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HomeMy WebLinkAbout2025-087PHASE 1 CASH DEPOSIT AND ESCROW AGREEMENT FOR COMPLIANCE RE: Ditch 5 Sand Mine SP -MA -95.02-12 (94060171) A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK THIS AGREEMENT is entered into this 22ndday of April by and between BABCOCK COQUINA MINE, LLC, a Florida limited liability company (Developer), and INDIAN RIVER COUNTY, a political subdivision of the State of Florida (County): WITNESSETH: WHEREAS, Developer is mining certain property within Indian River County and is required to post bonds insuring compliance with the requirements of the approved mining site plan; Indian River County Code Section 934.07; and restoration of the site. NOW, THEREFORE, in consideration of the agreements, promises, and covenants set forth herein, and other good and valuable considerations, the parties hereto agree as follows: 1. The Developer has tendered to the County Office of Management and Budget (Escrow Agent) the sum of Twenty Five Thousand Three Hundred Dollars ($25,300.00), the receipt whereof is hereby acknowledged, which sum shall be held in escrow by said Office, subject to the terms, conditions and covenants of this escrow agreement as assurance that Developer shall perform in all respects the obligations of Indian River County Code Chapter 934 with respect to site plan compliance. 2. Upon completion of the restoration of each mine phase, the Developer may obtain a disbursement from the escrow account by making a written request to Indian River County's Community Development Director. The request shall specify the amount of disbursement, and shall be accompanied by a sealed certificate from Developer's engineer that the mine is in compliance and has been restored in accordance with the most recent set of plans approved and on file with the County. 3. Within seven (7) working days after receipt of a disbursement request, the Community Development Director shall cause an inspection of the work for which payment is sought. If the Community Development Director is satisfied in all respects with the condition of the site and certifications, the Community Development Director shall deliver written notice to disburse to the County Office of Management and Budget. Upon receipt of the notice to disburse, the Office of Management and Budget shall make the disbursement described therein directly to Developer, at the address specified in the request for disbursement. A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK 4. Upon failure to comply with all the requirements of the site plan approval, including but not limited to unapproved off-site discharge of water, failure to confine hauling to approved hauling routes, operating in violation of the safety/security plan, excavating within required setbacks, mining of additional phases prior to restoration of the previous phase, and activity not consistent with permits issued by other jurisdictional agencies; or if Developer fails to perform all or any part of the obligations of restoration and reclamation, including, but not limited to mine abandonment prior to restoration, restoration not completed within the approved time frame, restoration not consistent with Chapter 934 of the Indian River County Code, and restoration activity not consistent with permits issued by other jurisdictional agencies, the County may utilize escrowed funds to achieve compliance or restoration. All funds remaining in the escrow account at the time default is declared by the County shall be available for use by the County. Said funds shall be disbursed to the County upon receipt by the Office of Management and Budget of a certified copy of a resolution of the Board of County Commissioners stating that Developer has failed to comply with Indian River County Code Chapter 934 site plan or restoration conditions of the mining approval, and that said funds are necessary to achieve compliance. All funds disbursed to County in excess of the final amount determined necessary by the County shall be returned to Developer, its legal representatives, successors or assigns, at the completion of site restoration. 5. Any interest earned during the term of escrow, less administrative expenses, shall be disbursed to Developer at close of escrow unless necessary for County to utilize in cure of developer's default. 6. The funds deposited hereunder exist solely for the protection, use and benefit of the County and shall not be construed or intended in any way, expressly or impliedly, to benefit or secure payment to any contractor, subcontractor, laborer, materialman, architect, engineer, attorney or other party providing labor, material, supplies, or services to Developer while such funds remain subject to this escrow agreement. The County shall not be liable to any of the aforementioned parties for claims against the Developer relating to the approved mining site. 7. Alternate security, in the form of performance bonds or fetters of credit, may be substituted with the approval of the County Attorney. 