Fillable New Bidder Packet 2017

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New Bidder Packet 2017

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Page 1 of 2
ARKANSAS TECH UNIVERSITY
REQUEST FOR LISTING AS BIDDER
Procurement and Risk Management Services
Young Building Suite 101
203 West O Street
Russellville, AR 72801-2222
Complete both pages of this form along with a
completed W9 form and return via fax to 479-
968-0633 or email to purchasing@atu.edu.
Return with a catalog/product listing
MAIL BID INVITATIONS TO:
COMPANY NAME: _______________________________________________________________
Dba: _______________________________________________________________
STREET ADDRESS: _______________________________________________________________
PO BOX: _______________________________________________________________
CITY, STATE, ZIP: _______________________________________________________________
TELEPHONE NO: ___________________________ FAX NO: ______________________
800 NO: ___________________________ WEB SITE: ______________________
E-MAIL: ________________________________________________________________
FEIN/TIN or SOCIAL SECURITY NO: __________________________________
HOME OFFICE ADDRESS: ________________________________________________________________
________________________________________________________________
BUSINESS DESIGNATION (check one):
CORPORATION
PARTNERSHIP
SOLE PROPRIETORSHIP
INDIVIDUAL
OTHER (explain)
IF YOUR BUSINESS IS CLASSIFIED AS A “MINORITY”, PLEASE CHECK BELOW:
AFRICAN
AMERICAN
HISPANIC
AMERICAN
AMERICAN
INDIAN
PACIFIC
ISLANDER
SERVICE-
DISABLED
VETERAN
Woman-
Owned
DO YOU COLLECT ARKANSAS SALES TAX? _______ (Yes or No)
I, the undersigned, hereby agree to faithfully abide by the Purchasing Laws of the State of Arkansas and the regulations of
the Department of Finance & Administration now in effect and any subsequent revisions thereof. I also understand that
my failure to submit a response to three (3) consecutive bid invitations on any one class or sub-class may cause
the University to discontinue sending bid invitations to me for that class or sub-class.
The University will be responsible only for orders placed by the Purchasing Department. Companies that accept orders
from University personnel without an official purchase order must look to the individual for payment.
SIGNATURE: _____________________________________ DATE: _______________________________
click to sign
signature
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Page 2 of 2
NAME: __________________________________________ TITLE: _______________________________
(typed or printed)
From the Commodity Class Index, select only those classes and sub-classes that you can furnish.
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
Class
Sub-Classes
BRAND NAMES:
ATU
COMMODITY
CLASS INDEX
As
of
October
13,2O1'l
Advertising
and
Promotional Specialties
Artist Equipment
and Supplies
Athletic
and Recreational
Supplies
and
Equipment
Audio
Visual Supplies
and
Equipment
Automobiles,
Trucks and
Accessories
Barber and
Beauty Shop
Equipment
and Supplies
Building
Materials
Buildings,
Fabricated
Classroom
Equipment
Clothing
Custodial
Supplies
Data
Processing
Equipment and
Supplies
Engineering
and Surveying
Equipment and Supplies
Farm and
Livestock Supplies
Flags, Poles,
Banners and
Signs
Food Service
Equipment
and Supplies,
Commercial
Furniture
Gases,
Welding and
Research
Grounds
Equipment
and
Landscape Supplies
Household
Appliances and
Supplies
HVAC
Equipment and
Supplies
ldentification
Cards
lnsurance
Laundry
Equipment
Library
Machines and
Supplies
Material
Handling Equipment
MedicalSupplies
Miscellaneous
Musical
lnstruments and Supplies
Office
Machines,
Equipment
and
Accessories
Printing
Safety and
First Aid
Equipment and
Supplies
Scientific
Laboratory
Equipment and
Supplies
Services,
Professional
Telecommunications
Equipment,
Voice and
Data
Theatrical
Equipment
and Supplies
Tools
ATU COMMODITY
CLASS ANd SUB.CLASS
As of October
13,2011
ADVERTISING
& PROMOTIONAL SPECIALTIES:
(not
otherwise classified)
691-00
{dvertisino: Clothinq
-
silkscreened
or embroidered
691-30
sino: Duolication of CD's. DVD's. etc.
