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HomeMy WebLinkAbout17- Professional Services Agreement, Parking Commission - Midwest Welding & Machine - Parking Garage Handrails oo.. PROFESSIONAL SERVICES AGREEMENT THIS AGREEMENT is made and entered into this 11th day of May, 2017 by and between the CITY OF BOZEMAN,MONTANA,a municipal corporation organized and existing under the laws of the State of Montana, 121 North Rouse Ave.,Bozeman,Montana 59771,hereinafter referred to as "City,"and, Midwest Welding&Machine,hereafter referred to as"Contractor". In consideration of the mutual covenants and agreements herein contained, the receipt and sufficiency whereof being hereby acknowledged,the parties hereto agree as follows: 1. Purpose: City agrees to enter this Agreement with Contractor for the purchase and installation of 28 handrails in the Bridger Park Downtown Garage further described in the attached "Appendix A"and by this reference made a part hereof. 2. Term/Effective Date: This Agreement is effective upon the date of its execution and will terminate on the 30th day of May 2018. 3. Scone of Work: Contractor will perform the work and provide the services in accordance with the attached"Appendix A". For conflicts between this Agreement and the Scope of Services,unless specifically provided otherwise,the Agreement governs. 4. Payment: City agrees to pay Contractor the amount specified in the Scope of Services for the products and work described in the "Appendix A". Any alteration or deviation from the described services that involves additional costs above the Agreement amount will be performed by Contractor after written request by the City,and will become an additional charge over and above the amount listed in the Scope of Services. The City must agree in writing upon any additional charges. 5. Contractor's Representations: To induce City to enter into this Agreement, Contractor makes the following representations: a. Contractor has familiarized itself with the nature and extent of this Agreement, the Scope of Services, and with all local conditions and federal, state and local laws, ordinances, rules, and regulations that in any manner may affect cost,progress or performance of the Scope of Services. b. Contractor represents and warrants to City that it has the experience and ability to perform the services required by this Agreement; that it will perform said services in a professional, Page l of 11 Professional Agreement,for Purchase and installulio?i of handruils in Bridger Park Downtoliw Garage, May 2017 competent and timely manner and with diligence and skill; that it has the power to enter into and perform this Agreement and grant the rights granted in it;and that its performance of this Agreement shall not infringe upon or violate the rights of any third party,whether rights of copyright,trademark, privacy,publicity, libel, slander or any other rights of any nature whatsoever, or violate any federal, state and municipal laws. The City will not determine or exercise control as to general procedures or formats necessary to have these services meet this warranty. 6. Independent Contractor Status/Labor Relations: The parties agree that Contractor is an independent contractor for purposes of this Agreement and is not to be considered an employee of the City for any purpose. Contractor is not subject to the terms and provisions of the City's personnel policies handbook and may not be considered a City employee for workers' compensation or any other purpose. Contractor is not authorized to represent the City or otherwise bind the City in any dealings between Contractor and any third parties. Contractor shall comply with the applicable requirements of the Workers' Compensation Act, Title 39, Chapter 71, MCA, and the Occupational Disease Act of Montana, Title 39, Chapter 71, MCA. Contractor shall maintain workers'compensation coverage for all members and employees of Contractor's business, except for those members who are exempted by law. Contractor shall furnish the City with copies showing one of the following: (1) a binder for workers' compensation coverage by an insurer licensed and authorized to provide workers' compensation insurance in the State of Montana; or (2) proof of exemption from workers' compensation granted by law for independent contractors. Contractor shall indemnify, defend, and hold the City harmless from any and all claims, demands, costs, expenses, damages, and liabilities arising out of, resulting from, or occurring in connection with any labor problems or disputes or any delays or stoppages of work associated with such problems or disputes. 