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7.1.F. - Page 29 <br /> Form W.9 Request for Taxpayer Give Form to the <br /> (Rev.December 2(111) requester. Do not <br /> Department of the Treasury Identification Number and Certification send to the IRS. <br /> Internal Revenue Service <br /> Name(as shown on your income tax return) <br /> City of Redwood City <br /> Business name/disregarded entity name.if different from above <br /> QCheck appropriate box for federal tax classification: <br /> g ❑ Individual/Sole proprietor ❑ C Corporation <br /> 0 S Corporation Partnership 0 TrusUestate <br /> a) ER <br /> ._o ❑ Limited liability company.Enter the tax classification(D=disregarded entity,C=corporation,P=partnership)► ❑Exempt payee <br /> 65 <br /> 4 <br /> a E Other(see instructions)► Municipality <br /> -4= Address)number,street,and apt.or suite no.) Requesters name and address(optional) <br /> o 1017 Middlefield Road <br /> a) City,state,and ZIP code <br /> Redwood City,CA 94063 <br /> List account number(s)here(optional) <br /> Part I Taxpayer Identification Number(TIN) <br /> Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line I Social security number <br /> resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other - <br /> entities,it is your employer identification number(EIN).if you do not have a number,see How to get a _ <br /> TIN on page 3. <br /> Note.If the account is in more than one name,seethe chart on page 4 for guidelines on whose Employer identification number <br /> number to enter. <br /> 9 4 6 0 0 1 1 1 6 <br /> Part II Certification <br /> Under penalties of perjury,I certify that: <br /> 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 <br /> 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 <br /> 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 1 am <br /> no longer subject to backup withholding,and <br /> 3. I am a U.S.citizen or other U.S.person(defined below). <br /> 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 <br /> 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 <br /> interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and <br /> generally,payments other than interest and dividends,you are not required to sign the Certification,but you must provide your correct TIN.See the <br /> instructions on page 4. <br /> Sign Signature of <br /> Here U.S.person l. Date► <br /> FOR COUNTY DEPARTMENT USE ONLY <br /> I approve this addition of a new PEED/vendor record or requested changes to existing PEED record. <br /> Date Requested: <br /> Requester Name: <br /> Authorized A/P Approver Signature: <br /> Form W-9 (rev 12-2011) <br /> ATTY/AGR.2015.0611RWC2020 County BH RS ADD 2015-2017 <br />