691-40
Advertisino: Pocket Portfolios & 3-rino Binders
695-50
See
Athletic 80*12for Athletic Apparel
See F/aos 34*00 for Flaos. Banners and Sr?ns
ARTIST EQUIPMENT
AND SUPPLIES:
(not
otherwise
classified)
0s0-00
Art:
Ceramic
and Potterv
233-20
Art: Foundrv
Equipment and Supplies
400-00
Art: Glass Blowino
233-35
Art:
Sculoturinq
Equipment and Supolies
050-80
ATHLETIC/RECREATIONAL
SUPPLIES & EQUIPMENT:
(not
othenrise
classified)
805-00
\thletic: Apparel
805-12
\thletic: Awards
805-1
5
\thletic: Baseball Eouioment
805-24
{thletic: Basketball
Equipment
805-30
{thletic: Field
Equipment
-
covers, stripinq machines, etc
805-35
\thletic: Fitness Center Eouioment
-
treadmills.
stationarv bicvcles. etc
80545
Athletic: Football Eouipment
805-48
Athletic: Golflno Eouioment
805-54
Athletic: Park. Plavoround & Swimmino Pool Eouioment
650-00
Athletic: Softball Eouioment
805-69
Athletic:
Tennis Eouipment
805-78
Athletic: Track Eouioment
805-81
Athletic: Trainer's Suoolies 805-84
Athletic:
Volleyball Equipment
805-90
Athletic: Weioht Liftino Eouioment
805-95
See Grounds
630-20 for Field Markinq
Paint
AUDIO VISUAL SUPPLIES & EQUIPMENT:
(not
otheruvise classified)
880-00
AV: CCTV Equipment
725-05
AV: DiqitalCameras
655-20
AV:
lntercom,
Other
Sound Equipment, Components,
Parts
480-00
AV: Lanouaoe Laboratories
480-18
AV: Microohones
480-36
AV: Music Svstems and Components
480-40
AV: Photoqraphic Equipment & Supplies
655-00
AV: Public Address
Svstems
480-47
AV: Radio Broadcastinq
Equipment
725-09
AV: Satellite Dishes
725-98
AV: Smartboards
880-50
AV: Television Broadcastinq
Eouioment
725-55
AV: Video Eouioment
725-74
AV: Wire and Cable 480-90
AU I UMOI lLtS. I RU(;KS & AUUESS(JI<ItsS:
(not
otnerwrse classrtredl 070-00
rutor hU€|. orl and Grease 405-00
Auto: Golf Carts 070-08
Auto:
School
Bus 070-33
Auto: Shoo Eouioment and Suoolies 075-00
Auto: Shoo Eouioment Cleaners
190-50
Auto: Tires and Tubes 860-00
Auto: Trailers 070-63
Auto: lrucKsters
and
Motonzed
worK uarts 070-18
Auto: Vans and Carryalls 070-90
BARBER AND
BEAUTY
SHOP
EQUIPMENT AND
SUPPLIES:
095-00
BUILDING MATERIALS:
(not
othenrise classified)
145-00
Bldo. Materials: Concrete Products and Suoolies
210-00
Bldq.
Materials: Door
Closers.
Holders. Thresholds. etc
450-26
Bldo. Materials: Electrical Eouioment & Suoolies
280-00
Bldo. Materials: Emeroencv Liohtino
280-58
Bldo. Materials: Glass and Glazino Suoolies
440-00
Bldo. Materials: Hardware and Allied
ltems
450-00
Bldo- Materials: lnsulation. Acoustical Tile. etc
010-00
Bldo.
Materials: Locks. Locksets, Kev
Blanks.
etc
450-55
Bldo. Materials:
Lumber. Plvwood, Pressboard, Sheetrock. Sidino
540-00
ldq. Materials:
Mailboxes
450-57
3ldo. Materials: Metals
-
Bars. Plates. Rods. Sheets. Tubinq
570-00
3ldo. Materials: Paint. Varnish.
Wall
Coverinqs
630-00
3ldo. Materials: Plumbino
670-00
Bldq. Materials:
Roofino
-
Nonwood
770-00
Bldq. Materials: Toilet Partitions and
Doors
670-72
Bldq.
