Exh 4F
AGENDA X7'ENI NO. 7'
Meeting Date: ~"~ ~-' 97
C[TY OF ATLANTIC BEACH
CITY COMMISSION MEETING
STAFF REPORT
AGENDA ITEM: Bids for Replacing A/C Units in City Hall
SUBMITTED BY: ~ Don C. Ford
DATE:
BACKGROUND:
August 5, 1999
The bids for the replacement of the air-conditioning units have been reviewed for
accuracy to the specifications and all bidders comply.
` We adverEised in the Times Union for two consecutive weeks and faxed
invitations to bid to 23 prospective bidders.
Of the two bids received staff recommends Weather Engineers with a bid of
$16,591 for the base bid and $9,041 for the alternative bid.
RECOMMENDATION: Approval of Bid from Weather Engineers
ATTACHMENTS: Memorandum to David Thompson
Bid from Weather Engineers
Bid from Ocean Stafe Heat and Air
REVIEWED BY CITY
MANAGER:
CITY OF
r~~i°cuzt,cc Seacl - ~~vzccf~
ice. -_ a.ei.. ~' k..-
MEMORANDUM
August 5, 1999
TO: David Thompson
FROM: Don C. Ford
hUU SEMitr'OLE ROAD
ATLA\TIC BEACH. FLORIDA 3223: ->44>
TELEPHOt\'E l9U4) 247•S3Up
FAX (~l(14) 247-S8U5
SUNCOM 852-ShUU
RE: Bids for Replacing A/C Units in City Hall .
The bids for the replacement of the air-conditioning units have been reviewed for
accuracy to the specifications and all bidders comply.
We advertised in the Times Union for two consecutive weeks and faxed
invitations to bid to 23 prospective bidders.
- Of the two bids received staff recommends Weather Engineers with a bid of
516,591 for the base bid and X9,041 for the alternative bid.
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1000 EDISON AVENUE
,:SONVILIE, FLORIDA 32204
Page No. of Pages
Alit [:ONntT10NING .HEATING • REFRIGERATION
PHONE 356-39153
24 HOUR SERVICE
I
PROPOSAL SUBMITTED 70 PHONE DATE
STREET JOB NAME
CITY, STATE A ZIP CODE JOB LOCATION
ARCHITECT DATE OF PLANS JOB PHONE
we hereby submit specifications and estimates tor:
......
•~-•-~-•----"---•----•----~•------•~••~-~"-----•V~e•will•remove--and••dispose-ofthe•existingequip7rrentand-install-xour•-~-~-°•~-
_....._....._._.___....._.... _..~w.__ .. _....._-.___...._....____......__....,..----....._..__.._...... ___M._
•-~~~ ---new-Heat Pump" ystem to'i>ry~lude:'
_..ti~._____.._ -__ _. _. .._....__......._.......__....._....___w____ ...._.__...
ew°Hea~t'Pump°~ ufdoo'r"Unit),-New AirHan~Ier"U'iiit`~Indoor U`nity',,
"•' ~~~~"~~`""'"Back'up~ieat-'strip,New Digital Ther"mostat; make recon`riection`s~~of existirig`• ~• ~•"'•"`_`...... .°.._.___ ...._.
.,..__.._.__. ...___.~..._ _._..__.. _.........r__~.~....... ._,______ .__._.__._._._ _..._._... ...---_.......__.___ .... _._._._
~Iiigliwaltage electrical circuits,low voltage circuits, d `rain line connections,
""~"~ "' '-- `A:><r~ucf - onne`ciions,`Freori'Pipe Connections
•"""'-~`-'°1Q'Y~ar~'ai'ts'&-labor Warranty; BiyaritEquipriienf wifli identical raiings as Carrier'equipn~ierit- ""
__..--_-_-.• isle -><ri-specs
~p ~rDpDSP hereby to furnish material and labor -complete in accordance with above specifications, for the sum of:
made as follows:
dollars (~ 16.591.40 ).
All material is Huaranteed to be as specified. All work to De eomptcted in a workmanlike
manner accordin8 to standard practices. Any alteration or deviation from above specitica•
lion's Involvin8 extra costs wltl be executed only upon written orders, and will become art
extra charge over and atwva the estimate. All a8reements contingent upon strikes, accidents
• delays beyond our eonVot. Owner to carry fire, tornado and other necessary insurance.
cur workers are fully covered Dy workmen's Compensation Insurance.