7. Indemnity/Waiver of Claims/Insurance: For other than professional services rendered,to the fullest extent permitted by law,Contractor agrees to release,defend,indemnify,and hold harmless the City, its agents, representatives, employees, and officers (collectively referred to for purposes of this Section as the City)from and against any and all claims, demands, actions, fees and costs (including attorney's fees and the costs and fees of and expert witness and consultants), losses,expenses,liabilities(including liability where activity is inherently or intrinsically dangerous) or damages of whatever kind or nature connected therewith and without limit and without regard to the cause or causes thereof or the negligence of any party or parties that may be asserted against, recovered from or suffered by the City occasioned by, growing or arising out of or resulting from or in any way related to: (i)the negligent, reckless, or intentional misconduct of the Contractor; (ii)any Page 2 of II Professional Agreement,for Purchase and installation of handrails in Bridger Park Downtown Garage, May 2017 negligent,reckless,or intentional misconduct of any of the Contractor's agents. For the professional services rendered, to the fullest extent permitted by law, Contractor agrees to indemnify and hold the City harmless against claims,demands,suits,damages,losses,and expenses,including reasonable defense attorney fees,to the extent caused by the negligence or willful misconduct of the Contractor or Contractor's agents or employees. Such obligations shall not be construed to negate,abridge,or reduce other rights or obligations of indemnity that would otherwise exist. The indemnification obligations of this Section must not be construed to negate, abridge, or reduce any common-law or statutory rights of the indemnitee(s) which would otherwise exist as to such indemnitee(s). Contractor's indemnity under this Section shall be without regard to and without any right to contribution from any insurance maintained by City. Should any indemnitee described herein be required to bring an action against the Contractor to assert its right to defense or indemnification under this Agreement or under the Contractor's applicable insurance policies required below the indemnitee shall be entitled to recover reasonable costs and attorney fees incurred in asserting its right to indemnification or defense but only if a court of competent jurisdiction determines the Contractor was obligated to defend the claim(s) or was obligated to indemnify the indemnitee for a claim(s)or any portion(s)thereof. In the event of an action filed against City resulting from the City's performance under this Agreement,the City may elect to represent itself and incur all costs and expenses of suit. Contractor also waives any and all claims and recourse against the City or its officers, agents or employees, including the right of contribution for loss or damage to person or property arising from,growing out of,or in any way connected with or incident to the performance of this Agreement except"responsibility for his own fraud, for willful injury to the person or property of another,or for violation of law,whether willful or negligent"as per 28-2-702,MCA. These obligations shall survive termination of this Agreement and the services performed hereunder. In addition to and independent from the above,Contractor shall at Contractor's expense secure insurance coverage through an insurance company or companies duly licensed and authorized to conduct insurance business in Montana which insures the liabilities and obligations specifically assumed by the Contractor in this Section. The insurance coverage shall not contain any exclusion for liabilities specifically assumed by the Contractor in subsection(a)of this Section. Page 3 of I Professional Agreement jot-Purchase and inslallulion of handrails in Bridger Park Downtown Garuge, May 2017 The insurance shall cover and apply to all claims, demands, suits, damages, losses, and } expenses that may be asserted or claimed against, recovered from, or suffered by the City without limit and without regard to the cause therefore and which is acceptable to the City and Contractor shall furnish to the City an accompanying certificate of insurance and accompanying endorsements in amounts not less than as follows: • Workers' Compensation—statutory; • Employers' Liability-$1,000,000 per occurrence; $2,000,000 annual aggregate; • Commercial General Liability - $1,000,000 per occurrence; $2,000,000 annual aggregate; The City of Bozeman,its officers, agents,and employees, shall be endorsed as an additional or named insured on a primary non-contributory basis on both the Commercial General and Automobile Liability policies. The insurance and required endorsements must be in a form suitable to City and shall include no less than a sixty(60)day notice of cancellation or non-renewal. The City must approve all insurance coverage and endorsements prior to the Contractor commencing work. Contractor shall notify City within two (2) business days of Contractor's receipt of notice that any required insurance coverage will be terminated or Contractor's decision to terminate any required insurance coverage for any reason. The City, must approve all insurance coverage and endorsements Prior to the Contractor commencing work. 8. Termination for Contractor's Fault: a. If Contractor refuses or fails to timely do the work,or any part thereof,or fails to perform any of its obligations under this Agreement, or otherwise breaches any terms or conditions of this Agreement,the City may,by written notice,terminate this Agreement and the Contractor's right to proceed with all or any part of the work("Termination Notice Due to Contractor's Fault"). The City may then take over the work and complete it,either with its own resources or by re-letting the contract to any other third party. b. In the event of a termination pursuant to this Section 8, Contractor shall be entitled to payment only for those services Contractor actually rendered. C. Any termination provided for by this Section 8 shall be in addition to any other remedies to which the City may be entitled under the law or at equity. Page 4 of 11 Professional Agreement for Purchase and installation of handrails in Bridger Park DoWntolNn Gal-age, May 2017 d. In the event of termination under this Section 8, Contractor shall, under no circumstances, be entitled to claim or recover consequential, special, punitive, lost business opportunity, lost productivity, field office overhead, general conditions costs, or lost profits damages of any nature arising,or claimed to have arisen,as a result of the termination. 