HomeMy WebLinkAboutC09-369MOA State of Colorado Eagle Airport Interchange1 1 �OLORAI)O DEPART1t�1T OF Project Code: 13230 Parcel No: 105, 105R, AC-105 TRANSPORTATION Project No: IM 0702-229 MEMORANDUM OF Location: Eagle Airport Interchange AGREEMENT County: Eagle State Highway No: 1-70 eement made on (date) is between the State of Colorado for the use and benefit of the Colorado ent of Transportation (GRANTEE) for the purchase of the parcel(s) listed above from the F ) Board of County Commissioners of Eagle County (GRANTOR). Just compensation was determined by an appropriate valuation procedure prepared in accordance with Colorado state laws and regulations. The amount of money and/or compensation listed below is full consideration for the following land, easements, improvements, and damages of any kind. Land (described in attached exhibits) Parcel 105 containing 6.962 ac of which 1.518 ac is in the 6.986 Sq.ft❑/acres® $715,000.00 existing Cooley Mesa Rd. and Parcel 105R containing .024 acres Permanent and Slope Easements (described in attached Sq.ftE]/acres❑ $0.00 exhibits) Temporary Easements (described in attached exhibits) Sq.ft[:]/acres❑ $0.00 Improvements n/a $0.00 Damages n/a $0.00 Gross Total $715,000.00 Less Credit $ Net Total $715,000.00 Other conditions: subject to the terms and conditions of the attached "Instrument of Release" by Federal Aviation Administration recorded May 27, 2009 at reception number 200910103 The GRANTOR: 1) Will, at the closing, pay all taxes (including prorated taxes for the current year) and special assessments for the current year; 2) Has entered into this agreement only because the GRANTEE has the power of eminent domain and requires the property for public purposes; 3) Be responsible for securing releases from all liens, judgments and encumbrances to deliver clear, unencumbered title to GRANTEE. Any encumbrance required to be paid by GRANTOR shall be paid at or before closing from the proceeds of the transaction hereby contemplated or from any other source; 4) Will execute and deliver to GRANTEE those documents indicated below; 5) Excepts from the subject property described herein in the attached Exhibits, the mineral estate and including all coal, oil, gas and other hydrocarbons, and all clay and other valuable mineral in and under said subject property. The GRANTOR hereby covenants and agrees that the GRANTEE shall forever have the right to take and use, without payment of further compensation to the GRANTOR, any and all sand, gravel, earth, rock, and other road building materials found in or upon said subject property and belonging to the GRANTOR; and 6) The GRANTOR further covenants and agrees that no exploration for, or development of any of the products, as described above, and owned by the GRANTOR heretofore or hereafter the date set forth above and hereby excepted will ever be conducted on or from the surface of the premises described in the attached Exhibits, and that in the event any of such operations may hereafter be carried on beneath the surface of said premises, the GRANTOR shall perform no act which may impair the subsurface or lateral support of said premises. These Page 1 of 2 CDOT Form #784 — 2/09a Editions prior to 2/09 are obsolete and may not be used ^ n �! covenants and agreements hereur-ler, shall inure to and be binding upon tr- GRANTOR and its heirs, personal Viand legal representatives, succes,„rs and assigns forever. 11%� NOTE: At GRANTOR'S sole discretion, the GRANTOR may convey the underlying mineral estate owned by GRANTOR to the GRANTEE. GRANTEE makes no representations about the nature, title or value of the mineral estate. In transactions where GRANTOR conveys the underlying mineral estate to GRANTEE, Paragraphs 5 and b, as set forth above, will be deleted from this Memorandum of Agreement and the conveyance document. ❑ GRANTOR conveys the underlying mineral estate to GRANTEE. Paragraphs 5 and b are hereby deleted from the Memorandum of Agreement and the conveyance document. The GRANTEE: 1) Will be entitled to specific performance of this agreement upon tender of the agreed consideration; 2) Will be held harmless from any claims against