Invitation to Bid. Tuesday, March 7, 2017 at 6:00 p.m.

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1 Table of Contents Invitation to Bid... 2 Section 1.0 Explanation of Services, Bidding and Service Agreement Scope of Work Contract Period Bidding Process Bidder Qualifications Award of Contract and Notice to Proceed The Contract... 5 ARTICLE 1 The Work... 5 ARTICLE 2 Alterations... 5 ARTICLE 3 Assignment of Contract... 5 ARTICLE 4 Owner s Right to Complete... 6 ARTICLE 5 General Stipulations... 6 ARTICLE 6 Payment... 7 Section 2.0 Contractor Operations Mowing Equipment Mowing Season Mowing Intervals per Site Seasonal Mowing Heights Removal of Trash & Debris Grass Clippings Existing Plant Material and Utility Appurtenances Payment Weed Whipping (String Trimming) Equipment Timing of Operation Existing Plant Material Objects to be Trimmed Payment Edge Pavement Equipment Description of Work Operation Edging Intervals Payment Section 3.0 Bid Section 4.0 NonDiscrimination Clause Section 5.0 Copeland AntiKickback Act Appendix Section A1 Maps Section A2 W Section A3 Sole Proprietor Section A4 Local Preference Policy

2 Invitation to Bid Project: Owner: Public Opening: Formal Action: Basis of Proposal: Description: Proposal Guarantee: City s Representative: Documents on File: Document Deposit: PreBid Conference: City Wide Mowing Contract City of Three Rivers Tuesday, February 21, 2017 at 2:00 p.m., City Commission Chambers, 333 W. Michigan Ave., Three Rivers, Michigan Tuesday, March 7, 2017 at 6:00 p.m. Lowest price provided on Bid Proposal Form Contracted Turf Mowing services for approximately 90 acres of publicly owned land comprised of 16 separate locations within the city limits. No Bid Bond is required towards to provision of proposal. Direct questions to Amy Roth aroth@threeriversmi.org Department of Public Services 1015 South Lincoln Avenue Three Rivers, MI Plans and Contract Documents may be obtained at the Department of Public Services, 1015 South Lincoln Avenue, Three Rivers, Michigan (269) A nonrefundable Twenty dollars ($20) fee will be charged for paper version of documents. No fee if downloaded, but contractor must Amy Roth to be included for addendums. A MANDATORY prebid conference will be held on Tuesday, February 7, 2017 at 2:00 pm. Three Rivers City Hall Commission Chambers Proposal Withdrawal: Withdrawal of any proposal is prohibited for a period of 30 days after the actual date of the opening of the proposals. Owners Right: The right is reserved by the City to award, accept or reject any or all proposals, to waive irregularities in any proposals, to delete any one or more parts or divisions in the interest of the City. Contract Start Date: April 1, 2017 Contract End Date: December 31,

3 Section 1.0 Explanation of Services, Bidding and Service Agreement 1.1 Scope of Work 1.2 Contract Period 1.3 Bidding Process A. The City of Three Rivers desires to retain a landscape contractor(s) to provide turf maintenance to several parcels of publicly owned land. There are twelve (12) areas to be included in the contract for services totaling approximately 90 acres of mowable land. See Section 2.0 of this document and the included maps of contract locations for additional description of services and areas to be included in this contract. B. Contractor is responsible for familiarizing himself/themselves with areas listed in this contract, obstacles to be trimmed around, terrain, slopes and lawn texture. A. The contract period for this service shall be April 1, 2017 to December 31, A. The City of Three Rivers reserves the right to accept or reject any and all bids provided in this process, and to waive any informalities in the proposals. B. No bid may be withdrawn for thirty (30) days after the deadline. C. Bids may be submitted up to 2:00 pm, Tuesday, February 21, Bids are to be delivered to the City Clerk, Three Rivers City Hall, 333 W. Michigan Ave. in an opaque envelope with the words City Wide Mowing Contract clearly printed on the outside. Also include the name, address and contact person of the company providing the bid, on the outside of the envelope. D. Bids by corporations must be executed in the corporate name by the president or vicepresident (or other corporate officer accompanied by evidence of authority to sign). The corporate address and state of corporation must be shown below the signature. 1.4 Bidder Qualifications A. Bidder and bidder s employees shall have a minimum of two (2) years experience in commercial property maintenance. B. Bidders will supply the following enclosed with their bid documents: Complete list of equipment to be used in carrying out the contract services. 3

4 A listing of at least three (3) commercial references, including company name, contact person and phone number, for past and current mowing contracts of similar size and scope. A listing of personnel who will be involved in the performance of this contract, and their related commercial property maintenance experience. A statement as to the company s employee training and safety procedures. C. In addition to price in the award, the City may give consideration to the skill, capacity and experience of the bidder and bidder s employees to perform the contract to the satisfaction of the City. 1.5 Award of Contract and Notice to Proceed A. Award will be made to the Contractor that provides the lowest bid for the entire contract. B. If the contract is to be awarded, it will be awarded to the lowest bidder whose evaluation by the City of Three Rivers indicates that the award will be in the best interest of the City. C. If the contract is to be awarded, the City will provide a Notice of Award within thirty (30) days after the day of the bid opening. The Contractor will then have seven (7) days to respond with an Acceptance of Award. D. Before a Notice of Award is provided to the Contractor, they will have two (2) weeks from the official Acceptance of Award to provide the following: A certificate of General Liability Insurance in the amount of $2,000,000 combined single limit for property damage and personal injury. Contractor shall name the City of Three Rivers as ADDITIONALLY INSURED as pertaining to the performance of mowing services for the term of this agreement. E. The Notice to Proceed will be provided (upon receipt of the above mentioned certificates) to the Contractor and Contract Documents signed by all parties prior to the Contractor beginning work or the City accruing costs associated with the provision of service. 4