9. Termination for City's Convenience: a. Should conditions arise which, in the sole opinion and discretion of the City, make it advisable to the City to cease work on the services provided, City may terminate this Agreement by written notice to Contractor("Notice of Termination for City's Convenience"). The termination shall be effective in the manner specified in the Notice of Termination for City's Convenience and shall be without prejudice to any claims that the City may otherwise have against Contractor. b. Upon receipt of the Notice of Termination for City's Convenience, unless otherwise directed in the Notice, the Contractor shall discontinue services and shall do only such work as may be necessary to preserve,protect,and maintain work already completed,in progress. C. In the event of a termination pursuant to this Section 13, Contractor is entitled to payment only for those services Contractor actually rendered and materials actually purchased or which Contractor has made obligations to purchase on or before the receipt of the Notice of Termination for City's Convenience,and reasonably incurred costs. It is agreed that any materials that City is obligated to purchase for the Contractor will remain the City's sole property. d. The compensation described in Section 13(c) is the sole compensation due to Contractor for its performance of this Agreement. Contractor shall, under no circumstances, be entitled to claim or recover consequential,special,punitive, lost business opportunity, lost productivity, field office overhead, general conditions costs, or lost profits damages of any nature arising,or claimed to have arisen,as a result of the termination. 10. Limitation on Contractor's Damages,Time for Asserting-Claim: a. In the event of a claim for damages by Contractor under this Agreement, Contractor's damages shall be limited to contract damages and Contractor hereby expressly waives any right to claim or recover consequential, special, punitive, lost business opportunity, lost productivity, field office overhead, general conditions costs, or lost profits damages of any nature or kind. Page 5 of I Professional Agreement.for Purchase and installation ofhandrails in Bridger Park Downtoivn Garage, May 2017 b. In the event Contractor wants to assert a claim for damages of any kind or nature, Contractor shall provide City with written notice of its claim, the facts and circumstances surrounding and giving rise to the claim, and the total amount of damages sought by the claim, within ten (10) days of the facts and circumstances giving rise to the claim. In the event Contractor fails to provide such notice, Contractor shall waive all rights to assert such claim. 11. Representatives: a. City's Representative: The City's Representative for the purpose of this Agreement shall be Ed Meece, Parking Program Manager, or such other individual as City shall designate in writing. Whenever approval or authorization from or communication or submission to City is required by this Agreement,such communication or submission shall be directed to Ed Meece as the City's Representative and approvals or authorizations shall be issued only by such Representative•, provided, however, that in exigent circumstances when City's Representative is not available,Contractor may direct its communication or submission to other designated City personnel or agents as listed above and may receive approvals or authorization from such persons. b. Contractor's Representative: The Contractor's Representative for the purpose of this Agreement shall be Joe Muller, or such other individual as Contractor shall designate in writing. Whenever direction to or communication with Contractor is required by this Agreement, such direction or communication shall be directed to Contractor's Representative; provided, however, that in exigent circumstances when Contractor's Representative is not available, City may direct its direction or communication to other designated Contractor personnel or agents. 12. Permits: Contractor shall provide all notices, comply with all applicable laws, ordinances,rules,and regulations,obtain all necessary permits,licenses,including a City of Bozeman business license. Page 6 of i l Professional Agreeinent.fbr Purchase and Installation of handrails in Bridger Park DoWnloirn Garage, May 2017 13 Laws and Regulations: Contractor shall comply fully with all applicable state and federal laws, regulations, and municipal ordinances including, but not limited to, all workers' compensation laws, all environmental laws, the Americans with Disabilities Act, and all non- discrimination, affirmative action, and utilization of minority and small business statutes and regulations. 