HomeMy WebLinkAbout5.C.1. Use of DWI Forfeiture Funds to Purchase Evidence Inventory SoftwareE ,
CITY OF SHAKOPEE
Police Department
Memorandum
TO:
FROM:
SUBJECT:
DATE:
INTRODUCTION:
Honorable Mayor and City Council
Mark McNeill, City Administrator
Craig Robson, Captain
c fh
Use of DWI Forfeiture Funds to Purchase Evidence Inventory
Software
September 6, 2011
The Police Department is requesting Council approval to enter into a software license
agreement with Tracker Products LLC and use DWI forfeiture fonds to purchase
evidence inventory software and hardware.
BACKGROUND:
The Police Department is requesting authorization to use DWI forfeiture funds to
purchase an evidence inventory software from Tracker Products LLC. The software is a
web based application that enables users to streamline the evidence process of entry,
auditing and inventory of property by using electronic bar coding system. Other metro
police agencies are using this product with a high level of satisfaction and police staff
have seen it in use through web demos and a site visit at the Maple Grove Police
Department.
The software can be customized to meet the specific demands of the Shakopee Police
Department and the licensing agreement allows for unlimited users. The software is web
based and has been reviewed and approved by the City's IT staff.
BUDGET IMPACT:
The first year of licensing includes software and hardware totaling $4,999.60. The
following subsequent licensing costs are estimated at $2875 annually. The police
department can opt out of the license agreement at any rime. Funds exist in the
department's DWI forfeiture account to support this purchase.
VISIONING RELATIONSHIP:
This action supports:
Goal E: Deliver effective and efficient public services by a staff of well- trained,
caring, and professional employees.
Strategy 6: Provide high quality services.
ALTERNATIVES;
1. Approve the purchase
2. Do not approve the purchase
3. Table and provide direction to staff
RECOMMENDATION:
Alternative #1. Staff recommends approval of the purchase.
ACTION REQUESTED:
If the Council concurs, they should, by motion, authorize the appropriate city staff to
enter into a license agreement with Tracker Products LLC and use DWI forfeiture funds
to purchase evidence inventory software at a cost of $4,999.60 to be paid from DWI
forfeiture funds.
Attachment: Tracker Products Service Agreement
TRACRF R PRODUCT S u, ; SOP TIYARI'. IR ICNG A MI I R I IS.RCRU "I T,,U- 11! SALT S,TRAUCII CPR9DI M S DOM INTRODUCTION
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Included in this document, you will find an itemized price quote for the implementation of Tracker Products software, a Tracker
Products software license agreement, It blank W -9 form (to be completed and returned) and a Tracker Products W -9 form. We
appreciate your interest in Tracker Products software and very much look forward to working with you to solve all of your
tracking needs. Please let. us know if you have any unanswered questions or concerns.
Sincerely,
The Tracker Products team
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Tracker Products LLC
Toll Free: (866) 438 -6565
Office: (8S9) 746 -9700
Fax: (866) 381 -4160
Email: sales@trackerproducts.com
IIACCPRPROM -C'I O LC I s0f IAYARt I U( L'G APO 11( I,AGRE MEN r) I + I I.s J I RA CKERPROD IT( IS COM
This quote is a formal proposal for the purchase, implementation and use of Tracker Products software by
PRICE QUOTE (esHmrr A)
Shakopee Police Department
Headquartered in Shakopee I Minnesota
Date: August 3 2011
*Pricing is valid for a period of 90 daps.
Number of software users
Si.Q>'' 0
Number of workstations
Unlimited
Number of concurrent software connections
Unlimited
Number of custom data field modules
Unlimited
Number of ite (firs year) i
10,00
Number of items (per subsequeai calendar years)
Retain and Trainine Total _
purchased) Version
Version (hosted or
$0.00
Unlimited
Number of locations
First year software total* """' ""
Annual renewal cost* $2,875.00
*First year software toted includes initial software purchase and the first fidl year of support and upgrades.
