HomeMy WebLinkAboutHexagon Transportation Consultants, Inc. (6)AGREEMENT
THIS AGREEMENT is made and entered into on the 31 day
ay of J ck-A 2011 by and
between the TOWN OF LOS ALTOS HILLS (hereinafter referred to as "TOWN") and
Hexagon Transportation Consultants, Inc. (hereinafter referred to as "CONTRACTOR").
In consideration of their mutual covenants, the parties hereto agree as follows:
1. CONTRACTOR, Shall provide or furnish the following specified services and/or
materials:
Provide Guardrail Study at Taaffe Road and Crosswalk
Study at Fremont Road.
2., EXHIBITS. The following attached exhibits are hereby incorporated into and made
a part of this Agreement:
Proposal from CONTRACTOR dated January 26, 2011
3. TERMS. The services and/or materials furnished under this Agreement shall
commence 2/1/2011 and shall be completed by 3/1/2011, unless terminated
pursuant to Section 5(f).
4. COMPENSATION. For the full performance of this Agreement:
a. TOWN shall pay CONTRACTOR an amount not to exceed eight thousand
dollars and zero cents ($ 8,000.00) within thirty (30) days following receipt of
invoice and completion/delivery of services/goods as detailed in Sections 1, 2,
and 3 of this Agreement and only upon satisfactory delivery/completion of
goods/services in a manner consistent with professional/industry, standards for
the area in which CONTRACTOR operates, TOWN is not responsible for paying
for any work done by CONTRACTOR or any subcontractor above and beyond
the not to exceed amount.
b. Town shall not reimburse for any of CONTRACTOR's costs or expenses to
deliver any services/goods. Town shall not be responsible for any interest or late
charges on any payments from Town to CONTRACTOR.
c. CONTRACTOR is responsible for monitoring its own forces/employees/agents/
subcontractors to ensure delivery of goods/services within the terms of this
Agreement., TOWN will not accept or compensate CONTRACTOR for
incomplete goods/services.
Town of Los Altos Hills Page I of 4
Short form
Updated 4123110
5. GENERAL TERMS AND CONDITIONS.
a. HOLD HARMLESS. CONTRACTOR agrees to indemnify, defend and hold
harmless the TOWN, its officers, agents and employees from any and all
demands, claims or liability of personal injury (including death) and property
damage of any nature, caused by or arising out of the performance of
CONTRACTOR under this Agreement. With regard to CONTRACTOR'S work
product, CONTRACTOR agrees to indemnify, defend and hold harmless the
TOWN, its officers, agents and employees from any and all demands, claims or
liability of any nature to the extent caused by the negligent performance of
CONTRACTOR under this Agreement.
b., INSURANCE. CONTRACTOR shall file with the TOWN a certificate of
insurance before commencing any services under this Agreement as follows:
I,. WORKERS COMPENSATION INSURANCE: Minimum statutory
limits.
I!. COMMERCIAL GENERAL LIABILITY AND PROPERTY DAMAGE
INSURANCE-., General Liability and Property Damage Combined.
$1,000,000.00 per occurrence including comprehensive form,
personal Injury, broad form personal damage, contractual and
premises/operation, all on an occurrence basis. If an aggregate limit
exists, it shall apply separately or be no less than two (2) times the
occurrence limit.
Ill.. AUTOMOBILE INSURANCE: $1,000,000.00 per occurrence.
iv,. ERRORS AND OMISSIONS INSURANCE: $1,000,000.00 aggregate,,
v. NOTICE OF CANCELLATION. The City requires 30 days written
notice of cancellation. Additionally, the notice statement on the
certificate should not include the wording "endeavor to" or "but failure
to mail such notice shall impose no obligation or liability of any kind
upon the company, its agents or representatives."
