Common use of Express Waiver: I desire to expressly Clause in Contracts

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx 6 City, state, and ZIP code Xxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 2 contracts

Samples: Vendor Agreement, Tips Vendor Agreement

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Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignNavigate360, Inc. Print or type See Specific Instructions on page 2. LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. dba Xxxxx Training or Navigate Prepared or SafePlans or School Check or P3 or Social Sentinel or Evolution Labs 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx Xxxxxxx Xxxxx Xxxxxxx, Xxxxx 000 6 City, state, and ZIP code XxxxxxXxxxxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 2 contracts

Samples: Tips Vendor Agreement, Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxx Xxxxx Digitally signed by Xxxxx Xxxxx 9/15/2020 Signature Date: 2020.09.15 10:55:13 -05'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 TIPS RFP 200901 Industrial and Facility Equipment, Chemicals, Supplies, and Services (including all PPE, Sanitizers, Pathogen Barriers, and Disinfectants) Proposed Goods & Services Gateway has a wide variety of PPE goods available to Texas TIPS members. Members can access these items at xxxxxxxxxxxx.xxx or by contacting one of our local offices. Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring Gateway Printing & DesignOffice Supply, Inc. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx 6 City, state, and ZIP code Xxxxxx, XX See instructions. 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:Xxxxxxxx Xx.

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxx Xxxxxxx Digitally signed by Xxxxx Xxxxxxx 10/15/2020 Signature Date: 2020.10.15 13:59:38 -05'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 5JQT -JOF $BSE -JOL: IUUQT://MJCFSUZUFDIVTB.DPN/UJQT-MJOF-DBSE Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignLiberty Technologies, Inc. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to certain entities, not individuals; see Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx Xxxxxxx Xx. Ste. 230A-2 6 City, state, and ZIP code XxxxxxFarmers Branch, XX 00000 TX 75234 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 DateFebruary 25, 2021 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. QYK BRANDS LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a C Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address 0 Xxxxxxx (numberxxxxxx, streetxxxxxx, and aptxxx xxx. or suite no.) 0000 XxXxxxxx Xx 6 City, state, and ZIP code Xxxxxx, XX See instructions. 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:XXXXXXX XXX.