Authorized
Signature __
Jeff Ra>d~t~ttba0unsultant
withdrawn by us I not accepted within days.
,C1j.r~~i~~le D~ ~I•D~liiBFl~ -The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized Signature
to do the work as specified. Payment will be made as outlined above.
Signature
Date c! P.ct:eptants. - - -
.. ~rn~rnstti
1000 EDISON AVENUE
.1. .SONVILIE, FLORIDA 32204
Page No.
T
~e~~~~ ~ ~~ ~ctG.
AIR CONDITIONING • HEATING • REFRIGERATION
of Pages
PHONE 356-3963
24 HOUR SERVICE
PROPOSAL SUBMITTED TO PHONE DATE
i fAl ni h
STREET JOB NAME
i ~ q _?~
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CITY, STATE AND ZIP CODE
~ ~ ~ JOB LOCATION
• ARCHITECT DATE OF PLANS JOB RHONE
We hereby submit specifications and estimates for:
••-•--•------------~•_----•-•------•---- ---Wewill•remove•and-dispose-of#he-eaistingAir~ffandler•and°install~~Few•---°-•-°
~. -•-American•Standard-Air$andlers.~~_....~..._.__.__~..._ _r..____... _._.~...____ . _..._.. _..~...._. _w_......_..~_---_.. ___.. _._
----•--- As-per-specs•to-include: all duct-connections•uecessar~:--The-total-inclndes-new-heat-sti~ips; ---~-•~~-- ~
•----••- reconnections-of•high•and•Iow voltage; drain•Iines materials; labor;~taa;-and•permits.-------~ ~•----- -•---
_...___._._._f4Year-~'arts...&L-abor°V~arranty.__.._...__...._._....~__.....__.._._.._ .........._...._~.~...-.----._.__._...__._......_.__.__......_._.._
~•
------•---•---American-Standard Equipment•witlr•identical-ratingsas~Trane iisted~~in-specs: -"~ ' -•--- •-••- ~•- _.__.__
~p ~rD~1IIBP hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
Nine Thousand Fo One Dollars dollars ($ 9,041.00 ~,
Payment to be made as follows:
Du in full
All malerlat is guaranteed to be as specified. All work to be completed in ~ workmanlike
Authorized
manner atcording to standard practices. Any alteration ar deviation from above specilica•
Si
gnature __
tloni involving extra costs wilt be esecuted only upon written orders, and will become an
•tra charge over and above the esUmste. Alt agreements contingent upon strikes, accidents Jeff' Ra>ugt,•~a~e~~tnsultant
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• cur workers are rutty covered by Workmen's Compensation Insurance. withdrawn by us it not accepted within ~ days.
,~ari`~#~ttrr of ~rn~rusttl-The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized Signature
to do the work as specified. Payment will be made as outlined above.
Signature
uaie of i+r:cepiance:
Ocean State Heating & "~ ~,~,,,~~,.
Air Conditioning, Inc. ~ CQMD[Y[EI@dIPdG
1476 Atlantic Boulevard HF~TI ~ Date• 8/3/99
Teptune Beach, Florida 32266 Customer ID:
(904) 249-8251 Fax (904) 249-8949 Loc #: BID N0. 9899-30
Pro osal submitted to: Job Information:
Name: City of Atlantic Beach Job name:
Street: 800 Seminole Rd lob location: North end of City Hall Building
City, Atlantic Beach, FL 32233
Phone: 247-5800 Job phone:
~'e hereby propose: To furnish, install, and service under warranty (stated below) products or related equipment
for our home in accordance with the conditions ands ecifications set forth in this ro osal.