vi. CERTIFICATE OF INSURANCE, Prior to commencement of services,
evidence of insurance coverage must be shown by a properly
executed certificate of insurance and it shall name "The Town of Los
Altos Hills, its elective and appointed officers, employees, and
volunteers" as additional insureds.,
vii., To prevent delay and ensure compliance with this Agreement, the
insurance certificates and endorsements must be submitted to:
Town of Los Altos Hills
26379 Fremont Road
Los Altos Hills, CA 94022
Town of Los Altos Hills Page 2 of 4
Shad form
Updaled 4123/10
c. NON-DISCRIMINATION. No discrimination shall be made in the employment of
persons under this Agreement because of the race, color, national origin, age,
ancestry, religion or sex of such person.,
d. INTEREST OF CONTRACTOR. It is understood and agreed that this
Agreement is not a contract of employment and does not create an employer-
employee relationship between the TOWN and CONTRACTOR. At all times
CONTRACTOR shall be an independent contractor and CONTRACTOR is not
authorized to bind the TOWN to any contracts or other obligations without the
express written consent of the TOWN. In executing this Agreement,
CONTRACTOR certifies that no one who has or will have any financial interest
under this Agreement is an officer or employee of TOWN.
e.. CHANGES. This Agreement shall not be assigned or transferred without
advance written consent of the TOWN, No changes or variations of any kind are
authorized without the written consent of the City Manager. This Agreement may
only be amended by a written instrument signed by both parties,.
f.. TERMINATION. This Agreement may be terminated by TOWN upon seven (7)
days written notice to CONTRACTOR. Monies owed for work satisfactorily
completed shall be paid to CONTRACTOR within 14 days of termination..
g. RECORDS. All reports, data, maps, models, charts, studies, surveys,
calculations, photographs, memoranda, plans, studies, specifications, records,
files, or any other documents or materials, in electronic or any other form, that
are prepared or obtained pursuant to this Agreement and that relate to the
matters covered hereunder shall be the property of the TOWN, CONTRACTOR
hereby agrees to deliver those documents to the TOWN at any time upon
demand of the TOWN., It is understood and agreed that the documents and
other materials, including but not limited to those described above, prepared
pursuant to this Agreement are prepared specifically for the TOWN and are not
necessarily suitable for any future or other use. Failure by CONTRACTOR to
deliver these documents to the TOWN within a reasonable time period or as
specified by the TOWN shall be a material breach of this Agreement. TOWN
and CONTRACTOR agree that until final approval by TOWN, all data, plans,
specifications, reports and other documents are preliminary drafts not kept by
the TOWN in the ordinary course of business and will not be disclosed to third
parties without prior written consent of both parties. All work products submitted
to the TOWN pursuant to this Agreement shall be deemed a "work for hire."
Upon submission of any work for hire pursuant to this Agreement, and
acceptance by the TOWN as complete, non-exclusive title to copyright of said
work for hire shall transfer to the TOWN. The compensation recited in Section 4
shall be deemed to be sufficient consideration for said transfer of copyright.
CONTRACTOR retains the right to use any project records, documents and
materials for marketing of their professional services.
Town of Los Altos Mills Page 3 of 4
Short form
Updalod,1123170
h. ENTIRE AGREEMENT. This Agreement represents the entire agreement
between the Parties. Any ambiguities or disputed terms between this Agreement
and any attached Exhibits shall be interpreted according to the language in this
Agreement and not the Exhibits.
6. INVOICING. Send all invoices to the contract coordinator at the address below,.
This Agreement shall become effective upon its approval and execution by TOWN., In
witness whereof, the parties have executed this Agreement the day and year first
written above,.
CONTRACT COORDINATOR and
representative for TOWN,- CO
Richard Chiu
Public Works Director
Town of Los Altos Hills By:
26379 Fremont Road
Los Altos Hills, CA 94022
7, q,--) ( I
Ae,,Jt-
Print name, Title
TOWN OF LOS ALTOS HILLS:
By. CJ.0
Carl Cahill, City Manager Date '
Town of Los Altos Hills Page 4 of 4
Short form
Updated 4123110
PIXAm TRANSPORTATION CONSULTANTS, INC.
January 26, 2011
Mr. Richard Chiu
Public Works Director
Town of Los Altos Hills
26379 Fremont Road
Los Altos Hills, CA 94022
Subject. Proposal to Conduct Two Traffic Studies in Los Altos Hills, California
Lear Mr,Chiu:
Hexagon Transportation Consultants, Inc, is pleased to submit this proposal to conduct two traffic
studies for Los Altos Hills: the Taaffe Road guardrail study, and the Tremont Road crosswalk
study.. These studies and their scopes of work are discussed in detail below.