14. Nondiscrimination: The Contractor will have a policy toprovide equal employment opportunity in accordance with all applicable state and federal anti-discrimination laws,regulations, and contracts. The Contractor will not refuse employment to a person,bar a person from employment, or discriminate against a person in compensation or in a term,condition,or privilege of employment because of race, color,religion, creed,political ideas, sex, age,marital status,national origin, actual or perceived sexual orientation, gender identity, physical or mental disability, except when the reasonable demands of the position require an age,physical or mental disability,marital status or sex distinction. The Contractor shall be subject to and comply with Title VI of the Civil Rights Act of 1964; Section 140, Title 2, United States Code, and all regulations promulgated thereunder. The Contractor shall require these nondiscrimination terms of its sub-Contractors providing services under this agreement. 15. Intoxicants; DOT Drug and Alcohol Regulations/Safety and Training: Contractor shall not permit or suffer the introduction or use of any intoxicants,including alcohol or illegal drugs, by any employee or agent engaged in services to the City under this Agreement. Contractor acknowledges it is aware of and shall comply with its responsibilities and obligations under the U.S. Department of Transportation(DOT)regulations governing anti-drug and alcohol misuse prevention plans and related testing. City shall have the right to request proof of such compliance and Contractor shall be obligated to furnish such proof. The Contractor shall be responsible for instructing and training the Contractor's employees and agents in proper and specified work methods and procedures. The Contractor shall provide continuous inspection and supervision of the work performed. The Contractor is responsible for instructing his employees and agents in safe work practices. 16. Modification and Assignability: This document contains the entire agreement between the parties and no statements, promises or inducements made by either party or agents of either party, which are not contained in this written Agreement,may be considered valid or binding. This Agreement may not be enlarged,modified or altered except by written agreement signed by both parties hereto. The Contractor may not subcontract or assign Contractor's rights, including the right to compensation or duties arising hereunder, without the prior written consent of City. Any subcontractor or assignee will be bound by all of the terms and conditions of this Agreement. Page 7 of l l Pruressional Agreement for Purchase and installation o 'handrails h7 Bridgey Park Doirnloivii Garage, May 2017 i 17. Reports/Accountability/Public Information: Contractor agrees to develop and/or provide documentation as requested by the City demonstrating Contractor's compliance with the requirements of this Agreement. Contractor shall allow the City, its auditors, and other persons authorized by the City to inspect and copy its books and records for the purpose of verifying that the reimbursement of monies distributed to Contractor pursuant to this Agreement was used in compliance with this Agreement and all applicable provisions of federal, state, and local law. The Contractor shall not issue any statements, releases or information for public dissemination without__ prior approval of the City. 18. Non-Waiver:A waiver by either parry any default or breach by the other parry of any terms or conditions of this Agreement does not limit the other party's right to enforce such term or conditions or to pursue any available legal or equitable rights in the event of any subsequent default or breach. 19. Attorney's Fees and Costs: That in the event it becomes necessary for either Party of this Agreement to retain an attorney to enforce any of the terms or conditions of this Agreement or to give any notice required herein,then the prevailing Party or the Party giving notice shall be entitled to reasonable attorney's fees and costs,including fees,salary,and costs of in-house counsel to include City Attorney. 20. Taxes: Contractor is obligated to pay all taxes of any kind or nature and make all appropriate employee withholdings. 21. Dispute Resolution: a. Any claim, controversy, or dispute between the parties, their agents, employees, or representatives shall be resolved first by negotiation between senior-level personnel from each parry duly authorized to execute settlement agreements. Upon mutual agreement of the parties,the parties may invite an independent,disinterested mediator to assist in the negotiated settlement discussions. b. If the parties are unable to resolve the dispute within thirty(30) days from the date the dispute was first raised, then such dispute may only be resolved in a court of competent jurisdiction in compliance with the Applicable Law provisions of this Agreement. 22. Survival: Contractor's indemnification shall survive the termination or expiration of this Agreement for the maximum period allowed under applicable law. 23. Headines: The headings used in this Agreement are for convenience only and are not Page S of I I Profilssional Agreement for Purchase and installation of handrails in Bridger Park Do19'ntown Gtirage, Ma)�2017 1 be construed as a part of the Agreement or as a limitation on the scope of the particular paragraphs to which they refer. 