8. This Agreement is the full and complete understanding of the parties and shall not be construed or amplified by reference to any prior agreement, discussion, or understanding, except as specifically mentioned herein. This Agreement shall not be assigned without the express written approval of the County. Any amendment, deletion, modification, extension, or revision hereof or hereto shall be in writing, and executed by authorized representatives of each party. IN WITNESS WHEREOF, the parties hereto have set their hands and seals. The effective date of this Agreement shall be the date of approval by the Board of County Commissioners. 2 Signed, sealed and delivered in the presence of: Signature: Print NAFne: C - Pa? c,,//'., Address: Avc• (.-:060.7 B o d c '-c &a 4d/ Signature: c� (1t-•�- Print Name: L Address: i��s ni• .�f/a.� �c fyv�. �'vGoa Bcach �. ��93/ Date: ATTEST: Ryan L. Butler, Clerk of Circuit Court and Comptroller Deputy Clerk OFFICE OF MANAGEMENT AND BUDGET By: Kristin Daniels OMB Director A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK BABCOCK COQUINA MINE, LLC, a Florida limited liability company B� Pr Ti Et PI Address: /,/is /V• 44/an41'c Arm • Cocoa /3each PL- X,257 / DEVELOPER 16 BOARD OF COUNTY OMMISSIONERS INDIAN RIVER COUNTY, FLORIDA ,.••,•u.. .Goh�r�,Iss�a (SEAL) APPROVED AS TO FORM AND LEGAL S� FFJGtt= By: Deputy County Attorney RIVER CO PHASE 1 CASH DEPOSIT AND ESCROW AGREEMENT FOR RESTORATION RE: Ditch 5 Sand Mine SP -MA -95-02-12 (94060171) A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERIC THIS AGREEMENT is entered into this 22nd day of April , 2025, by and between BABCOCK COQUINA MINE, LLC, a Florida limited liability company (Developer), and INDIAN RIVER COUNTY, a political subdivision of the State of Florida (County): WITNESSETH: WHEREAS, Developer is mining certain property within Indian River County and is required to post bonds insuring compliance with the requirements of the approved mining site plan; Indian River County Code Section 934.07; and restoration of the site. NOW, THEREFORE, in consideration of the agreements, promises, and covenants set forth herein, and other good and valuable considerations, the parties hereto agree as follows: 1. The Developer has tendered to the County Office of Management and Budget (Escrow Agent) the sum of Thirteen Thousand Two Hundred Dollars ($13,200.00), the receipt whereof is hereby acknowledged, which sum shall be held in escrow by said Office, subject to the terms, conditions and covenants of this escrow agreement as assurance that Developer shall perform in all respects the obligations of Indian River County Code Chapter 934 with respect to site restoration. 2. Upon completion of the restoration of each mine phase, the Developer may obtain a disbursement from the escrow account by making a written request to Indian River County's Community Development Director. The request shall specify the amount of disbursement, and shall be accompanied by a sealed certificate from Developer's engineer that the mine is in compliance and has been restored in accordance with the most recent set of plans approved and on file with the County. 3. Within seven (7) working days after receipt of a disbursement request, the Community Development Director shall cause an inspection of the work for which payment is sought. If the Community Development Director is satisfied in all respects with the condition of the site and certifications, the A TRUE :.OPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK Community Development Director shall deliver written notice to disburse to the County Office of Management and Budget. Upon receipt of the notice to disburse, the Office of Management and Budget shall make the disbursement described therein directly to Developer, at the address specified in the request for disbursement. 