the property or to any interest in the property, except for any benefits due under relocation law; 3) Will make payment after receiving acceptable conveyance instruments from the GRANTOR; 4) Will take possession and use of the parcel(s) when it deposits the consideration, as set forth above, into an escrow account for the benefit of the GRANTOR, or when GRANTEE disburses funds to GRANTOR. Transfer of title to the parcel(s) shall occur upon performance of any and all terms under this agreement, and release of the payment from escrow to the GRANTOR, unless other arrangements are made that follow Title III of the Uniform Relocation Assistance and Real Property Acquisition Act of 1970, as amended; and 5) Will prepare the following documents: ® General Warranty Deed ❑ Utility Easement ® Access Deed ❑ Permanent Easement ❑ Full Release(s) Book/Page: ❑ Slope Easement ❑ Partial Release(s) Book/Page: ❑ Temporary Easement ❑ Or (specify) (Special Warranty Deed) ❑ Title Company to prepare documents except Order Warrant $715,000.00 Payable to: Eagle County Colorado Order Warrant $ Payable to: Real Estate Specialist GRANTOR signature Attach form W-9 Sara J. Fisher, Chairman for Board of County Commissioners of Eagle County GRANTOR (if applicable) ko Lc--- Division approval (Region ROW GRANTEE signature Manager/Supervisor) cc: Project Development Branch — ROW Services (original) P g �jner CDOT Form #784 — 2/09a Refit-of--Way Manager , , Region Program Engineer/Resident Engineer ginee/09 are obsolete and may not be used cum �roa COLORADO DEPARTMENT OF TRANSPORTATION ShW R. 9"' Sit RsrWot Sit Re"ons Right of WayPans 4-" to TE10L AC12Z- R ion 3MR Gra22 Sotdlt Bth Stroat Room 317 - Proaci Numbar. fq 0702-229 pho Ju Colorado 8t30i Pro eet Location: Ec le X o t Ieterc erne Phone: 870 248-7232 FA1L (870} 248-7233 Pro � ��; right of Ray Plans Unit: Larry Baughman TDS ooee wa coo. sw.ol was rw a a..a • ��l '' Conneclor ► '1 ! 7EMA Ei !i4 orner SecR Its Eagte-Aliport flltel'r�mge Connector gears Y89'19St'L oars S97•t3Ot•V, etmev + ! I 3019.73 Union Pacific Railroad Co., T.5 S.,R.85 W.,6th P.M. Sec.2 �1 i. 65t00 Connector Connector o Delaware Corp. row ` f•Jyy 1 I t00l�lt 66+5597 2J IPart of W 1/2 Sec.2 SOQ00It — — Exlstinq Railroad Right-of-W� 100' wide fS l / y tin U -Pro?'sed c06i% access road Unbn, Paglfie Raflr_aad ,Co ?I $ S e Right of-tyoy /�' ! - //Right-of-Way.Project #,"NR-H;240-0, 8=116 �232 Y J ,! non ltot �a�7es, .. HWY- G a— , _ Con Ctar 7j��.. 1 7+ rt ,1 ): 67 77or 6 AP 4 N 1 Pf t73+gJ.SeAP 100 US / i / Cl/4 See.! Cal SIf01�6'G8'L IOeb3! RE104 Courses for Parcel IOSR 5 Cl Arc ■ 1.01' �/p��yy�nyer e�ep� �y :. a x�acCus-f3779W Rados - 5781SY 11 • I y 4� bears .WI 3 W Vy GJiNJ Ci%1 �vI•S i t•�y i�.el • s.99•. •�e�y L(]ty /_ 1 1 L2 R.S•lw:vv. 101A9 Lt S.7• 24ff 1036.71r �QS TRACT 53 = cx Arc a aowr L2 Uss•lsssv. t34• R OAR QF COU MI ON S !� �,� I 70t00 a RR • L7 lu•u•4sv. toxo Q 'L o ✓ I GLE N h 5 41 26L72 JW i 1 1 3 13 /Port W ! ' t x ; o • Lot 1 /c o /, /'�� p\/�\o �• a /Y % on+ t4r t I t �t o-1.oi• g "12 l ® i 11 In width TRACT 51 gg L L It Awl ee Al r 11 or GtalI of Parcel I= a '� WS 11 11 11 112 Lot 5 } � . ' / ey 75+OR00 '• r 1 ., ! ',, 111 111 I � !� g Lot 7 14 27M Cooley 1 IOQOO'rs t 1 26+00.0t1 v %� ` Ld 11 I ' �\ �` 4 8S001t late Lot 7 t1 --� �.r� > • 111 I I SS' 4=47 s 20 oroi+oge ac — � �eordore north '. 11 o1 Caote7 Rd 112 ' - �IV ExI g R01J Ends afnAlrPort Gateway Center lot 16 / B-M, P-41 Eagle County 9 i- �D u- 1141 Cooley 0 I v Cooley 30+49.74 ® 11 lot 14 lot is cc01•yy _ 1 M40M 41.22'rt ' +7QW 70,Wrt tat 13 90' ROW 1 70JVrt Coot e E.tIA y 12' y Drainage do 28+OQ.00 gg lltd'ely Eo:smanl on of 9- �•� 1 19 t10A0'rt �'i of C" Um Rd. 114 Ea+ssa � �29 utility _ r BOARD OF COUNTY COMMISSIONERS Lot 12 EAGLE COUNTY Part of W 1/2 Sec.2 r f r ..... I r_j AP 114 4 , A P 5j \"ow/ COLORADO DEPARTMENT OF TRANSPORTATION REAL PROPERTY TO BE ACQUIRED FROM PARCEL NO. 105 STA 67+28.19 TO STA 75+00.00 For PROJECT NO. IM 0702-229 Eagle Airport Interchange Board of County Commissioners Eagle County STATE HIGHWAY NO. 1-70 PROJECT CODE: 13230 ,%W L� EXHIBIT "A" PROJECT NUMBER: IM 0702-229 PARCEL NUMBER: 105 Project Code: 13230 