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Xxxxx XxXxxxx Digitally signed by Xxxxx XxXxxxx DN: C=US, X=xxxxxxxx@xxxxxx.xxx, O="Xxxxxx Security Systems, Inc. ", OU=Controller/Director of Human Resources, CN=Xxxxx XxXxxxx Date: 2021.03.16 12:28:21-05'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignSecurity Systems, Inc. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx 6 CitySee instructions. 00000 Xxxxxxxx Xxxxx 0 Xxxx, statexxxxx, and ZIP code XxxxxxXxxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxx Xxxxxxx Digitally signed by Xxxx Xxxxxxx Signature Date: 2021.01.24 11:08:59 -08'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. THE VERTICAL COLLECTIVE LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx See instructions. 000 X. XXXXXXXX XXXXXX - SUITE 119 6 City, state, and ZIP code XxxxxxXXXXXXX XXXXX, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 08/17/2020 Confidentiality Claim Form rev 10012020RP 02272019 RFP No. 200703 CERTIFICATIONS MBE - NATIONAL MINORITY SUPPLIER DEVELOPMENT COUNCIL SBE - DALLAS FORTH WORTH MINORITY SUPPLIER DEVELOPMENT COUNCIL RFP No. 200703 MBE - EMPIRE STATE DEVELOPMENT DIVISION OF MINORITY AND WOMEN BUSINESS DEVELOPMENT MBE - NYC DEPARTMENT OF SMALL BUSINESS SERVICES RFP No. 200703 MBE - FLORIDA STATE MINORITY SUPPLIER DEVELOPMENT COUNCIL Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. COGENT Infotech Corporation 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx Xxxxx Xxxx, Suite 108 6 City, state, and ZIP code XxxxxxXxxxxxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 3 2 – 0 0 8 3 9 0 4 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxx Xxxxxx Digitally signed by Xxxx Xxxxxx 09-13-2020 Signature Date: 2020.09.13 14:22:30 -07'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. Technologisty LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a P Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx 6 CityXxxxxxxx Xxxxx, stateXxx 000 0 Xxxx, xxxxx, and ZIP code XxxxxxXxx Xxxxx, XX 00000 XX, 00000-0000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Digitally signed by Xxxxxx Xx 1/20/2021 Signature Date: 2021.02.16 18:01:37 -05'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring K & Design, Inc. Print or type See Specific Instructions on page 2. F Drug Corp 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. Starside Drugs 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx See instructions. 00-00 Xxxx Xx 6 City0 Xxxx, statexxxxx, and ZIP code XxxxxxXxxxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 3/18/2021 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. XXXXX XXXXXXX 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. FIRST DEFENSE SOLUTIONS, LLC 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a P Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx XXXXXXX XXXX #000 6 City, state, and ZIP code XxxxxxXXXXX, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxx X. X. Xxxxx Digitally signed by Xxxxx X. X. Xxxxx 10/16/2020 Signature Date: 2020.10.16 11:29:27 -05'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. Xxxxx Xxxxxxx Xxxxx Xxxxx 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. MF Aerospace, LLC 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): ✔ Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address 0 Xxxxxxx (numberxxxxxx, streetxxxxxx, and aptxxx xxx. or suite no.) 0000 XxXxxxxx Xx See instructions. 00000 Xxxx Xxxx 6 City, state, and ZIP code XxxxxxWillis, XX 00000 TX 77318 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 July 17, 2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring XXXXX XXXX XXXXXX & DesignXXXXXX, Inc. Print or type See Specific Instructions on page 2. LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. BERRYDUNN 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a P Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx 6 CitySee instructions. 000 XXXXXX XXXXXX, stateXXXXX 0 0 Xxxx, xxxxx, and ZIP code XxxxxxXXXXXXXX, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 03-15-2021 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. Xxxx Xxxxxxxxxxx Favors 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. Biz Ops pf Texas, LLC 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): ✔ Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx See instructions. 00000 Xxxxx Xxxxxxx Xx 6 City, state, and ZIP code XxxxxxTomball, XX 00000 Tx,77375 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 e Signatur Date12/10/20 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address 0 Xxxxxxx (numberxxxxxx, streetxxxxxx, and aptxxx xxx. or suite no.) 0000 XxXxxxxx Xx 6 City, state, and ZIP code Xxxxxx, XX 00000 7 List account number(s) here (optional) See instructions. Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxxx Xxxxxx Digitally signed by Xxxxxx Xxxxxx 3/10/2021 Signature Date: 2021.03.10 07:43:31 -06'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignBLUE CHIP WHOLESALE SUPPLY, Inc. Print or type See Specific Instructions on page 2INC. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx 6 CityXXXXX XXXXXX XX 0 Xxxx, statexxxxx, and ZIP code XxxxxxXXXXXXX, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxx X. X. Xxxxx Digitally signed by Xxxxx X. X. Xxxxx 10/16/2020 Signature Date: 2020.10.16 11:29:27 -05'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. Xxxxx Xxxxxxx Xxxxx Xxxxx 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. MF Aerospace, LLC 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): ✔ Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx 6 CitySee instructions. 00000 Xxxx Xxxx 0 Xxxx, statexxxxx, and ZIP code Xxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 3/18/2021 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. XXXXX XXXXXXX 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. FIRST DEFENSE SOLUTIONS, LLC 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a P Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx XXXXXXX XXXX #000 6 City, state, and ZIP code XxxxxxXXXXX, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 February 26, 2021 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. SOUTHERN COMPUTER WAREHOUSE INC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation ✔ S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a S Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx X XXXXXXXX XXXX XXXX 300 STE 106 6 City, state, and ZIP code Xxxxxx, XXXXXXXX XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxx XxXxxx Digitally signed by Xxxxx XxXxxx DN: cn=Xxxxx XxXxxx, o=E-Rate Elite Services, Inc, ou, xxxxx=xxxxxxx@xxxxxxxxxx.xxx, c=US 4/12/2021 Signature Date: 2021.04.12 14:23:10 -04'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignE-Rate Elite Services, Inc. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation ✔ S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx See instructions. 00000 Xxx Xxx Xxxx. Xxxxx 000 6 City, state, and ZIP code XxxxxxXxxxxx Xxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