Taaffe Road Guardrail Study
This study would evaluate the possibility of installing a guardrail or other safety treatment on
Taaffe Road near Elena Road. There is a sharp curve on Taaffe Road near Elena Road.. We
understand that at least one vehicle has run off'the road at the curve and landed in a resident's
yard. We fuurther understand that there is a pedestrian and equestrian path along Taaffe Road that
could limit the space available to install a guardrail.. As the Town knows, installation of'guardrail
is expensive both for construction and maintenance. Therefore, guidelines have been established
for guardrail installation. The AASHTO guidelines are based on site conditions of slope height and
angle.. Other agencies have added a consideration of'vehicle volume and speed. (If there is a low
probability of'vehicles running off the road because oflow volume or low speed, it doesn't make
economic sense to install a guardrail even if the drop-off is severe.,) If a guardrail is found to be not
warranted or infeasible, Hexagon will explore other methods for increasing safety around the
curve.
The tasks to be included in the analysis are as follows:
Site Reconnaissance. Hexagon will visit the site and will measure the height of the slope and
the slope angle to the best of our ability. We will determine the amount of flat space available
to build a guardrail given the need to maintain the pedestrian and equestrian path.,
Trq is Data Collection.. Hexagon will conduct directional speed and volume tube counts on
Taaffe Road just before the curve leading to Elena Road for a one week period so both
weekday and weekend traffic volume data are collected.
3., Accident Data, The Town of Los Altos Hills will provide the accident history for the curve
on Taaffe Road.
4. Guardrail Warrant Analysis. Hexagon will use the guardrail guidelines from AASI-ITO and
other, publications to evaluate the need for a guardrail on Taaffe Road.
Mr. Richard Chiu
January 26, 2011
Page 2 of 3
5. Safety Treatments. Hexagon will describe other safety treatments that could be installed on
Taaffe Road to warn motorists of the curve and to slow traffic,.
6, Report. Hexagon will present its findings in a draft memo report.. Following review and
comment on the report by Town staff, Hexagon will produce the final report.
Freemont Road +Cros"valk Study
This study will evaluate the existing crosswalks on Fremont Road at Templeton Place and at Old
Altos Road. These crosswalks already exist but are near curves.. The analysis will determine
whether the crosswalks have adequate sight distance and will determine whether any additional
pavement markings or signs should be added. Hexagon will measure traffic speed on Fremont
Road, sight distance at the crosswalks, and will count pedestrian usage of the crosswalks.
The tasks to be included in the analysis for the project are:
L Site Reconnaissance and Observations. The physical characteristics of the segment of
Fremont Road at Templeton Place and at Old Altos Road will be determined. Sight distance
will be measured in both directions. Hexagon will observe existing traffic conditions and note
any special conditions or concerns.
2. Traffic Data Collection., Hexagon will conduct directional speed and volume tube counts at
two locations on Fremont Road for a one week period so both weekday and weekend traffic
volume data are collected.. Based on input from Los Altos Hills staff, Hexagon will make
field visits on two days for two hours each day at the busiest times to count pedestrians and
equestrians using the crosswalks..
3. Accident Data.. The Town of Los Altos Hills will provide the accident history for- Fremont
Road in the vicinity of the two study crosswalks for the past 3 years. Hexagon will review
and include the data in the traffic analysis.
4. Crossrvalk Evaluation. Hexagon will evaluate the two crosswalks for adequate sight distance
and existing usage.. If the crosswalks are recommended to stay, Hexagon will identify any
necessary pavement markings or signage to be added..
5. Report„ Hexagon will present its findings in a draft memo report., Fallowing review and
comment on the report by Town staff; Hexagon will produce the final report.
Time of Performance
Barring any unforeseen delays, a draft memo reports will be submitted for each study four weeks
after authorization to proceed, We are ready to start work immediately upon authorization..
111 W. St. John Street, Suite 850
San Jose, California 95113
Phone 408.971.5100 Fax 408.971.6102
Mr, Richard Chiu
January 26, 2011
hbb. Page 3 of 3
Cost of services
The total fee for both studies is quoted for a lump sum amount of $8,000. "Additional Services"
shall be provided upon authorization and will be billed separately based on a time and materials
basis.