4. Upon failure to comply with all the requirements of the site plan approval, including but not limited to unapproved off-site discharge of water, failure to confine hauling to approved hauling routes, operating in violation of the safety/security plan, excavating within required setbacks, mining of additional phases prior to restoration of the previous phase, and activity not consistent with permits issued by other jurisdictional agencies; or if Developer fails to perform all or any part of the obligations of restoration and reclamation, including, but not limited to mine abandonment prior to restoration, restoration not completed within the approved time frame, restoration not consistent,with Chapter 934 of the Indian River County Code, and restoration activity not consistent with permits issued by other jurisdictional agencies, the County may utilize escrowed funds to achieve compliance or restoration. All funds remaining in the escrow account at the time default is declared by the County shall be available for use by the County. Said funds shall be disbursed to the County upon receipt by the Office of Management and Budget of a certified copy of a resolution of the Board of County Commissioners stating that Developer has failed to comply with Indian River County Code Chapter 934 site plan or restoration conditions of the mining approval, and that said funds are necessary to achieve compliance. All funds disbursed to County in excess of the final amount determined necessary by the County shall be returned to Developer, its legal representatives, successors or assigns, at the completion of site restoration. 5. Any interest earned during the term of escrow, less administrative expenses, shall be disbursed to Developer at close of escrow unless necessary for County to utilize in cure of developer's default. 6. The funds deposited hereunder exist solely for the protection, use and benefit of the County and shall not be construed or intended in any way, expressly or impliedly, to benefit or secure payment to any contractor, subcontractor, laborer, materialman, architect, engineer, attorney or other party providing labor, material, supplies, or services to Developer while such funds remain subject to this escrow agreement. The County shall not be liable to any of the aforementioned parties for claims against the Developer relating to the approved mining site. 7. Alternate security, in the form of performance bonds or letters of credit, may be substituted with the approval of the County Attorney. 8. This Agreement is the full and complete understanding of the parties and shall not be construed or amplified by reference to any prior agreement, discussion, or understanding, except as specifically mentioned herein. This Agreement shall not be assigned without the express written approval of the County. Any amendment, deletion, modification, extension, or revision hereof or hereto shall be in writing, and executed by authorized representatives of each party. A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK IN WITNESS WHEREOF, the parties hereto have set their hands and seals. The effective date of this Agreement shall be the date of approval by the Board of County Commissioners. Signed, sealed and delivered in the presence of: Signature: Print Name: Address: /-// s /y. A Ila,,, -A,-c .4ve . Co c c e /3 a .c'G d07¢3/ Signature: _ Print Name: rujC-00 Address: i yis IV. Alpe. Coc oa Bca nh /-1 3c;?- 9.3 / Date: ATTEST: Ryan L. Butler, Clerk of Circuit Court and Comptroller By: deputy Clerk OFFICE OF MANAGEMENT AND BUDGET By: Ak #4 Kristin Daniels OMB Director BABCOCK COQUINA MINE, LLC, a Florida limited liability company r- I IUI IG. J / -/. ei `7 6. -/le" Address: /V A-llah76 c Ave C'o�o ,Scorch FL X493/ DEVELOPER BOARD OF COUNTY OMMISSIONE INDIAN RIVER COUNTY, FLORIQI�� '1�Ss���✓F9•, By: Joseph E. Flescher. Chairman B Approved: April 22" 2025-' ; f; j t;; �' •� (SEAL) APPROV D AS TCS ORM AND LEGAL Sk1 FI 0 % r �- By: / Susa •, i-Pra6o Deputy County Attorney PHASE 2,3 & 4 CASH DEPOSIT AND ESCROW AGREEMENT FOR RESTORATION RE: Ditch 6 Sand Mine SP -MA -96-02-12 (94060171) A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK THIS AGREEMENT is entered into this 22nd day of April , 2025, by and between BABCOCK COQUINA MINE, LLC, a Florida limited liability company (Developer), and INDIAN RIVER COUNTY, a political subdivision of the State of Florida (County): WITNESSETH: WHEREAS, Developer is mining certain property within Indian River County and is required to post bonds insuring compliance with the requirements of the approved mining site plan; Indian River County Code Section 934.07; and restoration of the site. NOW, THEREFORE, in consideration of the agreements, promises, and covenants set forth herein, and other good and valuable considerations, the parties hereto agree as follows: 1. The Developer has tendered to the County Office of Management and Budget (Escrow Agent) the sum of Thirty Nine Thousand Six Hundred Dollars ($39,600.00), the receipt whereof is hereby acknowledged, which sum shall be held in escrow by said Office, subject to the terms, conditions and covenants of this escrow agreement as assurance that Developer shall perform in all respects the obligations of Indian River County Code Chapter 934 with respect to site restoration. 