Income, and its instructions.
Page 3
However, the following payments made to a corporation and reportable on Form
1099-MISC are not exempt from backup withholding_ medical and health care
payments, attomeys' fees, gross proceeds paid to an attorney reportable under
section 60450), and payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify payees
that are exempt from reporting under FATCA. These codes apply to persons
submitting this form for accounts maintained outside of the United States by
certain foreign financial institutions. Therefore, if you are only submitting this form
for an account you hold in the United States, you may leave this field blank.
Consult with the person requesting this form if you are uncertain if the financial
institution is subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with "Not Applicable" (or any
similar Indication) written or printed on the line for a FATCA exemption code.
A—An organization exempt from lax under section 501(a) or any individual
retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A stale, the District of Columbia, a U.S. commonwealth or possession, or
any of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or more
established securities markets, as described in Regulations section
1.1472-1(c)(1)(f)
E—A corporation that is a member of the same expanded affiliated group as a
corporation described in Regulations section 1.1472-1(c)(1)(i)
F—A dealer in securities, commodities, or derivative financial instruments
(including notional principal contracts, futures, forwards, and options) that is
registered as such under the laws of the United Stales or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an entity
registered at all fines during the tax year under the Investment Company Act of
1940
1—A common trust fund as defined in section 584(x)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
M —A tax exempt trust under a section 403(b) plan or section 457(8) plan
Note. You may wish to consult with the financial institution requesting this form to
determine whether the FATCA code and/or exempt payee code should he
completed.
Line 5
Enter your address (number, street, and apartment or suite number). This is where
the requester of this Form W-9 will mail your information returns.
Line 6
Enter your city, state, and ZIP code,
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and you do not
have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer _
identification number (ITIN). Enter it in the social security number box. If you do not
have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an EIN, you may enter either your SSN
or EIN. However, the IRS prefers that you use your SSN.
If you are a single -member LLC that is disregarded as an entity separate from its
owner (see Limited Liability Company (l_LC) on this page), enter the owner's SSN
(or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC
is classified as a corporation or partnership, enter the entity's FIN.
Note. See the chart on page 4 for further clarification of name and TIN
combinations.
Now to get a TIN. If you do not have a TIN, apply for one Immediately. To apply
for an SSN, get Form SS -5, Application for a Social Security Card, from your local
SSA office or get this form online at www.ssa.gov. You may also get this form by
calling 1-800-772-1213. Use Farm W-7, Application for IRS Individual Taxpayer
Identification Number, to apply for an ITIN, or Form SS -4, Application for Employer
Identification Number, to apply for an EIN. You can apply for an EIN online by
accessing the IRS website at www.irs.gov/businesses and clicking on Employer
Identification Number (EIN) under Starting a Business. You can get Forms W-7 and
SS -4 from the IRS by visiting IRS.gov or by calling 1 -800 -TAX -FORM
(1-800-629-3676).
If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN
and write "Applied For" in the space for the TIN, sign and date the form, and give it
to the requester. For interest and dividend payments, and certain payments made
with respect to readily tradable instruments, generally you will have 60 days to get
a TIN and give it to the requester before you are subject to backup withholding on
payments. The 60 -day rule does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you provide your TIN to
the requester.
Note. Entering "Applied For" means that you have already applied for a TIN or that
you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use the
appropriate Form W-8.
Form W-9 (Rev. 12-2014)
Part II. Certification
To establish to the wNlholding agent that you are a U.S. person, or resident alien,
sign Form W-9. You maybe requested to sign by the withholding agent oven if
items 1, 4, or 5 below indicate otherwise.
For a joint account. Only the person whose TIN Is shown in Part I should sign
(when required), In the case of a disregarded entity, the person identified on line 1
must sign. Exempt payees, sae Ex'afnpt payen cudc carlier.
Signature requirements. Complete the certification as indicated in Items 1
through 5 below.
1. Interest, dividend, and barter exchange accounts opened before 1984
and broker accounts considered active during 1983. You must give your
correct TIN, but you do not have to sign the certification.