This price quote is good for 30 days.. This price quote assumes all project -related activities will be
completed within one ,year. Extended project schedules will require additional budget for project
administration.
We appreciate ,your consideration of Hexagon Transportation Consultants for this assignment.. If
,you have any questions, please do not hesitate to call,. Thank you..
Sincerely,
HEXAGON TRANSPORTATION CONSULTANTS, INC,;.
74--) gd-
Gary Black
President
Attachment: Contract Agreement
111 M St John Street, Suite 850
San Jose, California 95113 O
Phone 408.971.6100 Fax 408.971,6102
CONTRACT AGREEMENT TO )ENGAGE THE SERVICES OF
HEXAGON TRANSPORTATION CONSUIZANTS, INC.
Contract Number: 0132
THIS AGREEMENT, entered into by and between I-WXAGON TRANSPORTATION CONSULTANTS, INC, located at I I I W.
St. John Street, Suite 850, San Jose, CA 95113, hereinafter called "HEXAGON" and the party whose name and address is:
Firm Name: Town of Los Altos Hills
Street Address: 26379 Fremont Road
City and State: Las Altos Hills, California 94022
Telephone No.: (650) 947-2516
Fax No..
Attention: Richard Chiu, Public Works Director
Hereinafter called "CLIENT" concerns the proposed project of'CL•IENT. The following is a general description ofthe proposed
project which is hereinafter referred to as "PROJECT":
Guardrail Study for Tanffe Road and Crosswalk Study for Fremont Road in Los Altos bills, CA
Regarding the PROJECT, the CLIENT and HEXAGON agree as follows:
1. HEXAGON agrees to perform certain consulting services for CLIENT as detailed on our attached scope of services
letter dated .January 26, 2011.
2, CLIENT agrees to pay HEXAGON as compensation for its services as follows:
A lump sum amount equal to $8,000.
NOTE: Under the provisions of this agreement, a late payment FINANCE CHARGE will be computed at the
periodic rate of I r/% per month, which is an ANNUAL, PERCENTAGE RATE OF I8% and may be applied to any
unpaid balance commencing 30 days after the date of the original invoice.
3. The standard provisions set forth upon Exhibit A are hereby incorporated into and made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have accepted, made and executed this agreement upon the terms, conditions and
provisions stated above:
Hexagon Transportation Consultants, Inc.
By:
Gary IC. Black
President January 26. 2011
Title Date
Client
By:
Signature
Printed Name and Title
Date
Exhibit A — Page 1 of 2
Contract Number GB2
STANDARD PROVISIONS OF AGREEMENT
The CLIENT and HEXAGON agree that the following provisions shall be a part of their agreement:
L The CLIENT binds himself, his partners, successors, executors, administrator, and assigns to HEXAGON this
agreement in respect to all ofthe terms and conditions of this agreement.
2.. In the event that the PROJECT covered by this contract is required by a governmental agency or the CLIENT and in
the event that due to change of policy of said agency or CLIENT after the date of this agreement, additional office or
field work is required, the said additional work shall be paid for by CLIENT as extra work
3. The CLIENT shall pay as extra work the costs of any services not specifically included in the attached scope of
work.. Any extra work will be undertaken only with the advance approval of the CLIENT,
4. Should litigation be necessary to enforce any term or provisions of this agreement or to collect any portion of the
amount payable under this agreement, then all litigation and collection expenses, witness fees and court costs, and
attorney's fees shall be paid by the prevailing party,
5.. Pees and all other charges will be billed periodically as the work progresses, and the net amount shall be due at the
time of billing. Lump Sum work will be billed monthly on a percent complete basis. If the invoice is not paid
within .30 days, HEXAGON may, without waiving any claim or right against the CLIENT and without liability
whatsoever to the CLIENT, terminate the performance of the service.
G.. A late payment FINANCE CHARGE will be computed at the periodic rate of] % % per month, which is an
ANNUAL PERCENTAGE RATE OF 18% and may be applied to any unpaid balance commencing 30 days after
the date of the original invoice at the sole election of HEXAGON., In the event any portion or all of an account
remains unpaid 90 days after billing, the CLIENT shall pay all costs of collection and reasonable attorney's fees.