5 1.6 The Contract THIS CONTRACT, made the day of, 2017 by and between hereinafter called the Contractor and the City of Three Rivers, Michigan, hereinafter called the Owner. Whereas, the Owner is desirous of having the Contractor perform duties related to the City of Three Rivers, contract # 171 titled City Wide Mowing Contract and the Contractor has agreed to the same for the contract herein named; the Contractor and the Owner agree as follows: ARTICLE 1 The Work It is agreed that the Contractor shall furnish all the equipment and perform all of the work shown on the Drawings and described in the Specifications entitled, City of Three Rivers, City Wide Mowing Contract as prepared by the City, and shall do everything required by the Contract Documents; the Contract Documents being hereby defined to include the Contract, Bonds, Certificates of Insurance, Drawings, Specifications, Bid Proposal Form, Instructions to Bidders, Advertisement, and any supplements thereto agreed to by both parties. ARTICLE 2 Alterations It is agreed that the Contractor shall make alterations to the work under this Contract, as the Owner may especially order in writing. Compensation for such alterations shall be determined by the unit prices stipulated in the proposal hereof where appropriate, or by lump sum or unit prices mutually agreed upon at the time by the Owner and the Contractor. The Owner at his discretion may furnish to the Contractor any materials or supplies or transportation required for extra work. The Contractor shall not be entitled to any allowance for percentage on account of materials or supplies or transportation so furnished. It is agreed that all work that may be ordered by the Owner and performed under the provisions of this article shall be done by the Contractor in an effective and workmanlike manner and shall be subject to the same restrictions and liabilities as those which apply to the general work of this Contract; and the Contractor shall be responsible for the maintenance and protection of such work until the time of the final acceptance of the entire job by the Owner. It is further agreed that no claim against the Owner on account of alterations shall be valid unless such work had been previously ordered in writing and unless such claim has been presented for payment as soon as practicable after the completion of such work and before the making up of the monthly billing invoice. ARTICLE 3 Assignment of Contract It is agreed that the Contractor shall not assign or transfer this Contract or sublet any part of the work embraced in it, except with the written consent of the Owner to do so. 5

6 It is further agreed that all parts of the work which may be performed by a subcontractor shall be done in conformity with and be subject to all the provisions of the Contract Documents exactly as if performed by the Contractor and his immediate employees and workmen. No subletting of the work shall in any way diminish or weaken the responsibility of the Contractor for all parts of the work or lessen his obligations and liabilities under this Contract. It is likewise agreed that the Contractor shall not assign, either legally or equitably, any of the moneys payable to him under this Contract, or his claim thereto, except with the written consent of the Owner to do so. ARTICLE 4 Owner s Right to Complete It is agreed that; if at any time the Contractor should be adjudged a bankrupt; or if he should make a general assignment for the benefit of his creditors; or if a receiver should be appointed on account of this insolvency; or if he should persistently or repeatedly fail to supply enough properly skilled workmen or sufficient suitable materials for the work; or if he should habitually fail to make prompt payment to subcontractors or to pay promptly for materials and labor; or if he should persistently disregard laws or ordinances or the directions of the City s Representative; or if he should willfully and repeatedly violate any of the substantial provisions of this Contract; then in such case the Owner, upon receipt of a certificate from the City s Representative stating that sufficient cause exists to justify such action and stating the nature of said cause, after giving the Contractor and his sureties written notice thereof, may order him to discontinue all work under this Contract, or any part thereof. Thereupon the Contractor shall at once discontinue such work or such part thereof, and shall cease to have any right to the possession of the ground. The Owner shall have the right to finish the work, or such part thereof, by contract or otherwise as he may elect, and to charge the cost and expense of such completion to the Contractor. The Contractor shall not be entitled to receive any further payment until the work is finished. If the balance of the Contract price shall exceed the expense of finishing the work, including compensation for additional managerial and administrative service, the amount of such excess shall be paid to the Contractor; and if such expense shall exceed such unpaid balance, the Contractor shall pay to the Owner the amount of such excess. It is further understood and agreed that the foregoing provisions of this article are without prejudice to any other right or remedy which the Owner may have under this Contract. ARTICLE 5 General Stipulations It is agreed that the Contractor shall comply with the following general stipulations: Permits and Regulations The Contractor shall secure and bear the cost of any permits or licenses of a temporary nature necessary for the prosecution of the work. Public Liability and Property Damage Insurance The Contractor shall take out and maintain during the life of this Contract such Public Liability and Property Damage Insurance as shall protect him and any subcontractor performing work covered by this 6

7 Contract from claims for damages for personal injury including accidental death, as well as from claims for property damages which may arise from operations under this Contract whether such operations be by himself or by any subcontractor of by anyone directly or indirectly employed by either of them. The Contractor shall present the City with a copy of the policy which names the City of Three Rivers as additional insured. The minimum amounts of such insurance shall be as follows: Public Liability Insurance in an amount of not less than $2,000,000 for injuries, including accidental death to any one person, and subject to the same limit for each person, in an amount not less than $2,000,000 on account of an accident; and Property Damage Insurance in an amount of not less than $2,000,000. The Contractor shall require subcontractors, if any, not protected under the Contractor s Insurance policies, to take out and maintain Public Liability Insurance and Property Damage Insurance in the amounts set forth above. The Contractor shall furnish the Owner with satisfactory proof of coverage of the insurance required. Labor Laws and Ordinances The Contractor shall obey and abide by all the laws of the State of Michigan relating to the employment of labor on public work, and all the laws and requirements of the Owner regulating or applying to public improvements. Patents and Patent Rights The Contractor shall protect and save the Owner harmless against all claims or actions brought against the Owner by reason of any actual or alleged infringement upon patent rights in any article, material, process, machine, or appliance used by him in this work. ARTICLE 6 Payment And it is hereby agreed that, in consideration of the faithful and entire performance by the Contractor of his obligations under this contract, the Owner shall pay to him, at the time and in the manner hereinafter stipulated, an amount as determined by the measured quantities and the respective unit prices herein named. Such an amount shall be modified by such sum for alterations as may have been determined under the provisions of Article 2 herein and diminished by such sums as the Owner may lawfully deduct for work accomplished with noncompliant equipment as described in Section 2 of these specifications. At about the close of each month during which satisfactory progress has been made toward the completion of the work the Contractor will make and submit a monthly billing invoice indicating the property mowed and value of the work which has been done under this contract during the month, or since the date of the last preceding estimate. Such statement shall be made by a consideration of accounts for labor and work satisfactory performed. Any error or inaccuracy which may occur in any such progress estimate may be allowed for or corrected in any subsequent estimate. It is agreed that before the Contractor shall demand partial or final estimates or payments he shall furnish to the Owner, if and when requested to do so, supported, if 7