*Annual renewal cost includes support and upgrades for the years fallowing the initial purchase year. Annual renewal cost is required far
hosted version customers but optional fbr purchased version customers.
., �rm-c or;Trro A ,,rn Tn 1rrmrr: WFTA A TRACM -R PRODUCTS REPRESENTATIVE
DATA IMPORT
SYSTEM CUSTOMIZATION
$0.00
MISCELLANEOUS
Fvtras Tntal
$0.00
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Si.Q>'' 0
0
$0.00
F day
Additional days
,;.�,A,.OU
0
$0.00
Retain and Trainine Total _
(
$0.00
DATA IMPORT
SYSTEM CUSTOMIZATION
$0.00
MISCELLANEOUS
Fvtras Tntal
$0.00
TlnckerP.&I,,s,.f,,,O pnung and Gcxnm yreemem I P -aed -M
'ill CKE1 PRO W11II ' SOFTWdIU_ PRIU RG AND l (1 _=FAGRiA1WN (,5'11746 o11SAIISU- r'6AC'KLRFRC11I' r, 1 p:;l PRICa QUOTE (Estrin I A)
PDA DEVIC
Sym bol PDA scanner /si capture device (MC5590 P30DUQQA7WR)
c ; ?e'. (30
0 I
$0.00
Optional warranty for Symbol PDA scanner and signature capture devic
0
$0.00
$0,00
BAR CODE SCANNERS
Symbol US scanner(D5670 s- SR_'0007ZZR)
(':;59. P
2
$758.00
Symbolvnreless scanner (DS6 SP.20001WR)
°�� ) °
0
$0.00
Socket wireless Bluetooth scanner(CY284 -1242)
S5gg.00
0
$0.00
$0.00
SIGNATURE CAPTURE P ADS
Topaz SigLitc 5 x1 d esktop signature pad (T -S460- HSL -R)
N000
2
$59 8.00
Topaz IDLim 5x1 signature pad wit thumbprint identification (Tr Sow- HSB -R)
;3- � u
0
$0.00
$0.00
BAR CODE LA BEL PRINTERS
Zebra GK42 (Standard version) (. K t2- 1 00110 -000)
s< 'rti
1
$599.00
Zebra GK42 (Ne twork version) (GK42- 1002'10 -000)
V ['L
I 0
$0.00
Zebra 282P (Standard version) (282F-10110-000) j
,CW,
0
$0.00
Zebra 282P ( Networ k version) (282P- 101510 - 000)
{ 9,494 PO
( 0
Zebra SW (Standardversion) (S4A400- 2001- 0100'r)
; - 2-4 C(?
0
$0.00
Zebra S4M (Network version) (S4M00- 200'- 0200T)
';! _;_99. i;il
0
$0.00
Zebra QL420 mobile printer (Q4D LUTA0000 -00)
-� ?�r� \Oil
0
$0.00
_ _
$0.00
BAR CODE LABELS
Zebra GK420T- 4 x3 (TTL- 40
( S =' `.'P
4
$59.80
Zebra GK420T -4 x 6 ( -605)
0
$0.00
Zebra GK42 - 2.25 x 4 (1000 -)
a l R.4s.
0
$0.00
Zebra 282P - 2.25 x 1.25 (1 TL- 22124)
{ E; 5.94
0
$0.00
Zebra 282P - 125 x .8 (100095 21
{ 's. q, o_,
-'
p
$0.00
Ze bra 282P - 225 x.75 (900022 -0 75)
P'�
0
$0.00
Zebra 282P - 3 x 2 (10009529)
. - -
0
$0.00
Zebra 282P - 2.25 x 4 (1 000952 7)
S19 Q.
0
$0.00
Zeb 282P - 3 x 1 (1000
0
$0.00
SW - 4x3 (10000284)
'! -9
0
$0.00
QL42 - 3x4 (100001962)
10 0
$0.00
BAR CODE LABEL PRINTER 1Nk
Wax resin roll - GK420T (TRZ2343324
I t' 19.