Date: May 15, 2006 DESCRIPTION A tract or parcel No. 105 of the Department of Transportation, State of Colorado, Project No. IM 0702-229 containing 6.962 acres, more or less, in tracts 51 and 53 of Section 2, Township 5 South, Range 85 West, of the Sixth Principal Meridian, in Eagle County, Colorado, said tract or parcel being more particularly described as follows: Commencing at the W % corner of said Section 2, Thence S. 87°30'03" E., a distance of 2191.33 feet to a point on the existing southerly right-of-way of U.S. Highway 6 (Nov. 2004), said point also being the TRUE POINT OF BEGINNING; 1. Thence S. 7°12'54" E., a distance of 1036.84 feet; 2. Thence S. 85°14'47" W., a distance of 259.38 feet; 3. Thence N. 68*03'191' W., a distance of 203.96 feet; 4. Thence N. 79"21'55" W., a distance of 230.00 feet; 5. Thence N. 10138'05" E., a distance of 140.00 feet; 6. Thence S. 83°05'48" E., a distance of 230.49 feet; 7. Thence N. 56°57'36t' E., a distance of 160.04 feet; 8. Thence N. 1'131'16" E., a distance of 273.87 feet; 9. Thence N. 5*10118" W., a distance of 473.95 feet to the existing southerly right-of-way line of U.S. 6; 10. Thence along said line along the arc of a curve to the left having a radius of 5784.58 feet, a distance of 190.50 feet, (the chord of said arc bears S. 86°32'38" E., a distance of 190.49 feet), more or less, to the TRUE POINT OF BEGINNING. The above described parcel contains 6.962 acres, more or less of which 1.518 acres is in the existing Cooley Mesa Road. Basis of Bearings: The bearings referenced on this survey can be determined from any monuments set or found as shown on the Survey Control Diagram. The basis of bearings for project reference is a line from NGS Primary Airport Control Station Disk "BROWN" to NGS Secondary Airport Control Station Disk "EGE C" having a bearing of S 79° 20'42" 'W a distance of 3514.36 feet located in Section 2, T. 5 S., R. 85 W. of the Sixth Principal Meridian in Eagle County, Colorado. For and on Behalf of the Department of Transportation, State of Colorado Thomas D. Spor 222 South 6"' Street Grand Junction, CO 81503 COLORADO DEPARTMENT OF TRANSPORTATION REAL PROPERTY TO BE ACQUIRED FROM PARCEL NO. 105R STA 67+28.19 TO STA 75+00.00 For PROJECT NO. IM 0702-229 Eagle Airport Interchange Board of County Commissioners Eagle County STATE HIGHWAY NO. I-70 PROJECT CODE: 13230 EXHIBIT "A" PROJECT NUMBER: IM 0702-229 PARCEL NUMBER: 105R Project Code: 13230 Date: May 15, 2006 DESCRIPTION A tract or parcel No. 105R of the Department of Transportation, State of Colorado, Project No. IM 0702-229 containing 0.024 acres, more or less, in tracts 51 and 53 of Section 2, Township 5 South, Range 85 West, of the Sixth Principal Meridian, in Eagle County, Colorado, said tract or parcel being more particularly described as follows: Commencing at the W % corner of said Section 2, Thence S. 87030103" E., a distance of 2191.33 feet to a point on the existing southerly right-of-way of U.S. Highway 6 (Nov. 2004), said point also being the TRUE POINT OF BEGINNING; 1. Thence along said line along the arc of a curve to the left having a radius of 5784.55 feet, a distance of 1.01 feet, (the chord of said are bears S. 88055120" E., a distance of 1.01 feet); 2. Thence S. 7° 12154" E., a distance of 1036.70 feet; 3. Thence S. 82°45'41" W., a distance of 1.00 feet; 4. Thence N. 7°12'54" W., a distance of 1036.84 feet, more or less, to the TRUE POINT OF BEGINNING. The above described parcel contains 0.024 acres (1037 square feet), more or less. Basis of Bearings: The bearings referenced on this survey can be determined from any monuments set or found as shown on the Survey Control Diagram. The basis of bearings for project reference is a line from NGS Primary Airport Control Station Disk "BROWN" to NGS Secondary Airport Control Station Disk "EGE C" having a bearing of S 79° 20'42" W a distance of 3514.36 feet located in Section 2, T. 5 S., R. 85 W. of the Sixth Principal Meridian in Eagle County, Colorado. For and on Behalf of the Department of Transportation, State of Colorado Thomas D. Spor 222 South 6"' Street Grand Junction, CO 81503 \q� COLORADO DEPARTMENT OF TRANSPORTATION ACCESS