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Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. Uweport LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a P Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx 6 CityXxxxxxx xx xxx 000 0 Xxxx, statexxxxx, and ZIP code XxxxxxXxxxxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Xxxx Xxxx Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxx Xxxxxx Digitally signed by Xxxxx Xxxxxx 10/14/2020 Signature Date: 2020.10.14 10:15:11 -04'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. Reading Plus LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a C Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx 6 CitySee instructions. 000 X Xxxxx Xx., stateXxxxx 000 0 Xxxx, xxxxx, and ZIP code XxxxxxXxxxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 08/17/2020 Confidentiality Claim Form rev 10012020RP 02272019 RFP No. 200703 CERTIFICATIONS MBE - NATIONAL MINORITY SUPPLIER DEVELOPMENT COUNCIL SBE - DALLAS FORTH WORTH MINORITY SUPPLIER DEVELOPMENT COUNCIL RFP No. 200703 MBE - EMPIRE STATE DEVELOPMENT DIVISION OF MINORITY AND WOMEN BUSINESS DEVELOPMENT MBE - NYC DEPARTMENT OF SMALL BUSINESS SERVICES RFP No. 200703 MBE - FLORIDA STATE MINORITY SUPPLIER DEVELOPMENT COUNCIL Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. COGENT Infotech Corporation 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address 0 Xxxxxxx (numberxxxxxx, streetxxxxxx, and aptxxx xxx. or suite no.) See instructions. 0000 XxXxxxxx Xx Xxxxx Xxxx, Suite 108 6 City, state, and ZIP code XxxxxxPittsburgh, XX 00000 PA 15241 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 3 2 – 0 0 8 3 9 0 4 Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxx XxXxxx Digitally signed by Xxxxx XxXxxx DN: cn=Xxxxx XxXxxx, o=E-Rate Elite Services, Inc, ou, xxxxx=xxxxxxx@xxxxxxxxxx.xxx, c=US 4/12/2021 Signature Date: 2021.04.12 14:23:10 -04'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignE-Rate Elite Services, Inc. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation ✔ S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 0000 XxXxxxxx Xx See instructions. 00000 Xxx Xxx Xxxx. Xxxxx 000 6 City, state, and ZIP code XxxxxxXxxxxx Xxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. TEXAS MEDICAL CENTER SUPPLY LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a p Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx XXXXXXX XX. #C 6 City, state, and ZIP code Xxxxxx, XX XXXXXXX XXXXX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature 10/29/2020 Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 TOTE UNLIMITED FINE ARTS SUPPLIES FULL CATALOG AVAILIBLE AT: WWW. XXXXXXXXXXXXX.XXX Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignTOTE, Inc. Print or type See Specific Instructions on page 2INC. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. TOTE UNLIMITED 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 7875 0000 XxXxxxxx Xx X XXXXXXX XXX 6 City, state, and ZIP code Xxxxxx, XXXX XXXXX XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxx Xxxxx Digitally signed by Xxx Xxxxx 11/13/2020 Signature Date: 2020.11.13 10:37:57 -06'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP 02272019 Xxxxxxxxxxxxxxxxxx.xxx Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignDirector's Assistant, Inc. Print or type See Specific Instructions on page 2. LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) C Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a S Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx Xxxxxx Xxxx 6 City, state, and ZIP code Xxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 10/16/2020 Confidentiality Claim Form rev 10012020RP 02272019 Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignAries Building Systems, Inc. LLC Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) a P Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address 0 Xxxxxxx (numberxxxxxx, streetxxxxxx, and aptxxx xxx. or suite no.) 0000 XxXxxxxx Xx 00000 Xxxxxxxxxxx Xxxxx - Xxx 000 6 City, state, and ZIP code Xxxxxx, XX 00000 Houston,Texas 77034 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxxx Xxxxxx Digitally signed by Xxxxxx Xxxxxx 3/10/2021 Signature Date: 2021.03.10 07:43:31 -06'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignBLUE CHIP WHOLESALE SUPPLY, Inc. Print or type See Specific Instructions on page 2INC. 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC ✔ C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address 0 Xxxxxxx (numberxxxxxx, streetxxxxxx, and aptxxx xxx. or suite no.) See instructions. 0000 XxXxxxxx Xx XXXXX XXXXXX XX 6 City, state, and ZIP code XxxxxxLEANDER, XX 00000 TX 78641 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Signature Date 12/09/2020 8/10/2020 Confidentiality Claim Form rev 10012020RP 02272019 National Minority Supplier Development Council (NMSDC) Certification Historically Underutilized Business (HUB) Certification Property of Netsync Network Solutions. Confidential and Proprietary Information. Do Not Copy or Distribute. Form W-9 (Rev. December 2014November 2017) Department of the Treasury Internal Revenue Service Form W-9 (Rev. November 2017) Department of the Treasury nterna Revenue Service Request for Taxpayer Identification Number and Certification Request for Taxpayer Identification Number and Certification Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS Give Form to the requester. Do not send to the IRS. Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignNetsync Network Solutions Netsync Network Solutions Business name/disregarded entity name, Inc. Print or type See Specific Instructions on page 2. if different from above Exemptions (codes apply only to 2 Business name/disregarded entity name, if different from above 3 . page n Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC . C Corporation S Corporation Partnership Trust/estate 4 certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company✔ Prinot or type. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite noSee Specific Instructionos on pag3e 3.) 0000 XxXxxxxx Xx 6 City, state, and ZIP code Xxxxxx, XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxx Xxxxxxx Digitally signed by Xxxx Xxxxxxx Signature Date: 2021.01.24 11:08:59 -08'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & Design, Inc. Print or type See Specific Instructions on page 2. THE VERTICAL COLLECTIVE LLC 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address 0 Xxxxxxx (numberxxxxxx, streetxxxxxx, and aptxxx xxx. or suite no.) 0000 XxXxxxxx Xx See instructions. 000 X. XXXXXXXX XXXXXX - XXXXX 000 6 City, state, and ZIP code XxxxxxREDONDO BEACH, XX 00000 CA 90277 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number Part II Certification 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