2. Upon completion of the restoration of each mine phase, the Developer may obtain a disbursement from the escrow account by making a written request to Indian River County's Community Development Director. The request shall specify the amount of disbursement, and shall be accompanied by a sealed certificate from Developer's engineer that the mine is in compliance and has been restored in accordance with the most recent set of plans approved and on file with the County. 3. Within seven (7) working days after receipt of a disbursement request, the Community Development Director shall cause an inspection of the work for which payment is sought. If the Community Development Director is satisfied in all respects with the condition of the site and certifications, the A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK Community Development Director shall deliver written notice to disburse to the County Office of Management and Budget. Upon receipt of the notice to disburse, the Office of Management and Budget shall make the disbursement described therein directly to Developer, at the address specified in the request for disbursement. 4. Upon failure to comply with all the requirements of the site pian approval, including but not limited to unapproved off-site discharge of water, failure to confine hauling to approved hauling routes, operating in violation of the safety/security plan, excavating within required setbacks, mining of additional phases prior to restoration of the previous phase, and activity not consistent with permits issued by other jurisdictional agencies; or if Developer fails to perform all or any part of the obligations of restoration and reclamation, including, but not limited to mine abandonment prior to restoration, restoration not completed within the approved time frame, restoration not consistent with Chapter 934 of the Indian River County Code, and restoration activity not consistent with permits issued by other jurisdictional agencies, the County may utilize escrowed funds to achieve compliance or restoration. All funds remaining in the escrow account at the time default is declared by the County shall be available for use by the County. Said funds shall be disbursed to the County upon receipt by the Office of Management and Budget of a certified copy of a resolution of the Board of County Commissioners stating that Developer has failed to comply with Indian River County Code Chapter 934 site plan or restoration conditions of the mining approval, and that said funds are necessary to achieve compliance. All funds disbursed to County in excess of the final amount determined necessary by the County shall be returned to Developer, its legal representatives, successors or assigns, at the completion of site restoration. 5. Any interest earned during the term of escrow, less administrative expenses, shall be disbursed to Developer at close of escrow unless necessary for County to utilize in cure of developer's default. 6. The funds deposited hereunder exist solely for the protection, use and benefit of the County and shall not be construed or intended in any way, expressly or impliedly, to benefit or secure payment to any contractor, subcontractor, laborer, materialman, architect, engineer, attorney or other party providing labor, material, supplies, or services to Developer while such funds remain subject to this escrow agreement. The County shall not be liable to any of the aforementioned parties for claims against the Developer relating to the approved mining site. 7. Alternate security, in the form of performance bonds or letters of credit, may be substituted with the approval of the County Attorney. 8. This Agreement is the full and complete understanding of the parties and shall not be construed or amplified by reference to any prior agreement, discussion, or understanding, except as specifically mentioned herein. This Agreement shall not be assigned without the express written approval of the County. Any amendment, deletion, modification, extension, or revision hereof or hereto shall be in writing, and executed by authorized representatives of each party. 2 A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK IN WITNESS WHEREOF, the parties hereto have set their hands and seals. The effective date of this Agreement shall be the date of approval by the Board of County Commissioners. Signed, sealed and delivered in the presence of: BABCOCK COQUINA MINE, LLC, a Florida limited liability company Signature:: �'6p�ge' By: Print Nar�iePrin rrie: Jc P�'�.-4 Gni • GUe!! s Address: Tit e: Af-M � aq Coco Bea h �'� 3a43Email: w�l�.s soar �a., �'/. c� Signature: Gkc Phone: 15l7. CiPS'G - 7-1// a Print Name: 124 Address: Address: IgI5 /V. ,44/an/l'c Ave. Cv<o.a j3each cL d,pga m Cocoa 13ocpch CL 3.7sw DEVELOPER Date: ATTEST: Ryan L. Butler, Clerk of Circuit Court and Comptroller By: eputy Clerk OFFICE OF MANAGEMENT AND BUDGET t By: Kristin Daniels OMB Director BOARD OF COUNTY OMMISSIONERS INDIAN RIVER COUNTY, FLORIDAy.