AGREEMENT
The following agreement ("AGREEMENT") is made and entered into, in duplicate, as of the date executed by the Mayor and attested to by the City Clerk, by and between Wright Construction Engineering Corp hereinafter referred to as the "CONTRACTOR" and the City of Diamond Bar, California, hereinafter referred to as "CITY."
WHEREAS, pursuant to Notice Inviting Sealed Bids, bids were received, publicly opened, and declared on the date specified in the notice; and
WHEREAS, CITY accepted the bid of CONTRACTOR Wright
Construction Engineering Corp and;
WHEREAS, CITY has authorized the Mayor to execute a written contract with CONTRACTOR for furnishing labor, equipment and material for the Diamond Bar Community Center Slope Stabilization Project in the City of Diamond Bar.
NOW, THEREFORE, in consideration of the mutual covenants herein contained, it is agreed:
1. GENERAL SCOPE OF WORK: CONTRACTOR shall furnish all
necessary labor, tools, materials, appliances, and equipment for and do the work for the Diamond Bar Community Center Slope Stabilization Project in the City of Diamond Bar. The work to be performed in accordance with the plans and specifications, dated May 2022 (The Plans and Specifications) on file in the office of the City Clerk and in accordance with bid prices hereinafter mentioned and in accordance with the instructions of the City Engineer.
2. INCORPORATED DOCUMENTS TO BE CONSIDERED COMPLEMENTARY:
The Plans and Specifications are incorporated herein by reference and made a part hereof with like force and effect as if set forth in full herein. The Plans and Specifications, CONTRACTOR'S Bid dated August 16, 2022 together with this AGREEMENT, shall constitute the contract between the parties. This AGREEMENT is intended to require a complete and finished piece of work and anything necessary to complete the work properly and in accordance with the law and lawful governmental regulations shall be performed by the CONTRACTOR whether set out specifically in the contract or not. Should it be ascertained that any inconsistency exists between the aforesaid documents and this AGREEMENT, the following order of precedence shall apply: (1) This AGREEMENT; (2) The Plans and Specifications; and (3) Contractor's bid.
3. COMPENSATION: CONTRACTOR agrees to receive and accept the prices set forth in its Bid Proposal as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Said compensation in the amount of Five Hundred Ninety Four Thousand Five Hundred Seventy Dollars ($594,570)shall cover all expenses, losses, damages, and consequences arising out of the nature of the work during its progress or prior to its acceptance including those for well and faithfully completing the work and the whole thereof in the manner and time specified in the aforesaid contract documents; and also including those arising from actions of the elements, unforeseen difficulties or obstructions encountered in the prosecution of the work, suspension or discontinuance of the work, and all other unknowns or risks of any description connected with the work.
Final payment to Contractor shall be withheld for at least 30 days after the time in which Contractor has verified, to the City's satisfaction, that it has submitted all information to the Department of Industrial Relations required by Labor Code §1773.3.
4. TERM OF CONTRACT: CONTRACTOR agrees to complete the
work within One Hundred Twenty (120) working days from the date of the notice to proceed.
CONTRACTOR agrees further to the assessment of
liquidated damages in the amount of One Thousand Dollars ($1000) for each calendar day the work remains incomplete beyond the expiration of the completion date. CITY may deduct the amount thereof from any monies due or that may become due the CONTRACTOR under this AGREEMENT. Progress payments made after the scheduled date of completion shall not constitute a waiver of liquidated damages.
5. INSURANCE: CONTRACTOR shall not commence work under
this contract until he has obtained all insurance required hereunder in a company or companies acceptable to CITY nor shall the CONTRACTOR allow any subcontractor to commence work on his subcontract until all insurance required of the subcontractor has been obtained. The CONTRACTOR shall take out and maintain at all times during the life of this contract the following policies of insurance:
a. Workers' Compensation Insurance: Before beginning
work, the CONTRACTOR shall furnish to the CITY a
certificate of insurance as proof that he has taken
out full workers' compensation insurance for all
persons whom he may employ directly or through
subcontractors in carrying out the work specified
herein, in accordance with the laws of the State of
California. Such insurance shall be maintained in
full force and effect during the period covered by
this contract.
