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2376 RFQ 20/21-23 Prof Consulting Gp - (KEITH, Tetra Tech, Madrid Eng Gp)CITY OF SANFORD FINANCE DEPARTMENT Wednesday, October 27, 2021 PURCHASING DEPARTMENT TRANSMITTAL MEMORANDUM To: City Clerk RE: RFQ 20/21-23 Professional Consulting Services (KEITH, Tetra Tech, Madrid Engineering Group) The item(s) noted below is/are attached and forwarded to your office for the following action(s): ❑ Development Order ❑ Mayor's signature ❑ Final Plat (original mylars) ❑ Recording ❑ Letter of Credit ❑ Rendering ❑ Maintenance Bond ® Safe keeping (Vault) ❑ Ordinance ❑ Deputy City Manager ❑ Performance Bond ❑ Payment Bond ❑ Resolution ❑ City Manager Signature ❑ ❑ City Clerk Attest/Signature ❑ City Attorney/Signature Once completed, please: ❑ Return originals to Purchasing- Department ❑ Return copies Special Instructions: OC a/ % From Date TADept_forms\City Clerk Transmittal Memo - 2009.doc Sr�:FORp � jjCITY OF J &kNFORD FST. 1� •.,, CITY COMMISSION MEMORANDUM 21.220.0 OCTOBER 25, 2021 AGENDA To: PREPARED BY: SUBMITTED BY: SUBJECT: W S _ RM X Item No. Honorable Mayor and Members of the City Commission Marisol Ordonez, Purchasing Manager Norton N. Bonaparte, Jr., ICMA-CM, C RFQ 20/21-23; Professional Consulting Competitive Consulting Negotiation Ace STRATEGIC PRIORITIES: ❑ Unify Downtown & the Waterfront ❑ Promote the City's Distinct Culture Update Regulatory Framework Redevelop and Revitalize Disadvantaged Communities SYNOPSIS: KIM Services; Approval for the procurement under RFQ 20/21-23 for professional engineering consulting services procured under the Competitive Consulting Negotiation Act (CCNA) for various vendors is requested. FISCAL/STAFFING STATEMENT: Funding for the procurement of CCNA professional engineering consulting services will be provided based on a department's request for services. BACKGROUND: The City processed a new solicitation (RFQ 20/21-23) for professional engineering consulting services under the CCNA with 19 submissions of qualifications being received; however, only 11 proposals were evaluated and scored by the City's CCNA selection committee as the remaining eight proposals were presented and approved by the City Commission on September 27, 2021 as renewal contracts. Thus, the City will have procured a wide array of uniquely talented engineering firms to serve the needs of the City under continuing contract engagements under the terms of the CCNA. The rankings by scores of the selection committee for the 11 firms follows: Firm Name: Score: 1. Tetra Tech, Inc. 419 2. Madrid Engineering, Inc. 410 3. Keith Engineering Inspired Design 390 4. Bentley Architects & Eng. Inc. 382 5. KMA Design Grp. LLC 292 6. Nadic Engineering Srvc. Inc. 352 7. Dedging & Marine Consultants 368 8. JHS Environmental Engineering 312 9. Metro Consulting Grp. LLC 346 10. OM Engineering Srvc. Inc. 321 11. Traffic Engineering Data 315 The following are the three firms that the City's CCNA selection committee recommends be engaged in continuing contracts with the City in order to provide professional engineering consulting services in addition to the array of firms currently under continuing contracts with the City: 1. Tetra Tech, Inc. 2. Madrid Engineering, Inc. 3. Keith Engineering Inspired Design LEGAL REVIEW: The Assistant City Attorney has reviewed and has no legal objection with the procurement being implemented as proposed. The Assistant City Attorney will draft the appropriate contracts upon action by the City Commission. RECOMMENDATION: City staff recommends that the City Commission approve the procurement of the three additional professional engineering consulting firms to provide professional engineering consulting services to the City under continuing contracts under solicitation RFQ 20/21-23 and the provisions of the CCNA. SUGGESTED MOTION: "I move to approve the selection of the three additional professional engineering consulting firms and the award of continuing contracts, as proposed." Attachments: (1). Bid opening certification minutes, etc. (2). RFQ Evaluation Matrix (scoring form). CITY OF SANFORD, FLORIDA - PURCHASING DIVISION SOLICITATION OPENING CERTIFICATION AND MINUTES (Section 255.0518, Florida Statutes) A. Solicitation Title Professional Consulting Services-CCNA (Engineering Services) Number RFQ 20/21-23 Opening Date April 6, 2021 Time 2.00PMLmalTim Solicitation Documents Including Announcement of This Opening Are Available for Viewing or Downloading at www.myvendorlink.com Location of Opening: Commission Chamber & RingCentral https://v.ringcentral.com/join/29022169� 1. On this date the opening of the solicitation response identified above is hereby verified and the public announcements recorded below regarding the solicitations received were duly made. It is noted that no other business was conducted, there were no discussions and no input was received from anyone in attendance. There was no attendance record made. ❑ IFB- Announced the name of each bidder and the amount of their bid. ❑ RFP- Announced the name of each respondent. oRFQ- Announced the name of each respondent. ❑ If any submission was not opened and/or announced: check this item and indicate on tabulation below specific information as to why the submission was not opened or announced. W]All submissions were one 2. Name of City0e Certification (1 B . Sig Certification (2) By: d read. The tabulation below reflects the information read. nced the bids: Marisol Ordonez April 6, 2021 Marisol Ordonez, Purchasing Manager date printed name and title Signature date printed name and title 3. The public notice indicated by § 286.0105 and 286.011 Florida Statutes is not required because no rule, resolution, or formal action has taken place or considered at this opening. Therefore, a verbatim record of the solicitation specifically identified above is not required if a person, in accordance with City of Sanford Policy Number 15., elects to file a protest or appeal an action associated with the identified solicitation. 