11-006 Agreement, Michael Bench, Arborist ReviewCITY OF
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CUPERTINO
AGREEMENT
CITY OF CUPERTINO
10300 Torre Avenue
Cupertino, CA 95014
408-777-3200 NO. -032924
BY THIS AGREEMENT, made and entered into this 14th day of January. 2011, by and between the CITY OF
CUPERTINO (Hereinafter referred to as CITY) and __ M=lc....,h=a""'el:...::B""'e..,.!)..:C.:.::.h ____________ _
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: Arborist Review
EXHIBITS: The following attached exhibits hereby are made part of this Agreement: __ E_xh_i_b_it_1 _____ _
TERMS: The services and/or materials furnished under this Agreement shall commence on __ 1 .... 1 .... 14...,/2""0"""1 ..... 1 __
and shall be completed before not apellcablL
COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR: See Exhibit 1
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 performance of this Agreement. City shall not be liable for acts of Contractor in performing
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.
CONTRACT CO-ORDINATOR and representative for CITY shall be:
NAME Garv Chao, Citv Planner DEPARTMENT Communitv Development
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.
CONTRAC:O~_)
By ""' ~ .t..At.."···--..
Title A11chael L .13.GtJt.h &mstJlbN,, AdBo1-Usr
Tax ID/Soc. Sec.#
APPROVALS
CITY OF CUPERTINO:
By Gary Chao
Title City Planner
EXPENDITURE DISTRIBUTION
See Ex.1
'-~ ~
)~ Michael L. Bench
(., f";, Consulting Arborist
) ~j.·SlSl 7327 Langley Canyon Road
Prunedale, CA 93907
FEE SCHEDULE
$ 150.00 per hour On .. Site Consultation or Investigation (one hour minimum);
billed inl 5 minute increments after 1 hour.
$ 150.00 per hour Office Consultation, billed in 15 minute increments, to include:
• Person to person phone consultation.
• Plan or document review.
• Preparation of Reports, including preparation of responses by Email
or "Hard Copy" documents.
• Preparation of maps, photos, or sketches.
• Revisions of Reports, if requested in response to new or additional
information.
$ 150.00 per hour Public Hearing Attendance upon request
$ 50.00 per hour Travel over 30 miles from Prunedale office (when multiple appointments
can be done same day, travel time is divided between all clients).
$ 250.00 per hour Services related to Litigation
Additional Fees for Services upon Request
Field work requiring laboratory analysis or specialized equipment would be approved in
advance by client prior to performance of services.
Terms
Invoices are submitted upon completion of assignments.
Payment for Services is due within 30 days of receipt of Invoice.
Updated January 27, 2011
Michael L. Bench, Consulting Arborist
International Society of Arboriculture Certification # 1897
American Society of Consulting Arborists Member
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 Treaswy
Internal Revenue Service
Name (as shown on your income tax return)
C\i tv\ tC\1A12.L BeNcw <ll O> Business name, if different frorn above <~ Cl. t--..\ I C. \.-\-Pr EL-L. ./2I;.r..JC..H U:f..i:5u L TIN b AR6Dle.l5t c 0
Q) ~ Check appropriate box: j( Individual/Sole proprietor D Corporation D Partnership Exempt $,g D Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) .,. • _____ . D ... (.) D Other (see instructions) ~ payee
0 :i .,_, .j:i t: II) Address (number, street, and apt. or suite no.) Requester's name and address (optional) ·c: .E a. (.) ZIP
(optional)
(/)
1111':.f=n il!lllll Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid
backup withholding. For individuals, this is 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 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 rne), and
2. I am not subject to backup withholding because: (a) I arn exempt from backup withholding, or (b) I have not been notified by the lciternal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest· or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. I am a U.S . .citizen or ot1er 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 hot apply.
For mortgµge interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than i terest and dividends, you are not required to sign the Certification, but you must
pt·ovide your correct TIN. See the instructions on page I.I.
Sign
Here Signature of
U.S. person ._
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 you 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 Eixeliiption 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._ ~-//-!/
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 requir<:id 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 yollr U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form Wc9 to the partnershlj'.Hor'
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. Na. 10231X Form W-9 (Rev. 10-2007)
Form W-9 (Rev. I 0-2007)
• The U.S. grantor or other owner of a grantor trust and not the
trust, and
• The U.S. trust (other than a grantor trust) and not the
beneficiaries of the trust.
Foreign person. If you are a foreign person, do not use Form
W-9. Instead, use the appropriate Form W-8 (see Publication
515'; Withholding of Tax on Nonresident Aliens and F9reign .
Entities). ' ·
Nonresident alien who becomes a resident alien. Generally,
only a nonresident alien individual may use the terms of a tax
treaty to reduce or eliminate U.S. tax on certain types of income.