RIGHTS TO BE ACQUIRED FROM PARCEL NO. AC-105 STA. 67+ TO STA 75+ FOR Project No.1M 0702-229 Eagle Airport Interchange Board of County Commissioners Eagle County STATE HIGHWAY NO. 70 Project Code: 13230 \qw) lq / EXHIBIT "B" PROJECT NUMBER: IM 0702-229 Parcel AC-105 Project Code: 13230 Date: May 19, 2006 ACCESS DESCRIPTION EACH AND EVERY RIGHT OR RIGHTS OF ACCESS OF THE GRANTOR to and from any part of the right-of-way of Colorado State Highway No. 70, a freeway established according to the laws of the State of Colorado, and from and to any part of the real property of the Grantor in Tracts 51 & 53 of Section 2, Township 5 South Range 85 West, of the Sixth Principal Meridian, in Eagle County, Colorado, abutting upon said Highway, along or across the line or lines described as follows: IM 0702-229 AC-105 Westerly Line Project No. (Parcel No.) (Location of Line) Commencing at the NW Corner of said Section 2, thence S. 87°35'31" E., a distance of 2000.87 feet to a point on the existing southerly right-of-way of U.S. Highway 6 (July 2005), said point also being the TRUE POINT OF BEGINNING; l . Thence S. 5° 10' 18" E., a distance of 473.95 feet; 2. Thence S. 1 °3 I' l 6" W., a distance of 273.87 feet; 3. Thence S. 56°57'36" W., a distance of 160.04 feet; 4. Thence N. 83005'48" W., a distance of 230.49 feet, said also being the point of terminus of this description. NO ACCESS POINTS ALSO Southerly Line (Location of Line) Commencing at the A.P. I of Tract 54 of said Section 2, thence N. 4802520" W., a distance of 755.88 feet to the TRUE POINT OF BEGINNING; 1. Thence S. 79°21'55" E., a distance of 230.00 feet; 2. Thence S. 68*03119" E., a distance of 203.96 feet; 3. Thence N. 85°1447" E., a distance of 259.38 feet, said also being the point of terminus of this description; NO ACCESS POINTS ALSO Easterly Line (Location of Line) Commencing at the W % corner of said Section 2, Thence S. 87030'03" E., a distance of 2191.33 feet to a point on the existing southerly right-of-way of U.S. Highway 6 (Nov. 2004), said point also being the TRUE POINT OF BEGINNING; 1. Thence S. 7*12154" E., a distance of 942.72 feet. \"Or, NO ACCESS POINTS Basis of Bearings: The bearings referenced on this survey can be determined from any monuments set or found as shown on the Survey Control Diagram. The basis of bearings for project reference is a line from NGS Primary Airport Control Station Disk "BROWN" to NGS Secondary Airport Control Station Disk "EGE C" having a bearing of S 79°20'42" W a distance of 3514.36 feet located in Section 2, T. 5 S., R. 85 W. of the Sixth Principal Meridian in Eagle County, Colorado. For and on Behalf of the Department of Transportation, State of Colorado Thomas D. Spor 222 S. 6`h Street, rm. 317 Grand Jet., CO. 81501 CUNTYP TEAKEJ SIMONTONO 200910103 REa se.ee DOC. 5 4 ' 05127r2009 INSTRUMENT OF 111111111111111111111RELEASE THIS INSTRUMENT OF RELEASE, made by the United States of America, acting through the Federal Aviation Administration to the County of Eagle, Colorado. WHEREAS, The United States, acting by and through the Administrator, Federal Aviation Administration, granted Federal Funds for land acquisition and -development of the Eagle County Regional Airport, in Grant Agreements numbered AIP 3-08- 0020-01 through AIP 3-08-0020-43; and WHEREAS, Said Grant Agreements provide that said land is for airports use, and WHEREAS, The Administrator of the Federal Aviation Administration has determined that the hereinafter described land no longer serves the purpose for which it was acquired and made subject to certain terms, conditions, reservations and restrictions in said Grant Agreement. NOW THEREFORE, for and in consideration of the County of Eagle, Colorado, the Administrator of the Federal Aviation Administration, on behalf of the United States, hereby releases unto the County of Eagle, Colorado, the hereinafter described real property subject to the following provisions and reservations: 1. The County of Eagle, Colorado agrees to continue to be bound by and further agrees to reserve unto itself, its successors and assigns in any instruments of transfer conveying title or any interest in the hereinafter described real property, for the use and benefit of the public, a right of flight for the passage of aircraft in the airspace above the surface of the real property hereinafter described, together with the right to cause in said airspace such noise as may be inherent in the operation of aircraft now known or hereafter used for navigation of or flight in the said airspace and for use of said airspace for landing on, . taking off from, or operating on the Eagle County Regional Airport. 