24. Severability: If any portion of this Agreement is held to be void or unenforceable,the balance thereof shall continue in effect. 25. Applicable Law: The parties agree that this Agreement is governed in all respects by the laws of the State of Montana and the parties expressly agree that venue will be in Gallatin County, Montana,and no other venue. 26. Binding Effect: This Agreement is binding upon and inures to the benefit of the heirs, legal representatives,successors,and assigns of the parties. 27. No Third-Party Beneficiary: This Agreement is for the exclusive benefit of the parties, does not constitute a third-party beneficiary agreement, and may not be relied upon or enforced by a third party. 28. Counterparts: This Agreement may be executed in counterparts, which together constitute one instrument. 29. Integration: This Agreement and all Exhibits attached hereto constitute the entire agreement of the parties. Covenants or representations not contained therein or made a part thereof by reference,are not binding upon the parties. There are no understandings between the parties other than as set forth in this Agreement. All communications, either verbal or written,made prior to the date of this Agreement are hereby abrogated and withdrawn unless specifically made a part of this Agreement by reference. ****END OF AGREEMENT EXCEPT FOR SIGNATURES **** IN WITNESS WHEREOF,the parties hereto have executed this instrument the day and year first above written. CITY OF BOZEMAN,MONTANA MIDWEST WELDING&MACHINE CONTRACTOR By _ By Ed Meece,Par ng Program Manager r�t2 /� j� �) Print Name: 1"b �+ Print Title: r Page 9 of l 1 ProAessional Agreenteni inr Purchase and installation of handrails• in Bridger Park Doi4volm Garage, A1uy 2017 i APPR VED,AS TO FORM: Greg Sulloan,Bozeman City Attorney Page 10 of 11 Professional Agreement for Purchase and installation of handrails in Bridger Park Downtown Garage, May 2017 a APPENDIX Ae: Scope of work for purchase and installation of twent eight handrails in Brid er Park Downtown Gara e. Page I I of 11 Prokssionul AgreemenLfir Purchase cord inslullulinn Of hundruils in Bridger Park Downloi>>n Gnruge, Aluy 201 MUNT WLLD1115 G MRCINH Quote# 100t, I144 2320 No. 7�4 Avenue * Bozeman, MT 58715 J17-0013 DDSSMAN, MONTA)m PH: (406) 587-5417 - FAX (406) 587-5821 Quotation NAME: Mika Gray City of Bozeman Parking Garage PH: 682.3232 INQUIRED BY DATE F,O,B, SHIP VIA Mike 3.22.2017 Midwest Delivered INQUIRY NUMBER SALESPERSON PROPOSED SHIPPING TERMS Parking Garage ,Joe Our Truck 60% Down, net 10th QUANTITY i,_,_ET ON PEA TOTAL 28 1-114 Schad,40 Pipe handrails at 200 LP'.To be 36"tell with $65.100/LF $18,200.00 12"90 degree F'L"at one end. To be powder coated with exterior primer and color of choice, Rails to have feet with mounting holes. Price may change based on fabricated linear footage of railings. - -- 28 hails as described above, hot dip galvanized. S95,66/LF 626,600,00 -- Approximate Install of either chaise above(28 rolls), Price $4,560,00 Includes delivery and install with epoxy concrete anchors, Estimated time Is(2)Installers for(3) 8 hour days,or(48) man-hours on site, This includes all necessary Install tools, fasteners and time, Will be billed at Time+Materials with a do not exceed number of: E,2 G lb; ZOO. - We are Pleased to submit ihts quotation for your wnsid! �i j(�,� �'�, 7(v ice an order,f D assured it will reeelvc our prompt attention, ' Thin quote is subject to the following conditions: Wool eluded. No retainap njny be withheld, Delivery tines subject to material av; ?me part of any resultant order,ifehanges are required,it revised quot$t n and return a copy, Name joe Muller Title Estimator _-- n io E� E a 1 r r I ® DATE(MM/DD/YYYY)AC� CERTIFICATE OF LIABILITY INSURANCE 8/4/2016 THIS 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to 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). CONPRODUCER NAM AM T E: BISSELL AGENCY PHONE (406)586-6230 AIC,No:(406)586-0471 A No Ext 4055 Valley Commons Dr Unit A n/CRloDEss:ahoffart@bissellagency.com Bozeman, MT 59718 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A:Montana Farmers Union INSURED Midwest Welding & Machine Inc INSURER B:National Farmers Union 2320 N 7th Ave INSURER C:Montana State Fund BOZEMAN, MT 59715 INSURERD: (406)587-5417 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSD YrvD POLICY NUMBER MWDD/YYYY MM/DD/Y X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000 000 CLAIMS-MADE F_x1 OCCUR PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 5, 000 A CP00012282 7/l/16 7/l/17 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000, 000 POLICY CI ERO CT LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: COMBINED AUTOMOBILE LIABILITY Eaaccide 0 ELMIT $ 1, 000,000 X ANYAUTO BODILY INJURY(Per person) $ $ AALL UTOS OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED 1CA3892523 7/l/16 7/1/17 PROPERTY DAMAGE $ X HIRED AUTOS AUTOS Per accident $ X UMBRELLA LIAB OCCUR CB00001401 7/1/16 7/1/17 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE A EXCESS LIAB AGGREGATE $ 2,000,000 DIED I X I RETENTION$10,000 $ WORKERS COMPENSATION PE OT - STATUTE ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE / / E.L.EACH ACCIDENT $ 1000000 r C 03-451741-7 7/l/16 7117 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1, 000,000 DESCRIPTION OF OPERATIONS below Comprehensive $120,000 A Garage Keepers GA00001265 7/1/16 7/1/17 Collision $120,000 Deductible $500/$2,500 max DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Midwest Weling & Machine Inc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2320 N 7th Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Bozeman, MT 59715 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD 1 j i 3 ' STATE OF MONTANA DEPARTMENT OF LABOR & INDUSTRY I CONSTRUCTION CONTRACTOR REGISTRATION UNIT t CERTIFi�CATE .O..F C0NT:R"ACT0R , R t*'-ib I S T RAT T ON . 