Cuban Classical Ballet of Miami~oo~/ --~7~iy
m MIAMI BEACH ~ ~~~ ~- 9 ~~ n
~~~
City of Miami Beach Cultural Affairs Program and Cultural Arts Council
Fiscal Year 2009/10 Cultural Affairs Grant Agreement
This Grant Agreement is entered into this 24th day of Se tember, 2009, between the City of Miami Beach,
Florida (the City), and (Grantee).
Article I /Grant Description
1. Grantee: Cuban Classical Ballet of Miami
Grant Contact: Pedro Pablo Pena
Address: 900 SW 1st Street Ste. 306
City, State, Zip: Miami FL 33130
Phone, fax, a-mail : 305.549.7711, 305.549.7771, hballetorg~bellsouth.net
2. Grant amount: $10,432.80 50°6 paid upon execution of this Agreement. Remaining 50%
paid upon completion of Project and submission and approval of Final Report.
3. Project description: See Exhibit 1, attached hereto
4. Itemized budget: See Exhibits 2-A Project Budget and 2-B Grant Budget, attached hereto
5. Contract execution deadline: November 15, 2009
6. Expenditure deadline: September 30, 2010
7. Project completion date: ~~~~Y~`3c9 , Zb) O
8. Final Report deadline: Must be postmarked or delivered no later than 45 days after Project
completion date.
IN WITNESS WHEREO ,the parti s hereto have executed this Agreement this ~ day of ~L~ TeBL~, 2009.
' errera Bower, Mayor Signature ~ _
Attest:
Robert P rcher, City Clerk
carantee's co orate 5ea1 Here
p,
GRANTEE:
Federal ID #:
BY:
Printed Name of Organization's Authorized Representative
(City Attorney Approval Here)
APPROVED AS TO
FORM, LANGUAGE
ts< F F~CECUTION
Date
STATE OF FLORIDA, COUNTY OF MIAMI- DADE
The foregoing instrument was acknowledged before me
this~day of ~ f~nji ~r 2009, by
of
c:U L ~ not-for-profit
corporation.~I /She is personally known to me or has
produced as
identification. ~
Signature af'Notary Public
Notary Name: ~ ~ f
Notary Public, State of Florida
My Commission Expires: ~~ ~er ~ ~ ~ j~
r
;; KAIl~~l11 EVA C~ll't'V
:": MY COMMISSION ## DD740989
~~~,, • EXPIRES December 10, 2011
(407) 39P,•0153 FlarydaNOtaryServico.com
Article II /General Conditions
1. Parties: The parties to this Agreement are the Grantee listed in Article I, and the City of Miami Beach, a
municipal corporation organized under the laws of the State of Florida (City). The City has delegated the
responsibility of administering this Grant to the City Manager or his authorized designee, who shall be the Cites
Cultural Affairs Program Manager.
2. Project Description: The Grantee may only use the Grant for the purposes that are specifically described
in the Project Description, attached hereto as Exhibit No. 1. All expenditures will be subject to the terms of this
Agreement, and as specified in the itemized Grant Award Budget, attached hereto as Exhibit 2-B. A mandatory
dollar for dollar ($1 to $1) match is applicable to all Grant programs. Grant applicants must demonstrate
this match through cash, other matching grants and/or In-Kind contributions not in excess of 25% of the
total cash project budget. Line item changes to said Budget shall not exceed ten percent (10%) per category,
and shall, in no event, exceed the total amount of Grant funds. Notwithstanding the preceding sentence,
amendments to the itemized Grant Award Budget in Exhibit 2-B shall not be permitted without the prior written
consent of the Cultural Affairs Program Manager. Said requests shall be made in advance of the project's
commencement, in writing, detailing and justifying the need for such changes.
3. Reports: This Grant has been awarded with the understanding that the described Project will enhance
and develop the City's cultural community. To demonstrate that the Grant is fuifiNing, or has fulfilled, its purpose,
the Grantee must supply the Cultural Affairs Program Manager with a written Final Report documenting that the
Grantee has fulfilled all requirements. This report must be received by the Cultural Affairs Program Manager
within 45 days of the Project's completion date. Grantees completing their Project by the end of the Fiscal Year,
or September 30, 2010, must submit their final reports no later than November 15, 2010. New Grant awards
will not be released until all Final Reports for previous years' funding are received.
