VENDOR CARRIER SETUP PACKET - Crane Freight Carrier Setup... · to meet CCFS’ requirements, to include a complete Vendor Carrier Packet. Please read the directions carefully and

16685 Air Center Blvd. Attn.: Safety & Compliance

Houston, TX 77032 Tel.: 281-404-2900

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DBAN: September 17, 2010

Attn.:

Address: Via Certified Mail

City, State, & Zip

RE: VENDOR CARRIER SETUP PACKET Dear _____________________________, Thank you for expressing an interest in the CCFS Vendor Carrier Program. It is Crane Cartage Freight Services LLC's (CCFS) policy that all service providers, such as your company; comply with the CCFS Vendor Carrier Policy and procedures to include qualification prior to usage. Part of that process is the completion of the Vendor Carrier Setup Packet.

In order to become an approved service provider, you must first meet our legal, safety, compliance, and liability requirements. Therefore, it is imperative that you complete the Questionnaire and supply CCFS with legible copies of those documents listed on page 2.

Please submit the required information and documentation to our Houston office: Crane Cartage Freight Services, LLC; 16685 Air Center Blvd.; Houston, Texas 77032; attn.: Vendor Carrier Department – S&C/TCC. Alternatively, you can submit the packet via electronic mail to [email protected]. CCFS must receive and approve your company packet prior to you accepting any loads from CCFS; otherwise, there will delays in payment and other issues may arise. Please be aware that the carrier's approval is based on CCFS’ need and the carrier’s demonstrated ability to meet CCFS’ requirements, to include a complete Vendor Carrier Packet. Please read the directions carefully and complete each form. An incomplete packet and/or missing documentation will delay processing. Please refer any questions to the Vendor Carrier Department (S&C) at (281) 404-2918 or

please feel free to call me at ________________.

Sincerely, _________________________ Title:

CCFS Terminal:

Cc: Vendor Carrier Department (S&C/TCC) Encl:


Houston, TX 77032 Tel.: 281-404-2900

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Below is the list of forms and/or documents that must be completed and sent to CCFS. Please use the below list as your guide and checklist, this will ensure that all items are submitted. Also, if an item does not apply please write N/A over the selection box. Thank you.

Item

1. Vendor Carrier Questionnaire

2. Agent (Vendor) Carrier Agreement for Line Haul Services

3. Certification Regarding Debarment, Suspension, or Ineligibility for Award (Form C – 1 page)

4. EEO Compliance Certification Status (Form F – 2 pages)

5. Business Conduct Guidelines Acknowledgement (1 page)

6. W-9 (1 page) or W-8BEN for non-US companies

7. Proof of Insurance - Certificate of Insurance that list the following types of coverage and that list CCFS as certificate holder and additional insured in favor of auto liability, motor truck cargo, and general liability. On workers’ compensation, a statement to the affect of, “waiver of subrogation” must also be stated on the cert.

Automobile Liability - no less than 1 million dollars

General Liability - no less than 1 million dollars

Motor Truck Cargo Liability - no less than $250,000

Workers' Compenstation - as state required; otherwise, Occupational Accident coverage

Pollution/Enviornmental Liability Insurance (if applicable)

All insurance coverage must be bound by insurance carriers that have an A.B. Best rating of B+ or better.

8. Copy of Hazardous Materials Certificate of Registration (if applicable)

9. SmartWay Transport Partner verification

10.

Copy of Interstate Commerce Commission Permit (U.S. DOT Number)

11. Copy of any relevant state permits and/or authorities

12. CTAPA Certification

13. EDI documents

14. Other, please specify:


Houston, TX 77032 Tel.: 281-404-2900

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CCFS Vendor Carrier Questionnaire

Motor Carrier Broker (non-asset based) Broker (asset based) Carrier & Broker

Type of carrier (mark the one that applies) DOT#

Carrier Name as shown on DOT Authority MC#

DBAN (as listed on W-9 or W-8BEN) Broker# (if applicable)

Physical Address City, State, & Zip

Mailing Address (if same leave blank) City, State, Zip

1.

Primary Contact (Print Name) 24 hr telephone nbr.

2.

Secondary Contact (Print Name) 24 hr telephone nbr.

Company Officers (list all company officers): Name Title SS#

Carrier Information: Question Response

1. SCAC code

2. Are you a Canadian carrier domiciled in Canada? If yes, provide copy.

3. Do you have a Common Operating Authority? If yes, provide copy.

4. Do you have a Contract Operating Authority? If yes, provide copy.

5. Do you have a Broker Operating Authority? If yes, provide copy.

6. Are you hazmat certified? If yes, provide copy.


Houston, TX 77032 Tel.: 281-404-2900

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7. What number of your drivers are Hazmat certified?