Express Waiver: I desire to expressly. waive any claim of confidentiality as to any and all information contained within our response to the competitive procurement process (e.g. RFP, CSP, Bid, RFQ, etc.) by completing the following and submitting this sheet with our response to Education Service Center Region 8 and TIPS. Xxxxxx Xxxxxxxx Digitally signed by Xxxxxx Xxxxxxxx 3-18-21 Signature Date: 2021.03.18 13:42:06 -05'00' Date 12/09/2020 Confidentiality Claim Form rev 10012020RP W-9 Form W-9 (Rev. December 2014October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification a Go to xxx.xxx.xxx/XxxxX0 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Xxxxxx Flooring & DesignALLIED FIRE PROTECTION-SA, Inc. Print or type See Specific Instructions on page 2. LP 2 Business name/disregarded entity name, if different from above Print or type. See Specific Instructions on page 3. 3 Check appropriate box for federal tax classification; check classification of the person whose name is entered on line 1. Check only one of the following seven boxes: . 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnershipPartnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check : Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) a Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 0000 XxXxxxxx Xx 6 CityXXXXXX XX 0 Xxxx, statexxxxx, and ZIP code Xxxxxx, XXXXXXXX XX 00000 7 List account number(s) here (optional) Requester’s name and address (optional) Part I Taxpayer Identification Number (TIN) Employer identification number 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 resident alien, sole proprietor, or disregarded entity, see the instructions for Part I instructions on page 3I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3TIN, later. Note. : If the account is in more than one name, see the instructions for line 1 1. Also see What Name and Number To Give the chart on page 4 Requester for guidelines on whose number to enter. Social security number – – or Part II Certification Under penalties of perjury, I certify that:

Appears in 1 contract

Samples: Tips Vendor Agreement

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