I 4
$79.80
Wax resin roll - 282P (800 -102)
S; ^'
0
I $0.00
Wax resin roll- SW(02000BI,11445)
10 ?!
0
$0.00
. -..
$0.00
SERVE.R(S)
$0.00
EXTRAS
j
$0.00
$0.00
I
I
I
Shipping 1
{
$30.00
Hardwar Total
( $2,124.60
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,..... -..,. 1, 11,11 ice 1K1 I TCr'V AG.RI I%, (=9, ➢4a ,01 SAI ; *S,,:T`AUYERVRUDLCTS(OM PRICE QUOTG(cXHlnff A)
a. Software total $2,875.00
b. Hardware total $2,124.60
c. Setup and training total $0.00
d. Extras total $0.00
C. Sales tax $0.00
L Grand total $4,999.60
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SOFT WAR F LICENSE AGREEMENT
Software license and professional services agreement with Tracker Products LLC for the implementation
and use of bar code tracking software application
This software license and professional services agreement ( "Agreement ") dated this 3 day of Augusts. 2011 (the
"Execution date ") is entered between Tracker Products LLC and (the "Vendor') and Shakopee Police Department ( the
"Licensee" or "Agency ").
The vendor wishes to license computer software to the licensee and the licensee wishes to purchase the software license under
the terms and conditions stated below.
In consideration of the provisions contained in this agreement and for other good and valuable consideration, the receipt and
sufficiency of which is acknowledged, the parties agree as follows:
MEW81M.
1. Under this agreement the vendor grants to the licensee a non - exclusive and non - transferrable license (the "License") to
use Tracker Products bar code tracking application (the "Software ").
2. This software shall allow up to Unlimited simultaneous connections (The total number of authenticated software
users accessing the licensee's tracking system at a given time) —and— 2,000 items entered into the licensee's
tracking system per calendar year —and— 10,000 items entered into the licensee's tracking system during the initial
calendar year.
3. Software includes either:
A. (Hosred I/ersion Customers) The hosted site and any related printed, electronic and online documentation and any
other files that may accompany the product.
—or
B. (fuse /cased `v8asinn Ciesronaerc) The executable computer programs and any related printed, electronic and online
documentation and any other files that may accompany the product.
4. Title, copyright, intellectual property rights and distribution rights of the software remain exclusively with the vendor.
Intellectual property rights include the look and feel of the software. This agreement constitutes a license for use only and
is not in any way a transfer of ownership rights to the software.
5. This agreement grants a single server license to the licensee. The licensee is allowed access one live site and one test site
on the server, as further specified in the Proposal, attached hereto as Exhibit "A" and incorporated herein by reference.
6. The rights and obligations of this agreement are rights granted to the licensee only. The licensee may not transfer or
assign any of the rights or obligations granted under this agreement to any other person or legal entity. The licensee may
not make available the software for use by one or more third parties. -
7. The software may not be mortified, reverse- engineered, or de- compiled in any manner through current or future available
technologies.
8. Failure to comply with any of the terms under the license section will be considered a material breach of this agreement.
Licensee shall pay vendor for the Software, hardware and services provide ( "Project ") in accordance with the provisions of
this Section, Section C and the Proposal attached hereto as Exhibit "A ". Vendor's compensation for all products and work
performed in accordance with this agreement (not including all reimbursable items and applicable sales tax) shall not exceed
$4,999.60 without prior written authorization from licensee. No rate changes shall be made during the term of this
agreement without the prior written approval of licensee. -
1. License fee. The license fee for the software described in this agreement will consist, of the initial purchase price of
$2.875.00 plus applicable sales tax. The license fee shall include the first year of software support and maintenance
service.