8. Are you CTPAT certified? If yes, provide copy.

9. What number of your drivers are CTPAT certified?

10. Are you FAST certified? If yes, provide copy.

11. What number of your drivers are FAST Certified?

12. Are you ACE/E-Manifest Certified? If yes, provide copy.

13. Are you a Responsible Care Partner? If yes, provide copy.

14. Do you have a Satisfactory DOT Safety Rating? If yes, provide copy.

15. What is your Unsafe Driving Basic Score?

16. Do you currently have an alert associated with this unsafe driving basic?

17. What is your fatigued driving basic score?

18. Do you currently have an alert associated with this fatigued driving basic?

19. What is your driver fitness basic score?

20. Do you currently have an alert associated with this driver fitness basic?

21. What is your controlled substances basic score?

22. Do you currently have an alert associated with this controlled substances basic?

23. What is your vehicle maintenance basic score?

24. Do you currently have an alert associated with this vehicle maintenance basic?

25. What is your cargo maintenance basic score?

26. Do you currently have an alert associated with this cargo maintenance basic?

27. Last audit?

28. Do you have 24-hour dispatch?

29. Can you provide team service if requested?

30. Do you have satellite tracking for tractors?

31. Do you have satellite tracking for trailers?

32. Do you have web-tracking capabilities?


Houston, TX 77032 Tel.: 281-404-2900

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Driver & Equipment Information:

Number of Drivers Non-CDL: CDL:

Number of contract drivers Number of employee drivers

Number of hazmat drivers: Reserved

Number of vehicles Pickup Trucks: Vans:

Straight Trucks: Tractors:

Number of Trailers 48: 52:

Dry: Roller:

Reefer:

Do you use third party vendors to assist you? Number of carriers?

Summary of driver qualification process:

Summary of third party vendor qualification process, to include insurance and other requirements:

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Agent (Vendor) Carrier Agreement for Line Haul Services This AGREEMENT is made and entered into on ___________________, 20____, by and between Crane Cartage Freight Service Inc. (BROKER) and ________________________________ (CARRIER). 1. TERM. The Term of this Agreement shall be for a period of one (1) year;

provided that either party may terminate this Agreement at any time by giving a thirty (30) days written notice. The Agreement shall automatically renew for an additional one-year terms unless otherwise terminated in accordance with this provision.

2. CARRIER’S OPERATING AUTHORITY AND COMPLIANCE WITH LAW. CARRIER

represents and warrants that it is duly and legally qualified to provide, as a contract carrier, the transportation services contemplated herein. CARRIER agrees to provide BROKER with copies of all required and necessary permits granting it authority to act as a contract carrier. CARRIER further represents, warrants, and agrees to comply with all federal, state, and local laws within the United States, Mexico, and Canada regarding the provisions of the transportation services contemplated under this Agreement. In the event that CARRIER is requested by the BROKER to transport any shipment required by the U.S. Department of Transportation to be placarded as a hazardous material, the parties agree that the additional provisions included in Appendix A shall apply for each such shipment.

3. PERFORMANCE OF SERVICES. CARRIER’s service under this Agreement is

specifically designed to meet the distinct needs of BROKER and its customers under the specified rates and conditions set forth herein. CARRIER shall transport all shipments provided under this Agreement without delay, and all occurrences which would be probable or certain to cause delay shall be communicated, via phone, e-mail or fax, to BROKER by CARRIER immediately, but in no event more than one hour after such occurrence. This Agreement does not grant CARRIER an exclusive right to perform the transportation-related services for BROKER or its customers.

4. QUALITY STANDARDS. CARRIER agrees that it shall render services and perform

its obligations under this Agreement in a courteous, customer-focused, service-oriented, professional, business-like manner. CARRIER shall report any information regarding customer dissatisfaction to BROKER in writing within twenty-four (24) hours of notification or complaint by the customer. CARRIER further agrees to complete BROKER’s Agent/Vendor packet and to ensure that all necessary documents are current and remain current while AGREEMENT is in force. CARRIER further represents that CARRIER and CARRIER’s owner,

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employees, independent contractors, agents, etc. do not and will present a conflict of interest between CARRIER and BROKER.