In accordance with the provisions of Section 3700
of the California Labor Code, every CONTRACTOR
shall secure the payment of compensation to his
employees. The CONTRACTOR, prior to commencing
work, shall sign and file with the CITY a
certification as follows:
"I am aware of the provisions of Section 3700 of
the Labor Code which requires every employer to be
insured against liability for workers' compensation
or to undertake self-insurance in accordance with
the provisions of that Code, and I will comply with
such provisions before commencing the performance
of work of this contract."
b. For all operations of the CONTRACTOR or any subcontractor in performing the work provided for herein, insurance with the following minimum limits
and coverage:
1) General Liability - $5,000,000 per occurrence
for bodily injury, personal injury and
property damage. If Commercial General
Liability insurance or other form with a
general aggregate limit is used, either the
general aggregate limit shall apply separately
to this AGREEMENT or the general aggregate
limit shall be twice the required occurrence
limit.
2) Automobile - $5,000,000 per accident for
bodily injury and property damage.
3) Employer's Liability - $5,000,000 per accident
for bodily injury or disease.
c. Each such policy of insurance provided for in
paragraph b. shall:
1) Be issued by an insurance company approved in
writing by CITY, which is authorized to do
business in the State of California.
2) Name as additional insured the City of Diamond
Bar, its officers, agents and employees, and
any other parties specified in the bid
documents to be so included;
3) Specify it acts as primary insurance and that
no insurance held or owned by the designated
additional insured shall be called upon to
cover a loss under the policy;
4) Contain a clause substantially in the
following words:
"It is hereby understood and agreed that this
policy may not be canceled nor the amount of
the coverage thereof reduced until thirty (30)
days after receipt by CITY of a written notice
of such cancellation or reduction of
coverage."
5) Otherwise, be in form satisfactory to the
CITY.
d. The policy of insurance provided for in
subparagraph a. shall contain an endorsement which:
1) Waives all right of subrogation against all
persons and entities specified in subparagraph
4.c.(2) hereof to be listed as additional
insured in the policy of insurance provided
for in paragraph b. by reason of any claim
arising out of or connected with the
operations of CONTRACTOR or any subcontractor
in performing the work provided for herein;
2) Provides it shall not be canceled or altered
without thirty (30) days' written notice
thereof given to CITY.
e. The CONTRACTOR shall, prior to performing any work
under this AGREEMENT, deliver to the City Manager
or his designee the original policies of insurance
required in paragraphs a. and b. hereof, or deliver
to the City Manager or his designee a certificate
of the insurance company, showing the issuance of
such insurance, and the additional insured and
other provisions required herein.
f. Self-Insured Retention/Deductibles. All policies
required by this AGREEMENT shall allow CITY, as
additional insured, to satisfy the self-insured
retention (“SIR”) and/or deductible of the policy
in lieu of the Owner (as the named insured) should
CONTRACTOR fail to pay the SIR or deductible
requirements. The amount of the SIR or deductible
shall be subject to the approval of the City
Attorney and the Finance Director. CONTRACTOR
understands and agrees that satisfaction of this
requirement is an express condition precedent to
the effectiveness of this AGREEMENT. Failure by
CONTRACTOR as primary insured to pay its SIR or
deductible constitutes a material breach of this
AGREEMENT. Should CITY pay the SIR or deductible
on CONTRACTOR’s behalf upon the CONTRACTOR’s
failure or refusal to do so in order to secure
defense and indemnification as an additional
insured under the policy, CITY may include such
amounts as damages in any action against CONTRACTOR
for breach of this AGREEMENT in addition to any
other damages incurred by CITY due to the breach.
6. PREVAILING WAGE: Notice is hereby given that in
accordance with the provisions of California Labor Code, Division 2, Part 7, Chapter 1, Articles 1 and 2, the CONTRACTOR is required to pay not less than the general prevailing rate of per diem wages for work of a similar character in the locality in which the public works is performed, and not less than the general prevailing rate of per diem wages for holiday and overtime work. In that regard, the Director of the Department of Industrial Relations of the State of California is required to and has determined such general prevailing rates of per diem wages. Copies of such prevailing rates of per diem wages are on file in the Office of the City Clerk of the City of Diamond Bar, 21825 Copley Drive, Diamond Bar, California, and are available to any interested party on request.
CITY also shall cause a copy of such determinations to be posted at the job site.