2. Interest, dividend, broker, and barter exchange accounts opened after
1983 and broker accounts consfderad inactive during 1963. You must sign the
certification or backup withholding will apply. If you are subject to backup
withholding and you are merely providing your correct TfN to the requester, you
must cross out item 2 in the certification before signing the form.
3. Real estate transactions. You must sign the certification. You may crass out
item 2 of the certification.
4. Giber payments. You must give your rot recl TIN, but you do not have to sign
the cera lieaUcin unless ytw have been not ilied that you have previously givers an
Incorrect TIN. "Other payments" include payments made In the course of the
eegUastsr'S trade or business for rants, royalties, goods !other khan bllis for
merchandise), medical and health care services (including payments to
corporations), paymen;s to a nonemployee for services. payments made in
selilement of payment card and lhfr i party network transactions, payments to
certain INhing boat craw rnombers and ffaheamen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage Interest paid by you, acqu)sltlon or abandonment of secured
property, cancellation of debt, qualified tuition program payments funder
section 529), IRA, Coverdnll ESA, Archer MSA or HSA contdbuiions or
distributions, and pension distributions. You must give your correct TIN, but you
do net have to sign the certification.
What Name and Number To Give the Requester
For inls type of account! I Give name and SSN uf_
1. Individual
2. Two or more individuals (joint
account)
3. Custodian account of a minor
(Uniform Gift to Minors Act)
4. a. The usual revocable savings
trust (grantor Is also trustee)
b. So-called trust account that is
not a legal or valid trust under
state law
5. Sole proprietorship or disregarded
entity owned by an individual
6. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i)
(A))
The individual
The actual owner of the account or
if combined funds, the first
individual on the account'
The minor'
The grantor -trustee
The actual owner'
The owner'
The grantor'
For this type of account: I Give name and EIN of:
7. Disregarded entity not owned by an
The owner
individual
8. A valid trust, estate, or pension trust
Legal entity'
9. Corporation or LLC electing
T he corporation
corporate status on Form 8832 or
Form 2553
10. Association, club, religious,
The organization
charitable, educational, or other tax-
exempt organization
11. Partnership or multi -member LLC
The partnership
12. A broker or registered nominee
The broker or nominee
13. Account with the Department of
The public entity
Agriculture in the name of a public
entity (such as a slate or local
government, school district, or
prison) that receives agricultural
program payments
14. Grantor trust filing under the Form
The trust
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Ftegutalfons section 1.671-4(b)(2)(i)
1rn
List first and circle the name of the person whose number you Furnish. If only one person on a
joint account has an SSN, that person's number must be fumshed:
`Girde the minor's name and lumish the mir,oe's SSN.
Psge 4
You must show your individual name and you may also enter your bLlyne65 or DBA name on
the "Business nomeydlsregarded entity" name line. You may use either Yolx SSN Of EIN (it you
have one), but the IRS encourages you to use your SSN,
'List first and circle the name of the bust, estate, or pension trust. (Do not furnish the TIN of the
personal representative or trustee unless the legal entity itself Is not designated in the account
title.) Also see Special rules for parfnershibs on page 2.
'Note. Grantor also must provide a Form W-9 to trustee of trust.
Note. It no name is circled when more than one name is listed, the number will be
considered to be that of the first name listed.
Secure Your Tax Records from Identity Theft
Idonlily theft occurs when someone uses your personal Information such as your
name, SSN, or other !dent tying Informallnn, without your permisslon, to commit
fraud Or other cdmes. An identity thlef may pse your SSN to get a fob or may life a
tax return using your SSN to receive a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer.
If your lax records are affected by identity theft and you receive a notice from
the IRS, respond right away to the name and phone number printed on the IRS
notice or letter.
If you r tax records are not currently aNeclad by identity theft but you think you
are at risk due to a last or stolen purse or wallet, questionable credit card activity
or credit report, contact The IRS identity Theft Hollins at 1 -Boo -90&4490 or submit
Form 14039.
For more information, see Publication 4535, Identity Theft Prevention and Victim
Assistance.