4. Florida Statute 119.071: Sealed bids, proposals, or replies received by an agency pursuant to a competitive solicitation are exempt from s. 119.07(1) and s. 24(a), Art. I of the State Constitution until such time as the agency provides notice of an intended decision or until 30 days after opening the bids, proposals, or final replies, whichever is earlier. Note -City of Sanford Procurement Procedure 6-500 mandates that as applicable to an IFB: the name of each bidder and the specific amount of the bid will be shared at the opening, for an RFP or RFQ the name of each person or firm will be shared at the opening. (Florida Statues may be found at. hitp:Uww)v.teg state fl.us/statutesl) Bidder/Proposer I Bid Base Alternate Bid / Wi-+nitiai here if tabulation is attached in lieu of using the above tabulation or if additional pages are attached. It is noted that this is page one of % pages.' ' Page 1 of 1 City of Sanford Doc April 6, 2021 Bid Opening Date: April 6, 2021 at 2:OOPM Local Time Location: Commission Chambers - Solicitation: RFQ 20/21-23 Professional Consulting Services- CCNA (Engineering Services) RingCentral Meeting was available on April 6, 2021 at 2:OOPM Local Time https:Hv.rinfzcentral.com/ioin/290221695 Bid Tabulation Sheet 1. Bentley Architects and Engineers, Inc. 2. CPH Inc. 3. John D Hermann/Arminimus Consultants 4. SMW GeoScience Inc. 5. Madrid Engineering Inc. 6. KEITH Engineering Inspired Design 7. KMA Design Group, LLC 8. NADIC Engineering Services Inc. 9. Professional Services Inc. 10. Reiss Engineering Inc. 11. AVCON Inc. 12. Dedging & Marine Consultants 13. JHS Environmental Engineering 14. Ardaman and Associates Inc. 15. Tetra Tech, Inc. 16. METRO Consulting Group, LLC 17. OM Engineering Services, Inc. 18. Traffic Engineering Data Solutions, Inc. 19. Terracon Consultants, Inc. Art Woodruff Sheena Britton terry S. Wiggins, Sr. Patrick Austin Patty Mahany Norton N. Bonaparte, Jr. Mayor District 1 District 2 District 3 District 4 City Manager City Hall, 2nd Floor • 300 N. Park Avenue • Sanford, FL 32771-1244 • PO Box 1788 • Sanford FL, 32772-1788 p. 407.688.5020 • f. 407.688.5021 o sanfordfl.gov o '� 3 �� a S z e � c n• �_ c . — a z n 0 z n n n 'b h n m o cc n w C J 0 x = — — — n H n 70 0 oa - - d n z 0 o v n Csi 03 fj fi >� A � t IoW C ^ N 1G C Mei ^ 0 ?. oa o as '0 cn n "9 y 00 a v0i ~ n �. CD (N C1. o c L' y ►l \ fes• _ O n � A h Z n � AGREEMENT BY AND BETWEEN THE CITY OF SANFORD, FLORIDA AND TETRA TECH INC. FOR SOLICITATION NUMBER: RFQ 20/21-23/CCNA MASTER AGREEMENT THIS CCNA ASTER 4PREEMENT (hereinafter the "Agreement") is made and entered into this Oday of , 2021, by and between the City of Sanford, Florida, a Florida municipality, (hereinafter referred to as the "City"), whose mailing address is 300 North Park Avenue, Sanford, Florida 32771, Tetra Tech Inc., a Delaware corporation, ("Tetra Tech" throughout) whose principal and mailing address is 3475 East Foothill Boulevard, Pasadena, California 91107. The City and Tetra Tech may be collectively referenced herein as the "Parties". WITNESSETH: IN CONSIDERATION of the mutual covenants, promises, and representations contained herein and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties hereto agree as follows: Section 1. Recitals. The above recitals are true and form a material part of this Agreement upon which the Parties have relied. Section 2. Authority. Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The persons executing this Agreement for each party certify that they are authorized to bind the party fully to the terms of this Agreement. Section 3. Scope of Agreement. This Agreement is for the consulting and engineering services as set forth in the Consultant's Competitive Negotiation Act (the "CCNA" as set forth in Section 287.055, Florida Statutes) and the procurement solicitation documents relating hereto, the responses thereto from Tetra Tech and the work orders and documents related thereto as issued by the City (all of which are incorporated herein as if fully set forth herein verbatim) and it is recognized Tetra Tech shall perform services as otherwise directed by the City all of such services to include all labor and materials that may be required including, but in no way limited to, the goods and services provided by subconsultants as may be approved by the City within the amount of compensation to be paid to Tetra Tech This is a continuing services contract under the provisions of the CCNA and within the scope of the professional service of engineering as defined in Section 471.005(7), Florida Statutes, or its successor provisions. Section 4. Effective Date and Term of Agreement. This Agreement shall take effect on the date that this Agreement is fully executed by the Parties hereto. This Agreement shall remain in effect until the services provided under all City work orders have been fully performed in accordance with the requirements of the City; provided, however, that, the indemnification provisions and insurance provisions of the City's �' t standard contractual terms and conditions shall not terminate and the protections afforded to the City shall continue in effect subsequent to such services being provided by Tetra Tech No services have commenced prior to the execution of this Agreement that would entitle Tetra Tech for any compensation therefor. Section 5. Compensation. The Parties agree to compensation as set forth in the City's work orders as issued from time -to -time. Section 6. Standard Contractual Terms and Conditions. All "Standard Contractual Terms and Conditions", as provided on the City's website, apply to this Agreement. Such Terms and Conditions may be found at the City's website; which can be reached at: (https://www.sanfordfl.gov/departments/finance/purchasing/contract- terms-and-conditions or www. SanfordFL.gov), or a successor link. The Parties shall also be bound by the purchasing policies and procedures of the City as well as the controlling provisions of Florida law. Work orders shall be used, in accordance therewith, in the implementation of this Agreement to the extent deemed necessary by the City in its sole and absolute discretion. Additionally, the Parties agree that the provisions of all Federal rules and procedures, and any other matters required to be incorporated herein are incorporated into this Agreement (such as, but not limited to, any and all required contract clauses by agencies such as the Federal Emergency Management Agency and the Florida Department of Economic Opportunity or their successor agencies). All services shall be subject to the provisions of the CCNA and all controlling requirements of Federal law. Section 7. Tetra Tech's Mandatory Compliance with Chapter 119, Florida Statutes, and Public Records Requests. (a). In order to comply with Section 119.0701, Florida Statutes, public records laws, Tetra Tech must: (1). Keep and maintain public records that ordinarily and necessarily would be required by the City in order to perform the service. (2). Provide the public with access to public records on the same terms and conditions that the City would provide the records and at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law. (3). Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. (4). Meet all requirements for retaining public records and transfer, at no cost, to the City all public records in possession of Tetra Tech upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public 21' records disclosure requirements. All records stored electronically must be provided to the City in a format that is compatible with the information technology systems of the City. (b). If Tetra Tech does not comply with a public records request, the City shall enforce the contract provisions in accordance with this Agreement. (c). Failure by Tetra Tech o grant such public access and comply with public records requests shall be grounds for immediate unilateral cancellation of this Agreement by the City. Tetra Tech shall promptly provide the City with a copy of any request to inspect or copy public records in possession of Tetra Tech and shall promptly provide the City with a copy of Tetra Tech's response to each such request. (d). IF THE CONTRACTORIVENDOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S (VENDOR'S) DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT (407) 688-5012, TRACI HOUCHIN, MMC, FCRM, CITY CLERK, CITY OF SANFORD, CITY HALL, 300 NORTH PARK AVENUE, SANFORD, FLORIDA 32771, TRACI.HOUCHIN@SANFORDFL.GOV. Section 8. Time is of the Essence. Time is hereby declared of the essence as to the lawful performance of all duties and obligations set forth in this Agreement. Section 9. Entire Agreement/Modification. This Agreement and the provisions thereof, together with all standard contractual terms and conditions, as provided on the City's website and the controlling requirements of Federal law, and including, without limitation, the documents attached hereto, constitute the entire integrated agreement between the City and Tetra Tech and supersedes and controls over any and all prior agreements, understandings, representations, correspondence and statements whether written or oral in connection therewith and all the terms and provisions contained herein constitute the full and complete agreement between the Parties hereto to the date hereof. This Agreement may only be amended, supplemented or modified by a formal written amendment of equal dignity herewith. Section 10. Severability. If any term, provision or condition contained in this Agreement shall, to any extent, be held invalid or unenforceable, the remainder of this Agreement, or the application of such term, provision or condition to persons or circumstances other than those in respect of which it is invalid or unenforceable, shall not be affected thereby, and each term, provision and condition of this Agreement shall be valid and enforceable to the fullest extent permitted by law when consistent with equity and the public interest. 3 11 ' Section 11. Waiver. The failure of the City to insist in any instance upon the strict performance of any provision of this Agreement, or to exercise any right or privilege granted to the City hereunder shall not constitute or be construed as a waiver of any such provision or right and the same shall continue in force. Section 12. Captions. The section headings and captions of this Agreement are for convenience and reference only and in no way define, limit, describe the scope or intent of this Agreement or any part thereof, or in any way affect this Agreement or construe any provision of this Agreement. Section 13. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, but all of which, taken together, shall constitute one and the same document. Section 14. Binding Effect. This Agreement shall be binding upon and inure to the benefit of the successors in interest, transferees and assigns of the Parties. Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The signatories hereof represent that they have the requisite and legal authority to execute this Agreement and bind the respective Parties herein. Section 15. Remedies. The rights and remedies of the Parties, provided for under this Agreement, are in addition to any other rights and remedies provided by law or otherwise necessary in the public interest. Section 16. Governing law, Venue and Interpretation. This Agreement is to be governed by the laws of the State of Florida. Venue for any legal proceeding related to this Agreement shall be in the Eighteenth Judicial Circuit Court in and for Seminole County, Florida. This Agreement is the result of bona fide arms length negotiations between the City and Tetra Tech, and all Parties have contributed substantially and materially to the preparation of the Agreement. Accordingly, this Agreement shall not be construed or interpreted more strictly against any one party. than against any other party and all provisions shall be applied to fulfill the public interest. IN WITNESS WHEREOF, the City and Tetra Tech have executed this instrument for the purpose herein expressed. SIGNATURE BLOCKS FOLLOW: 41P J Attest: CITY OF SANFORD Traci Houchin, MMC, FCRM r;.r ArtWoodruff City Clerk ��'�""°� Mayor ,+a -Date: r Approved as to form and r legal sufficiency. vk f''iis' hey ��: �,,)^A� .r'".• m40,J,J,.-- Colbert, CityoAttorrn Air on Attest: .4 C/9 L� rbnce<Jenkins Vice President Tetra Tech, Inc., a Delaware Corporation. By: Jon F, P.E. Vice President Dated: 5�f',� OTETRATECH CERTIFICATE TETRA TECH, INC. To The City of Sanford, Florida: I hereby certify to you that I am the duly elected and qualified Senior Vice President, General Counsel and Secretary of Tetra Tech, Inc., a Delaware corporation (the "Company"), and that as such, I am authorized to execute this Certificate on behalf of the Company. I further certify to you on behalf of the Company that: Jon Fox, Vice President within the Company's Resilient and Sustainable Infrastructure Division of the Government Services Group, is authorized and empowered, in accordance with the Company's Signature Approval Authority Matrix, as approved by the Company's Board of Directors, to execute for and on behalf of the Company, Solicitation Number: RFQ 20/21-23/CCNA Master Agreement between the Company and the City of Sanford, Florida. IN WITNESS WHEREOF, I have hereunto set my hand as of this 18th day of October, 2021. Preston Hopscill Senior Vice President, General Counsel and Secretary FEB 4 1988 Form (liev. October 2018) Ososnmant of [ho Treasury Internal Rmenua Seavtce Y NAme (as shown on Tetra Tech, Inc. quest for TaxPayer Identification Number and Certification Go to wwcvr 9:"(Fen"W9 for instructions and the latest tnfonnaffan ie tax return). ttarrre is reaucect on res• r ,._ __, ._ _ _ .... _ .. _ name. Give Form to the requester. Do not send to the IRS. ID 3 Ctwck appropriate box for federal tax cle s 0 iot1--seven!»xue, fficatiofe of the person whose rnanree is erlaaed on ince 1. Check CL only ate of the 4 Exempiio, (codes Y only to not rri o singlemmember LLpm for a C Coryaa! on ❑ 5 corporation ❑ Partners tip D Trusuestato t O13 O7 ° 3) Ddu we e❑ Limited r�biGfy COmParri Enha the tax {C=C carporatian, SSSP) Exempt P$Yso Dade (d any) .!s Nota: Check rho apWopriatc b= in the Gns `"O`r'°`�''a'. Pa7'.arh� > t: LLC if the LLC is classified as a single '''Ole ton the tax claastficaaon at rho single -member ovmer. pa not check another LLC that s not d ^�0 matrlr¢r LLC that is dsmgardad from the owner unless the owner of the LLC is Fxgnppon Nom FATCA repomng Is ftlegerded Nam the Owner should the rom Me owner fa nese fccibox fortans pwpaae�. Otherwise, a eingla-memb� LLC that � (danh apOrl.nd., aPAnoPriate box torthe tact c:assitM„auon of tis owner. 