~~ A/C Heat Pump Carrier Mode138YDA060 AlH Model FK4BNB006 KW 10 -14 SEER,
D A/C Heat Pump Model A/H Model KW
Programmable Thermostat
D Space Gard Filter
0 Electronic Air Cleaner *Two -3SYD060-300 I-phase,
=.~~- Condensate Drain Hook-Up 5 ton, 2 speed condensors
D Concxete Condensing Unit Pad
D Hot Water Recovery Unit Two FK4BNB006, variable
Q All Work Done in Accordance with E~sting Code speed Air Handlers
.~~~ All Required Permits
~ Venting Bath Fan and Range Hood *'I~vo -10 KW 3-phase heater
Remo~~al of Existing Equipment from Premises
Connect Electrical to Equipment from Eusting Source Two --Space Gard Filters
D Install Ne~v Amp Electrical Service and Farrel
~ Refrigerant Tubing 'Two Programmable Thermostats
Q New Return Inlets
p Ductwork: Connect to new AHU's only & seal duct in AHU closet only
T~~ 24 Hour Emergency Service
='~y (IO) Year Warranty Parts And Labor (10) Year Warranty Compressors
.~,~ Other: Float Switch and Coastal Filters on condensor units.
=~~ Exclusions: condensor Breaker for single phase by Others.
We propose hereby to furnish complete as above specified, for the sum of:
Twenty-five Thousand Six Hundred Eighty Dollars And No/100*****'****** Dollars (525,680.00)
Payment terms will be: In Full Upon Completion
It is agreed and understood by the parties that all equipment and parts which are sold pursuant hereto shall NOT become fia-tures or part of the real
estate where the}' arc placed. Said parts and equipment shall at all times remain the personal property and the title thereto shall remain in the seller
until pa}znent in full is received. Buyer hereby a~ees that all parts and equipment ma}~ be repossessed in the event of non-pa}Znent.
I have the authorit3~ to order the tivork as outlined above. I agree to pay
all costs and reasonable attorne}•'s fees if this proposal is placed in the
hands of an attorney for collection.
Signature
Date
Ocean State Heating &
Air Conditioning, Inc.
1476 Atlantic Boulevard
'Teptune Beach, Florida 32266
,~04) 249-8251 Fax (904) 249-8949
~~- ~~
CONDITtflNINfl
HE~T1H\`~
PRE}FC}SAL
Date: 8-3-99
Customer ID:
Loc #: EID N0. 9899-30
Pro osal submitted to: Job Information:
Name: City of Atlantic Beach Job name: Public Safety Building
Street: 800 Seminole Rd ~ Job location: 850 Seminole Rd
City, Atlantic Beach, FL 32233 Atlantic Beach
Phone: 247-5800 Job phone: 247-5863
e hereby propose: To furnish, install, and service under warranty (stated below) products or related equipment
for our home in accordance with the conditions ands ecifications set forth in this ro osal.
A/C Heat Pump Trane Air Handler - 2 1/2 tons Model TWE030C100 KW 10
AIC Heat Pump Trane Air Handler - 4 tons Model TWE048C100 KW 10
A/C Heat Pump Trane Air Handler - 7 Z12 tons Model TWE090C100 KW 15
D Programmable Thermostat
~ Hot Water Recovery Unit
p Condensate Drain Hook-Up
~ Concrete Condensing Unit Pad
~~-~= Modifications of Supply and/or Return Plenum
D All Work Done in Accordance with Existing Code
p All Required Permits
~ Venting Bath Fan and Range Hood
Removal of Existing Equipment from Premises
~'~~ Connect Electrical to Equipment from E~sting Source
~ Install New Amp Electrical Service and Panel
~ Refrigerant Tubing
Q Nex~ Return Inlets
~~~ Warranty: on TWE030C100 and TWE048CI00 - 10 years Parts and Labor
Warranty: on TWE090C100 - 5 years Parts and Labor
=~~n 24 Hour Emergency Service
~t,~~ Other: Mastic Duct Joints. EZ Trap
~~-. Exclusions: All Electrical. Existing Ductwork, Condensors.
We propose hereby to famish complete as above specified, for the sum of:
Eight Thousand Nine Hundred Seventy-five Dollars And No/100************* Dollars ($8,975.00)
Payment terms will be: In Full Upon Completion
It is a~ecd and understood by the parties that all equipment and parts which arc sold pursuant hereto shall NOT become fia-tures or part of the real
estate where they are placed. Said parts and equipment shall at all times remain the personal property and the title thereto shall remain in the seller
until payment in full is received. Buyer hereby agees that all parts and equipment may be repossessed in the event ofnon-payment.
I have the authority to order the work as outlined above. I agree to pay
all costs and reasonable attorney's fees if this proposal is placed in.the
hands of an attorney for collection.