�oti�Miss�o,; By: Jos ph E. Fle her Chalrrrlan C Approved: April 22, 202�z >" `oma' (SEAL) APPROV��jjD AS TO FOR AND LEGAL SI�FFICIEM By,- Su y:Su an J/"Pca oc ,/ Deputy County Attorney :,. r PHASES 2, 3 & 4 CASH DEPOSIT AND ESCROW AGREEMENT FOR COMPLIANCE RE: Ditch 6 Sand Mine SP -MA -95-02-12 (94060171) A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. allTLER, CLERK THIS AGREEMENT is entered into this 22nd day of April , 2025, by and between BABCOCK COQUINA MINE, LLC, a Florida limited liability r.: company (Developer), and INDIAN RIVER COUNTY, a political subdivision of the. State of Florida (County): WITNESSETH: WHEREAS, Developer is mining certain property within Indian River County and is required to post bonds insuring compliance with the requirements of the approved mining site plan; Indian River County Code Section 934.07; and restoration of the site. NOW, THEREFORE, in consideration of the agreements, promises, and covenants set forth herein, and other good and valuable considerations, the parties �. hereto agree as follows: 1. The Developer has tendered to the County Office of Management and Budget (Escrow Agent) the sum of Fifty Six Thousand Dollars ($56,000.00), the receipt whereof is hereby acknowledged, which sum shall be held in escrow by said Office, subject to the terms, conditions and covenants of this escrow agreement as assurance that Developer shall perform in all respects the obligations of Indian River County Code Chapter 934 with respect to site plan compliance. 2. Upon completion of the restoration of each mine phase, the Developer may obtain a disbursement from the escrow account by making a written request to Indian River County's Community Development Director. The request shall specify the amount of disbursement, and shall be accompanied by a sealed certificate from Developer's engineer that the mine is in compliance and has been restored in accordance with the most recent set of plans approved and on file with the County. 3. Within seven (7) working days after receipt of a disbursement request, the Community Development Director shall cause an inspection of the work for which payment is sought. If the Community Development Director is satisfied in all respects with the condition of the site and certifications, the Community Development Director shall deliver written notice to disburse to the County Office of Management and Budget. Upon receipt of the notice to disburse, the Office of Management and Budget shall make the disbursement described therein directly to Developer, at the address specified in the request for disbursement. A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK 4. Upon failure to comply with all the requirements of the site plan approval, including but not limited to unapproved off-site discharge of water, failure to confine hauling to approved hauling routes, operating in violation of the safety/security plan, excavating within required setbacks, mining of additional phases prior to restoration of the previous phase, and activity not consistent with permits issued by other jurisdictional agencies; or if Developer fails to perform all or any part of the obligations of restoration and reclamation, including, but not limited to mine abandonment prior to restoration, restoration not completed within the approved time frame, restoration not consistent with Chapter 934 of the Indian River County Code, and restoration activity not consistent with permits issued by other jurisdictional agencies, the County may utilize escrowed funds to achieve compliance or restoration. All funds remaining in the escrow account at the time default is declared by the County shall be available for use by the County. Said funds shall be disbursed to the County upon receipt by the Office of Management and Budget of a certified copy of a resolution of the Board of County Commissioners stating that Developer has failed to comply with Indian River County Code Chapter 934 site plan or restoration conditions of the mining approval, and that said funds are necessary to achieve compliance. All funds disbursed to County in excess of the final amount determined necessary by the County shall be returned to Developer, its legal representatives, successors or assigns, at the completion of site restoration. ` 5. Any interest earned during the term of escrow, less administrative expenses, shall be disbursed to Developer at close of escrow unless necessary for County to utilize in cure of developer's default. 