5. RECEIPTS AND BILLS OF LADING. Each shipment hereunder shall be evidenced

by a Uniform (Standard) Bill of Lading naming CARRIER as the transporting carrier. Upon delivery of each shipment made hereunder, CARRIER shall obtain a receipt showing the kind and quantity of product delivered to the consignee of such shipment at the destination specified by BROKER or its customer, and CARRIER shall cause such receipt to be signed by the consignee. Any terms, conditions, and provisions of the bill of lading manifest or other form of receipt or contract shall be subject and subordinate to the terms, conditions and provisions of this Agreement. CARRIER shall notify BROKER immediately of any exception made on the bill of lading or delivery receipt.

6. CARRIER’S OPERATION. CARRIER shall at its sole cost and expense: (a) furnish

all equipment necessary or required for the performance of its obligations hereunder (the Equipment); (b) pay all expenses related, in any way, with the use and operation of the Equipment; (c) maintain the Equipment in good repair, mechanical condition and appearance; and (d) utilize only competent, able, legally licensed personnel. CARRIER shall have full control of such personnel shall perform the services hereunder as an independent contractor. CARRIER shall assume complete responsibility for all state and federal taxes, assessments, insurance (including, but not limited to, workers’ compensation; unemployment compensation, disability, pension and social security insurance) and any other financial obligations arising out of the transportation performance hereunder.

7. INDEMNITY. CARRIER shall defend, indemnify, and hold BROKER and its

customer harmless from and against all loss, liability, damage, claim, fine, cost or expense, including reasonable attorney’s fees, arising out of or in any way related to the performance or breach of this Agreement by CARRIER, it’s employees or independent contractors working for CARRIER; (collective, the “claims”), including, but not limited to, claims for or related to personal injury (including death) property damage and Carrier’s possession, use, maintenance, custody or operation of the Equipment, provided, however, that Carrier’s indemnification and hold harmless obligations under this paragraph will not apply to any portion of such claim attributable to the sole negligence of BROKER or its customer. In addition, CARRIER shall defend, indemnify and hold BROKER and its customer harmless from and against all loss, liability, damage, claim, fine, cost or expense, including reasonable attorney fees, related to any claim made by CARRIER or its employees or independent contractors against BROKER or its customers seeking to recover damages, including personal injury or death, or employment related benefits, including but not limited to, workers’ compensation or unemployment compensation, with respect to the

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transportation services provided under this Agreement. CARRIER’s indemnification obligations shall survive the termination of this Agreement.

8. INSURANCE. CARRIER shall produce and maintain, at its sole cost and expense,

the following insurance coverage during the term of this Agreement:

8.1. Comprehensive General Liability insurance with a minimum combined single limit of not less than ONE MILLION DOLLARS ($1,000,000) for each occurrence. Such insurance policy shall include coverage for bodily injury, property damage, premises/operations, products/completed operations, contractual, independent contractors, road damage, property damages, and personal injury. Such policy or policies shall include cross liability (severability of interest).

8.2. Commercial Automobile Liability insurance with a combined single limit

of not less than ONE MILLION DOLLARS ($1,000,000) for each occurrence with respect to all vehicles owned, non-owned, hired or assigned to transport shipments on behalf of BROKER. Such insurance policy shall include coverage for any and all liabilities for personal injury (including death) and property damage arising out of the ownership, maintenance, use or operation, including loading and unloading of the equipment operated by CARRIER under this Agreement.

8.3. Statutory Workers’ Compensation Insurance and Employee Liability

coverage in such amounts and in such form as required by applicable state law.

8.4. All Risk Broad Form Motor Truck Cargo Legal Liability Insurance in the

amount not less ONE MILLION DOLLARS ($1,000,000) per occurrence for Truckload shipments. Such insurance policy shall name BROKER as an additional insured and provide coverage to BROKER, its customer or the owner and/or consignee for any loss, damage or delay related to any properly coming into the possession of preclude coverage relating to cargo claims. Notwithstanding the minimum insurance limits required in this Subparagraph 8(d), CARRIER shall remain liable for the full actual value of any loss or damage claim without limitation.

8.5. In the event CARRIER transports international bonded goods on

BROKER’s behalf, CARRIER shall provide and maintain a Customs Bond in the amount not less than FIFTY THOUSAND DOLLARS ($50,000). Before accepting any such bonded shipment, CARRIER warrants that it is duly and legally qualified to transport bonded goods across the Mexican and US boarders. CARRIER shall adhere to the custom bond requirements set forth in Title 19 of the Code of Federal Regulations. CARRIER shall be

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responsible for all fines and penalties associated with the use of the customs bond and indemnify CRANE CARTAGE, its subsidiaries, agents, directors, officers, employees, and affiliates arising from the incorrect usage of the customs bond by the CARRIER, its agents, or employees.