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2. Sales tax. The vendor will charge licensee applicable state or local sales tax unless licensee provides proper sales tax
exemption documentation and supporting W9 information.
3. Hosted version* annual renewal agreement (See &claw fbr -applicable, details).
A. *Purchased version — Maintenance and support agreement: Thereafter, an optional annual maintenance and
support agreement is available to the licensee for the sum of $2.875.00 per year, subject to an increase in cost
not to exceed five percent in any given year. The annual maintenance and support agreement is not required. Opting
out or electing not to renew the maintenance and support agreement will not cause the licensee's purchased software
to be disabled in any way. The Licensee may enter into a written amendment to this agreement for these services at
any time during the term of this agreement.
B. "Hosted version — Annual hosting, support, maintenance and upgrades Thereafter, an annual hosting,
maintenance and support fee will be charged to the licensee for the sum of $2,875.00 per year, subject to an
increase in cost not to exceed five percent in any given year, rmless agreement is terminated prior to renewal.
4. Hardware. Initial Hardware purchase as further described in the Proposal attached hereto as Exhibit "A" for the
purchase price of $2.124.60 plus applicable sales tax.
5. On -site setup and training. On -site system setup and user training for a date to be mutually agreed upon for the sum
of $0.00 . Compensation for any authorized additional on -site training services shall be paid in accordance with the
Proposal as set forth in Exhibit "A ".
1. Software. Within three (3) business days of this signed license agreement, your hosted site or purchased staging site will
be made available for use. Pull payment is due within thirty (30) days of access information being provided. Software
costs may be invoiced separate from hardware, training and miscellaneous costs (See line item 7a of Proposal, Exhibit
"A„)
2. Hardware. Payment for all hardware is due within thirty (30) days of receipt of Hardware. Hardware costs may be
invoiced separate from training, Software and miscellaneous item costs (See line item 7b of Proposal, Exhibit "A ").
3. Training. Payment for training is due within thirty (30) days of on -site training completion. Training costs may be
invoiced separate from hardware, software and miscellaneous item costs. (See line item 7c of Proposal, Exhibit "A ").
4. Accounts payable, hrvoices shall be provided in writing as specified in the section entitled "Notices."
To the fullest extent permitted by law, vendor shall indemnify, defend and hold harmless Agency, its Council, boards and
commissions, officers, agents, volunteers, and employees (collectively, the "Indemnified Parties ") from and against any and all
claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages,
actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation,
attorney's fees, disbursements and court costs) of every kind and nature whatsoever (individually, a "Claim"; collectively,
"Claims "), which may arise from or in any manner relate (directly or indirectly) to any breach of the tetras and conditions of
this agreement, or any work performed or services provided under this Agreement including, without limitation, defects in
workmanship or materials or vendor's presence or activities conducted on the Project (including the negligent and/or willful
acts, errors and /or omissions of vendor, its principals, officers, agents, employees, vendors, suppliers, vendors, subcontractors,
anyone employed directly or indirectly by any of them or for whose acts they may be liable or any or all of them).
Notwithstanding the foregoing, nothing herein shall be construed to require vendor to indemnify the Indemnified Parties from
any Claim arising from the negligence or willful misconduct of the Indemnified Parties. Nothing in this indemnity shall be
construed as authorizing any award of attorney's fees in any action on or to enforce the terms of this agreement. This indemnity
shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as
a limitation upon the amount of indemnification to be provided by the vendor.
E. WARRANTS AND REPRESENTATIONS
The vendor warrants and represents that it is the copyright holder of the software. The vendor warrants and represents that
granting the license to use this software is not in violation of any other agreement, copyright or applicable statute.