Signature
Date
CITY OF ATLANTIC BEACH
IIWITATION TO BID
BID NO. 9899-30
NOTICE is hereby given that the City of Atlantic Beach, Florida, will receive sealed bids, IN
TRIPLICATE, in the Office of the Purchasing Agent, 1200 Sandpiper Lane, Atlantic Beach,
Florida 32233, unti12:30 PM, Wednesday, August 4,1999, to REPLACE TWO A/C HEAT
PUMP SYSTEMS AT CITY HALL BUILDING, AND RE-PIl'E SYSTEM; AND, AS AN
ALTERNATE, REPLACE THREE AIR HAIVDLER/I~ATERS AT PUBLIC SAFETY
BUILDING. Thereafter, at 3:00 PM, the bids will be opened and read aloud in the City Hall
Commission Chamber, 800 Seminole Road, Atlantic Beach, Florida..
Bids shall be enclosed in an envelope endorsed "BID N0. 9899-30 -REPLACE TWO A/C
HEAT PUMP SYSTEMS AT CITY HALL BUILDING, AND RE-PIPE DUCT SYSTEM;
AND, AS AN ALTERNATE, REPLACE THREE AIR HANDLERlHEATERS AT PUBLIC
SAFETY BUILDING - TO BE OPENED AT 3:OO;~pm, WEDNESDAY, AUGUST 4, 1999."
Bid Forms, and information regarding the bid, maybe obtained from the Office of the Purchasing
Agent, 1200 Sandpiper Lane, Atlantic Beach, telephone (904) 247-5818.
DOCUMENTS REOUTRED TO BE SUBMITTED IN BID PACKAGE AT BID OPENTNG•
1. ORIGINAL Insurance Certificates (copies, Xeroxes, and facsimiles are UNACCEPTABLEI
naming the City of Atlantic Beach as Certificate Holder, showing the bidder has obtained and will
continue to carry Workers' Compensation, public and private liability, and property damage
insurance during the life of the contract.
2. Three (3) references from companies or individuals for whom the bidder has completed work
or provided a product during the past 12 months, of a comparable size and nature as this project.
However, naming the City of Atlantic Beach as a reference on past projects is
UNACCEPTABLE.
3. Proof of OCCUPATIONAL License (copies ARE acceptable).
4. Bid submitted IN TRIPLICATE (three (3) sets)
5. Signed copy of Documents Requirements Checklist.
Bid prices shall remain valid for sixty (60) days after the public opening of the bids. Goods and
services shall meet all requirements of the Ordinances of the City ofAtlantic Beach, Florida.
The City of Atlantic Beach reserves the right to reject any or all bids or parts of bids, waive
informalities and technicalities, make award in whole or part, with or without cause, and to make
the award in what is deemed to be in the best interest of the City of Atlantic Beach.
A person or affiliate who has been placed on the convicted vendor list following a conviction for a
public entity crime may not submit a bid on a contract to provide any goods or services to a public
entity, may not submit a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real property to a public entity,
may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under
a contract with any public entity, and may not transact business with any public entity in excess of
the threshold amount provided in Section 287.017, for a period of 36 months from the date of
being placed on the convicted vendor Iist., (Section 287.133(2)(a), FLORIDA STATUTES).
BASE BID
Specifications for replacement of two 5-ton, air-to-air heat pumps at north end of the City Hall
Building - 800 Seminole Road:.
Carrier -Tech 2000 Variable Speed Heat Pump
Cooling Type:
Efficiency:
Capacity:
Heating Type:
F:K4CNB006
Efficiency:
Capacity:
47 Rating:
17 Rating:
Baclti-up Type:
Backup Efficiency:
Cooling Cost
Heating Cost
Warranty Requirements:
Two Speed Heat Pump 38YDA060
14.0 SEER
57,000 BTIJH
Two Speed Heat Pump
8.3 AFUE/HSPF
57,000 BTUH
O.BTUH, O.COP
O.BTUH, O.COP
None
100.0
$843.00
5400.00
Ten (10) Year, All Parts & Labor/Ten (10) Year Compressor.
These specifications are for CARRIER equipment.- The City will aIlow other brands of equipment
providing those brands meet or exceed the Carrier specifications.
ALTERNATE BID:
Specifications for replacement of Heater/A.ir Handler at Public Safety Building:
Trane Model No.
Trane Model No.
Trane Model No.