4. Amount of Grant and Payment Schedule: The total amount of the Grant is specified in Article I-2 (subject
to the restrictions therein). In awarding this Grant, the City assumes no obligation to provide financial support of
any type whatsoever in excess of the total Grant amount. Cost overruns are the sole responsibility of the
Grantee. The Grant funds will only be supplied to the Grantee following the Mayor and City Commission's
approval of the award, and execution of this Agreement by the parties hereto.
5. Program Monitoring and Evaluation: The Cultural Affairs Program Manager may monitor and conduct an
evaluation of the Project under this Grant, which may include, with or without limitation, visits by City
representatives to observe the Project, or Grantee's programs, procedures, and operations, or to discuss the
Grantee's programs with Grantee's personnel. The Grantee agrees to utilize the standardized Audience Survey
adopted by the Cultural Arts Council to obtain specific feedback from program participants.
6. Bank Accounts and Bonding: Monies received pursuant to this Agreement shall be kept in accounts in
established Miami-Dade County banks or savings and loan associations whose identities shall be disclosed in
writing to the Cultural Affairs Program Manager with the identity and title of individuals authorized to withdraw or
write checks on Grant funds.
7. Accountin and Financial Review: Funded activities must take place within the City's fiscal year for
which they are approved (October 1 -September 30).The Grantee shall keep accurate and complete books
and records of all receipts and expenditures of Grant funds, in conformance with reasonable accounting
standards. These books and records, as well as all documents pertaining to payments received and made in
conjunction with this Grant, including, without limitation, vouchers, bills, invoices, receipts and canceled checks,
shall be dated within the fiscal year for which they are approved and retained in Miami-Dade County in a secure
place and in an orderly fashion by the Grantee for at least two (2) years after the Expenditure Deadline specified
in Article I-5. These books, records, and documents may be examined by the City, and/or its authorized
representatives, at the Grantee's offices during regular business hours and upon reasonable notice.
Furthermore, the City may, at its expense, audit or have audited, all the financial records of the Grantee,
whether or not purported to be related to this Grant.
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8. Publics and Credits: The Grantee must include the City of Miami Beach logo and the following credit
line in all publications related to this Grant: City of Miami Beach, Cultural Affairs Program, Cultural Arts Council.
Failure to do so may preclude future grant funding from the City in the same manner as if Grantee defaulted
under this Agreement, pursuant to Article II-12.
9. Liability and Indemnification: The Grantee shall indemnify and hold harmless the City and its officers,
employees, agents and contractors, from any and all liability, losses or damages, including attorneys' fees and
costs of defense, which the City or its officers, employees, agents and contractors may incur as a result of
claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating to, or
resulting from the performance if this Agreement by the Grantee or its officers, employees, agents, servants,
partners, principals or contractors. Grantee shall pay all claims and losses in connection therewith and shall
investigate and defend all claims, suits or actions of any kind or nature in the name of the City, where applicable,
including appellate proceedings, and shall pay all costs, judgments, and attorneys' fees which may issue
thereon. Grantee expressly understands and agrees that any insurance protection required by this Agreement,
or otherwise provided, shall in no way limit its obligation, as set forth herein, to indemnify, hold harmless and
defined the City or its officers, employees, agents and contractors as herein provided.
If the Grantee is a government entity, this indemnification shall only be to the extent and within the
limitations of Section 768.28 Florida Statute, subject to the provisions of that Statute whereby the Grantee entity
shall not be held liable to pay a personal injury or property damage claim or judgment by any one person which
exceeds the sum of $100,000, or any claim or judgment or portions thereof, which, when totaled with all other
claims or judgments paid by the government entity arising out of the same incident or occurrence, exceed the
sum of $200,000 from any and all personal injury or property damage claims, liabilities, losses or causes of
action which may arise as a result of the negligence of the Grantee entity.
10. Assgnment: The Grantee shall not be permitted to assign this Grant, and any purported assignment
will be void, and shall be treated as an event of default pursuant to Article II-12.
11. Compliance with Laws: The Grantee agrees to abide by and be governed by all applicable Federal,
State, County and City laws, including but not limited to Miami-Dade County's Conflict of Interest and Code of
Ethics Ordinance, as amended, which is incorporated herein by reference as if fully set forth herein, and Chapter
2, Article VI I of the Miami Beach City Code, as amended, which is incorporated herein by reference as if fully set
forth herein.