6. The funds deposited hereunder exist solely for the protection, use and benefit of the County and shall not be construed or intended in any way, expressly or impliedly, to benefit or secure payment to any contractor, subcontractor, laborer, materialman, architect, engineer, attorney or other party providing labor, material, supplies, or services to Developer while such funds remain subject to this escrow agreement. The County shall not be liable to any of the aforementioned parties for claims against the Developer relating to the approved mining site. 7. Alternate security, in the form of performance bonds or letters of credit, may be substituted with the approval of the County Attorney. 8. This Agreement is the full and complete understanding of the parties and shall not be construed or amplified by reference to any prior agreement, discussion, or understanding, except as specifically mentioned herein. This Agreement shall not be assigned without the express written approval of the County. Any amendment, deletion, modification, extension, or revision hereof or hereto shall be in writing, and executed by authorized representatives of each party. IN WITNESS WHEREOF, the parties hereto have set their hands and seals. The effective date of this Agreement shall be the date of approval by the Board of County Commissioners. Signed, sealed and delivered in the presence of: Signature: Print Nares C . Pam. /1•n Address: i yi s IV - A f/an Co cow Signature. GCCG - Print Name: uC Address: h/, 4 711 ntA1IC C oa ejx� z2e�- r h Date: ATTEST: Ryan L. Butler, Clerk of Circuit Court and Comptroller By: Deputy Clerk OFFICE OF MANAGEMENT AND BUDGET . By: Kristin Dan els OMB Director A TR: COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK BABCOCK COQUINA MINE, LLC, a Florida limited liability company DEVELOPER BOARD OF COUNTY OMMISSIONERS INDIAN RIVER COUNTY, FLORIDA,." •�'0tii;4.' By: oseph E. Flescher, Chaidm6n B Approved: April 22, 2025 (SEAL) APPROVED AS TO FORM AND LE=CY: By: Susan J.' *Wo Deputy County Attorney § Tutt INDIAN tHl§ t9 COPY e Form ■ ■ -- (Rev. Marl Department of the Treasury Internal Revenue Service i MAT 7M$ IS A TRUE AND CORRECT NAL ON FILE IN PMS OWICE. Request for Taxpayer Identification Number and Certification Go to www.irs.gov/FormW9 for instructions and the latest information. Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. Give form to the requester. Do not send to the IRS. Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a 1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded FM m entity's name on line 2.) m�I BABCOCK COQUINA MINE LLC resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other - 2 Business name/disregarded entity name, if different from above. 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check 4 Exemptions (codes apply only to or only one of the following seven boxes. certain entities, not individuals; asee o ❑ Individual/sole proprietor ❑ C corporation 1:1S corporation ❑ Partnership [:]Trust/estate instructions on page 3): CM ai G ❑✓ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) . . . . C Exempt payee code (if any) Q. o U Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax Exemption from Foreign Account Tax `o 2 classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner. Compliance Act (FATCA) reporting S❑ Other (see instructions) code (if any) a u (Applies to accounts maintained 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification, m and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check instructions ❑ outside the United States.) ha this box if you have any foreign partners, owners, or beneficiaries. See . . . . . . . . . aa') 5 Address (number, street, and apt. or suite no.). See instructions. Requester's name and address (optional) U) 100 94th ST. SW 6 City, state, and ZIP code VERO BEACH FL 32968 7 List account number(s) here (optional) IMB Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a I Social security number FM m m�I resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other - entities, it is your employer identification number (EIN). If you do not have a number, see How; o get a or TIN, later. Emolover identification number Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. 82 - 1 1 6 1 5 1 9 1 8 1 6 1 1 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. 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are -not required jo-tign the certification, but you must provide your correct TIN. See the instructions for Part ll, later. Sign Signature of Here I U.S. person moi! - -- Date G,� General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. What's New Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the "LLC" box and enter its appropriate tax classification. New line 3b has been added to this form. A flow-through entity is rceo complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065). Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat. No. 10231X Form W-9 (Rev. 3-2024)