CONTRACTOR shall forfeit, as penalty to CITY, not more than two hundred dollars ($200.00) for each laborer, workman or mechanic employed for each calendar day or portion thereof, if such laborer, workman or mechanic is paid less than the general prevailing rate of wages hereinbefore stipulated for any work done under this AGREEMENT, by him or by any subcontractor under him.
CONTRACTOR and any of its subcontractors must be registered with the Department of Industrial Relations pursuant to Labor Code section 1725.5, which precludes the award of a contract for a public work on any public works project awarded after April 1, 2015. This Agreement is subject to compliance monitoring and enforcement by the Department of Industrial Relations.
7. APPRENTICESHIP EMPLOYMENT: In accordance with the
provisions of Section 1777.5 of the Labor Code, and in accordance with the regulations of the California Apprenticeship Council, properly indentured apprentices may be employed in the performance of the work.
CONTRACTOR is required to make contribution to funds
established for the administrative of apprenticeship programs if he employs registered apprentices or journeymen in any
apprenticeship trade on such contracts and if other CONTRACTORS on the public works site are making such contributions.
CONTRACTOR and subcontractor under him shall comply with the requirements of Sections 1777.5 and 1777.6 in the employment of apprentices.
Information relative to apprenticeship standards, wage
schedules and other requirements may be obtained from the Director of Industrial Relations, ex-officio the Administrator of Apprenticeship, San Francisco, California, or from the Division of Apprenticeship Standards and its branch offices.
8. LEGAL HOURS OF WORK: Eight (8) hours of labor shall
constitute a legal day's work for all workmen employed in the execution of this contract, and the CONTRACTOR and any subcontractor under him shall comply with and be governed by the laws of the State of California having to do with working hours set forth in Division 2, Part 7, Chapter 1, Article 3 of the Labor Code of the State of California as amended.
CONTRACTOR shall forfeit, as a penalty to City, twentyfive dollars ($25.00) for each laborer, workman or mechanic employed in the execution of the contract, by him or any subCONTRACTOR under him, upon any of the work hereinbefore mentioned, for each calendar day during which the laborer, workman or mechanic is required or permitted to labor more than eight (8) hours in violation of the Labor Code.
9. TRAVEL AND SUBSISTENCE PAY: CONTRACTOR agrees to pay travel and subsistence pay to each workman needed to execute the work required by this contract as such travel and subsistence payments are defined in the applicable collective bargaining agreements filed in accordance with Labor Code Section 1773.8.
10. CONTRACTOR'S LIABILITY: The CITY and its officers,
agents and employees ("Indemnitees") shall not be answerable or accountable in any manner for any loss or damage that may happen to the work or any part thereof, or for any of the materials or other things used or employed in performing the work; or for injury or damage to any person or persons, either workers or employees of CONTRACTOR, of its subcontractors or the public, or for damage to adjoining or other property from any cause whatsoever arising out of or in connection with the performance of the work. CONTRACTOR shall be responsible for any damage or injury to any person or property resulting from defects or obstructions or from any cause whatsoever.
CONTRACTOR will indemnify Indemnities against and will hold and save Indemnitees harmless from any and all actions, claims, damages to persons or property, penalties, obligations or liabilities that may be asserted or claimed by any person, firm, entity, corporation, political subdivision, or other organization arising out of or in connection with the work, operation, or activities of CONTRACTOR, its agents, employees, subcontractors or invitees provided for herein, whether or not there is concurrent passive negligence on the part of CITY. In connection therewith:
a. CONTRACTOR will defend any action or actions filed
in connection with any such claims, damages,
penalties, obligations or liabilities and will pay
all costs and expenses, including attorneys' fees,
expert fees and costs incurred in connection
therewith.
b. CONTRACTOR will promptly pay any judgment rendered
against CONTRACTOR or Indemnitees covering such
claims, damages, penalties, obligations and
liabilities arising out of or in connection with
such work, operations or activities of CONTRACTOR
hereunder, and CONTRACTOR agrees to save and hold
the Indemnitees harmless therefrom.
c. In the event Indemnitees are made a party to any
action or proceeding filed or prosecuted against
CONTRACTOR for damages or other claims arising out
of or in connection with the work, operation or
activities hereunder, CONTRACTOR agrees to pay to
Indemnitees and any all costs and expenses incurred
by Indemnitees in such action or proceeding
together with reasonable attorneys' fees.