12. DefaultlTermination Provisions: In the event the Grantee shall fail to comply with any of the provisions
of this Agreement, the Cultural Affairs Program Manager may terminate this Agreement and withhold or cancel
all or any unpaid installments of the Grant upon giving five (5) calendar days written notice to the Grantee, and
the City shall have no further obligation to the Grantee under this Agreement. Further, in the event of
termination, the Grantee shall be required to immediately repay to the City all portions of the Grant which have
been received by the Grantee, as of the date that the written demand is received.
In the event that this Grant is terminated, the following provisions will also apply:
a. For first-time violations -Grantee shall be required to submit a final report with documentation of
expenditure of all Grant funds already received (first half) up to the termination date.
Additionally, Grantee will be ineligible to apply and/or receive a grant in the subsequent City fiscal year.
However, Grantee will be allowed to apply for grants in future fiscal years.
b. For more than first-time violations -Any compliance infractions beyond first-time violations will be
considered by the Cultural Affairs Program Manager, on a case-by-case basis. As part of his consideration, the
Cultural Affairs Program Manager shall obtain the recommendation of the Cultural Arts Council, but the final
decision as to whether Grantee may be allowed to apply for future grants shall remain within the sole discretion
of the City.
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Any uncommitted Grant funds which remain in the possession or under the control of the Grantee as of
the date of the Expenditure Deadline specified in Article 1-5 must be returned to the City within fifteen (15) days
after the Expenditure Deadline. If such funds have been committed but not expended, the Grantee must request
in writing from the Cultural Affairs Program Manager an extension of the Expenditure Deadline which, if
approved, shat( be for a period not to exceed one (1) year.
Grant funds which are to be repaid to the City pursuant to this Section are to be repaid upon demand by
delivering to the Cultural Affairs Program Manager a certified check for the total amount due, payable to the City
of Miami Beach, Florida.
These provisions shall not waive or preclude the City from pursuing any other remedies that may be
available to it under the law.
13. Indulgence Will Not be Waiver of Breach: The indulgence of either party with regard to any breach or
failure to perform any provision of this Agreement shall not be deemed to constitute a waiver of the provision or
any portion of this Agreement either at the time the breach or failure occurs, or at any time throughout the term
of this Agreement.
14. Written Notices: Any written notices required under this Agreement will be effective when delivered in
person or upon the receipt of a certified letter addressed to the Grantee at the address specified in Article I-1 of
this Agreement, and to the City when addressed as follows: Gary Farmer, Cultural Affairs Program Manager,
City of Miami Beach Dept. of Tourism and Cultural Development,1700Copvention Center Drive, Miami Beach,
Florida 33139-1819.
15. Captions Used in this Agreement: Captions, as used in this Agreement, are for convenience of
reference only and should not be deemed or construed as in any way limiting or extending the language or
provisions to which such captions may refer.
16. Contract Represents Total Agreement: This contract, including its special conditions and exhibits,
represents the whole and total agreement of the parties. No representations, except those contained within this
agreement and its attachments, are to be considered in construing its terms. No modifications or amendments
may be made to this Agreement unless made in writing signed by both parties, and approved by appropriate
action by the Mayor and City Commission.
Article III /Miscellaneous Provisions
17. The Grant awarded herein is the result of an extensive public review process, which found that the
Grantee is performing a public purpose through the programs, projects, and/or services recommended for
support. As such, use of Grant funds for any program component not meeting this condition will be considered a
breach of the terms of this Agreement and will allow the City to seek remedies including, but not limited to, those
outlined in this Grant Agreement.
18. The Grantee also accepts and agrees to comply with the following Special Conditions:
The Grantee hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C.
2000d et seq.) prohibiting discrimination on the basis of race, color, national origin, handicap, or sex.
The Grantee hereby agrees that it will comply with City of Miami Beach Ordinance No. 92-2824, as
amended from time to time, prohibiting discrimination in employment, housing and public accommodations on
account of race, color, national origin, religion, sex, sexual orientation, handicap, marital status, or age.
The City endorses the clear mandate of the Americans with Disabilities Act of 1990 (ADA) to remove
barriers, which prevents qualified individuals with disabilities from enjoying the same employment opportunities
that are available to persons without disabilities.