BWV748p100A1
NWE090C100FA
BWEV030A100E1
The specifications for the ALTERNATE BID are for TRANS equipment. The City will allow
other brands of equipment providing those brands meet or exceed the TRANS specifications.
Warranty Requirements: Ten (10} Year, All Parts & Labor/Ten (10} Year Compressor.
BID NO. 9899-30 -REPLACE TWO A/C HEAT PUMP SYSTEMS AT CITY HALL
BUILDING AND RE-PIPE SYSTEM• AND AS AN ALTERNATE REPLACE THREE AIR
HANDLER/I~ATERS AT PUBLIC SAFETY.
TOTAL LUMP SUM PRICE BID FOR BASE BID -REPLACE TWO (2) 5-TON, AIR-TO-AIR
HEAT PUMPS AT NORTH END OF CITY HALL BUILDING, 800 SEMINOLE ROAD:
• Dollars
TOTAL LUMP SUM PRICE BID FORALTERNATEBID -REPLACEMENT OF HEATER/
AIR FL4NDLER AT PUBLIC SAFETY BUILDING:
S
Dollars
SUBMITTAL:
BY
BIDDER
BUSINESS ADDRESS
SIGNATURE
CITY, STATE & ZIl' CODE TITLE
DATE
CONTACT PERSON:
BUSINESS TELEPHONE
TELEPHONE NUMBER:
TAXPAYER IDENTIFICATION NUMBER (Federal Employer Identification Number OR
Social Security Number):
CITY OF ATLANTIC BEACH
DOCUMENT REQUIREMENTS CHECKLIST
ORIGINAL Insurance Certificates (copies, Xeroxes, or facsimiles are
UNACCEPTABLEI naming the City of Atlantic Beach as Certificate Holder,
naming the City of Atlantic Beach as Certificate Holder, showing they have
obtained and will continue to carry Workers' Compensation, public and private
liability, and property damage insurance during the life of the contract.
Three (3) references from companies or individuals for whom the bidder has
completed work or provided a product during the past 12 months, of a comparable
size and nature as this~project. However, naming the City ofAtlantic Beach as a
reference on past projects is UNACCEPTABLE.
Proof of OCCUPATIONAL License (copies ARE acceptable).
Bid submitted IN TRIPLICATE (three (3) sets).
Signed copy of Documents Requirements Checklist.
The.nbove requirements have been noted and are understood by bidder.
SIGNED: (Bidder, or Agent)
DATE:
BID NO
ror~ 1111'9 ~j, Request for Taxpayer Give form to the
(Rev December 1996) ldentifieation Number and Certification requester. Do N07
pt;artment of the Treasury send to the 1RS.
internal Revenue Service
~ ~ U (
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T i
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Name (If a joint account or you changed your name, see Specific Instructions on page 2.)
E3usiness name. if different from above. (See Specific Instructions on page 2.)
Check appropriate box: (_f IndividuaVSole proprietor ~ Corporation (J Partnership U Other >` ...............................
Address (number, street, and apt. or suite no.)
City, state, and 21P code
Identification Number
Enter your T1N in the appropriate box. For
individuals, this is your social security number
(SSN). However, if you are a resident alien OR a
sole proprietor, see the instructions on page 2.
For other entities, it is your employer
identification number (E1N). If you do not have a
number, see How To Get a T1N on page 2.
Note: Jf the account is in mare than one name,
see the chart on page 2 for guidelines on whose
number to enter.
Soetal security number
IITl~I-I
OR
Employer identification number
Litt account number(s) here (optional)
For Payees Exempt From Backup
Withholding (See the instructions
on page 2.)
Certification
Under penalties of perjury, I certily that: ;,,
1. The number shown on this form is my correct taxpayer identiRcation number {or ! am vraiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a} I am exempt from backup w(thholding, 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.
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 properly, cancellation of debt, contributions to an individual retirement
arrangement (IRA). and generally, payments other than interest arid dividends. you are not required to sign the Certification, but you must
provide your,correct T1N. (See the instructions on page 2.}
~ Sign ~
Here Signature } Date Y
Purpose of Form.-A person who is
required to file an information return with
the IRS must get 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
progeny, cancellation of debt. or
contributions you made to an IRA.
Use Form W-9 to give your correct 71N
to the person requesting it (the requester)
and. when applicable. to:
1. Certify the TIN you are giving is
correct (or you are waiting for a number to
be issued),
2. Certify you are not subject to backup
vaithholding, or
3. Claim exemption from backup
withholding it you are an exempt payee.