8 requested, by sworn statements, satisfactory evidence that all persons, who have supplied labor, materials, or equipment for the work embraced under this Contract have been fully paid for the same; and that in case such evidence be not furnished as aforesaid, such sums as the Owner shall deem necessary to meet the lawful claims of such persons may be retained by the Owner from any moneys that may be due to or become due to the Contractor under this Contract until such liabilities shall be fully discharged and the evidence thereof be furnished to the Owner. As soon as practicable after such monthly billing invoice is made up and certified and upon its approval by the Owner, the Owner shall pay to the Contractor, on account, a sum equal to one hundred percent (100%) of the amount of such invoice; except that the Owner may deduct and retain out of any such partial payment of sum sufficient to meet any undischarged obligations of the Contractor for labor, materials or equipment furnished for the work. The progress estimates and payments thus provided for will include all alterations which may be done under the provisions of Article 2 of this Contract on the same basis as other work is included. All such work is regarded herein as essentially a part of the Contract and not merely an addition to it. IN WITNESS WEREOF, the parties hereto have set their hands and seals; in quadruplicate, the date and year first above written. WITNESSES WITNESSES CITY OF THREE RIVERS, MICHIGAN By City Manager Attest City Clerk (NAME OF CONTRACTOR) By Approved as to Form and Content City Attorney An appropriation has been made and funds are available. Accounting Officer 8

9 2.1 Mowing Section 2.0 Contractor Operations The Contractor shall furnish, operate and maintain suitable and adequate equipment necessary to perform the mowing operation in an approved safe, workmanlike manner without hindrance, delay or damage to public property. The equipment shall be capable of doing a neat job of mowing without misses or skips Equipment Equipment shall meet all federal, state, and local safety requirements. A minimum of two (2) production mowers shall be available to be used concurrently within the contract area. The production mowers must have a minimum 42 cutting deck width. The equipment must be commercially available, in good repair, and shall be maintained so as to produce a clean, sharp cut to the grass at all times. At any time the City s representative may make inspections to the equipment, if deficiencies are found, mowing operations will cease until equipment has had maintenance procedures completed to bring said equipment into compliance with no cost to the city for operations completed with noncompliant equipment. Equipment which in any way pulls or rips grass, or damages the turf through scalping or rutting shall not be allowed and will be deemed noncompliant. If such damage is identified by the City s representative, it will be brought to the attention of the Contractor in the form of a written warning. A payment deduction will be incurred by the Contractor if damage continues. Failure to correct the problem may result in cancellation of the Contract. The Contractor will provide their own means of transporting equipment between contracted mowing locations. Trailer must meet Department of Motor Vehicle s specifications Mowing Season The mowing season will begin April 1 and end November Mowing Intervals per Site Weekly (as needed): Gleason Ball Fields Memory Isle Park City Hall Riverside Cemetery BiWeekly (or as needed): Bowman Park Lafayette Park North Main Parking Lot & Carnegie Center Scidmore Park Broadway & Fourth Street Scouter Park City Well Fields 5, 6 & 7 Wastewater Treatment Plant DPS Commission on Aging (COA) T.R. Public Library 9

10 2.1.4 Seasonal Mowing Heights May thru June 2.5 July thru August 3.0 September thru October 2.5 Maximum height before mowing (all season) 5.0 These seasonal mowing heights apply to all contracted sites, however, the infield and outfield areas at the Gleason Ball Fields shall be cut throughout the year at Removal of Trash & Debris Contractor is responsible for removal of any litter, trash and/or debris found on site prior to commencing mowing activity. At no time shall any litter, trash or debris be mowed over. If the objects are trash, they shall be placed in the nearest trash receptacle. Compostable items shall be brought to the DPS compost area Grass Clippings Grass clippings shall not be left in windrows. Grass clippings shall not be blown into streets or onto street curbs. Grass clippings shall be dispersed, or collected and dumped at the City DPS facility. Cost of removal and disposal shall be included in the mowing price. The use of mulching blades is an acceptable alternative to the collection of grass clippings so long as clippings are not clumped or windrowed. If grass clippings are blown into roadways or park shelters by mowers, they shall be blown back out of the streets/shelters before leaving the site Existing Plant Material and Utility Appurtenances The Contractor shall protect all existing plant material on site and will be held liable for replacement or any or all landscape harmed during contract maintenance. The Contractor shall also protect existing water boxes and sanitary cleanouts on site and will be held liable for repair or replacement of any or all resulting from damage during contract maintenance Cemetery Care The Contractor shall take great care within the Cemetery to protect the headstones, grave markers, flag holders, and decorations. Grass clippings shall be removed from headstones after each mowing. Additional cleanup shall be completed in preparation of the Memorial Day weekend. Veterans flag holders shall be treated with extreme care, and any that are knocked over shall be returned to the upright position. Also, any flags that are knocked over shall also be returned to the upright position. 10