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The City also endorses the mandate of the Rehabilitation Act of 1973 and Section 504 and prohibits
discrimination on the basis of disability and requires that Grant recipients provide equal access and equal
opportunity and services without discrimination on the basis of any disability.
19. GOVERNING LAW AND EXCLUSIVE VENUE
This Agreement shall be governed by, and construed in accordance with, the laws of the State of
Florida, both substantive and remedial, without regard to principles of conflict of laws. The exclusive venue for
any litigation arising out of this Agreement shall be Miami-Dade County, Florida, if in State court, and the U.S.
District Court, Southern District of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT,
Grantor AND Grantee EXPRESSLY WAIVE ANY RIGHTS
EITHER PARTY MAY HAVE TO A TRIAL BY JURY OF ANY CIVIL LITIGATION RELATED TO, OR ARISING
OUT OF, THIS AGREEMENT.
-The remainder of this page is left intentionally blank-
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Exhibit 1 /Revised Project Description
Organization: Cuban Classical Ballet of Miami
Completely describe Project approved by the Grants Panel and in a separate narrative detail all revisions to
the Project based upon the City Commission approved award. Please be as specific as possible; name of
event, specific dates, venues, times, artists, etc. Use extra page if necessary.
Project description as approved by Grants Panel:
The Cuban Classical Ballet of Miami will present for the first time the Coppeliafutl-length ballet in the City
of Miami Beach. CCBM will perform Coppelia for its 2010 Season on Saturday February 20th at 8:00 PM,
and on Sunday February 21st at 5:00 PM at the Fillmore Miami Beach at the Jackie Gleason Theater.
The ballet choreography is by Magaly Suarez after Marius Petipa. This is a charming, funny ballet full of
humor and ballet mime. The ballet is based upon a story by E.T.A. Hoffmann entitled "Der Sandmann"
("The Sandman"), which was published in 1815. The ballet premiered in 1870. It has become one of the
classical repertoire's most famous ballets. It tells the tale of a mad inventor and the life-like doll he
creates. The full-length ballet Coppelia will star Cuban Principal Dancers with an exquisite corps de ballet,
breathtaking scenery and costumes from the Grand Kirov Ballet of Russia. The ballet music by Leo
Delibes will be recorded.
Coppelia will be performed by guests Cuban Prima Ballerina Lorena Feijoo and Principal Dancer Tarps
Domitro from the San Francisco Ballet; and by the Cuban Principal Dancers Miguel Angel Blanco and
Hayna Gutierrez from Cuban Classical Ballet of Miami. Pedro Pablo Pena and Magaly Suarez, both the
artistic directors for this production, want to please the audience and enrich the repertoire with a fine
example of `a complete bodily form of expression'.
Project description as revised (if applicable) based upon the C~ Commission approved award
Changes to projects awarded under the Artistic Disciplines program must still adhere to the requirement that the work
is new or has never before been presented in Miami Beach.
The Cuban Classical Ballet of Miami will put together for the first time two performances of the Sleeping
Beauty full-length ballet at the Fillmore Miami Beach at the Jackie Gleason Theater on Saturday February
20~' at 8:00 PM, and on Sunday February 21 S' at 5:00 PM. The ballet is based on a French fairy tale by
Charles Perrault, and it was the first successful ballet composed by Tchaikovsky. The Sleeping Beauty
has become one of the classical repertoire's most famous ballets of a magical fairy tale. The production
will be staged by Magaly Suarez, after original version by Marius Petipa, and set to Tchaikovsky's
ravishing score. It consists of a Prologue and three Acts. The Sleeping Beauty full-length ballet will star
Cuban and Latin Principal Dancers with an exquisite corps de ballet, breathtaking scenery and costumes
from the Grand Kirov Ballet of Russia. The performance will be complimented by the Miami Symphony
Orchestra under the direction of Conductor Eduardo Marturet.
The Sleeping Beauty Ballet will be performed by guests Cuban Prima Ballerina Lorena Feijoo and
Principal Dancer Taras Domitro from the San Francisco Ballet; by Roberta Marquez from The Royal Ballet
of England; and by the Cuban Principal Dancers Miguel Angel Blanco and Hayna Gutierrez from Cuban
Classical Ballet of Miami. Lorena Feijoo, who was born and trained in Cuba, has been selected to
participate in this production because she has danced every major classical role in ballet's repertoire to
critical acclaim. Roberta Marquez has recently danced Aurora in the Monica Mason and Christopher
Newton production of The Sleeping Beauty for the Royal Ballet. Tarps Domitro, Miguel Angel and Hayna
are recent exiled Cuban principal dancers that have been dazzling the American audience with
spectacular dancing.
