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Envirosight LLC - 593-19 (2) Final contractJuly 18, 2019 Sent Via Email: aclark@envirosight.com Alice Clark Envirosight, LLC 111 Canfield Ave, Unit B3 Randolph, NJ 07869 Welcome to BuyBoard! Re: Notice of The Local Government Purchasing Cooperative Award Proposal Name and Number: Sewer Inspection and Cleaning Products, Proposal No. 593-19 Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company a BuyBoard® contract based on the above-referenced Proposal. The contract is effective 10/1/2019 through 9/30/2020, with two possible one-year renewals. The contract documents are those identified in Section 3 of the General Terms and Conditions of the specifications. To view the items your company has been awarded, please review the proposal tabulation No. 593-19 on the following web-site: www.buyboard.com/vendor. Only items marked as awarded to your company can be sold through the BuyBoard contract. In addition, on this website you will find the membership list which will provide you with the names of all entities with membership in our purchasing cooperative. Enclosed with this letter you will find the following documents: 1. Vendor Quick Reference Guide 2. BuyBoard License and Identity Standards You are advised that receipt of a purchase order directly from a Cooperative member is not within the guidelines of the Cooperative. Accepting purchase orders directly from Cooperative members may result in a violation of the State of Texas competitive bid statute and termination of this Cooperative BuyBoard contract. Therefore, all purchase orders must be processed through the BuyBoard in order to comply. Please forward by email to info@buyboard.com any order received directly from a Cooperative member. If you inadvertently process a purchase order sent directly to you by a Cooperative member, please email the order info@buyboard.com and note it as RECORD ONLY to prevent duplication. As an awarded vendor a BuyBoard user id and password will be sent via e-mail 2 to 3 business days prior to the start of your contract. On behalf of the Texas Association of School Boards, we appreciate your interest in the Cooperative and we are looking forward to your participation in the program. If you have any questions, please contact Cooperative Procurement Staff at 800-695-2919. Sincerely, Arturo Salinas Department Director, Cooperative Procurement v.6.5 September 4, 2019 Sent Via Email: aclark@envirosight.com Alice Clark Envirosight, LLC 111 Canfield Ave, Unit B3 Randolph, NJ 07869 Welcome to BuyBoard! Re: Notice of National Purchasing Cooperative Piggy-Back Award Proposal Name and Number: Sewer Inspection and Cleaning Products, Proposal No. 593-19 Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a BuyBoard® contract based on the above-referenced Proposal. As provided for in the Proposal and your National Purchasing Cooperative Vendor Award Agreement, you are authorized to sell the goods and services awarded under the Proposal to National Cooperative members in states other than Texas through the BuyBoard. The contract is effective 10/1/2019 through 9/30/2020, with two possible one-year renewals. The National Cooperative membership list is available at our website www.buyboard.com/vendor. The list identifies the current members that may purchase awarded goods and services under your National Cooperative BuyBoard contract. You are advised that receipt of a purchase order directly from a National Cooperative member is not within BuyBoard guidelines. Accepting purchase orders directly from Cooperative members may result in a violation of applicable competitive procurement law and termination of this National Cooperative BuyBoard contract. Therefore, all purchase orders from National Cooperative members must be processed through the BuyBoard. Please forward by e-mail to info@buyboard.com any order received directly from a National Cooperative member. If you inadvertently process a purchase order sent directly to you by a National Cooperative member, please fax the order to the above number and note it as RECORD ONLY to prevent duplication. As an awarded vendor a BuyBoard user id and password will be sent via e-mail 2 to 3 business days prior to the start of your contract. On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any questions, please contact Cooperative Procurement Staff at 800-695-2919. Sincerely, Arturo Salinas Department Director, Cooperative Procurement v.6.5 Envirosight US Dealer Sales Channel A&H Equipment – Pennsylvania & West Virginia 1124 McLaughlin Run Road Bridgeville, PA 15017 Phone: 412-257-1160 Fax: 412-257-4471 EJ Weber ejweber@ahequipment.com Bell Equipment - Michigan 74 Northpoint Drive Lake Orion, MI 48359 Phone: 866-597-0716 Clark Bushman cbushman@bellequip.com Best Equipment Company – Indiana, Ohio, and Kentucky 5550 Poindexter Drive 12359 Abbey Road Indianapolis, IN 46235 North Royalton, OH 44133 Phone: 317-823-3050 Phone: 440-237-3515 Fax: 317-823-3060 Fax: 440-237-3565 Bill Stoddard billstoddard@bestequipmentco.com Bruce Municipal Equipment - Wisconsin N60 W 15835 Kohler Lane Menomonee Falls, WI 53051 Phone: 262-252-4744 Fax: 262-252-3955 Jim Weedman jbweeds@aol.com Environmental Products of Florida - Florida 2525 Clarcona Rd 450 NW 27 Avenue Apopka, FL 32703 Ft. Lauderdale, FL 33311 Phone: 407-798-0004 Phone: 954-518-9923 Fax: 407-798-0014 Fax: 954-518-9926 Nick Causey ncausey@epofc.com Environmental Products of Georgia – Georgia 4410 Wendell Dr SW Atlanta, GA 30336 Phone: 404-693-9700 Fax: 404-693-9690 Casey Meehan cmeehan@epofc.com Green Equipment Company - Texas 2563 Gravel Drive Fort Worth, TX 76118 Phone: 817-589-2704 