Note: tf a requester gives you a form other
than a W-9 to request your TIN, you must
use the requester's loan if it is substantially
similar to this Form W-9.
What Is t3ackup Withholding?-Persons
making certain payments to you must
withhold and pay to the 1R5 31% of such
payments under certain conditions. This is
called "backup withholding." Payments
that may be subject to backup wtthholding
Requester's name and address (optional)
include 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.
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 not be subject to backup
withholding. Payments you receive vfill be
subject [o backup withholding if:
7. You do not furnish your TIN to the
requester, or
2. The IRS tells the requester that you
furnished an incorrect TIN, or
3. 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
4. You do not certify to the requester
that you are not subject to backup
withholding under 3 above (for reportable
interest and dividend accounts opened
after 1983 only), or
5. You do not certify your TIN when
required. See the Part III instructions on
page 2 for details.
Certain payees and payments are
exempt from backup withholding. See the
Part II instructions and the separate
Instructions for the Requester of Form
W-9.
Penalties
Failure To Furnish TlN.-If you fail to
furnish your correct TIN to a requester, you
are subject to a penalty of 550 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.-(( you make a
false statement with no reasonable basis
that results in no backup withholding, you
are subject to a 5500 penalty.
Criminal Penalty for Falsifying
Information.- Willfully falsifying
certifications or affirmations may subject
you to criminal penalties including fines
and/or imprisonment.
Misuse of T1Ns.-1( the requester ,
discloses or uses 7lNs in violation of '
Federal law, the requester may be subject
to civil and criminal penalties.
Cat. No. 10231X Form Ulf-9 (Rev. 72-9G)
Form W-9 (Rev. 72.96)
Page 2
Specific Instructio Part II F P
nS - or aaees Exempt From
Name.-I( you are an individual, you must
generally enter the name shown on your
social security card. 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; fist first
and then circle the name of the person or
entity whose number you enter in Part I of
the form.
Sole Proprietor.-You must enter your
individual name as shown on your social
security card. You may enter your
business, trade, or "doing business as'
name on the business name line.
Other Entities.-Enter the business name
as shown on required Federal tax
documents. This name should match the
name shown on the charter or other legal
document creating the entity. You may
enter any business, trade, or "doing
business as" name on the business name
line.
Part 1-Taxpayer Identification Number
(TIN)
You must 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 Now 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, using your EIN may result in
unnecessary notices to the requester.
Note: See the chart on this page for further
clarification of name and T!N combinations.
How To Get a TIN.-1f you do not have a
TIN, apply for one immediately. To apply
for an SSN, get Form SS-5 from your local
Social Security Administration office. Get
Form W-7 (o apply for an ITIN or Form
SS-4 to apply for an EIN. You can get
Forms W-7 and SS-4 from the IRS by
calling 1-800-TAX-FORM
(1-800-829-3676).
If you 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, you will
generally have 60 days to get a 71N and
give it to the requester. Other payments
are subject to backup withholding.
Note: Writing Applied For" means That
you have already applied fora T!N OR that
you intend to apply for one soon.
Backup Withholding
Individuals Qncluding sole proprietors) are
not exempt from backup withholding.
Corporations are exempt from backup
withholding for certain payments, such as
interest and dividends. For more
information on exempt payees, see the
separate Instructions for the Requester of
Form W-9.
If you are exempt from backup
withholding, you should still complete this
form to avoid possible erroneous backup
withholding. Enter your correct TIN in Part
I, write "Exempt' in Part II, and sign and
date the form.
If you are a nonresident alien or a foreign
entity not subject to backup withholding,
give the requester a completed Form W-8,
Certificate of Foreign Status.
Part III-Certification
For a joint account, only the person whose
TIN is shovm in Part I should sign (when
required).
1. Interest, Dividend, and Barter
Exchange Accounts Opened Beforo 1984
and Broker Accounts Considered Active
During 1983. 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 1983. 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 cerJfication. You may cross out
item 2 of the certification.
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 Qncluding payments to
corporations), payments to a nonemployee '
for services Qncluding attorney and
accounting fees), and payments to certain
fishing boat crew members. '
5. Mortgago Interest Paid by You,
Acquisition or Abandonment of Secured f
Property, Cancellation of Debt, or IRA '
Contributions. You must give your correct ,
TIN, but you do not have to sign the e
certification.