728�1 U--4Co FL Enter your TIN in the - •" „'�'i uvf backup viAhokiing. Fo individuals, h s e TIN provided must match the is generally your social security name given on Ho 1 However. avoid 3 resident alien, sole Proprietor, or disregarded entity, tY number (SSI. However, fora entities, it is your employer i (EI sed the instructions for part I, later. For other L 77N, tater. pioY identification number (EtNk N you do not have a number, see How to get a Note- if the account is in more than one name, see the Inst Nuruct ons for info 1. Also see torr Number To Give the Requester for guidelines on whose number to enter. What Name end C Under penalties of parjuty, I certify rftati t. The number shown on the form is my correct taxpayer identification number (or! am wailing for a number to be Issued to me)and 2. I am not subject to backup w'nthholding because: (a) i am exempt from Service ORS) that 1 am subject to backup withhot backup withholding, or (b)1 have not been notified by the Internal novenae no longer subject to backup withholdi a re�R of a failure to report all Interest or dividends, or (c) the IRS has notified me that 1 am 3. i am a U.S. clizen or other U.S. n9. and Parson (defined below), and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct, Certifioatlon instruettons. You must cross out item 2 above if you have been notified by the IRS that you are currendYs ubject to back WhhltoUN because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not acquisition or abandonment of secured property, cancellation of debt, contributions apply, For mortgage interest other Ulan interest arid dividends are not buttons to an individual retirement arrangementted' required to -sign the certification, but you must provide your correct TINSx theinstructionses fo lPartt JI later. Sign Here Signature at U''Orson® General instructions Section references are to the Internal Revenue Code unless Wtorwise noted. Futur'a 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/F0rmW9. 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 identifir tt on number (TTN) which may be your social security number (SSM, Individual taxpayer identification number (MM, adoption taxpayer identification number (ATIN), or employer Identificationtdoptidopti t�M, to report on an information return the amount paid to ion number you, or other amount reportable on an information retort. Examples of Information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) Data ,� /Ok Q • Form 1og9-DIV r �) (dividends, iruf+xtl those from stooks or mutual • Form 1099 -"SC (various types of income, prizes, awards. or gross Proceeds) • Form 1099-8 (stock or mutual fund sales and certain other transactions by brokers) • Form 109" (proceeds from real estate transactions) • Form 1099-1( (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1o98 -E (student loan interest), 1098-T (tuition) • Form 1099-0 (canceled debq • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. Person (including a resident Wien), to Provide your correct TTN. it you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholdng. Sea What is backup withholding, later. Cat No. 10231x Form tin -s (Rev. to -2018) AGREEMENT BY AND BETWEEN THE CITY OF SANFORD, FLORIDA AND MADRID ENGINEERING GROUP, INC. FOR SOLICITATION NUMBER: RFQ 20/21-23/CCNA MASTER AGREEMENT THIS CCNA I ASTER AGREEMENT (hereinafter the "Agreement") is made and entered into this _41 day of _, 2021, by and between the City of Sanford, Florida, a Florida municipality, (hereinafter referred to as the "City"), whose mailing address is 300 North Park Avenue, Sanford, Florida 32771, Madrid Engineering Group Inc., a Florida corporation, ("Madrid Engineering Group" throughout) whose principal and mailing address is 2030 State Road 60 East, Bartow, Florida 338304268. The City and Madrid Engineering Group may be collectively referenced herein as the "Parties". WITNESSETH: IN CONSIDERATION of the mutual covenants, promises, and representations contained herein and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties hereto agree as follows: Section 1. Recitals. The above recitals are true and form a material part of this Agreement upon which the Parties have relied. Section 2. Authority. Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The persons executing this Agreement for each party certify that they are authorized to bind the party fully to the terms of this Agreement. Section 3. Scope of Agreement. This Agreement is for the consulting and engineering services as set forth in the Consultant's Competitive Negotiation Act (the "CCNA" as set forth in Section 287.055, Florida Statutes) and the procurement solicitation documents relating hereto, the responses thereto from Madrid Engineering Group and the work orders and documents related thereto as issued by the City (all of which are incorporated herein as if fully set forth herein verbatim) and it is recognized Madrid Engineering Group shall perform services as otherwise directed by the City all of such services to include all labor and materials that may be required including, but in no way limited to, the goods and services provided by subconsultants as may be approved by the City within the amount of compensation to be paid to Madrid Engineering Group This is a continuing services contract under the provisions of the CCNA and within the scope of the professional service of engineering as defined in Section 471.005(7), Florida Statutes, or its successor provisions. Section 4. Effective Date and Term of Agreement. This Agreement shall take effect on the date that this Agreement is fully executed by the Parties hereto. This Agreement shall remain in effect until the services provided under all City work orders have been fully performed in accordance with the requirements of the City; provided, however, that, the indemnification provisions and insurance provisions of the City's I I Page standard contractual terms and conditions shall not terminate and