11 2.1.9 Payment Payment for mowing will be made in response to monthly billing invoices by the Contractor. The Contractor shall include all locations and number of occurrences of mowing for each location in said billing invoice. Number of occurrences for each location shall not exceed the number as specified in Section described above, unless so directed by the City s representative. The number of occurrences multiplied by the contract price for that location will provide the amount to be paid. 2.2 Weed Whipping (String Trimming) The Contractor shall furnish, operate and maintain suitable and adequate equipment necessary to perform the weed whipping operation in an approved safe, workmanlike manner without hindrance, delay or damage to public property Equipment Gas powered string trimmers with an engine size of 25cc or greater are required. A minimum of two (2) string trimmers shall be available to be used concurrently within the contract area Timing of Operation String trimming shall occur immediately following mowing operations for each location as time allows. The maximum time allowed for completion of string trimming after mowing operations for that location are finished, shall be 24 hours Existing Plant Material The Contractor shall protect all existing plant material on site and will be held liable for replacement of any or all landscape harmed during contract maintenance. The girdling of trees is not acceptable, and the Contractor will be held responsible if it is determined that such girdling has killed part or all of a tree. Care shall be given to landscape bed areas, the destruction of perennial plants, annual flowers, shrubs or native grasses is not acceptable, and the Contractor will be held liable for damage Objects to be Trimmed Any and all vertical protrusions from the ground; posts, walls, trees, etc., shall be trimmed to a height equal to the surrounding mowed area. Scalping of an area by trimming will not be accepted. If such scalping is identified by the City s representative, it will be brought to the attention of the Contractor in the form of a written warning. A payment deduction will be incurred by the contractor if scalping continues. Failure to correct the problem may result in cancellation of the Contract Payment Payment for Weed Whipping shall be included in the cost of mowing operations. 11

12 2.3 Edge Pavement The Contractor shall furnish, operate and maintain suitable and adequate equipment necessary to perform the edging of pavement in an approved safe, workmanlike manner without hindrance, delay or damage to public property Equipment Equipment for the completion of this work operation may be powered by gas engine or by a hand implement, by the Contractors own discretion Description of Work Operation The Contractor will remove overgrown sod and dirt to the edge of pavement via means available to the Contractor, collect waste material and bring it to the DPS compost site Edging Intervals Edging of pavement shall occur twice annually. Once in the month of May and once in the month of August. Contractor shall provide a minimum of 24 hours written notice ( is acceptable) prior to pavement edging beginning. If required written notice is not provided, contractor will not be paid for edging activities Payment Payment for edging of pavement will be made in response to a billing invoice by the Contractor. The Contractor shall include the locations and number of occurrences of edging for each location in said billing invoice. Number of occurrences for each location shall not exceed the number as specified in Section described above, unless so directed by the City s representative. The number of occurrences multiplied by the contract price for that location will provide the amount to be paid. 12

13 Item No. Sub Item Location Section 3.0 Bid Mowing or Edging Qty Unit Unit Price Total Price 1 e Bowman Park Edging 2 EA $ 1 m Bowman Park Mowing 16 EA $ 2 e N. Main Pkg Lot & Carnegie Ctr Edging 2 EA $ 2 m N. Main Pkg Lot & Carnegie Ctr Mowing 16 EA $ 3 1 Riverside Cemetery Mowing 24 EA $ 3 2 Riverside Cemetery Mowing 24 EA $ 3 3 Riverside Cemetery Mowing 24 EA $ 3 4 Riverside Cemetery Mowing 24 EA $ 3 5 Riverside Cemetery Mowing 24 EA $ 3 C Riverside Cemetery Mowing 16 EA $ 3 D Riverside Cemetery Mowing 16 EA $ 3 E Riverside Cemetery Mowing 16 EA $ 3 F Riverside Cemetery Mowing 16 EA $ 3 G Riverside Cemetery Mowing 16 EA $ 3 H Riverside Cemetery Mowing 16 EA $ 3 I Riverside Cemetery Mowing 16 EA $ 3 J Riverside Cemetery Mowing 16 EA $ 3 O Riverside Cemetery Mowing 16 EA $ 3 P Riverside Cemetery Mowing 16 EA $ 3 Q Riverside Cemetery Mowing 16 EA $ 3 R Riverside Cemetery Mowing 16 EA $ 3 S Riverside Cemetery Mowing 16 EA $ 3 T Riverside Cemetery Mowing 16 EA $ 3 U Riverside Cemetery Mowing 16 EA $ 3 V Riverside Cemetery Mowing 16 EA $ 3 W Riverside Cemetery Mowing 16 EA $ 3 X Riverside Cemetery Mowing 16 EA $ 3 Z Riverside Cemetery Mowing 16 EA $ 3 SB Riverside Cemetery Mowing 16 EA $ Bid (page 1) subtotal 13

14 Item No. Sub Item Location Mowing or Edging Qty Unit Unit Price Total Price 4 m Scouter Park Mowing 16 EA $ 5 e Geiber Park, Broadway & S Main Edging 2 EA $ 5 m Geiber Park, Broadway & S Main Mowing 16 EA $ 6 m WWTP Mowing 16 EA $ 7 m DPS Mowing 16 EA $ 8 m Pioneer Park/Gleason Ball Fields Mowing 22 EA $ 9 m Scidmore Park Mowing 16 EA $ 10 e T.R. Public Library Edging 2 EA $ 10 m T.R. Public Library Mowing 16 EA $ 11 e Commission on Aging (COA) Edging 2 EA $ 11 m Commission on Aging (COA) Mowing 16 EA $ 12 e Memory Isle Edging 2 EA $ 12 m Memory Isle Mowing 22 EA $ 13 e City Hall Edging 2 EA $ 13 m City Hall Mowing 22 EA $ 14 m City Well Fields #5,6,7 Mowing 16 EA $ 15 m Lafayette Park Mowing 16 EA $ Bid (page 2) subtotal Bid Total 14