Materials: Water Heaters, Storaqe
(lndustrial)
670-91
See Grounds 670-17 for lrioation Svsfems
See Grounds
750-70 for Readv Mix
BUILDINGS. FABRICATED:
(not
othenrise classified)
150-00
Buildinos: Aluminum and Steel Buildinos. Portable
150-12
Buildinos: Greenhouses
15042
Buildinos:
ModularBuildinqs
1 50-50
CLASSROOM ECIUIPMENT:
(not
otherwise
classified)
785-00
Classroom: Blackboards. Chalkboards & Markerboards
785-15
Classroom:
Bulletin Boards. Chanqeable Letter
Boards, Directories
785-25
Classroom:
Clocks, Timers and Watches
195-00
CLOTHING:
(exceot
athletic)
200-00
Clothino: Badoes. Buttons. Taos and Pins
-
ldentification 080-00
Clothino:
Emblems
and Shoulder
Patches
200-21
Clothino:
Robes for
Choirs and Graduation
200-51
Clothino: Uniforms - Band 200-72
llolhino' llniforms
-
Poliee
200-73
See Adveftisino 691
-30
for
Silkscreened/Embroidered Clothinq
See
Athlefics
80*12
for Athletic Apparel
CUSTODIAL SUPPLIES:
485-00
Custodial: Floor
Maintenance Machines 360-00
Sustodial: Plastic Trash Baqs and
Liners
665-24
DATA PROCESSING EQUIPMENT AND SUPPLIES:
(not
othenrise classified)
205-00
DP: Bursters. Decollators. Detachers
205-04
DP: Cables, Patch and Data
480-98
DP: Fiber Ootic Cable & Accessories
205-41
DP: LocalArea Networks
(LAN)
Eouipment
20542
DP: Servers and Mainframes
205-43
DP: Server and Mainframe Drives 20547
DP:
Server and
Mainframe
Software
20545
DP: Memorv 205-98
DP: Microcomouters
(MAC)
205-53
DP: Microcomouters
(PC's)
205-52
DP:
Notebook
Computers
205-65
DP: Printers
205-68
DP:
Software
205-54
DP: Uninterruotible Power Suoolv 205-92
DP: Wireless Eouioment and Suoolies 205-95
ENGIN EERING-SURVEYING EQUI PMENT
& SUPPLIES
:
(not
otherwise classified)
300-00
Enoineerino: Electronic Testino. Measurino & Analvzino Eouio 730-00
Enqineerino: Kits
-
Assemblv
-
breadboard, circuit boards, etc
730-25
Enqineerinq: Measurinq lnstruments
-
multimeters, voltmeters, etc
730-35
Enoineerino: Oscilloscooes 73048
Enqineerino: Power Suoplies
730-50
=noineerino:
Testino & Trainino Eouioment
-
hvdrostatic. metalluroical. etc 845-00
FARM AND LIVESTOGK SUPPLIES:
(not
othenrise classified) 825-00
arm:
Aqricultural lmplements. Accessories
and
Parts 020-00
arm: Animals and Livestock 040-00
arm: hencrno 325-00
arm: Fertilizers and Soil conditioners 330-00
Farm:
Seed. Sod. Soil& lnoculants
790-00
arm: Sprayinq Equipment
-
Crop and
Livestock
810-00
Farm: Veterinarv Eouioment and Suoolies 875-00
I.LAGS. P(JLES. ETANNEF(S AND SIGNS:
345-00
Flaos: Markers. Plaoues.
Siqns & Traffic Control Devices 550-00
laos: Marl(no L,evrces
(stencrls)
555-00
FOOD
SERVICE
EQUIPMENT
& SUPPLIES
.