However, most tax treaties contain a provision known as a
"saving clause." Exceptions specified in the saving clause may
permit an exemption from tax to continue for certain types of
income even after the payee has otherwise become a U.S.
resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an
exemption from U.S. tax on certain types of income, you must
attach a statement to Form W-9 that specifies the following five
items:
1. The treaty country. Generally, this must be the same treaty
under which you claimed exemption from tax as a nonresident
alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that
contains the saving clause and its exceptions.
4. The type and amount of income that qualifies for the
exemption from tax.
5. Sufficient facts to justify the exemption from tax under the
terms of the treaty article.
Example. Article 20 of the U.S.-China income tax treaty allows
an exemption from tax for scholarship income received by a
Chinese student temporarily present in the United States. Under
U.S: liiw, this student will become a resident alien for tax
purposes if his or her stay in the United States exceeds 5
calendar years. However, paragraph 2 of the first Protocol to the
U.S.-China treaty (dated April 30, 1984) allows the provisions of
Article 20 to continue to apply even after the Chinese student
becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of
the first protocol) and is relying on this exception to claim an
exemption from tax on his or her scholarship or fellow~hip
income would attach to Form W-9 a statement that includes the
information described above to support that exemption.
If you are a nonresident alien or a foreign entity not subject to
backup withholding, give the requester the appropriate
completed Form W-8.
What is backup withho!ding? Persons making certain payments
to you must under certain conditions withhold and pay to the
IRS 28% of such payments. This is called "backup withholding."
Payments that may be subject to backup withholding include
interest, tax-exempt interest, dividends, broker and barter
exchange transactions, rents, royalties, nonemployee pay, and
certain payments from fishing boat operators. Real estate
transactions are not subject to backup withholding.
You will not be subject to backup withholding on payments
you receive if you give the requester your correct TIN, make the
proper certifications, and report all your taxable interest and
dividends on your tax return.
Payments you receive will be subject to backup
withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II
instructions on page 3 for details),
3. The IRS tells the requester that you furnished an incorrect
TIN,
Page 2
4. The IRS tells you that you are subject to backup
withholding because you did not report all your interest and
dividends on your tax return (for reportable interest and
dividends only), or
5. You do not certify to tlie reques~er that you are not subject
to backup withholding under 4 above (for reportable interest and
dividend accounts opened after 1983 only) ..
Certain payees and· payments are exempt .from backup
withholding: See the instructions b~low and the separate
Instructions for the Requester of Form W-9.
Also see Special rules for partnerships on page 1 .
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a
requester, you are subject to a penalty of $50 for each such
failure unless your failure is due tq reasonable cause and not to
willful neglect.
Civil penalty for false information with respect to
withholding. If you make a false statement with no reasonable
basis that results in no backup withholding, you are subject to a
$500 penalty.
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subject you to criminal
penalties including fines and/or imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in
violation of federal law, the requester may be subject to civil and
criminal penalties.
Specific Instructions
Name
If you are an individual, you must generally enter the name
shown on your income tax return. However, if you have changed
your last name, for instance, due to marriage without informing
the Social Security Administration of the name change, enter
your first name, the last name shown on your social security
card, and your new last name.
If the account is in joint names, list first, and then circle, the
name of the person or entity whose number you entered in Part I
of the forrn.
Sole proprh~tor. ·EntQr your individual name as shown on your
~ .. t 1i.n,'tqi;nfta;>( !etur~.,ooJ~~)~ne. You may enter your
business, tr'fl.de, or"rdo1ng business-as (OBA)" name on the
"Business name" line.
Limited liability company (LLC). Check the "Limited liability
company" box only and enter the appropriate code for the tax
classification ("D" for disregarded entity, "C" for corporation, "P"
for partnership) in the space provided.
For a single-member L.LC {including a foreign LLC with a
domestic owner) that is disregarded as an entity separate from
its owner under Regulations section 301.7701-3, enter the
owner's name on the "Name" line. Enter the LL.C's name on the
"Business name" line.
For an LLC classified as a partnership or a corporation, enter
the LL.C's name on the "Name" line and any business, trade, or
OBA name on the "Business name" line.
Other entities. Enter your business name as shown on required
federal tax documents on the "Name" line. This name should
match the name shown on the charter or other legal document
creating the entity. You may enter any business, trade, or OBA
name on the "Business name" line.
Note. You are requested to check the appropriate box for your
status (individual/sole proprietor, corporation, etc.).
Exempt Payee
If you are exempt from backup withholding, enter your name as
described above and check the appropriate box for your status,
then check the "Exempt payee" box in the line following the
business name, sign and date the form.
CUPERTINO
February 17, 2011
Michael Bench
AGREEMENT
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
TELEPHONE: (408) 777-3223 • FAX: (408) 777-3366
WEBSITE: www.cupertino.org
A fully executed copy of your agreement with the City of Cupertino is enclosed. If you have any
questions or need additional information, please contact the Planning Department at ( 408) 777-
3308.
Sincerely,
Kirsten Squarcia
City Clerk's Office
Enclosure
cc: Planning