15 By checking this box, I acknowledge receipt of all addendums to this bid process. The undersigned agrees that: 1. If awarded this contract he/she will faithfully execute the duties and complete work in accordance with the contract documents contained in this package. 2. That he, or a company representative, attended the prebid conference and agrees to all condition and information discussed at that conference. 3. The Number of Mows shown above is approximate and can be more or less (per mowing season). Also, the Mowing Intervals per Site is estimated and will vary each season based on the weather. 4. That he/she has not directly or indirectly entered into any combination, collusion, undertaking or agreement with any other bidders in regards to the provision of this bid proposal. Nor has he/she induced any bidder or bidders into refraining from providing a bid proposal, and this proposal is without reference or regard to any other proposal, and without agreement, understanding or combination with any other prospective bidder or agent thereof in any way or manner whatsoever. Signed: By: (Company Name) (Signature of Company Representative) (Print Name) Address: Date: 15

16 Section 4.0 NonDiscrimination Clause (FEDERAL EXECUTIVE ORDER 11246) The contractor will comply with all provisions of Executive Order of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor, as follows: a. The contractor will not discriminate against any employee or applicant for employment because of race, religion, color, sex or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, color, sex, or national origin. Such action shall include, but not be limited to, the following: Employment upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. b. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, creed, religion, color, sex, or national origin. c. The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency contracting officer, advising the labor union or workers representative or the contractor s commitments under Section 202 of Executive Order No of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. d. The contractor will comply with all provisions of Executive Order No of September 24, 1965, and the rules, regulations and relevant orders of the Secretary of Labor. e. The contractor will furnish all information and reports required by Executive Order No of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation and to ascertain compliance with such rules, regulations, and orders. f. In the event of the contractor s noncompliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts in such other sanctions 16

17 may be imposed and remedies invoked as provided in Executive Order No of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. g. The contractor will include the provisions of paragraph a through g in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order No of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contract will take such action with respect to any subcontract or purchase order as the contracting agency may direct as a means of enforcing such provisions, including sanctions for noncompliance; Provided, however, that in the event the contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the contracting agency, the contractor may request the United States to enter into such litigation to protect the interest of the United States. Section 5.0 Copeland AntiKickback Act Title 18, U.S.C. June 24, 1948 Section 874, Kickbacks from Public Employees: Whoever, by force, intimidation, or threat or procuring dismissal from employment, or by any other manner whatsoever induces any person employed in the construction, prosecution, completion, or repair of any public building, public work, or building or work financed in whole or in part by loans or grants from the United States, to give up any part of the compensation to which he is entitled under his contract of employment, shall be fined not more than $5,000 or imprisoned not more than five years, or both. 17

18 Appendix 18

19 Section A1 Maps 19

20 : á }ª Œ ú ûü Ž ± ú ÿ Š Œ Œ Ž h ij rm çè & % $ K [Z \ ¹¼ Ÿ Y [Z Y [Z Œ ~ ó ïô õ ï s /0 Large Mowing Locations Three Rivers, MI " # >? A B " # $ % & ' ( ) * +,. / 0 % & *, :, / *, ; < = ü ý þ ÿ þ ƒ ¾ À À Á s Â Ã Ä º ¹ ;< = A B C D Ø Ù Ú Û Ü Ý Þ ß A B C D E F 8 V V W V ~ «Å Æ Ç È É Ê Å É Ë Ì Í Ó Ô Õ Ö Ö 8 14 ú ÿ ýþ ² ± µ ± ²³ Ï Ð Ñ Ò l Ï Ò { } ~ q r ü ÿ Ž 12 q o mp no lm k ~ š { 13 Š ˆ 15 L M N O P Q R S ä å æ Yã â T U ) * ) ( ' ª u z xy vw u /., + L M N M I J K H I G H E F G 5 V á àw ± ² ³ J K µ 7 4 «5 h i j k l j m n o n p h d & e f g $ % & } }~ { ½»¼ ¹º ] ^ _` a b q r s r t q r z w ƒ z u u œ œ ž Ÿ š Ÿ œž œ YZ X VW ' ( ) * * +, ' áz áw " # $ % & 9 : ; < z w y x vw t tu u ðñò ï ˆ c d e f g e \ [ Z[ XY X VW 4 Î : ; < 9 9 = ì í î ï ð ñ ò ] ó ô õ õ ^ ö _ í õ ô ø ù ú û O P Q R S / ` a b c. T U c 8 9 f ö t ø r ù q r é ê ë ì ê í î» ½»»» ¼ ½»»» ¾ ½»» À Á» Â Ã Ä Å Æ Ç Â È É Ê Â Ë Ì Ì Í C D E F G H I J M N P N O Q R S Q S S S < T S = S S M S S U S N O N O = V W X R U P Y Z = S S [ S M S N \ A S ] M S ^ N _ \ U S T S =? \ S = S M N O K C L C C C D C E C F C G C H U M S N O _ M M S S S M ` = \ S N O a \ \ Z S \ \ b S \ = b S S N O c d e > P Î ÏÐ Ñ ÒÓ Ï Ô Õ Ö Ø Ö Ù Ú Õ Ö Û Ü Ý Ù Þ ß à Ó Ö ÏÕ Ð Ô Ó Ú Ú Õ à Ý Ü Û á Õ â ÏÛ Ü Ù ã ä á Ö Õ Õ å Ïæ Õ Ö Ð Ó Ö Õ ß Ù Û ÒÕ ç Ó Ò Ý Ù Þ ß à Ó Ö ÏÕ Ð è Ó ß à Ð á Ó Ò Ò ß Ù Û Ý Õ Û Ó é Õ ß Ó Ð Ð Þ Ñ á ê ä Ù Ù Ý Û Ó Ï ß Ó ß Õ ë Ó Ñ Û è ÒÕ ç Ó Ò Ý Ù Þ ß à Ó Ö Ü ÒÙ Ñ Ó Û ÏÙ ß è Ó ß Ù ã ã ÏÑ ÏÓ Ò Ð Þ Ö æ Õ Ü ã Ö Ù Ô Ó Ñ Õ Ö Û Ïã ÏÕ à Ð Þ Ö æ Õ Ü Ù Ö ß Õ Õ à Ð Û Ù Ý Õ Ñ Ù Ô Ú ÒÕ Û Õ à ê