COMMERCIAL:
160-00
Food: Cutlerv. Dishes. Flatware. Glassware and Utensils 240-OO
Food: Refriqeration Eouioment and Accessories
740-00
FURNITURE:
Furniture: Auditorium & Stadium Seatino 420-04
Furniture: Classroom 420-84
Furniture: Dormitorv
420-16
Furniture: Hospital 410-00
Furnrture:
Laboratory 415-00
Furniture: Librarv
420-56
Furniture:
Lounqe 420-60
Furniture: Mattresses & Bedsprinos
420-68
Furniture: Non-Office 420-OO
Furniture: Office 425-OO
Furniture:
Work Benches. Shoo Desks & Tables 450-92
GASES. WELDING AND RESEARCH:
(not
otherwise classifiedl 430-00
Gases: Laboratory
-
Arqon, Helium, Hvdroqen,
Nitroqen 430-42
Gases: Rare or Hiohlv Purified for Research 430-72
LJK(,UNUI' ts,tJUIPMtsN I
'I
LANL'SGAPI, SUPPLIES:
(NOt
OthETWiSE CIASSitiEdI
515-00
irounds: L;oncrete Proctucts & suDoltes
210-00
Grounds: Culverts & Pioe
-
Corruoated Metal 235-00
Grounds:
Fencino
325-00
irounds: Fertrlrzers & sorl condrtroners
330-00
irounds: lrrioation Svstems
670-17
irounds: Nurserv & Greenhouse Suoolies
595-00
Grounds: Paint - Concrete & Asohalt Markino 630-1 0
Grounds:
Paint -
Field Markino
630-20
Grounds: Readv-Mix
Concrete
750-70
Grounds: Sand & Gravel
750-77
Grounds: Seed. Sod. Soil& lnoculants 790-00
irounds: I ractor Mowers
020-68
See F/aos 345-00 for Flaos and Flao Poles
HOUSEHOLD APPLIANCES AND SUPPLIES:
(not
otherurise classified)
045-00
Household:
Draperies,
Curtains and Upholsterv
265-00
Household: Floor
Coverinos
355-00
Household: Lrnens 850-00
Household: Venetian Blinds. Awninos
& Shades
870-00
HVAG EOUIPMENT AND SUPPLIES:
(NOt
OIhETW'SE CIASSiTiEd} 030-00
HVAC: Filters and Filter Media
030-60
HVAC: Heatino Units & Ventilation Eouioment & Accessories 455-00
HVAC: Steam & Hot Water Specialties & Accessories 815-00
HVAC: Steam Boilers, Steam Heatinq & Power Plant Equio 820-00
HVAC: Water Treatinq Chemicals 885-00
IDENTIFICATION CARDS:
080-{0
Ds: Laminatino Presses. Film lD Pouches & Suoolies 66542
INSURANCE. PROPERTY:
478-00
lnsurance: Athletic
478-50
lnsurance: Camos - Accident 478-04
lnsurance: Emolovee Accident & Health
478-03
lnsurance: Errors & Omissions
478-56
lnsurance: lnternational Students
-
Accident & Health
478-02
LAUNDRY
EQUIPMENT,
HOUSEHOLD: 500-00
Laundrv: Drvers
-
not household 500-15
Laundry:
supplres
Laundrv: Washer-Extractors - not household 500-87
LIBRARY MACHINES
& SUPPLIES:
525-00
Librarv: Microfilm Eouioment & Suoolies 575-00
I,IATERIAL HANDLING EQUI PMENT:
(not
otherwise
classified) 560-00
Matl Hdlq: Forklifts 560-75
Matl Hdlq: Tanks
-
Mobile, Portable,
Stationarv
830-00
MEDICAL SUPPLIES:
(not
othenrvise classified)
475-00
Medical: Hosoital Eouioment 465-00
Medical: Scales & Weiohino Aooaratus 780-00
Medical: Teachino Aid Model Bodv Parts 495-77
Medical: X-Rav Eouioment
and Suoolies
900-00
MISCELLANEOUS:
(describe)
950-00
Retail
950-30
I/IUSIGAL
INSTRUMENTS
& SUPPLIES:
(not
othenvise classified) 580-00
[4usic: Band & Choral Risers 580-05
Mlusic: Band lnstruments & Accessories 580-10
Music: Electronic
Musical lnstruments 250-25
Musrc: Oroans. Pranos & Accessofles
580-50
Mlusic: Strinoed lnstruments
580-80
CFFICE MACHINES, EQUIPMENT
&
ACCESSORIES:
(not
othenarise classified) 600-00
Jtttce: ualculators
600-22
Cffice: Cash Registers
600-30
)ffice: Check Machines 600-36
Cffice: Coov Machines
(lease)
600-98
Cffice: Coov Machines
(ourchase)
600-41
Cffice: Fax Machines
840-30
Office: Foldino & lnsertino Machines
600-65
Office: lmorinted Pens & Pencils
620-40
Office:
Mailino Machines
600-71
Office: Office Supplies
615-00
Office: Optical Scanners 600-50
Office: Paoer
and
Envelopes
(blank)
645-00
Office: Punchino & Bindino Machines
700-74
Office: Ribbons & Toner Cartridqes
610-00
PRINTING. FLAT FORMS:
(not
othenryise classifiedl 695-00