7.. In the event all or any portion of the work prepared or- partially prepared by HEXAGON be suspended, abandoned,
or terminated by the CLIENT, the CLIENT shall pay HEXAGON for the work performed on an hourly basis using
Hexagon's standard rates, not to exceed any maximum contract amount specified herein, to the date of termination,
all reimbursable expenses, and reimbursable termination expenses.
8. 1-IEXAGON makes no representation concerning the cost figures made in connection with maps, plans,
specifications, or drawings other- than that all cost figures are estimates only and HEXAGON shall not be
responsible for fluctuations in cost factors.
9. No conditions or representations altering, detracting from, or adding to the terms hereof'slnall be valid unless printed
or written hereon or evidenced in writing by either party to this agreement and accepted in writing by the other.
10. HEXAGON shall not be responsible for damages resulting from delays in performance caused by any factors
beyond HEXAGON'S reasonable control, In the case of the happening of any such cause of delay, the time of
completion shall be extended accordingly,
Exhibit A — Page 2 of 2
Contract Number GB2
STANDARD PROVISIONS OF AGREEMENT CONTINUED
11. HEXAGON makes no warrant, either express or implied, as to its finding, recommendations, specifications, or
professional advice except that they were set forth after being prepared in accordance with generally accepted
engineering practices and under the direction of a registered professional engineer'.
12.. The CLIENT agrees to limit HEXAGON'S liability to the CLIENT and/or the owner, and to all construction
contractors and subcontractors on the PROJECT, due to HEXGAON'S negligent acts, errors or omissions, such that
the total aggregate liability of HEXAGON to all those named shall not exceed the amount permitted by law.
13. In the event any provision of this agreement shall be held to be invalid and unenforceable, the other provisions of
this agreement shall be valid and binding on the parties hereto.
14. HEXAGON reserves the right to hire and terminate sub -consultants and vendors as HEXAGON deems necessary in
order to complete the PROJECT.
15. Services provided within this agreement are for the exclusive use of the CLIENT.
16. This contractual agreement must be executed by the CLIENT and returned to HEXAGON within 30 days of the date
of this contract, HEXAGON reserves the right to determine whether contracts executed by the CLIENT after this 30
day period are valid and binding.
17. Each Party, HEXAGON and CLIENT shall procure and maintain for, the duration of the contract insurance against
claims for injuries to persons or damages to property which may arise from or in connection with the performance of
the work hereunder by the Parties, their agents, representatives, or employees. Parties shall maintain insurance
limits of no less than $1,000,000 per occurrence for General Liability, $1,000,000 per accident for Automobile
Liability, Statutory limits for Workers' Compensation, and $1,000,000 per accident for Employers Liability.
HEXAGON shall also maintain $1,000,000 per claim in limits for Professional Liability or Errors and Omissions
Coverage. The Parties shall name each other, their respective officers, officials, employees and volunteers as
additional insured as respects liability arising out of'work or operations performed by or on behalf of the other party;
or automobiles owned, leased, hired or borrowed by the HEXAGON. Parties shall furnish each other with original
certificates and amendatory endorsements effecting coverage required by this clause.. All certificates and
endorsements are to be received and approved before work commences. However, failure to do so shall not operate
as a waiver of these insurance requirements.
18.. Each Party will, at its sole expense, indemnify, defend and hold the other Party and its officers, trustees, owners,
employees and agents harmless from and against any and all claims, suits, costs, expenses (including attorneys*
fees), losses, damages or liabilities (including those arising from injury or damage to persons or property) which the
other Party may incur or suffer as a result of or in connection with (i) the acts, omissions, negligence or other'
conduct by or on behalf of the Party or, its members, employees, agents or contractors, and/or (ii) the breach by the
Party of this Agreement_
Form ®g
Request for Taxpayer
Give form to the
(Rev. October 2007)
Identification Number and Certification
requester. Do not
Geptinmera DI 1110 Trosuny
Internal Revenue Service
otherwise noted
send to the IRS,
Purpose of Form
Name (as shown an your income tax return)
Cv
0
States,
tz
Business name. if different from above �( /
�iL �c n110 A %� T 9c` tiL t 0 ✓l-,-
oChock
appropriate box: ❑ Individual/Sole proprietor K Corporation ❑ Partnership
❑
Exempt
301.7701-7)
Limited liability company Enter the tax dassHionfton ([t=dlsragarded entity, C=corporatlon, P�partnership) ........