21 W HOFFMAN ST E HOFFMAN ST N MAIN ST Landscape Bed Landscape Bed Memorial/Statue EAST ST W CUSHMAN ST E CUSHMAN ST Contractor Notes Located in First District 2.42 Acres Residential Area Contractor Operations Weed Whip Mow Pavement Edging ² Feet Bowman Park Contractor Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

22 N MAIN ST N Main Parking PORTAGE AV Carnegie Center JOSHUA DR Contractor Notes Located in First District 0.28 Acres (total 2 sites) Buisness District Contractor Operations Weed Whip Mow Pavement Edging ² Feet N Main Parking & Carnegie Ctr Contractor Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

23 EVANS RD FOURTH AV A B L K N Z M O X C D H J I G SB 2 Q R T P S XA W E F 1 U V 3 UNNAMED_ST_ Contractor Notes Located in Fourth District 27.5 Acres Contractor Operations Weed Whip Mow ² Cemetery Contractor Work Three Rivers, MI Legend Three Rivers # Feet This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Mowing Areas

24 E MICHIGAN AV UNNAMED_ST_206 MIDDLE ST SECOND AV FIRST AV S MAIN ST RIVER DR Contractor Notes Located in Fourth District 2.2 Acres Residential Area Contractor Operations Weed Whip Mow ² Feet Scouter Park Contract Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

25 FOURTH ST E BROADWAY ST FIFTH ST S MAIN ST PEARL ST ALLEY Contractor Notes Located in Second District 0.68 Acres (Total 2 sites) Residential Area ² Feet Broadway & 4th Broadway & S Main Contract Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Contractor Operations Weed Whip Mow Legend Mowing Areas Three Rivers #

26 RAILROAD CT S LINCOLN AV HOME ST S CONSTANTINE ST WOLF RD CONSTANTINE RD Contractor Notes Located in Third District Acres Residential Area Contractor Operations Weed Whip Mow ² Feet WWTP Contract Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

27 S LINCOLN AV WOLF RD Contractor Notes Located in Third District 1.70 Acres Residential Area Contractor Operations Weed Whip Mow ² Feet DPS Contract Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

28 HILL ST S ERIE AV SWARTZ ST W BROADWAY ST Contractor Notes Located in Third District 7.03 Acres Business District Contractor Operations Weed Whip Mow ² Feet Pioneer Park & Gleason Ball Fields Contract Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

29 N CONSTANTINE ST S CONSTANTINE ST W MICHIGAN AV SOUTH ST SPRING ST MILLARD ST Contractor Notes Located in Third District Acres (Total 3 Sites) Residential Area Contractor Operations Weed Whip Mow ² Feet Scidmore & Rohrer Parks Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

30 N ERIE AV N DOUGLAS AV W MICHIGAN AV S ERIE AV S DOUGLAS AV Contractor Notes Located in Third District 1.20 Acres Business District Contractor Operations Weed Whip Mow Concrete Edging ² Feet Library Contracted Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

31 S DOUGLAS AV SOUTH ST Contractor Notes Located in Third District 1.20 Acres Business District Contractor Operations Weed Whip Mow Concrete Edging ² Feet Commision on Aging (COA) Contracted Work Three Rivers, MI This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Legend Mowing Areas Three Rivers #

32 N ANDREWS ST N CONSTANTINE ST WEST ST PEALER ST MOORE ST RAILROAD DR PORTAGE AV N MAIN ST PRIVATE DR W MICHIGAN AV SPRING ST Contractor Notes Located in Third District 10 Acres Residential Area/Business Contractor Operations Weed Whip Mow Pavement Edging Memory Isle Park Three Rivers ² Three Rivers, MI Legend # Feet This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Mowing Areas

33 N CONSTANTINE ST W MICHIGAN AV S CONSTANTINE ST SPRING ST Contractor Notes Located in Third District 0.10 Acres Residential Area/Business Contractor Operations Weed Whip Mow Pavement Edging City Hall Three Rivers ² Three Rivers, MI Legend # Feet This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Mowing Areas

34 ARNOLD ST N DOUGLAS AV Contractor Notes Located in Third District 2.3 Acres Residential Area/Business Contractor Operations Weed Whip Mow ² Wells Contractor Work Three Rivers, MI Legend Three Rivers # Feet This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Mowing Areas

35 W ARMITAGE ST E ARMITAGE ST N MAIN ST W BENNETT ST E BENNETT ST Contractor Notes Located in First District 1.9 Acres Residential Area Contractor Operations Weed Whip Mow ² LaFayette Park Contractor Work Three Rivers, MI Legend Three Rivers # Feet This map is provided by the City of Three Rivers (the "City"). The person or entity receiving this map (the "User") agrees: (1) that there are no warranties of any kind; (2) that use of this map is at the Users sole risk; (3) that hte City shall not be liable for any damages to User or any thrid party; and (4) this map may not be used by any third party without the specific written consent of the City. Mowing Areas