Printino: Books-cataloos-maoazines-oamohlets-brochures-oosters
Printinq: Continuous,
Snap-Sets &
Mailers
697-00
Printinq: Envelopes
695-10
Printino: Labels
695-30
Printino: Newsorint
695-74
Pnntrnq: uDtrcal scanner Forms
695-82
Printino: Securitu Transcriots
695-83
Printinq: Silk
Screeninq
-
see Advertisinq for
pocket portfolios/binders
695-80
Printino: Tickets
695-90
See
Services
783-54
for Mailinq Seryrbes
SAFETY & FIRST AID EQUIPMENT
& SUPPLIES:
(not
othenrise
classified)
340-00
Safetv:
Emeroencv
Showers & Wash
Stations
340-1 8
Safetv: Fire Protection Eouioment & Suoolies
335-00
Safetv: Manneouins & Models for First Aid & Safetv lnstruction
340-68
Safety: Markers, Plaques, Siqns
& Traffic Control Devices 550-00
Safetv: Police Eouioment and Suoolies
680-00
SCIENTIFIGLABORATORYSUPPLIES:
(notothenrviseclassified)
495-00
Sci: Air
Qualitv
Monitorinq
Equipment
493-04
Sci: Boats. Motors. Marine & Wildlife Suoolies
1 15-00
Sci: Campino & Outdoor Equioment
450-1 5
Sci: Chemical Lab Eouioment & Suoolies
175-00
Sci: Chromatooraohs
493-12
Sci: Controllinq, lndicatinq & Recordino lnstruments & Supplies
220-OO
ci: Maior Lab Eouio - Bioloov/Chemistrv/Environmental/Microbioloov
493-00
Sci: Maior Lab Eouioment for Analvsis & Research
490-00
Sci: Microscooes & Accessories
490-58
Sci: Nanotechnoloqv Suoolies & Eouioment
493-50
Sci: Phvsics Eouioment
490-74
Sci: Soil Testino Aooaratus & Accessories 845-81
Sci: Soectrometers. Soectroohotometers. etc
490-81
Sci:
Telescopes
625-89
Sci' lA/aler Orralifu Manilnrinn Fnrrinmcnl
493-96
Sci: Wildlife Bands. Labels & Taos 080-80
Sci:
Wildlife Trackinq Eouioment 725-90
See
Fumiture 41*00 for Lab Fumiture
SERVICES. PROFESSIONAL:
(not
otherwise classifiedl 783-00
Serv:
Accountants
and CPA's
783-04
Serv: Advertisino 783-07
Serv: Aoricultural 783-08
Serv:
Architect 783-01
serv: Attornevs 783-06
Serv: Auto Mechanic 783-09
Serv: Cleanino Caroets and Uoholsterv
783-1 0
Serv: Cleaninq Exhaust Hoods
783-95
Serv: Collection Services
783-05
Serv: Custodial Services
783-11
Serv: Davcare
783-12
erv: L'emolttron 783-15
Serv: Elevator lnsoections
783-19
Serv: Enoineer
783-02
Serv: Fi re Alarm-Exti nou isher-Su ooression Svstem I nsoections 783-24
Serv: General Contractinq-Asohalt
783-25
serv: General contracttno-caroentrv
783-31
Serv:
General Contractinq
-
Maior Construction Over
$20,000
783-26
Serv:
General
Contracting-Liqht Construction below
$20,000
783-29
Serv: General Contractinq-Concrete
783-27
Serv: General Contractino: Electrical 783-30
Serv: General Contractino:
Excavation
and
Dirt 783-32
Serv: General Contractinq:
Masonrv
783-34
Serv: General Contractino: Floorino 783-33
Serv: General Contractinq: HVAC
783-35
Serv: General Contractinq: Paintino
783-36
Serv: General Contractino: Securitv Svstems 783-37
Serv: General Contractino: Plumbino 783-40
Serv: General Contractino: Roofino 78345
Serv: GeneralContractinq: Voice and Data
783-38
Serv: Hazardous Materials
Removal,
Haulinq & Disposal
783-28
Serv: Lawn Care
783-50
Serv: Mailino Service 783-54
Serv: Marketino and Public Relations
783-03
Serv: MedicalCare
783-51
Serv: Movino Service
783-55
Serv:
Pest
Control
783-20
Serv: Restaurants and Caterino
783-60
Serv:
Recvclinq
783-57
erv: Securitv Guard
783-70
Serv: Third Partv Financinq
783-23
Serv: Trash
783-80
Serv:
Truckino-haulino-delivery-courier
783-82
Serv: Water Treatment
783-85
Serv: Window Washino
783-90
TELECOMMUNICATIONS
EQUIPMENT,
VOICE & DATA:
840-00
Telecom:
Emerqency Telephones
-
elevators,
etc
840-10
Telecom:
Network Control &
Test Equipment
84040
Telecom: Visuallv lmoaired Eouioment
840-20
See Office 840-30 for Fax Machines
THEATRICAL EOUIPMENT & SUPPLIES:
(not
othelwise classified) 855-00
Theatrical: Curtains, Draperies,
Drops. etc.