the protections afforded to the City shall continue in effect subsequent to such services being provided by Madrid Engineering Group No services have commenced prior to the execution of this Agreement that would entitle Madrid Engineering Group for any compensation therefor. Section 5. Compensation. The Parties agree to compensation as set forth in the City's work orders as issued from time -to -time. Section 6. Standard Contractual Terms and Conditions. All "Standard Contractual Terms and Conditions", as provided on the City's website, apply to this Agreement. Such Terms and Conditions may be found at the City's website; which can be reached at: (https://www.sanfordfl.gov/departments/finance/purchasing/contract- terms-and-conditions or www. SanfordFL.gov), or a successor link. The Parties shall also be bound by the purchasing policies and procedures of the City as well as the controlling provisions of Florida law. Work orders shall be used, in accordance therewith, in the implementation of this Agreement to the extent deemed necessary by the City in its sole and absolute discretion. Additionally, the Parties agree that the provisions of all Federal rules and procedures, and any other matters required to be incorporated herein are incorporated into this Agreement (such as, but not limited to, any and all required contract clauses by agencies such as the Federal Emergency Management Agency and the Florida Department of Economic Opportunity or their successor agencies). All services shall be subject to the provisions of the CCNA and all controlling requirements of Federal law. Section 7. Madrid Engineering Group's Mandatory Compliance with Chapter 119, Florida Statutes, and Public Records Requests. (a). In order to comply with Section 119.0701, Florida Statutes, public records laws, Madrid Engineering Group must: (1). Keep and maintain public records that ordinarily and necessarily would be required by the City in order to perform the service. (2). Provide the public with access to public records on the same terms and conditions that the City would provide the records and at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law. (3). Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. (4). Meet all requirements for retaining public records and transfer, at no cost, to the City all public records in possession of Madrid Engineering Group upon termination of the contract and destroy any 21Page duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the City in a format that is compatible with the information technology systems of the City. (b). If Madrid Engineering Group does not comply with a public records request, the City shall enforce the contract provisions in accordance with this Agreement. (c). Failure by Madrid Engineering Group to grant such public access and comply with public records requests shall be grounds for immediate unilateral cancellation of this Agreement by the City. Madrid Engineering Group shall promptly provide the City with a copy of any request to inspect or copy public records in possession of Madrid Engineering Group and shall promptly provide the City with a copy of Madrid Engineering Group's response to each such request. (d). IF THE CONTRACTORIVENDOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S (VENDOR'S) DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT (407) 688-5012, TRACI HOUCHIN, MMC, FCRM, CITY CLERK, CITY OF SANFORD, CITY HALL, 300 NORTH PARK AVENUE, SANFORD, FLORIDA 32771, TRACI.HO00HIN@SANFORDFL.GOV. Section 8. Time is of the Essence. Time is hereby declared of the essence as to the lawful performance of all duties and obligations set forth in this Agreement. Section 9. Entire Agreement/Modification. This Agreement and the provisions thereof, together with all standard contractual terms and conditions, as provided on the City's website and the controlling requirements of Federal law, and including, without limitation, the documents attached hereto, constitute the entire integrated agreement between the City and Madrid Engineering Group and supersedes and controls over any and all prior agreements, understandings, representations, correspondence and statements whether written or oral in connection therewith and all the terms and provisions contained herein constitute the full and complete agreement between the Parties hereto to the date hereof. This Agreement may only be amended, supplemented or modified by a formal written amendment of equal dignity herewith. Section 10. Severability. If any term, provision or condition contained in this Agreement shall, to any extent, be held invalid or unenforceable, the remainder of this Agreement, or the application of such term, provision or condition to persons or circumstances other than those in respect of which it is invalid or unenforceable, shall not be affected thereby, and each term, provision and condition of this Agreement shall 31 Pa!, c be valid and enforceable to the fullest extent permitted by law when consistent with equity and the public interest. Section 11. Waiver. The failure of the City to insist in any instance upon the strict performance of any provision of this Agreement, or to exercise any right or privilege granted to the City hereunder shall not constitute or be construed as a waiver of any such provision or right and the same shall continue in force. Section 12. Captions. The section headings and captions of this Agreement are for convenience and reference only and in no way define, limit, describe the scope or intent of this Agreement or any part thereof, or in any way affect this Agreement or construe any provision of this Agreement. Section 13. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, but all of which, taken together, shall constitute one and the same document. Section 14. Binding Effect. This Agreement shall be binding upon and inure to the benefit of the successors in interest, transferees and assigns of the Parties. Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The signatories hereof represent that they have the requisite and legal authority to execute this Agreement and bind the respective Parties herein. Section 15. Remedies. The rights and remedies of the Parties, provided for under this Agreement, are in addition to any other rights and remedies provided by law or otherwise necessary in the public interest. Section 16. Governing law, Venue and Interpretation. This Agreement is to be governed by the laws of the State of Florida. Venue for any legal proceeding related to this Agreement shall be in the Eighteenth Judicial Circuit Court in and for Seminole County, Florida. This Agreement is the result of bona fide arms length negotiations between the City and Madrid Engineering Group, and all Parties have contributed substantially and materially to the preparation of the Agreement. Accordingly, this Agreement shall not be construed or interpreted more strictly against any one party. than against any other party and all provisions shall be applied to fulfill the public interest. IN WITNESS WHEREOF, the City and Madrid Engineering Group have executed this instrument for the purpose herein expressed. SIGNATURE BLOCKS FOLLOW: 41Paor e Attest: Traci Houchin, MMC, FCRM City Clerk CITY OF SANFORD By: Art Wood Mayor Approved as to form and legal sufficiency. ,a ;r iam L Colbert, City Att ne i '/6 Attest: /I C/q Madrid Engineering Group, Inc., a Florida corporation. Stephen Tarte CEO Sheila Tarte President / Dated: / e21 ci/ 51 �' Form W-9 Request for Taxpayer Give Form to the Re%, cc. ote- 2015" Identification Number and Certification requester. Do not 0--pan're"! of elle Tres:ix'f 10- Go to www irS,gOV1FOhmV1r9 for instructions and the latent inf—.+;— send to the IRS, irorrie tc, "!fIlmi Narne lS f 1401`eZ 00 tNS oe, not leave, fills ii'le ofan k. 2 Bus"r(?sss an a, ,:Ititv rfalne, if to rb )�-p Madrid CPWG 3 Crc-c�. aplyuptizil4p for M fcIftymng se,�e,, coxes. CII)CK 001,- One 04 the 4 F�vt�iiplioii. ("Zdes app Y 00EY to unteties. rov. indivrdj&s, see :cal yauat'Sole Potinutor of C 0". crrar,o" Or, Page 3): fA parwerfn,p LJ Trosivestate 1, VZiYV.L —1 -it irlil Fn!c-, Vl�� tA�N P 0 atV.5vita tj\ C!, S 11C. f lra� I'X r, cass'N.-C as a s,u FxwnW,wtfr ;nFATCAiLpor1iog lie -,nio"iber 1.1 C, M; 1110 or Iv I i.{, ir, if �s M wmower LL.' tPL1I t�, not (f�,o in .j? c P lot Ll 'S 'eder,,E 5 f`- dism.flamed -rorrl frili ownf',t'ShOu C. rhelk vie it-ppfo, Qtfj�,,,, Miiwbkr LLC [list; Coqe Elf Er"Y .... ..... . - �ojjl. -ex for t��v !tri t1asVica"'On o� Owner, E; rA art X S i U c. St.ZIP of "iu;t-� -m! Accucswl,'., fall,(! dft(, JUCYQ'S5 opliolaf, ;2030 State Road 60 East .. ......... .. rty, W.'a, I ante ei i� Bartow FL 3383.0. 7 Lis! ac, -Our;' 1Mre iopzicw,l i aixpayer Ident fication Number (TfNj Enter your TIN in the appropriate box. Tre TIN wovided mu,,I rriatch the raire giver, an firte I to a Social security number backup wilhh;.)Iding, For ilidividuals• this is generally your s( tat security ;,,b(�, void resident ilsen Sole propffetor, Oe ' disregarded entity. . hr- lowever. for a entities. it is YOV er!'PlOyer iden see I , inStfUctions for Part 1. later. For other identification fluo'be, (EIN), if you do mot have ljk,rlb, TIN, later .see Fiow to gel or Note: It the accCulll is r.•: thar one POrne. Set- the instructions for I'lle 1, Also see lWitig Mifne, aro Employerentification number %1mbilt To Give the R&Quesler for guidelines (In vvhost� nurf tber to enter , ------ 5'9-;31115'617 1 -!311151617 212' order) of pejuj (,,,tlfy that: 1 TIie nunit,&, Shruywr, of, ,,)is form is f ­`Y IZJAPTyi.r iderlitication n rnl).r for I art veelltirlg fora nurribet to be issued to inn l; arid 2 1 am not subject to, backup Vithholding because: ,ai i dill fiaxPfnpt from bnckupl withholding. Or (bt 1 have not I:feen rectified by file Interral Revenue Service i , IRS) that I ani subject to back�,,p vi;thholding.afia resol of a laillire to alt Ortel est ! w diVdellds. cr fell the IRS has rotififA me that I am. ro longer subject to backup withholding; arid 1 1 am , U.S. citizen or other (,i.S.person idel,tred telovj. i, -d t. The FA -'--A co-jclseo,t,.eej of! thistlorrnI ,f lny: ind atairi tvat 1 &M exempt from FATCA reporting is correct. Certification instructions, yuj niust c ,rnss ouitem 2 above ;f you have beer noifir,,d by the IRS that you 3le cueren!;y subject to ba(,kjp withholding you have %jilej to rel.10,1 Z�.Il lillfyel Decause -it illid dividw,�ii; of,, vrur For real �-,,tate trarf!;ac*.w)r,,�,, lt�-irt 2 does riot apply, acqut ilOn Or abandonment of secii-ere -.top Y. �;dlf.t!!13110-iof debt. corldhiAnns to a,- rp re .s _ pit rly. For frior%jage interest caid. Other the n interest and cividerics. vol. are n( I, mell, arTangern-en? ilRAI, and generally, payments •gn the cortifi"arICn tt;t "'kr" q h't Parr It, later, -Signature -cf— Here I U.S. person 1--4 10/19/2021 , Date! Genera'I Instructions Ser"Or te'c-e--, -' to tile internal Revl,Vue Code otfa r- se noted. Future developments. or file WX Xit developments related to Fulfil W-9 and its Instructions, Sue 1, ,)s lec islatioll f�lj I I published. go to www.; Ittey Wert VV9, a( Oct Purpose of Form An irldividUal Or L -lit"; Form, tiV 9 requpste,�,, rpfIui,pfj , the an rin i"f0alicill 'the IPS Must Obta:n your correct I 1,paytj identification rumbe! il IN) which stay be ycl it social security cumber ISM, irdivi&al laxpavet idewtificalionI 'liumbe, rITIN)adoption taxPaYer 04WItificalion number to I IN3. or et,10o, wer identification titnibef, ,lEIN), to report on ar information return th*+ ,lnlotivl paid Ire you. or Other 3mO-'.nt rePOIJbIle 0a all inforr!i-jtjori ?L.IL.rfl. Exam,), s of 1 0, I matior -etums ir�dLjde, b— are rot limited to- the following. - Form 1099 -INT tinterest earned or paid] Oaf ^40 10:>:ttx • Form 1099-01V (dividends. including those frot-,l stocks or mutual wes. a,,ivards. or q,�,ss i'larious lype,� of il c jrne • Form 1090-8 Ist ock or mutual ft,nd Siles bred certain other ransactiuns by brc*ers± • Pon-ri Trwi-S (proce.ec is front T-Ral estate trarsactionsl • f tflu", pall-, fransacturs) F,';Fr" 1098 lhorrne mQrtgage wte,,!stl, ity98-t. Ica, zt,re 1098-T itotfor"i - I . • Form 1099-C (Canceled debt) • "Orin I099 -A Orab,1nfjoqf-:lc,-1 .)o r f,,rp S I _id prcpe y thse Fo,rn Vj-y oniy j; yo, area U,S, PelsonEincludino a residont 10 Prc-vide TIN, return FOMI W-9 to flip rrRjaester ",th a TW, you rn;gfn DocuSign Envelope ID: 15B38439-9860-41CF-BA90-85C1D8B88FF7 AGREEMENT BY AND BETWEEN THE CITY OF SANFORD, FLORIDA AND KEITH AND ASSOCIATES, INC. FOR SOLICITATION NUMBER: RFQ 20/21-23/CCNA MASTER AGREEMENT THIS CCNA MASTER AGREEMENT (hereinafter the "Agreement") is made and entered into this p4 day of . -, 2021, by and between the City of Sanford, Florida, a Florida municipality, (hereinafter referred to as the "City"), whose mailing address is 300 North Park Avenue, Sanford, Florida 32771, Keith and Associates Inc., a Florida corporation doing business as "KEITH", ("Keith and Associates" throughout) whose principal and mailing address is 301 East Atlantic Boulevard, Pompano Beach, Florida 33060. The City and Keith and Associates may be collectively referenced herein as the "Parties". WITNESSETH: IN CONSIDERATION of the mutual covenants, promises, and representations contained herein and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties hereto agree as follows: Section 1. Recitals. The above recitals are true and form a material part of this Agreement upon which the Parties have relied. Section 2. Authority. Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The persons executing this Agreement for each party certify that they are authorized to bind the party fully to the terms of this Agreement. Section 3. Scope of Agreement. This Agreement is for the consulting and engineering services as set forth in the Consultant's Competitive Negotiation Act (the "CCNA" as set forth in Section 287.055, Florida Statutes) and the procurement solicitation documents relating hereto, the responses thereto from Keith and Associates and the work orders and documents related thereto as issued by the City (all of which are incorporated herein as if fully set forth herein verbatim) and it is recognized Keith and Associates shall perform services as otherwise directed by the City all of such services to include all labor and materials that may be required including, but in no way limited to, the goods and services provided by subconsultants as may be approved by the City within the amount of compensation to be paid to Keith and Associates This is a continuing services contract under the provisions of the CCNA and within the scope of the professional service of engineering as defined in Section 471.005(7), Florida Statutes, or its successor provisions. Section 4. Effective Date and Term of Agreement. This Agreement shall take effect on the date that this Agreement is fully executed by the Parties hereto. This Agreement shall remain in effect until the services provided under all City work orders have been fully performed in accordance with the requirements of the City; provided, I I pa g e DocuSign Envelope ID: 151338439-9860-41 CF-BA90-85C1D8B88FF7 however, that, the indemnification provisions and insurance provisions of the City's standard contractual terms and conditions shall not terminate and the protections afforded to the City shall continue in effect subsequent to such services being provided by Keith and Associates No services have commenced prior to the execution of this Agreement that would entitle Keith and Associates for any compensation therefor. Section 6. Compensation. The Parties agree to compensation as set forth in the City's work orders as issued from time -to -time. Section 6. Standard Contractual Terms and Conditions. All "Standard Contractual Terms and Conditions", as provided on the City's website, apply to this Agreement. Such Terms and Conditions may be found at the City's website; which can be reached at: (https://www.sanfordfl.gov/departments/finance/purchasing/contract- terms-and-conditions or www. Sanford FL.gov), or a successor link. The Parties shall also be bound by the purchasing policies and procedures of the City as well as the controlling provisions of Florida law. Work orders shall be used, in accordance therewith, in the implementation of this Agreement to the extent deemed necessary by the City in its sole and absolute discretion. Additionally, the Parties agree that the provisions of all Federal rules and procedures, and any other matters required to be incorporated herein are incorporated into this Agreement (such as, but not limited to, any and all required contract clauses by agencies such as the Federal Emergency Management Agency and the Florida Department of Economic Opportunity or their successor agencies). All services shall be subject to the provisions of the CCNA and all controlling requirements of Federal law. Section 7. Keith and Associates' Mandatory Compliance with Chapter 119, Florida Statutes, and Public Records Requests. (a). In order to comply with Section 119.0701, Florida Statutes, public records laws, Keith and Associates must: (1). Keep and maintain public records that ordinarily and necessarily would be required by the City in order to perform the service. (2). Provide the public with access to public records on the same terms and conditions that the City would provide the records and at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law. (3). Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. (4). Meet all requirements for retaining public records and transfer, at no cost, to the City all public records in possession of Keith and Associates upon termination of the contract and destroy any 21P i e DocuSign Envelope ID: 15B39439-9860-41CF-BA90-85C1D8B88FF7 duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the City in a format that is compatible with the information technology systems of the City. (b). If Keith and Associates does not comply with a public records request, the City shall enforce the contract provisions in accordance with this Agreement. (c). Failure by Keith and Associates to grant such public access and comply with public records requests shall be grounds for immediate unilateral cancellation of this Agreement by the City. Keith and Associates shall promptly provide the City with a copy of any request to inspect or copy public records in possession of Keith and Associates and shall promptly provide the City with a copy of Keith and Associates' response to each such request. (d). IF THE CONTRACTOR/VENDOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S (VENDOR'S) DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT (407) 688-5012, TRACI HOUCHIN, MMC, FORM, CITY CLERK, CITY OF SANFORD, CITY HALL, 300 NORTH PARK AVENUE, SANFORD, FLORIDA 32771, TRACI.HOUCHIN@SANFORDFL.GOV. Section 8. Time is of the Essence. Time is hereby declared of the essence as to the lawful performance of all duties and obligations set forth in this Agreement. Section 9. Entire Agreement/Modification. This Agreement and the provisions thereof, together with all standard contractual terms and conditions, as provided on the City's website and the controlling requirements of Federal law, and including, without limitation, the documents attached hereto, constitute the entire integrated agreement between the City and Keith and Associates and supersedes and controls over any and all prior agreements, understandings, representations, correspondence and statements whether written or oral in connection therewith and all the terms and provisions contained herein constitute the full and complete agreement between the Parties hereto to the date hereof. This Agreement may only be amended, supplemented or modified by a formal written amendment of equal dignity herewith. Section 10. Severability. If any term, provision or condition contained in this Agreement shall, to any extent, be held invalid or unenforceable, the remainder of this Agreement, or the application of such term, provision or condition to persons or circumstances other than those in respect of which it is invalid or unenforceable, shall not be affected thereby, and each term, provision and condition of this Agreement shall be valid and enforceable to the fullest extent permitted by law when consistent with equity and the public interest. 