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Exhibit 2-A: Project Budget /Revised Total Project Budget
Name of organization: Cuban Classical Ballet of Miami
Date(s) of Project: Saturday February 20th and Sunday February 21St. 2010.
Attach a copy of the total Project budget or list cash expenses and cash revenues
specifically identified with your program, project or events. Round off all numbers to the
nearest dollar.
PLEASE SEE ATTACHMENT.
EXPENSES REVENUES
CASH IN-KIND CASH IN-KIND
Personnel -artistic - _ Admissions
Personnel -technical - _ Contracted services
Personnel -administration _ _ Tuitions
Outside artistic fees/services _ Corporate support
Outside other fees/services _ _ Foundation support
Marketing/Publicity - _ Individual support
Space rental _ _ Government grants
Utilities _ _ Federal
Equipment rental _ _ State
Office supplies -
Other Costs: (Itemize below) Other Contributions (Itemize below)
Total cash expenses _
Total in-kind expenses `
Total project expenses
CASH ~ IN-KIND
City of Miami Beach Grant Award 10,432.80
Total cash revenues
Total in-kind revenues
Total project revenues
CASH ~ IN-KIND
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Cuban Classical Ballet of Miami
THE SLEEPING BEAUTY BALLET Budget
Year 2010
EXPENSES
CASH
IN-KIND
Personnel -Artistic
Personnel -Technical
Personnel -Administrative
Outside Artistic Fees/Services
Outside Other Fees/Services
Marketing/Publicity
Space Rental
Utilities
Equipment Rental
Supplies/Materials
Other Costs
Printing (Programs)
Postage
In County Travel
Out of County Travel
Insurance
Union
Live Orchestra
Set (scenery)
Costumes
$ 38,000
$ 5,000
$ 14,000
$ 14,000
$ 3,000
$ 23,000
$ 3,000
$ 2,000
$ 4,000
$ 2,000
$ 3,000
$ 1, 000
$ 3,000
$ 2,000
$ 2,000
$ 6,000
$ 26,000
$ 15,000
$ 8,000
$25,000
$15,000
$2,000
$1,000
REVENUES
CASH IN-KIND
Admissions $ 65,000
Contracted Services $ -
Tuitions $ -
Corporate Support $ 25,000
Foundation Support $ 15,000
Individual Support $ 8,000
Government Grants $ -
Federal $ 10,000
State $ _
Local. $ 30,000
Cash on Hand $ 10,567
Other revenues $ -
Miami Beach Grant Amount $10,432.80
$28,000
$15,000
Total cash expenses $ 174,000 Total cash revenues . $ 174,000
Total in-kind expenses $ 43,000 Total in-kind revenues $43,000
TOTAL PROJECT EXPENSES $ 217,000 TOTAL PROJECT REVENUES $ 217,000
Exhibit 2-B: Project Budget /Revised Grant Award Budget
Name of organization: Cuban Classical Ballet of Miami
Date(s) of Project: _Saturdav February 20th & Sunday February 21St, 2010.
Grant Award: $10,432.80
Directions: Identify and itemize cash expenses to be paid from Grant award funds. Grant awards may only
be spent within budget categories declared below. Line item changes to said Budget shall not exceed ten
percent (10%) per category, so long as said expenditures do not exceed the total amount of Grant funds
Grant Expenses
Personnel -artistic 2 000 Equipment Rental
Personnel -technical _ Space rental (Performance
Related Only)
Outside artistic fees 1 432.80
Marketing/Publicity 2 000 Total Other Costs (itemize
Below)
Printing
Description Amount
Postage _
Ballet Set (Scenanr) $5,000
TOTAL (must equal grant award): $10,432.80
Grant requirements
Grant funds must be spent within budget categories agreed upon in grant agreement.
All publications associated with City of Miami Beach cultural grant support must include the City of Miami
Beach logo and the following byline: City of Miami Beach, Cultural Affairs Program, Cultural Arts Council."