Contractor's obligations under this section apply regardless of whether or not such claim, charge, damage, demand, action, proceeding, loss, stop notice, cost, expense, judgment, civil fine or penalty, or liability was caused in part or contributed to by an Indemnitee. However, without affecting the rights of CITY under any provision of this AGREEMENT, Contractor shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by agreement between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY active negligence accounts for only a percentage of the liability involved, the obligation of Contractor will be for that entire portion or percentage of liability not attributable to the active negligence of CITY.
So much of the money due to CONTRACTOR under and by virtue of the contract as shall be considered necessary by CITY may be retained by CITY until disposition has been made of such actions or claims for damages as aforesaid.
It is expressly understood and agreed that the foregoing provisions are intended to be as broad and inclusive as is permitted by the law of the State of California. This indemnity provision shall survive the termination of the AGREEMENT and is in addition to any other rights or remedies which Indemnitees may have under the law.
This indemnity is effective without reference to the
existence or applicability of any insurance coverage which may have been required under this AGREEMENT or any additional insured endorsements which may extend to Indemnitees.
CONTRACTOR, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation and contribution against the Indemnitees, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to activities or operations performed by or on behalf of the CONTRACTOR regardless of any prior, concurrent, or subsequent passive negligence by the Indemnitees.
11. NON-DISCRIMINATION: Pursuant to Labor Code Section
1735, no discrimination shall be made in the employment of persons in the work contemplated by this AGREEMENT because of the race, color or religion of such person. A violation of this section exposes the CONTRACTOR to the penalties provided for in Labor Code Section 1735.
12. PAYMENT FUND: A City Council resolution established a Project Payment Account, encumbered money in the current budget, and assigned that money to the Project Payment Account, which is the sole source of funds available for payment of the contract sum set forth in Section 3 of this AGREEMENT. CONTRACTOR understands and agrees that CONTRACTOR will be paid only from this special fund and if for any reason this fund is not sufficient to pay CONTRACTOR, CONTRACTOR will not be entitled to payment. The availability of money in this fund, and CITY's ability to draw from this fund, are conditions precedent to CITY's obligation to make payments to CONTRACTOR.
13. PRESENTATION OF CLAIMS: Any claim, as that term is
defined in Public Contract Code §9204, shall be submitted in accordance with Section 9204 and shall contain a sufficient description of the claim, the basis therefore and documentation in support of the claim. The claim shall be processed as more fully set forth in the Plans and Specifications.
14. TERMINATION: This AGREEMENT may be terminated by the CITY, without cause, upon the giving of a written "Notice of Termination" to CONTRACTOR at least thirty (30) days prior to the date of termination specified in the notice. Upon receipt of such notice, Contractor shall immediately cease work, unless otherwise directed by the Notice of Termination. In the event of such termination, Contractor shall be paid for services satisfactorily rendered and expenses reasonably and necessarily incurred prior to the effective date of termination, unless the Notice of Termination is issued for cause, in which event the City may withhold any disputed compensation. Contractor shall not be entitled to any claim for lost profits.
State of California
"CONTRACTOR'S" License No. 995153
CONTRACTOR'S Business Phone(760) 599-3915 X102
CONTRACTOR'S emergency phone which can be reached at any time:
(760) 599-3915 X102
IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT with all the formalities required by law on the respective dates set forth opposite their signatures.
Wright Construction Engineering Corp
By: ______________________________________
Title: _________________________________
Date:
By:
Title:
Date:
CITY OF DIAMOND BAR, CALIFORNIA
By: __________________________ ____________
Ruth M. Low, MAYOR Date
ATTEST:
By: ___________________________ _______________
Kristina Santana, CITY CLERK Date
APPROVED AS TO FORM:
________________________________ ________________
David A DeBerry, CITY ATTORNEY Date
President
9/6/22
9-6-22
*NOTE: If Contractor is a corporation, the City requires the following signature(s):
-- The Chairman of the Board, the President or a VicePresident, AND (2) the Secretary, the Chief Financial Officer, the Treasurer, an Assistant Secretary or an
Assistant Treasurer. If only one corporate officer
exists or one corporate officer holds more than one
corporate office, please so indicate. OR
-- The corporate officer named in a corporate resolution as authorized to enter into this Agreement. A copy of
the corporate resolution, certified by the Secretary
close in time to the execution of the Agreement, must
be provided to the City.