36 Mow Contract Work Sheet E. Broadway ( ) * +,. * +. / 0 1 * ) 3 7 * ( ) / * 1 3 / + : 6 ) 3 ; 7 * 6 5 ; < = ( ) 3. 3 / + 0 > 0 / 3 > 6 * 6 5 / 3? 3 * 1 * 6 ) * +,. : 6 ) 3 ; A + 3 / ; / B : C < 6 ) 6 6 ) 3 / 3 / 3 > 0 D / / > 6 * > 5 E * > 2 F : G < 6 ) 6 H ) * +,. * ) 3 A + 3 / I 3 / * + E F : J < 6 ) 6 6 ) 3 7 * ) I I > I * 4 I / > A + 3 / 0 / > 5 6 ) * / 2. / 6 5 F > 2 : K < 6 ) * +,., 5 > H > 5 6 ) * / 2. / 6 5 D * 6 ) 0 H 6 6 ) ? * 8 *? D / * >? 0 > + 3 > ) 3 7 * 6 5 = ± ² ³ " # " $ % & " $ ' ª œ «š w x y z { } ~ x ƒ L M N O P Q R P S T U X % # $ % $ V $ " W $ ˆ Š Œ Š ˆ Ž ˆ Š ˆ Š Œ Š ˆ Œ Š ˆ š œ ž š Ÿ œ œ š œ š ª š š œ Y Z [ \ ] ^ Z _ ` a b c a d e ` a f g h d i j k ^ a Z ` [ _ ^ e e ` k h g f l ` m Z f g d n o l a ` ` p Z q ` a [ ^ a ` j d f ] ` r ^ ] h d i j k ^ a Z ` [ s ^ j k [ l ^ ] ] j d f h ` f ^ t ` j ^ [ [ i \ l u o d d h f ^ Z j ^ j ` v ^ \ f s ] ` r ^ ] h d i j k ^ a g ] d \ ^ f Z d j s ^ j d n n Z \ Z ^ ] [ i a q ` g n a d _ ^ \ ` a f Z n Z ` k [ i a q ` g d a j ` ` k [ f d h ` \ d _ e ] ` f ` k u

37 Section A2 W9 A19

38 Form W9 (Rev. December 2011) Department of the Treasury Internal Revenue Service Name (as shown on your income tax return) Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. Business name/disregarded entity name, if different from above Check appropriate box for federal tax classification: Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate Exempt payee Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) Other (see instructions) Address (number, street, and apt. or suite no.) Requester s name and address (optional) City, state, and ZIP code 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 the Name line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Social security number 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). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Sign Here Signature of U.S. person General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners share of effectively connected income. Date Note. If a requester gives you a form other than Form W9 to request your TIN, you must use the requester s form if it is substantially similar to this Form W9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: An individual who is a U.S. citizen or U.S. resident alien, A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, An estate (other than a foreign estate), or A domestic trust (as defined in Regulations section ). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners share of income from such business. Further, in certain cases where a Form W9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. Cat. No X Form W9 (Rev )

39 Form W9 (Rev ) Page 2 The person who gives Form W9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: The U.S. owner of a disregarded entity and not the entity, The U.S. grantor or other owner of a grantor trust and not the trust, and The U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person, do not use Form W9. Instead, use the appropriate Form W8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a saving clause. Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W8. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS a percentage of such payments. This is called backup withholding. Payments that may be subject to backup withholding include interest, taxexempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part II instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See the instructions below and the separate Instructions for the Requester of Form W9. Also see Special rules for partnerships on page 1. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W9 if the name or TIN changes for the account, for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Name If you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name. If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered in Part I of the form. Sole proprietor. Enter your individual name as shown on your income tax return on the Name line. You may enter your business, trade, or doing business as (DBA) name on the Business name/disregarded entity name line. Partnership, C Corporation, or S Corporation. Enter the entity's name on the Name line and any business, trade, or doing business as (DBA) name on the Business name/disregarded entity name line. Disregarded entity. Enter the owner's name on the Name line. The name of the entity entered on the Name line should never be a disregarded entity. The name on the Name line must be the name shown on the income tax return on which the income will be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a domestic owner, the domestic owner's name is required to be provided on the Name line. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on the Business name/disregarded entity name line. If the owner of the disregarded entity is a foreign person, you must complete an appropriate Form W8. Note. Check the appropriate box for the federal tax classification of the person whose name is entered on the Name line (Individual/sole proprietor, Partnership, C Corporation, S Corporation, Trust/estate). Limited Liability Company (LLC). If the person identified on the Name line is an LLC, check the Limited liability company box only and enter the appropriate code for the tax classification in the space provided. If you are an LLC that is treated as a partnership for federal tax purposes, enter P for partnership. If you are an LLC that has filed a Form 8832 or a Form 2553 to be taxed as a corporation, enter C for C corporation or S for S corporation. If you are an LLC that is disregarded as an entity separate from its owner under Regulation section (except for employment and excise tax), do not check the LLC box unless the owner of the LLC (required to be identified on the Name line) is another LLC that is not disregarded for federal tax purposes. If the LLC is disregarded as an entity separate from its owner, enter the appropriate tax classification of the owner identified on the Name line.

40 Form W9 (Rev ) Page 3 Other entities. Enter your business name as shown on required federal tax documents on the Name line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the Business name/ disregarded entity name line. Exempt Payee If you are exempt from backup withholding, enter your name as described above and check the appropriate box for your status, then check the Exempt payee box in the line following the Business name/ disregarded entity name, sign and date the form. Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding. The following payees are exempt from backup withholding: 1. An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2), 2. The United States or any of its agencies or instrumentalities, 3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities, 4. A foreign government or any of its political subdivisions, agencies, or instrumentalities, or 5. An international organization or any of its agencies or instrumentalities. Other payees that may be exempt from backup withholding include: 6. A corporation, 7. A foreign central bank of issue, 8. A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States, 9. A futures commission merchant registered with the Commodity Futures Trading Commission, 10. A real estate investment trust, 11. An entity registered at all times during the tax year under the Investment Company Act of 1940, 12. A common trust fund operated by a bank under section 584(a), 13. A financial institution, 14. A middleman known in the investment community as a nominee or custodian, or 15. A trust exempt from tax under section 664 or described in section The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 15. IF the payment is for... Interest and dividend payments THEN the payment is exempt for... All exempt payees except for 9 Broker transactions Exempt payees 1 through 5 and 7 through 13. Also, C corporations. Barter exchange transactions and patronage dividends Payments over $600 required to be reported and direct sales over $5,000 1 Exempt payees 1 through 5 Generally, exempt payees 1 through 7 2 Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a singlemember LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on page 2), enter the owner s SSN (or EIN, if the owner has one). Do not enter the disregarded entity s EIN. If the LLC is classified as a corporation or partnership, enter the entity s EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at You may also get this form by calling Use Form W7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W7 and SS4 from the IRS by visiting IRS.gov or by calling 1800TAXFORM ( ). If you are asked to complete Form W9 but do not have a TIN, write Applied For in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering Applied For means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W8. Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W9. You may be requested to sign by the withholding agent even if item 1, below, and items 4 and 5 on page 4 indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on the Name line must sign. Exempt payees, see Exempt Payee on page 3. Signature requirements. Complete the certification as indicated in items 1 through 3, below, and items 4 and 5 on page Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 1 See Form 1099MISC, Miscellaneous Income, and its instructions. 2 However, the following payments made to a corporation and reportable on Form 1099MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney, and payments for services paid by a federal executive agency.