2. That the County of Eagle, Colorado expressly agrees for itself, its successors and assigns to restrict the height of structures, objects of natural growth and other obstructions on the hereinafter described real property to a height of not more than 6,540 ft. above mean sea level. 3. That the County of Eagle, Colorado, expressly agrees for itself, its successors and assigns to prevent any use of the hereinafter described real property which would interfere with landing or taking off of aircraft at the Eagle County Regional Airport, or otherwise constitute an airport hazard. In the event the aforesaid covenant is breached, the grantor is to reserve the right to enter upon the land released hereunder and to remove the offending structure or object and to cut the offending growth, all of which shall be at the expense of the grantee. 4. The County of Eagle, Colorado agrees to expend a sum of $715,000 within five (5) years after the date of execution of this Agreement for otherwise eligible Airport Improvement Program development work at the Eagle County Regional Airport. It is understood and agreed that this amount will not be eligible as Owner matching funds for development under the Airport Improvement Program (AIP). 5. The County of Eagle, Colorado agrees to maintain accurate records of expenditures which will be in accordance with accepted business practices and open for inspection by FAA at any time for three years after the date of completion of the expenditure required by paragraph 4 above. By this Instrument of Release, the United States of America by and through the Administrator, Federal Aviation Administration, hereby releases the real property described below from all the remaining conditions, reservations and restrictions except those reserved herein, contained in the identified Grant Agreements. \,Now, \fto� Parcel 105R A tract or parcel No. 105R of the Department of Transportation, State of Colorado, Project No. IM 0702-229 containing 0.024 acres, more or less, in tracts 51 and 53 of Section 2, Township 5 South, Range 85 West, of the Sixth Principal Meridian, in Eagle County, Colorado, said tract or parcel being more particularly described as follows: Commencing at the W '/ corner of said Section 2, Thence S. 87030'03" E., a distance of 2191.33 feet to a point on the existing southerly right-of-way of U.S. Highway 6 (Nov. 2004), said point also being the TRUE POINT OF BEGINNING; 1. Thence along said fine along the arc of a curve to the left having a radius of 5784.58 feet, a distance of 1.01 feet, (the chord of said arc bears S. 88055'20" E., a distance of 1.01 feet); 2. Thence S. 7012'54" E., a distance of 1036.70 feet; 3. Thence S. 82045'41" W., a distance of 1.00 feet; 4. Thence N. 07012'54" W., a distance of 1036.84 feet, more or less, to the TRUE POINT OF BEGINNING. The above described parcel contains 0.024 acres (1037 square feet), more or less. lft� �qw� The real property is located in the County of Eagle, State of Colorado, and legally described as follows: Parcel 105 A tract or parcel No. 105 of the Department of Transportation, State of Colorado, Project No. IM 0702-229 containing 6.962 acres, more or less, in tracts 51' and 53 of Section 2, Township 5 South, Range 85 West, of the Sixth Principal Meridian, in Eagle County, Colorado, said tract or parcel being more particularly described as follows: Commencing at the W '/4 corner of said Section 2, Thence S. 87030'03" E., a distance of 2191.33 feet to a point on the existing southerly right-of-way of U.S. Highway 6 (Nov. 2004), said point also being the TRUE POINT OF BEGINNING; 1. Thence S. 7012'54" E., a distance of 1036.84 feet; 2. Thence S. 85014'47" W., a