Fifty-Nine Thousand Four Hundred Fifty-Seven and Zero Cents 59,457.00
16 BID SCHEDULE
CITY OF DIAMOND BAR
CONTRACT DOCUMENTS AND SPECIFICATIONS
DIAMOND BAR COMMUNITY CENTER SLOPE STABILIZATION PROJECT CITY PROJECT NO. FP20500
ITEM
NO.
ESTIMATED
QUANTITY UNIT
DESCRIPTION
WRITTEN IN WORDS
UNIT
PRICE AMOUNT
1 1 L.S. MOBILIZATION
2 130 L.F. REMOVAL OF EXISTING CONCRETE
V-DITCH
3 2,600 S.F. CLEARING & GRUBBING
4 1,660 S.F. REMOVAL OF EXISTING CONCRETE
PAVEMENT
5 13 L.F. INSTALL 6” CURB & GUTTER
6 1 L.S. ADJUST VAULT TO GRADE
7 164 L.F. CONSTRUCT CONCRETE V-DITCH
8 1,720 S.F. CONSTRUCT CONCRETE PAVEMENT
9 1 L.S. EROSION CONTROL
10 90 L.F. INSTALL 4” HDPE STORM DRAIN
11 7 E.A. INSTALL 12” SQUARE GRATES
12 1 L.S. ROOF DRAIN INVESTIGATION
13 161 C.Y. STRUCTURE EXCAVATION
14 97 C.Y. STRUCTURE BACKFILL
$65,000.00
$110.00
$36.50
$15,000.00
$65.00
$350.00
$3,000.00
$150.00
$200.00 $19,400.00
$2,500.00
$18,040.00
$24,150.00
$3,000.00
$2,450.00
$5,850.00
$15,000.00
$62,780.00
$16,600.00
$20,020.00
$2,600.00
$65,000.00
$2,500.00
$300.00
$10.00
$7.70
$20.00
$3,900.00
$18.00
$60.00 $3,360.00
$500.00 $6,000.00
$20,000.00 $20,000.00
$2.00 $59,380.00
$650.00 $40,950.00
$170.00 $166,430.00
Five Hundred Ninety-Four
$105.00
$15.00
$10.00
$4,000.00 $4,000.00
$3,360.00
$5,250.00
$16,000.00
$8,550.00
$594,570.00
Thousand Five Hundred Seventy And Zero Cents
59,457.00
Bid Items 18 thru 25 10% Redlands, CA 92373
450 Kansas St., Suite 104,
CSLB: 674829
DIR: 1000026865
David Ollis Landscape
Development, Inc
Supply & Install
Install cages & pour concrete
Items 15 & 16, Drilling &
20%
1249 W. Washington Ave.,
Escondido, CA 92029
CSLB: 624663
Curtis Drilling CO. DIR: 1000006928
for piles
9%
Supply & Install Reinforcing
Bid Items 7, 8 & 17
Thousand, Oaks, CA 91360
3082 Camino Del Zuro,
CSLB: 1067182
DIR: 1000840847 Shea Reinforcing Steel, Inc
Steel
X
X
37 CERTIFICATION WITH REGARD TO THE PERFORMANCE OF
PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE
EQUAL OPPORTUNITY CLAUSE AND THE FILING OF REQUIRED REPORTS The bidder , proposed subcontractor , hereby certifies that he has , has not , participated in a previous contract or subcontract subject to the Equal Opportunity Clause, as required by Executive Orders 10925, 11114, or 11246, and that he has , has not , filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filing requirements.
(COMPANY)
BY:
(TITLE)
DATE: , 20 .
NOTE: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7 (b) (1), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the Equal Opportunity Clause. Contracts and subcontracts which are exempt from the Equal Opportunity Clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt).
Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations.
Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7 (b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period of such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor.
X
X
SHEA REINFORCING STEEL, INC.
Matthew Shea
Vice President
August 19 22
x
SRS
Form W-9
(Rev. October 2018)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
▶ 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) ▶ 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) ▶
4 Exemptions (codes apply only to
certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
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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 ▶ Date ▶
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)
Wright Construction Engineering Corp
✔
2625 S Santa Fe Ave.,
San Marcos, CA 92069
City of Diamond Bar
21810 Copley Dr.,
Diamond Bar, CA 91765
46 5724187
8/16/22