F. ACCEPTANCE
All terms, conditions and obligations of this agreement will be deemed to be accepted by the licensee ( "Acceptance ") upon
execution of this agreement by all parties. - -
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"FR A C KLR PRO I)U<II LIC. SOFTWARL PlRI, 1,G ANDI I<I " *I SL A(atr.L3 I FLT ('.N)'.r 1MISAI SIogMACKFUROO II C SOFT\ §'A R h LICENSE AGUEMENT
G. USER SUPPORT SERVICES
1. The licensee shall be entitled to one year of phone support available 5:00 a.m. EST to 5:00 p.m. EST or 24 hours, 7 days
a week when pre - arranged by an annual maintenance and support agreement, at no additional cost. Refer to Section B(2)
for optional annual maintenance and support agreement.
2. The licensee shall be entitled to maintenance upgrades and bug fixes, at no additional cost, for a period of one year from
the date of Acceptance.
3. At any time the licensee can request a full copy of all data and it will be provided in database or excel format. The
licensee is the owner of all data inputted to the system and Tracker will in no way view or modify that data unless
requested by the licensee.
H. TERM
The term of this software license shall commence upon acceptance and is perpetual in existence and shall remain in effect until
terminated by either party as set forth herin.
L TERMINATION
(a) This agreement will be terminated and the license forfeited where the licensee has failed to comply with any of the terms
of this agreement or is in material breach of this agreement. On termination of this agreement for any reason, the licensee will
promptly destroy the software or return the software to the vendor.
(b) Each party shall have the right to terminate this agreement without cause upon ninety (90) days prior written notice to the
other party. If the city has not breached this agreement and Tracker Products terminates the agreement, within (30) thirty days
Tracker Products shall refund to the city that portion of the annual fee paid by the city that is equivalent to the remainder of
the current tern of this agreement. If Tracker Products has not breached the agreement and the city terminates this agreement,
Tracker Products shall retain all of the annual fee paid by the city for the current term of this agreement.
(c) Within sixty (60) days.of termination of this agreement, Tracker Products shall provide the city with a copy of all city data
contained in Tracker Products system. Within a reasonable time after providing the city data, Tracker Products shall delete and
remove all of the city data from Tracker Products servers and data storage facilities and shall verify to the city that this has been
accomplished.
The vendor will be free of liability to the licensee where the vendor is prevented from executing its obligations under this
agreement in whole or in part due to Force Majeure, such as earthquake, typhoon, flood, fire, and war or arty other unforeseen
and uncontrollable event where the vendor has taken any and all appropriate action to mitigate such an event.
K. CONTROLLING LAW AND VENUE
The laws of the State of Minnesota shall govern this Agreement and all matters relating to it and any action brought relating
to this Agreement shall be adjudicated in the State of Minnesota .
L. MISCELLANEOUS
1. This agreement can only be modified in writing signed by both the vendor and the licensee.
1 Changes to this agreement within fifteen business days of the Execution Date will be subject to a twenty percent
restocking fee based on the total hardware mid software cost. Changes to this agreement after fifteen days will be trade
upon mutual agreement of licensor and licensee. No full or partial refunds will be expressed or guaranteed after fifteen
days from the date of this agreement. Sales of special order hardware items will not be restocked.
3. This agreement does not create or imply any relationship in agency or partnership between the vendor and the licensee.
4. Headings are inserted for the convenience of the parties only and are not to be considered when interpreting this
agreement. Words in the singular mean and include the plural and vice versa. Wards in the masculine gender include the
feminine gender and vice versa. Words in the neuter gender include the masculine gender and the feminine gender and
vice vela.
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5. If any tern, covenant, condition or provision of this agreement is held by a court of competent jurisdiction to be invalid,
void or unenforceable, it is the parties' intent that such provision be reduced in scope by the court only to the extent
deemed necessary by that court to render the provision reasonable and enforceable and the remainder of the provisions of
this agreement will in no way be affected, impaired or invalidated as a result.
6. This agreement contains the entire agreement between the parties. All tmderstandings have been included in this
agreement. Representations which may have been made by any party to this agreement may in some way be inconsistent
with this final written agreement. All such statements are declared to be of no value in this agreement. Only the written
terms of this agreement will bind the parties,
7. This agreement and the terms and conditions contained in this agreement apply to and are binding upon the vendor's
successors and assigns.