3 1 P a e DocuSign Envelope ID: 151338439-9860-41CF-BA90-85C1 D81388FF7 Section 11. Waiver. The failure of the City to insist in any instance upon the strict performance of any provision of this Agreement, or to exercise any right or privilege granted to the City hereunder shall not constitute or be construed as a waiver of any such provision or right and the same shall continue in force. Section 12. Captions. The section headings and captions of this Agreement are for convenience and reference only and in no way define, limit, describe the scope or intent of this Agreement or any part thereof, or in any way affect this Agreement or construe any provision of this Agreement. Section 13. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, but all of which, taken together, shall constitute one and the same document. Section 14. Binding Effect. This Agreement shall be binding upon and inure to the benefit of the successors in interest, transferees and assigns of the Parties. Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The signatories hereof represent that they have the requisite and legal authority to execute this Agreement and bind the respective Parties herein. Section 15. Remedies. The rights and remedies of the Parties, provided for under this Agreement, are in addition to any other rights and remedies provided by law or otherwise necessary in the public interest. Section 16. Governing law, Venue and Interpretation. This Agreement is to be governed by the laws of the State of Florida. Venue for any legal proceeding related to this Agreement shall be in the Eighteenth Judicial Circuit Court in and for Seminole County, Florida. This Agreement is the result of bona fide arms length negotiations between the City and Keith and Associates, and all Parties have contributed substantially and materially to the preparation of the Agreement. Accordingly, this Agreement shall not be construed or interpreted more strictly against any one party. than against any other party and all provisions shall be applied to fulfill the public interest. IN WITNESS WHEREOF, the City and Keith and Associates have executed this instrument for the purpose herein expressed. SIGNATURE BLOCKS FOLLOW: 4 DocuSign Envelope ID: 15B38439-9860-41CF-BA90-85C1D8B88FF7 Attest: Traci Houchin, MMC, FCRM City Clerk O Approved as to form and legal sufficiency. icry 4A, •�'l,:tr J'�• f rl I' o Bert, C(y Att rney lk,o A//%J/C-; /L) X-�7 Attest: 19-<11k FDocuSigned by: F^JG�oI{�t uv,�,f,V�t/b4 --- oonsnoo•�s•�>.cr Elizabeth Underwood Secretary CITY OF SANFORD By: Art Woodruff Mayor Date: Keith and Associates, Inc., a Florida corporation, doing business as "KEITH". ocuSigned by: By: Fob", d1L 1`t,titit,—�jbWA e8+'^'BBB 4d A+8 Adolphine Keith-Lazowick President/Treasurer Dated: 10/18/2021 51Pa`e DocuSign Envelope ID: B8DC1241-7144-4429-A95E-24723DOB D8D3 i axpayer Ioenuncation NUMber (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. ole For individuals, this is generally your social security number (SSNr. However, for a — m — 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. or Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number Number To Give the Requesterfor guidelines on whose number to enter. F__i___l Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that 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�oj required sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. Sign Signature of / (� a„ Here U.S. person► !' /�4 Date► i � ?� e 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/FcrmW9. 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) a 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) e Form 1099-S (proceeds from real estate transactions) o Form 1099-K (merchant card and third party network transactions) o Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) e Form 1099-C (canceled debt) a 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) W11111111119 Request for Taxpayer Give Form Identification Number Certification Form to the (Rev. October 2018) and requester. Do not Department of the Treasury Internal Revenue Service P Go to www.irs.gov/FormW9 for instructions and the latest information. send to the IRS. 1 Name (as shown on your income tax return). Name Is required on this line; do not leave this line blank. Keith and Associates, Inc. 2 Business name/disregarded entity name, If different from above dba KEITH m3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to ro following seven boxes. certain entities, not individuals; see a o ❑ Individual/sole proprietor or 21 C Corporation ❑ S Corporation ElPartnership ❑ Trust/estate instructions on page 3): o single member LLC Exempt payee code (if any) CL ❑ Limited liability company. Enter the tax classification (C --C corporation, S=S corporation, P=Partnership) ► o` Note; Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC Exemption from FATCA reporting u) if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is n another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that code (f any) Is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions b -m E]Oth) oL c+M� to account. men5ined uuL:,fi the U.S,1 y 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional 301 East Atlantic Boulevard 6 City, state, and ZIP code Pompano Beach, FL 33060 7 List account number(s) here (optional) i axpayer Ioenuncation NUMber (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. ole For individuals, this is generally your social security number (SSNr. However, for a — m — 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. or Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number Number To Give the Requesterfor guidelines on whose number to enter. F__i___l Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that 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�oj required sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. Sign Signature of / (� a„ Here U.S. person► !' /�4 Date► i � ?� e 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/FcrmW9. 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) a 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) e Form 1099-S (proceeds from real estate transactions) o Form 1099-K (merchant card and third party network transactions) o Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) e Form 1099-C (canceled debt) a 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)