Allowable Grant Expenditures as Relates to Grant Project:
• Artistic and technical fees directly related to the proposed program or event
• Production costs related to the proposed program, project or event
• Honoraria
• Equipment rental and expendable materials
• Marketing
• Publicity
• Equipment rental and personnel necessary to provide program accessibility as mandated by the
Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation.Act of 1973
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Grant Use Restrictions (grant funds may not be used towards):
• Remuneration of City of Miami Beach employees for any services rendered as part of a project
receiving a grant from Cultural Affairs grants programs
• Administrative salaries or fees
• "Bricks and mortar" or permanent equipment; unless the purchase price is less than the cost of
rental.
• City of Miami Beach services (permit fees, off duty police, electricians, insurance, etc.)
• Debt reduction
• Indirect or general operating costs related to the operation of the organization (Cultural Anchors
excluded from this restriction)
• Travel or transportation
• Social/Fundraising events, beauty pageants or sporting events
• Hospitality costs including decorations or affiliate personnel with the exception of artists
• Cash prizes
• Lobbying or propaganda materials
• Charitable contributions
• Events not open to the public; unless the event serves to specifically benefit City of Miami Beach
government and has been previously approved as such be the Cultural Affairs Program Manager
Required supporting materials for final reports submitted within 45 days upon completion of grant
project:
• Copies of all receipts, invoices and expenditures of grant monies. CATEGORIZE ALL
RECEIPTS, INVOICES AND CANCELLED CHECKS (front and back copies), ETC.
ACCORDING TO THE GRANT BUDGET (i.e. -all artists payments, separate from
advertising payments). Invoices AND checks must be dated within the 2009-10 Fiscal
Year
• Proof of logo and credit line in project publications and advertisements
• Proof of performance(s), such as programs, brochures and flyers.
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Form W-9
{Rev. oCtober z~7}
Departrr~rtt of the Tre;xsury
6nternal Revenue Sorvice
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Request for Taxpayer ~~e form to the
Identification Number and Certification t~equester. °° "ot
send to the IRS.
rvame (as snows on your income tax return)
Cuban Classical BaNet of Miami, htc
Business name, it different from atxrve
-_-
Check appropriate box: ^ IndividualTSo~ propriety ® Corporation ^ Partnership
^ limited liability ~mpany. Enter the tax ciassificatron (D=disregarded entity, G~orpyation, P=partnership) - _ . ~ _ .. , ^ Exempt
^ Cther (see irt5ttxtiorts} - payee
Address (number, street, and apt. y suite no.}
Requester's name and address {optionaq
~ SW 1st Street Ste. 3Q6
City, state, and 21P code
Mlaati ~ 3313Q
List account numbers} here {optional}
Enter your TIN in the appropriate box. The TIN provided must match the name given on line t to avoid Social ~~y number
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 gef a TlN on page 3. or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose ~++Plotter klerttlflcariort numbs.
number to enter. ZO S713495
Under penalties of perjury, 1 certify that:
t. 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) 1 am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that 1 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 1 am no longer subject to backup withholding, and
3. I am a U.S, citizen or other U.S. person (defined below),
Certification insbuctions. You must cross out item 2 above ff you have been notfied by the IRS that you are currentty subject to backup
withholding because you have failed to report elf 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.
Sin ~`_`::'~' _°'"
9 Signature of
Here u.s. pe-sa+ -
General Instructions
Section references are to the Interne{ Revenue Code uMess
otherwise noted.
Purpose of Form
A person who is required to file an information return with the
IRS must obtain your corcect 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 W-9 on{y 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:
t . 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 allocab{e share of any partnership income from
a U.S. trade or business is not subject to me withholding tax on
foreign partners' share of effectively connected income.
Nate. If a requester gives you a forts other than Form W-9 to
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-g.
°a~ - ~ /301 ~
Definition of a U.S. person.~For federal tax purposes, you are
considered a U.S. person if you are:
• An individua{ 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
301.7701-7).
Special ruffs for partnerships. Partnerships that conduct a
trade ar business in the United States are generalty required to
pay a withholding tax on any foreign partners' share of income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding
on its allocable share of net income from the partnership
conducting a trade or business in the United States is in the
following cases:
• The U.S. owner of a disregarded entity and not the entity,
Cat. Nd. 1023tX Form W-9 (Rev. 10.2407)