distance of 259.38 feet; 3. Thence N. 68003'19" W., a distance of 203.96 feet; 4. Thence N. 791121'55" W., a distance of 230.00 feet; 5. Thence N. 10038'05" E., a distance of 140.00 feet; 6. Thence S. 83105'48" E., a distance of 230.49 feet; 7. Thence N. 56057'36" E., a distance of 160.04 feet; 8. Thence N. 01031'16" E., a distance of 273.87 feet; 9. Thence N. 05010'18" W., a distance of 473.95 feet to the existing southerly right-of-way line of U.S. 6; 10. Thence along said line along the arc of a curve to the left having a redius of 5784.58 feet, a distance of 190.50 feet, (the chord of said arc bears S. 86032'38" E., a distance of 190.49 feet), more or less, to the TRUE POINT OF BEGINNING. The above described parcel contains 6.962 acres, more or less of which 1.518 acres is in the existing Cooley Mesa Road. `q� By its acceptance of this Instrument of Release the County of Eagle, Colorado covenants and agrees for itself, its successors and assigns to comply with and observe all the limitations set forth herein, expressly limited to the above described property. IN WITNESS WHEREOF the United States of America has caused this Instrument of Release to be executed as of the -� day of 2009. UNITED STATES OF AMERICA Administrator, Federal Aviation Administration BY- -ax' 9 Manager, Den�d Airports District Office ATTEST: ACCEPTED: By 3%�w; '` B Cy ounty Clerk '`�,,� = Chairman, Board f County Commissioners, Eagle Colorado APPROVED: County u TERM SHEET 1) Requested hearing date: Alwww "Pm 2) For County Manager signature: No 3) Requesting department: Attorney 4) Title: Memorandum of Agreement between State of Colorado and Eagle County Regarding the Eagle Airport Interchange 5) Check one: Consent: _XX On the Record: 6) Staff submitting: County Attorney Representative 7) 9j Purpose: To accomplish the sale of I-70 Right of Way to the Colorado Department of Transportation Schedule: NA 9) Financial considerations: Contract amount? CDOT to pay County $715,000.00 Has agreement amount been fully budgeted? N/A How much of the budgeted funds will remain after execution of this contract? Does agreement comply with Eagle County's Purchasing/Bidding/Request For Proposal guidelines set forth in Resolution 2006-071? N/A If no, list in detail the reason for non-compliance including any exceptions set forth in Resolution 2006-072. List dollar amount of all bids and provide detail for your choice of vendor, including but not limited to, such items as price, quality, experience, local preference, etc. 10) Other: qg BY PRO /D J _ FORM Eagle uoontyAttomey's Office -ra®le County Commissi�tfoe Form WM 9 (Rev. October 2007) Department of the Treasury Internal Revenue Service 114Me, Request for Taxpayer 1-"� Give form to the Identification Number and Certification requester. Do not send to the IRS. Name (as shown on your income tax return) Eagle County Government Business name, if different from above Check appropriate box: ❑ Individual/Sole proprietor ❑ Corporation ❑ Partnership Exempt ElLimited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) No....... ❑ payee ❑ Other (see instructions) ► Address (number, street, and apt. or suite no.) P. O. Box 850 City, state, and ZIP code Eagle, CO 81631 List account number(s) here (optional) rer Identification Number i Requester's name and address (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 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. 84 6000762 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. 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 Here U.S. person ► General Instructions `.-I 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. Date ► 2 _ 0" —0 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: • The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W-9 (Rev. 10-2007) 5AC12 FecE,.,-- US Airbill } 1,5 8575 3303 3197 F. 02 o xnb., 1215-4625-6 9701 328-351 EAGLE COUNTY GOVERNMENT 500 BROADWAY ay EAGLE y� CO Zp 81631 0337779570 0`►� Ship and track packages at fedex.com Simplify yourshipping. Manage your account. Access all the tools you need. 4a Express Package Sentic��`e jjj- Packagesupm 150lbs. 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