Vrclims or Identity theft who are exparlenning economic harm or a system
problem, or are seeking help in resolving tax problems that have not been resolved
through normal channels, may be etlglble for I-axpayer Advocate Service (TAS)
assistance. You cart reach TAS by calling the TAS tO4vea rasn intake Ilne at
1-877-777-4778 orTTYfrDD 1-800-829-4059,
Protect yourself from suspicious emails or phlshing schemes. Phishing is the
creation and use of email and websiles designed tomimlc legilimale business
emalls and Webskes. The moll cununun aur Is Sendiny do eirtdil lu a user falsely
clafrrilag to be an eslahllshed legitimate enterprise in an attempt to scam the user
into stunendering private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emalls. Also, the IRS does
not request personat detailed information through small or ask taxpayers for the
PIN numbers, oasswords, or similar secret access Intermation for their Credit card,
bank, or other financial accounts.
11 you receive an unsolicfled email daim(ng to be from the IM, forward this
message to phfshing®Hs.gov. You may also report misuse of the IRS name, logo,
or other IRS properly to the Treasury Inspector General for Tax Adarinlslrat fon
(ff43TA) at 1.600=366-4484. You can forward suspicious email; to tha Federal
Trade Commisslon at: spAmOuce.gov or contact them at wvnv.fW,gov#d(herr or
1-877-10THEFT (1-877-438-4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct
TIN to persons lincluding lederaT agencies) who are requlrcd to file Information
ralUmS with the IRS to report Interest, dMdands, or e.erfaln other income paid to
you: mortgage interest you paid; the acqu(stion or ablmdeaMlant of sectired
property; the cancellation of debt; or contributions you made to an IRA. Archer
MSA, or HSA. The person collecting this form uses the Information on The form to
file information returns with the IRS, reporting the above information. Routine uses
of this Information inctude giving it to the DeMrtment of Jusllrn for c1v11 and
criminal litigation word to cities, slates. the Districl of Columbia, and U.S,
commonwealths and possessions for use In administering their laws. The
Information also may be disclosed to other countries under a Treaty. to federal and
state agencles to enforce civil and criminal laws, er to federal jaw enforcement and
intelligence agenctes to combat terrorism. You must provide your TIN whether or
not you are required to Ilia a tax retum. Under section 3do6. payers must generally
withhold a percentage of taxable intnrrai, dividend, and eertaiA othts payments to
a payee who does not give a TIN to the payer. Certain penalties may also apply For
providing false or fraudulent information.
' BUILD the BEST
FOUR SEASONS"
jUISUNROOMS
Independently Owned & Operated
Ozark Sunrooms & More, Incorporated
850 East Henri de Tonti Blvd
Springdale, AR 72762
(888) 467-9900 (479) 306-9900
Fax (479) 361-9591
hl# :lw�lwww_azarksunroams cam Email: info ozarkselnraoms.cvm
May 29, 2018
Mr. Wade Abernathy
Facilities and Building Projects Manager
City of Fayetteville
Dear Wade:
Please use this letter as Ozark Sunrooms & Mores' quote to build a Four Seasons Sunroom Wall
System and a Straight Eave Glass Roofed sunroom at 945 S. College, Fayetteville, AR 72701.
The specifics are listed below:
• One wall 10' wide and 9' tall. It will have glass kicks and windows that slide open with
screens and dual locks and glass transoms. The windows, kicks, and transoms will be 36"
wide.
• The Straight Eave Glass Roof will have a projection of 6' 5-1/2" and will be 17' 9-3/4" wide
and an attaching height of 9'5-3/16". There will be one 36" door on the left wall. The door
will have a triple lock system and the windows will have double locks.
• The room is very similar to the one we did for the animal facility.
• No wiring is included in this bid.
• Price for this project is $30,725.00.
Price includes labor, shipping, taxes, and material.
Please let me know what other information you need to complete the bid.