41 Form W9 (Rev ) Page 4 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. Other payments include payments made in the course of the requester s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual The individual 2. Two or more individuals (joint The actual owner of the account or, account) if combined funds, the first individual on the account 1 3. Custodian account of a minor The minor 2 (Uniform Gift to Minors Act) 4. a. The usual revocable savings The grantortrustee 1 trust (grantor is also trustee) b. Socalled trust account that is The actual owner 1 not a legal or valid trust under state law 5. Sole proprietorship or disregarded The owner 3 entity owned by an individual 6. Grantor trust filing under Optional The grantor* Form 1099 Filing Method 1 (see Regulation section (b)(2)(i)(A)) For this type of account: Give name and EIN of: 7. Disregarded entity not owned by an The owner individual 8. A valid trust, estate, or pension trust Legal entity 4 9. Corporation or LLC electing The corporation corporate status on Form 8832 or Form Association, club, religious, The organization charitable, educational, or other taxexempt organization 11. Partnership or multimember LLC The partnership 12. A broker or registered nominee The broker or nominee 13. Account with the Department of The public entity Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 14. Grantor trust filing under the Form The trust 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulation section (b)(2)(i)(B)) Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: Protect your SSN, Ensure your employer is protecting your SSN, and Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at or submit Form For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance. Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS tollfree case intake line at or TTY/TDD Protect yourself from suspicious s or phishing schemes. Phishing is the creation and use of and websites designed to mimic legitimate business s and websites. The most common act is sending an to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. The IRS does not initiate contacts with taxpayers via s. Also, the IRS does not request personal detailed information through or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration at You can forward suspicious s to the Federal Trade Commission at: spam@uce.gov or contact them at or 1877IDTHEFT ( ). Visit IRS.gov to learn more about identity theft and how to reduce your risk. 1 List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person s number must be furnished. 2 Circle the minor s name and furnish the minor s SSN. 3 You must show your individual name and you may also enter your business or DBA name on the Business name/disregarded entity name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. 4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 1. *Note. Grantor also must provide a Form W9 to trustee of trust. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.

42 Section A3 Sole Proprietor (Use this if you are not required to carry Workers Compensation Insurance) A24

43 SOLE PROPRIETOR FORM For Sole Proprietor s with Employees For workers compensation purposes we are required to maintain verification regarding workers compensation coverage for all of our independent contractors. You must provide the following information if you: a) Are a sole proprietor with employees. Attach to this form evidence of workers compensation insurance on your employees. 1) Name of Sole Proprietor: 2) Federal Tax Identification Number or last 4 digits of Social Security No. 3) I am doing business as: Please attach one of the following: A copy of the assumed name certificate you filed with the county; or Your business card; or A copy of your advertisement (Yellow Pages, Newspaper, etc.); or List one other business or private homeowner that you have worked for during the period of July 1, through current date, including the name and address: Please complete the following statement: I,, a Sole Proprietor with employees will provide services to the City of Three Rivers on a periodic basis. I do understand that I am not entitled to workers compensation benefits under Michigan s Law, therefore, I am personally responsible for any injuries/illnesses I may sustain while performing my services to said entity. Dated at:, on this day of,. Signed: Sole Proprietor STATE OF MICHIGAN, COUNTY OF On this day of, before me personally appeared, who being duly sworn did state that s/he is not entitled to workers compensation benefits as indicated under Michigan s Law, and will not hold responsible the above named entity s/he may provide services to for any injury(ies) illness(es) s/he may sustain while performing such indicated services. Notary Public, County My commission expires

44 WORKERS COMPENSATION INSURANCE SOLE PROPRIETOR FORM For Sole Proprietor s with NO Employees For workers compensation purposes we are required to maintain verification regarding workers compensation coverage for all of our independent contractors. You must provide the following information if you: a) Are a sole proprietor with no employees, and b) Do not carry workers compensation insurance. 1) Name of Sole Proprietor: 2) Federal Tax Identification Number or last 4 digits of Social Security No. 3) I am doing business as: Please attach one of the following: A copy of the assumed name certificate you filed with the county; or Your business card; or A copy of your advertisement (Yellow Pages, Newspaper, etc.); or List one other business or private homeowner that you have worked for during the period of July 1, through current date, including the name and ddress: Please complete the following statement: I,, a Sole Proprietor with no employees will provide services to the City of Three Rivers on a periodic basis. I do understand that I am not entitled to workers compensation benefits under Michigan s Law; therefore, I am personally responsible for any injuries/illnesses I may sustain while performing my services to said entity. Dated at:, on this day of,. Signed: Sole Proprietor STATE OF MICHIGAN, COUNTY OF On this day of, before me personally appeared, who being duly sworn did state that s/he is not entitled to workers compensation benefits as indicated under Michigan s Law, and will not hold responsible the above named entity s/he may provide services to for any injury(ies) illness(es) s/he may sustain while performing such indicated services. Notary Public, County My commission expires