11362. REGISTRA7tON. N0. MIDWEST WELDINGAND MACHINE INC 2320 N 7TH AVE BOZEMAN, MT 59715 Effective Date: Aug 11, 2016 Expiration Date: Aug 10,2018 Employer . Additional information on back. Please notify this agency of any changes within io days. W— Request for Taxpayer Give Form to the requester.Do not tRe� Yuyu t 2013) Identification Number and Certification send to the IRS. LuF to w'-t of the Treasury internal Revenue Seance Hanna(as shown on your income tax return) j Midwest Welding&Machine,Inc. Eusotass name/disregarded entity name,if different from above �--- Exemptions(see instructions): Check appropriate box for federal tax classification: Indviduat/sole proprietor ❑ C Corporation 0 S Corporation ❑ Trust/estate Partnership ❑ Exempt payee code(if any) � Q i ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)P Exemption from FATCA reporting o code(if any) •' m s 71 rather(see instructions) CL ,i"U -Address(number,street,and apt.or suite no.) Requester's name and address(optional) 0 2320 North Seventh Avenue to City,state.and ZIP code v _ Bozeman MT 59715 List account number(s)here(optional) ® V Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line social security number reavoid backup withholding.For individuals,this is your social security number However,for a -m - resident alien,sole proprietor,or disregarded entity,see the Part I instructions onn 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. Employer Identification number Note.if the account is in more than one name,see the chart on page 4 for guidelines on whose number to enter. $ 7 - 0 H34 3 6 MOO Certification Under penalties of perjury,I certify that: I. 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, f nrn 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 atr:a t_i 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 becar.rse you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage n(eiest 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. Herr U.S.person of Date P 03/25/2014 Here U.S. erson P� General'ace( Instructions 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 :section reterences are to the Internal Revenue Code unless otherwise noted. exempt from the FATCA reporting,is correct. Future developments.The IRS has created a page on IRS.gov for information Note.if you are a U.S.person and a requester gives you a form other than Form about Form vv-9.at www.irs.gov/w9.information about any future developments W-9 to request your TIN,you must use the requester's form if it is substantially affecting Form W-9(such as legislation enacted after we release it)will be posted similar to this Form W-9. on that Uege Definition of a U.S.person.For federal tax purposes,you are considered a U.S. Purpose of Form person if you are: •An individual who is a U.S.citizen or U.S.resident alien, a person,;,1110 15 required to file an information return with the IRS must obtain your • partnership,corporation.company,or association created or organized in the of rect taxpayer identification number(TIN)to report,for example,income paid to U A pa panited States or under the laws of the United States, vou,oayrnents mace to you in settlement of payment card and third party network transactions,real estate transactions,mortgage interest you paid,acquisition or •An estate(other than a foreign estate),or abaru c:,er=.ct secured property,cancellation of debt,or contributions you made .A domestic trust(as defined in Regulations section 301.7701-7). to a ur f=ui,i`id 9only if you are a U.S.person(including a resident alien),to Special rules for partnerships.Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section ,;,,•., ;,y :orract TIN to the person requesting it(the requester)and,when 1446 on any foreign partners'share of effectively connected taxable income from aophc- Dle.u:: such business.Further,in certain cases where a Form W-9 has not been received, G--r illy that the TIN you are giving is correct(or you are waiting for a number the rules under section 1446 require a partnership to presume that a partner is a to u,, r�„cl foreign person,and pay the section 1446 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 ra,that yap are not subject l0 backup withholding,or Ci,Win a>.empuon from backup withholding if you are a U.S.exempt payee.if and avoid section 1446 withholding on your share of partnership income. appi:_tiulr: you are also certifying that as a U-S.person,your allocable share of any oarinersnip income from a U,S.trade or business is not subject to the Cat.No.10231X Form w-9(Rev.3-2013)