Fax: 817-284-1107 Brandon Baker brandonbaker@greenequipco.com J.F. McDermott – Connecticut, Massachusetts, Rhode Island, Vermont, New Hampshire, Maine 1235 Auburn Street Whitman, MA 02382 Phone: 508-580-7740 Fax: 508-580-7747 Brian Kennedy jfmcdermottco@aol.com Haaker Equipment – Southern California, Southern Nevada and Arizona 2070 North White Avenue LaVerne, CA 91750 Phone: 909-598-2706 Bryan Fox bryanf@haaker.com Joe Johnson USA – New York State including New York City 62 LaGrange Avenue 1373 Indian Fields Road Rochester, NY 14613 Feura Bush, NY 12067 Phone: 585-254-7700 Fax: 585-254-9122 Aaron Gieseke agieseke@jjeusa.com Key Equipment – Kansas, Missouri, Southern Illinois, Oklahoma 13507 Northwest Industrial Drive 6716 Berger Ave Bridgeton, MO 63044-1245 Kansas City, KS 66111 Phone: 314-298-8330 Phone: 913-371-8260 Fax: 314-298-8376 Fax: 877-262-0149 Josh Kingsley jkingsley@keyequipment.com MacQueen Equipment – Minnesota, Eastern North Dakota, South Dakota 595 Aldine Street St. Paul, MN 55104 Phone: 651-645-5726 Fax: 651-645-6668 Bill McCarthy bmccarthy@macqueeneq.com Metroquip - Idaho 1953 E. Commercial Street Meridian, ID 83680 Phone: 208-344-3318 Fax: 208-345-8366 Ray Smith rsmith@metroquip.com Neverest Equipment Company – Colorado, Utah and Wyoming 3541 Ward Road Wheat Ridge, CO 80033 Phone: 303-898-9475 Fax: 303-898-9475 Brian Balchumas brian@neverestequipment.com Nebraska Environmental Products - Nebraska 2621 West M Court Lincoln, NE 68522 Phone: 402-435-0061 Fax: 402-435-0644 Greg Oliverius greg@transiowaeg.com Normont Equipment – Montana and Western North Dakota 1157 Wire Mill Rd Black Eagle, MT 59414 Phone: 406-453-4344 Luke Stewart lstewart@nmeqco.com Pete’s Equipment – New Mexico 1412 Broadway NE Albuquerque, NM 87102 Phone: 505-252-6969 Fax: 505-242-4156 Bill Pedigo bpedigo@petesequip.com Public Works Equipment – North Carolina, South Carolina, Eastern Tennessee 3405 Westwood Industrial Drive Monroe, NC 28110 Phone: 704-289-6488 Fax: 704-283-2266 Reed Davis reed@pweasi.com Sansom Equipment – Mississippi, Alabama, Western Tennessee 1225 Vanderbilt Road Birmingham, AL 35234 Phone: 205-324-3104 Fax: 205-324-2679 Jeff Bodiford jeffb@secequip.com Standard Equipment – Northern Illinois (Chicagoland Area) and Hawaii 2033 W Walnut Street Chicago, IL 60612 Phone: 312-829-1919 Fax: 312-829-6142 Mike O’Connor moconnor@standardequipment.com Trans – Iowa - Iowa 4607 SE Rio Ct. Ankeny, IA 50021 Phone: 515-289-9994 Fax: 515-289-9995 Eric Thorson eric@transiowaeq.com True North Equipment – Oregon, Washington, and Alaska 3150 SE Century Blvd – Suite 100 Hillsboro, OR 97123 Phone: 503-848-3276 Jim Brown jbrown@truenorthenviro.com Virginia Public Works – Virginia & Maryland 8383 Old Richfood Road Mechanicsville, VA 23116 Phone: 804-730-4040 Fax: 804-730-4033 Luke Kahelski luke@vpwe.com WinCan, LLC – Wincan Orders Only 200 Cedar Ridge Drive Unit 207 Pittsburgh, PA 15205 Phone: 412-489-6229 Melanie Westerfield m.westerfield@wincam.com Pipeline Renewal Technologies – QuickLock Orders Only 111 Canfield Ave Unit B3 Randolph, NJ 07869 Phone: 973-252-6700 Alice Clark aclark@envirosight.com Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to www.irs.gov/FormW9 for instructions and the latest information. Give Form to the requester. Do not send to the IRS.Print or type. See Specific Instructions on page 3.1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) a Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 6 City, state, and ZIP code Requester’s name and address (optional) 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid 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 entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Social security number – – or Employer identification number – Part II 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. I 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. I 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 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 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 for Part II, later. Sign Here Signature of U.S. person a Date a General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. 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 (EIN), 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) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) 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 TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) tions HAAKER EQUIPMENT COMPANY ✔ 2070 N WHITE AVE LA VERNE, CA 91750 9 5 2 7 5 6 0 6 4 1-16-19 Signature of U.S. person). Sign Hero Date ► 9 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and its Instructions, such as legislation enacted after they were published, go to Invw.Irs.gov/FormW9. Purpose of Form M 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 (E(N), 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-GIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 109941 (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) • Form 1098 (home mortgage Interest), 1098-E (student loan Interest), 1098-T (tuition) • Form 1099•C (canceled debt) • Form 1099•A (acquisition or abandonment of secured property) 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 wfth a 77N, you might be subject to backup withholding. See What is backup withholding, later. Employer Identification number 1 or Give Form to the requester. Do not send to tho IRS. Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification ► Go to www.irs.govlFormW9 for instructions and the latest Information. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Neverest Equipment Company LLC 2 Business name/disregarded entity name, tf different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on fine 1. Check only one of the following seven boxes. q Individual/sole proprietor or q C Corporation q S Corporation q partnership q Tnnt/estate single-member LLC o Limited Lability company. Enter the tax classification (C•C corporation, S4 corporation. P•Partnership) ► S Note: Check the appropriate box In the tine above for the tax classification of the single-member owner. Do not check tic if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that Is disregarded from the owner should check the appropriate box for the tax classification of Its owner. o Other (see Instructkins)1 5 Address (number. street. and apt. or suite no.) See instructions. 6681 Colorado Blvd Unit 5 0 City. state, and ZIP code Commerce City CO 80022 4 Exemptions (codes apply only to certain entities, not incrrviduals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) Pa** b waxen mobtahoef beds lb US) Requester's name and address (optional) 7 List account number(s) here (optional) UM Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The 71N provided must match the name given on line 1 to avoid 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 entitles, It Is your employer Identification number (EIN). If you do not have a number, see How to get a 77N, later. Note: It the account Is In more than one name, see the Instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Part II 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 2.1am 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 tam subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that 1 am no longer subject to backup withholding; and 3.1am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (If an 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 and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured properly, cancellation of debt, contributions to an Individual retirement arrangement (RA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correctliN. See the Instructions for Part II, later. Cat No. 10231X Form W-9 (Rev. 10-2018) Social security number 4WD ••• 2 6 2 8 3 2 1 5 7 January 21, 2019 Form W-9 Request for Taxpayer Give Form to the (Rev. December 2011} Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service Name (as shown on your Income tax return} C\i Business name/disregarded entity name, If different from above Ql a. Check appropriate box for federal tax classification: C: 0 D Individual/sole proprietor D C Corporation D S Corporation D Partnership D Trust/estate Cl)"' C. §D Exempt payee �+:l D Limited llablllty company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershlp) � ... C.l --------------------------------0 2 ...... Cu,'C .5 D Other (see Instructions} � a.C.l !5 C.l Address (number, street, and apt. or suite no.} Cl) C. U) City, state, and ZIP code Requester's name and address (optional} Ql Ql Cl) List account number(s} here (optional} •:.f:1 , .. Taxpayer Identification Number (TIN) I Social security number I Enter �our TIN in -t�e app�opriate ?o�. !he TIN �r�vided mus� match �he name given on the "Name" line to avoid backup w1thhold1ng. For 1nd1v1duals, this 1s your social security number (SSN). However, for a resident alien, 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. DJ] -[I] -I I I I I Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. I Employer identification number ITJ-1 I I 11 111 1@11M 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. I 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.I am a U.S. citizen or other U.S. person (defined below). 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 4. Sign Signature of Here U.S. person � Date � General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage Interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 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. exemptpayee. 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. Note. If 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). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S, status and avoid withholding on your share of partnership income. Cat. No. 10231X Form W-9 (Rev. 12-2011) Pipeline Renewal Technologies 3/14/16 27 1844228 111 Canfield Ave. Unit B3 Randolph, NJ 07869 x Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to www.irs.gov/FormW9 for instructions and the latest information. Give Form to the requester. Do not send to the IRS.Print or type. See Specific Instructions on page 3.1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) a Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 6 City, state, and ZIP code Requester’s name and address (optional) 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid 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 entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Social security number –– or Employer identification number – Part II 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. I 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. I 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 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 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 for Part II, later. Sign Here Signature of U.S. person a Date a General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. 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 (EIN), 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) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) 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 TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) ends, you are not required to sign the ctions Envirosight, LLC ✔P 111 Canfield Ave, Unit B3 Randolph, NJ 07869 33 1009158