855-22
l-heatrical: Liqhtinq
855-50
Theatrical: Liohtino/Dimmino
Controls
855-44
TOOLS. HAND:
(not
otherwise classified)
445-00
fools: Concrete Buooies. Carts. Saws.
Finishers. etc
755-55
Tools: Electrician
280-81
Tools: Locksmith
450-56
Tools:
Machinerv & Heaw Hardware
545-00
Tools: Paintino
635-00
fools:
Pressure Sprav Washers
810-95
l-ools: Weldino
895-00
,".,
lllr-g
(Rev.
October 2007)
Department ot the
Treasury
lntmal
Revenue Service
Request
for
Taxpayel
ldentification
Number
and Gertification
Give form
to the
requester,
Do not
send to the IRS.
-
Exemot
U
puy""
cri
o
o)
(u
o.
c
o
oP
oi
>.=
:E
oi
E-o
ro
'6
o
o
o
o
o
a
Name
(as
shown on
your
income tax
return)
Business name,
if different from
above
Signature
of
U.S.
person
)
Requester's name
and address
(optional)
List
account
number(s)
here
(optional)
ldentification
Number
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
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
(ElN).
lf
you
do not have a number, see How to
get
a
I/N
on
page
3.
Note. lf the
account is in more than
one
name,
see
the
chart on
page
4 for
guidelines
on
whose
number to
enter.
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 lnternal
Revenue
Service
(RS)
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
(lRA),
and
generally, payments
other
than interest
and dividends,
you
are not required
to
sign
the
Certification, but
you
must
provide
your
conect
TlN.
See
the instructions
on
page
4.
General
Instructions
Section
references
are
to the lnternal Revenue
Code unless
othenruise
noted.
Purpose of Form
A
person
who is required to file an information return with the
IRS must obtain
your
conect taxpayer identification number
(l'lN)
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
lRA.
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
glving
is
correct
(or you
are
waiting for a number to be issued),
2. Certily that
you
are not subject to
backup
withholding,
or
3. Claim
exemption
from
backup
withholding
if
you
are a U.S.
exempt
payee.
lf
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. lf
a
requester
gives you
a form
other
than
Form W-9 to
request
your
TlN,
you
must
use
the requester's
form if it is
substantially similar to this Form
W-9.
Social security number
Oate
)
Definition
of a U.S.
person.
For federal tax
purposes,
you
are
considered a U.S.
person
if
you
are:
o
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,
o
An
estate
(other
than
a
foreign estate), or
o
A
domestic
trust
(as
defined in Regulations section
301.7701-7).
Specia! 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
padners'
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.
The
person
who
gives
Form W-9 to the
partnership
for
purposes
of establishing its U.S. status and avoiding withholding
on
its
allocable share of
net income from the
partnership
conducting a trade or business in the United States is in the
following cases:
o
The
U.S. owner of
a
disregarded entity and
not
the entity,
Sign
Here
Check appropriate
box: E
lndividual/Sote
proprietor
E Corporation
E
eartnersnip
E
urit"o
liability company.
Enter the tax
classification
(D=disregarded
entity, c=corporation,
P=partnership)
>
-.... -.
!
Otnerlseeinstructions)
>
Address
(number,
street,
and apt. or suite no.)
City, state, and ZIP
code
Cat. No. 10231X
rorm W-9
(Bev.
10-2007)
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New Bidder Packet 2017

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