M. ADDITIONAL PROVISIONS (APPLIES TO HOSTED VERSION CUSTOMERS ONt S')
At any time the primary client contact may request a full copy of their Tracker Products database in a compressed ,zip file. The
client can choose between having the file emailed to them or downloading the file from a secure FIP site.
ht the event that Tracker Products goes out of business or ceases to operate for any reason, a fully functional, current copy of the
purchased version shall be supplied at no additional cost.
N. NOTICES
All notices, demands, requests or approvals to be given under the terms of this agreement shall be given in writing, and
conclusively shall be deemed served when delivered personally, or on the thud business day after the deposit thereof in the
United States mail, postage prepaid, first -class mail, addressed as hereinafter provided. All notices, demands, requests or
approvals from vendor to licensee shall be addressed to licensee at:
Attn:
All notices, demands, requests or approvals from licensee to vendor shall be addressed to vendor at
Attn: Products Licensing
Tracker Products LLC
PO Box 1026
Florence, KY 41022
Phone: 859-746-9700
In witness whereof, the parties have caused this agreement to be executed on the day and year first written above.
LICENSEE
Approved as to form:
Name:
Signature:
Date:
VENDOR.
Tracker Products LLC
A Kentucky Limited Liability Company
B y:
Benjamin D. Townsend, Managing Member
Date:
aid I P 8 ono
TRACk 11 PRONUC , 5 1A,C ISM Fl: S \k PItKR'C AND i 61 MiA(IRI'l M IT 1 Sq t11 SAl FS;L I:Q_GRPRUDUCI'S.( "ON!
REQUEST FOIL CUSTOMER TAX to - M9
=orm
Request for Taxpayer
Give form to the
,Rev. October 2007)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
nternal Revenue Service
Name (as shown on your income tax return)
N
N
M
Business name, if different from above -
a
C
O
o, c
Check appropriate box: ❑ Individual /Sole proprietor ❑ Corporation ❑ Partnership
Exempt
r
❑ Limited liability company. Enter the tax classification (D= disregarded entity, C= corporation, P= partnership) ®- -... -.
❑ payee
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0 2
❑ Other (see Instructions)
—
Address (number, street, and apt. or suite no.)
Requester's name and address (optional)
A :
City, state, and ZIP code
to
List account number(s) here (optional)
N
taxpa Identification Number (°riN)
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 ent
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. 1 am a U.S. citizen or other U.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 instructions on page 4.
Sign I Signature of
Mere U.S. person ® Date ll�
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 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.
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:
a The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231X
Foos W -$ (Rev. 10 -2007)
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FRAC'11LR PRODUCTS TA\ In - W9
W ill
Request for Taxpayer
Give form to the
)ctobar 2007)
Identification Number and Certification
requester. Do not
rent of theT..wy
or
send to the IRS.
ftevenUe Service
n to enter.
61 , 1389617
Name (as shown on your income tax return)
Tracker Products, U.0
Business name, if different from above
Check appropriate box: ❑ Individual /Sole proprietor ❑ Corporation ❑ Partnership
Z Limited liability company. Enter the tax classification (D= disregarded entity, C= corporation, P= partnership) ®
Exempt
E]
--- - --
E] Other (see Instructions)
payer
Address (number, street, and apt. or suite no.)
Requester's name and address (optional)
528 Graves Avenue Suite 201
City, state, and ZIP code
Erlanger, KY 41018
List account number(s) here (optional)
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 entitles, 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
n to enter.
61 , 1389617
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. 1 am a U.S. citizen or other U.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 instructions on page 4.
Sign Signature of
Here I US. earem,
General Instruction
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 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.
� Y� � 7niaDt�®
Defrnit�n 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:
s The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231%
Form W -9 (Rev. 10 -2007)
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