Regards,
Q
f�-u
Bill Boss
Owner
pkc
Abernathy, Waylon
From: John Cooke <modernexteriors@icloud.com>
Sent: Tuesday, June 05, 2018 6:43 PM
To: Abernathy, Waylon
Subject: Re: Sunroom project
Wade, you can find some information on their website www.temosunrooms.com. However, what I can tell you is this.
The framing of the windows is T6 aircraft grade aluminum which is 3-5/8" thick. The operable windows are 60" in height
and are dual sliders allowing both sashes to slide side to side as well as can lift out. Each window has a full removable
screen. Above the operable 60" sashes will be a fixed glass transom. The windows have cardinal 366 solar glass that is
self cleaning with a 3/4" spacer with Low E tempered glass. The windows have adjustable latches that lock to the frame
on the inside and are very secure. Each window is built into a wall section that is manufactured and shipped to use in its
complete form. If you need anything else that is not available on the website please let me know and I will do my best to
get the information to you. John Cooke- Modern Exteriors
Sent from my iPad
> On Jun 5, 2018, at 4:09 PM, Abernathy, Waylon <wabernathy@fayetteville-ar.gov> wrote:
> Can you send some product data on the Temo product?
> Wade Abernathy
> Facilities and Building Projects Manager City of Fayetteville
> wabernathy@fayetteville-ar.gov T 479-575-8361
> -----Original Message-----
• From: John Cooke [mailto:modernexteriors@icloud.com]
> Sent: Tuesday, June 05, 2018 3:44 PM
> To: Abernathy, Waylon <wabernathy@fayetteville-ar.gov>
> Subject: Re: Sunroom project
> Wade, thank you for clarifying your specifications. Based on the dimensions you sent me, I am recommending Temo
sunrooms product 3-5/8" wall system with dual sliding window system with 3/4" thick glass windows with solar glass
with low E/argon with 36" entry door with deadbolt keyed lock. Project cost= $23,830.89. John Cooke- Modern Exteriors
> Sent from my iPad
>> On Jun 4, 2018, at 7:22 AM, Abernathy, Waylon <wabernathy@fayetteville-ar.gov> wrote:
>> Will call this am.
>> Wade Abernathy
>> Facilities and Building Projects Manager City of Fayetteville
>> wabernathy@fayetteville-ar.gov T 479-575-8361
Abernathy, Waylon
From: Dave Anderson <dave@floriangreenhouse.com>
Sent: Thursday, May 31, 2018 3:14 PM
To: Abernathy, Waylon
Subject: RE: sunroom
Your original dimensions was 10" x 9', thought you were filling in under a soffit, not a 10' x 9' curtain wall, That will
change the price, also the number of sections/ bays will be more than drawn (4 in the 10' wall, 7 in the 17'-9" sunroom).
The glass is fixed, not operable
The material cost will now be $25,600.00, estimated labor cost $8,000.00
From: Abernathy, Waylon <wabernathy@fayetteville-ar.gov>
Sent: Thursday, May 31, 2018 3:25 PM
To: dave@floriangreenhouse.com
Subject: RE: sunroom
This is a sketch of the proposed sunroom.
The windows need to be low a and operable.
Wade Abernathy
Facilities and Building Projects Manager
City of Fayetteville
wabernathv[zDfavetteville-ar.gov
T 479-575-8361
CITY OF
WOO FAYETTEVILLE
ARKANSAS
From: Dave Anderson[ma iIto: dave @florlan reenhouse.comj
Sent: Thursday, May 31, 2018 12:02 PM
To: Abernathy, Waylon <wabernath fa etteville-ar. ov>
Subject: sunroom
Mr. Abernathy,
Per your request, the material cost for a custom sunroom based on your dimensions will be $21,069.00 shipped to
Fayetteville, AR. Estimated labor cost to install on a prepared site $6,680.00. If this fits into your budget I will send a
formal quote as needed.
Thank you,
Dave Anderson
Sales Manager
Florian Solar Products LLC.
(800)356-7426 Ext.108
Direct: 843-545-0748
dave(@floriaiiRreenhouse.com
www.FlorianGreenhouse.com
www.FlorianSolar.com