Privacy Act Notice
Section 6709 of the Internal Revenue Code
requires you'to give your correct TIN to
persons who must file information returns
with the IRS to report interest. dividends,
and certain other income paid to you.
mongage interest you paid, the acquisition
or abandonment of secured property,
cancellation of debt, or contributions you
made to an IRA. The IRS uses the
numbers for identification purposes and to
help verify the accuracy of your tax return.
The IRS may also provide this information
to the Department of Justice for civil and
criminal litigation and to cities, states, and
the District of Columbia to carry out their
tax laws.
You must provide your TIN whether or
not you are required to file a tax return.
Payers must generally withhold 37% of
taxable interest, dividend, and certain other
payments to a payee who does not give a
TIN to a payer. Certain penalties may also
apply.
Wi~at Name and Number To
Give ttie Requester
For this type ofaccount:l Give name and SSN or:
1. lndrvidual The individual
2. Two or more The actual oviner or the
individuals (Joint aCetwnt y it Combined
aceounq funds, the lust indiviCual
on the account '
3. CustoCian account cf The minor r
a minor (Uniform Gitt
to Minors Act)
4. a. The uwat The granty.trustec '
revocable savings
uvst (grantor Is
also trustee)
D, so-called vast The actual ownCf '
account that Is no;
a legal y valid Vas;
under state law
S. So;e propriety ship The oxne: '
For thls type or aceoun;:I Give name and EtN or:
6. Solo proprietorship
7. A vaLd Wst. estate. y
pension trust
8. Corporate
9. Association. club.
religbus, eharltabte.
cCuc~tiorul, y otnir
tax-exempt
orgatuaGon
to. Partner-,tap
7 t. A broker y registered
nominee
22. Account vith the
Department of
Agriculture in the name
of a public entity Isucn
as a state y local
governmcnC school
district, or prison) chat
receives agricultural
program payments
The owner ~
LCgal entity'
Tne corpyaGon
Tne ygarulation
The partnership
The Drokcr y nominee
The public entity
lht first and etrGe the rume of the person wtwse
number you ftm'r'Jt, lr oNy one person on a joint
account has nn SSN, that person's rwmber must t:e
ufrLShed.
Cirt:le the miny's name and furnish the miny's SSN.
You must show your individual Warne, but you may also
n[er your tWSineSS y 'doing business as' name, You
may the either your SSN y EIN (t you have one).
List first and eircJe the name o! the legal trust. estate.
or pension trust (Do not rtxniSR the TIN or the porsonal
representative or wstee unless the legal entity itself is
not designated In rho account tiue.)
Note: Il no name is circled when more Phan one
name is listed, the number wilt be considered fo
be that or the first name listed.
' BII? N0. 9899-30 -REPLACE TWO A/C HEAT PUMP SYSTEMS AT CITY HALL
BUILDING, AND RE-PIPE SYSTEM; AND, AS AN ALTERNATE, REPLACE THREE AIR.
HANDLER/I~ATERS AT PUBLIC SAFETY BUILDING.
FAD-TO ("BROADCAST")_LIST:
OCEAN STATE HEATING AND AIR CONDITIONING
FAX 249-8949
TAYLOR HEATING AND AIR CONDITIONING
FAX 389-3209
~'II,LIAMS AIR-CONDITIONING AND HEATING
FAX 384-6114
AIR TEMP SYSTEMS
FAX 355-1060
AIR-CONDITIOI~rING, INC.
FAX 389-0970
DONOVAN HEATING AND AIR-CONDITIONING
FAX 241-8814
~,.
ESTES HEATING & AlR-CONDITIONING
FAX 241 X482
AIR ENGINEERS
FAX 646-9037
ABLE PRODUCTS COMPANY
FAX 724-0979
THIGPEN HEATING AND AIR-CONDITIONING
FAX 4489090
WEATHER ENGINEERS
FAX 356-4969
MCCALL CENTRAL AIR
FAX 387-6341
SNYDER AIR CONDITIONING
FAX 641-2329
COASTAL HEATING AND AIR-CONDITIONING
FAX 247-6466
SMITH SUPERIOR HEATING & COOLING
FAX 693-0338