❑ payee
o
❑ Other (oee insvucfims) 4
resident alien), to provide your correct TIN to the person
requesting It (the requester) and. when applicable, to:
from such business Fuliher, In certain cases where a Form W-9
Address (number, street, and apt. or suite noi)
Requester's
1 Certify that the TIN you are giving Is correct (or you are
r
name and address (optional)
Therefore, If you are a U.S person that is a partner in a
Town of Los Altos Hills
28379 Fremont Road
City, state, and ZIP code
3 Claim exemption from backup withholding d you are a U S
p p g Y
6-:,. J c: 5e :531( 3
Los Altos hills, CA 94022
4D
List account number(s) here (optiano
KIM Taxpayer Identification Number (Ti
[titer your TIN in tile appropriate box. The TIN provided must match the name given on Une 1 to avoid Social security number
backup vAthholding For individuals, this I$ your social security number (SSN) However, for a resident
ellen, sole proprietor, or disregarded entity, see the part I Instructions on page 3 For outer entitles, It is
your employer Identification number (SIN) If you do not have a number. see Now to get a 77N on page 3 ar
Note. If the account Is In more than one name, see the chart o11 page A for guidelines on whoseemployer identification number
number to enter. °97 7 i 0,o/ -786'7.5-
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 6 person (defined below)
Certification Instructions, You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, item 2 does not apply
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt. contributions to an individual retirement
arrangement (IRA), and generally, paymegIs other than Interest and dividends, you are not required to sign the Certification. but you must
provide your correct TIN. See the instrni4lons qn page A.
Sestet
Here
fl
Signature of
U.S. Y
person ^
i -J� 2� f
Date •
General lnstruction
Definition of a U,.S, person. For federal tax purposes, you are
Section references are to the Internal Re snug Code unless
considered a US person K you are:
otherwise noted
• An Individual who is a U S citizen or U S resident alien.
Purpose of Form
r A partnership, corporation, company, or association created or
organized in the United States or under the laws or the United
A person who is required to file an information return with the
States,
IRS must obtain your correct taxpayer identification number (TIN)
s An estate (other than a foreign estate), or
to report, for example, income paid to you, real estate
s A domestic trust (as defined In Regulations section
transactions, mortgage interest you paid, acquisition or
301.7701-7)
abandonment of secured property. cancellation of debt. or
contributions you made to an IRA
Special rules for partnerships. Partnerships that conduct a
Use Form W-9 only if you are a U 5 person (Including a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners' share of income
resident alien), to provide your correct TIN to the person
requesting It (the requester) and. when applicable, to:
from such business Fuliher, In certain cases where a Form W-9
has not been received, a partnership Is required to presume that
1 Certify that the TIN you are giving Is correct (or you are
a partner is a foreign person, and pay the withholding tax
wailing for a number to be Issued).
Therefore, If you are a U.S person that is a partner in a
2 Certify that you are not subject to backup withholding, or
partnership conducting a trade or business In the United States.
provide Form W-9 to the partnership to establish your U S.
3 Claim exemption from backup withholding d you are a U S
p p g Y
status and avoid withholding on your share of partnership
exempt payee. It applicable. you are also certifying that as a
Income
U S person. your allocable share of any partnership income from
a U S. trade or business Is not subject to the withholding tax on
foreign partners' share of effectively connected Income
The parson who gives Form W-9 to the partnership for
purposes of establishing its U 5 status and avoiding withholding
Note. If a requester gives you a form other than Form W9 to
on its allocable share of net Income from the partnership
conducting a trade or business in the United States Is in the
request your TIN, you must use the requester's form if it Is
following cases:
substantially similar to this Form W-9
o The U S. owner of a disregarded entity and not the entity,
Gat No 10231x Fomt W-9 (Rev 10-2007]