11-003 Agreement, The Galivant Group, General Plan, Housing ElementCITY OF
fl
CUPERTINO
AGREEMENT
CITY OF CUPERTINO
10300 Torre Avenue
Cupertino, CA 95014
408-777 -3200
BY THIS AGREEMENT, made and entered into this 141
h day of January, 2011. by and between the CITY OF
CUPERTINO (Hereinafter referred to as CITY) and __ ~T ..... h~e_G~a~l .... iv~a~n~t~G .... r~o_u~p ____________ _
Address City Zip Phone
(Hereinafter referred as CONTRACTOR), in consideration of their mutual covenants, the parties hereto agree as
follows:
CONTRACTOR shall provide or furnish the following specified services and/or materials: See Exhibit 1
EXHIBITS: The following attached exhibits hereby are made part of this Agreement: _.-E=x=h""'i=b..;..;;it'-'1'-------
TERMS: The services and/or materials furnished under this Agreement shall commence on 1/14/2011
and shall be completed before 2/28/2011
COMPENSATION: For the full pertormance of this Agreement, CITY shall pay CONTRACTOR: $1,275.00
GENERAL TERMS AND CONDITIONS
Hold Harmless Contractor agrees to save and hold harmless the City, its officers, agents and employees from any
and all damage and liability due to negligence, errors and omissions, including all costs of defending any claim, caused
by or arising out of the pertormance of this Agreement. City shall not be liable for acts of Contractor in pertorming
services described herein.
Insurance Should the City require evidence of insurability, Contractor shall file with City a Certificate of Insurance
before commencing any services under this Agreement. Said Certificate shall be subject to the approval of City's
Director of Administrative Services.
Non-Discrimination No discrimination shall be made in the employment of persons under this Agreement because of
the race, color, national origin, ancestry, religion or sex of such person.
Interest of Contractor It is understood and agreed that this Agreement is not a contract of employment in the sense
that the relationship of master and servant exists between City and undersigned. At all times, Contractor shall be
deemed to be an independent contractor and Contractor is not authorized to bind the City to any contracts or other
obligations in executing this agreement. Contractor certifies that no one who has or will have any financial interest
under this Agreement is an officer or employee of City.
Changes This Agreement shall not be assigned or transferred without the written consent of the City. No changes or
variations of any kind are authorized without the written consent of the City. '1J ENTERED CONTRACT CO-ORDINATOR and representative for CITY shall be:
NAME Vera Gil, Senior Planner DEPARTMENT __ --"C~o~m.:..:..:..:.m=u~n=it~y~D~e~v~e~lo~p~m=..;:;.e..;..;;n~t--
This Agreement shall become effective upon its execution by CITY, in witness thereof; the parties have executed this
Agreement the day and year first written above.
CITY OF CUPERTINO:
By Gary Chao ~{_A--
Title City Planner
APPROVALS EXPENDITURE DISTRIBUTION
1,000.00
110-7302-6111 275.00
January 11, 2011
Community Development
City of Cupertino
Traci Caton
GENERAL PLAN
26 pages or 13 sheets
1 00# matte text
Digital files supplied
Full color both sides (CMYK)
30 sets
3 hole drilled
Each set shrinkwrapped
$325.00 + Tax
HOUSING ELEMENT
GThi::1~ t a~~van.
gFDlJP·
I 3 9 5 FRANKLIN STREET
SANTA CLARA, CA 95050
140 pages, 70 sheets color both sides
100# matte text
Digital files supplied
Full color both sides (CMYK)
3 hole drilled
Each set shrinkwrapped
30 sets
$950. 00 + tax
EXHIBITl
Phone 650.207.2884 Fax 408.26I.7677 email freddie@galivantgroup.com
Form W-9 Request for Taxpayer Give form to the
(Rev. October 2007) Identification Number and Certification requester. Do not
send to the IRS. Department of the Treasury
Internal Revenue Service
Name (as shown on your income tax return)
C\i Fredericka Allen Tilford Q)
Ol Business name, if different from above o:l
0. The Galivant Group c
0
Q) Ill Check appropriate box: IXJ Individual/Sole proprietor 0 Corporation D Partnership c. § 0 Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) ' O Exempt ~:;::; -------payee ... I) 02 0 Other (see instructions) 1 ........ Address (number, street, and apt. or suite no.) c: Ill Requester's name and address (optional) ·c: .E ei 'i-1j 6t,Ov {-w.J~+'V\~ . C) 0.. I) 1395 Franklin Street ~
I) City, state, and ZIP code 6;mww11r~ .e..ue-lofment-Q) c. Santa Clara CA 95050 en
Q) List account number(s) here (optional) Q)
CJ)
I :.F.TI •• Taxpayer Identification Number {TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number
backup withholding. For individuals, this is 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. or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number
number to enter.
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure.to report all interest or dividends, or (c) th'e IRS has
notified me that I am no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. See the irJ)3tructions on nge 4. fi '/JI A~---
. , __ / "' ~V\-_\__ ---
Sign Signature of ·------> ~L ~~·-Ci?JHL<~--fa =,, ;~~,./
Here u.s. person ----· -;:<-~.eJL<> · ·
General Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
Purpose of Form
A person who is required to file an information return with the
IRS must obtain your correct taxpayer identification number (TIN)
to report, for example, income paid to you, real estate
transactions, mortgage interest yqu paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
Use Form W-9 only if you are a U.S. person (including a
resident alien), to provide your correct TIN to the person
requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S.
exempt payee. If applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income from
a U.S. trade or business is not subject to the withholding tax on
foreign partners' share of effectively connected income.
Note. If a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
Date January 14, 2011
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
? An individual who is a U.S. citizen or U.S. resident alien,
? A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
States,
? An estate (other than a foreign estate), or
? A domestic trust (as defined in Regulations section
301.7701-7).
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners' share of income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding
on its allocable share of net income from the partnership
conducting a trade or business in the United States is in the
following cases:
? The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231X Form W-9 (Rev. 10-2007)