8.6. BY INITIALING BELOW, CARRIER CERTIFIES THAT IT DOES NOT INTEND

TO HANDLE BONDED GOODS UNDER THIS AGREEMENT ON BROKER’S BEHALF AND, AS SUCH, IS NOT REQUIRED TO MAINTAIN THE CUSTOM BOND REQUIRED BY THIS PARAGRAPH 8(e). (CARRIER’s Initials) __________

8.7. CARRIER shall furnish to BROKER written certificates of insurance as

described herein from the insurance CARRIER showing that such insurance has been procured, is being properly maintained, the expiration date, and specifying that written notice or cancellation or modification of the policies shall be given to BROKER at least thirty (30) days prior to such cancellation or modification. Upon request, CARRIER shall provide BROKER with copies of the applicable insurance policies. CARRIER agrees and shall cause its insurer to agree that CARRIER’s insurance policies will be primary to any insurance carried by BROKER without right of contribution from BROKER or its insurance policies. CARRIER further agrees and shall cause its insurer to agree to waive their rights of subrogation against BROKER. All amounts of claims, losses, or damages resulting from deductible clauses or self-insured retention shall be the sole responsibility of CARRIER. CARRIER further agrees that all coverages must be issued by an insurance company qualified to write such coverage in the state(s) where the CARRIER is operating and rated B+ or better, Class VIII or better by A.M. Best Co.

8.8. CRANE CARTAGE shall be named as an additional insured on the CGL and

AL policies, as a loss payee on the Cargo Liability policy, and as an alternative employer on the Workers’ Compensation and Employers’ Liability policies. All policies subject to this Agreement shall waive any rights of subrogation and include an endorsement that such coverage shall be primary and non-contributory to any other insurance obtained by CRANE CARTAGE or its Customers.

9. FREIGHT LOSS, DAMAGE OR DELAY. CARRIER shall have the sole and exclusive

care, custody and control of each shipment from the time it is first tendered to CARRIER for transportation until delivery to the consignee accompanied by the appropriate receipts as specified in Paragraph 5. CARRIER assumes the liability of a common carrier for loss, delay, damage to or destruction of any and all of the Shipper’s goods or property while under CARRIER’s care, custody, or control.

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Within twenty-four (24) hours of any loss, delay, damage or destruction of any shipment, in whole or in part, CARRIER shall provide detailed written notice to BROKER of same. CARRIER shall pay to BROKER or allow BROKER to deduct from the amount BROKER owes CARRIER, the full actual loss for the kind and quantity of commodities so lost, delayed, damaged, or destroyed. In the event of any such deduction, BROKER shall provide CARRIER with written notice and supporting documentation of same. CARRIER shall be liable to BROKER for all economic loss, including consequential damages, which are incurred by BROKER or its customer for any freight loss, damage or delay. CARRIER understands and agrees that no liability limitations, or declared value shall apply with respect to the shipment, transported by CARRIER under this Agreement.

10. PAYMENTS. CARRIER will charge and BROKER will pay for transportation

services performed under this Agreement the rates and charges as shown on separate Rate Confirmation Sheets to be signed and agreed to by CARRIER and BROKER before each shipment made under this Agreement. CARRIER represents and warrants that there are no other applicable rates or charges except those established in this Agreement or in any Rate Confirmation Sheet signed by BROKER. Payment by BROKER will be made within thirty (30) days of services rendered by CARRIER pursuant to this Agreement provided that (1) CARRIER reports all Proofs of Delivery (“POD”) to BROKER via telephone at _________________within one hour of delivery to Consignee,;(2) CARRIER is in full compliance with the requirements of the CRANE CARTAGE Agent Policy and this Agreement; and (3) CARRIER provides BROKER with (a) all delivery receipts (b) one signed copy of the Shipper’s bill of lading, including originals (top copies) of any government bills of lading and continuation sheets, where applicable (c) any documentation related to the shipment(s) that are necessary for BROKER to properly submit an invoice for freight charges to BROKER’s customer, consignee, or other party responsible for such payments. In the event service is provided and it is subsequently discovered that there was no applicable rate in the existing Schedule of Rates or supplements, the parties agree that the rate paid by BROKER and collected by CARRIER shall be the agreed upon contract rate. CARRIER agrees that BROKER has the exclusive right to handle all billing of freight charges to its customer for the transportation services provided herein and as such, CARRIER agrees to refrain from all collection efforts against BROKER’s customer, the shipper, receiver, consignor, or consignee. CARRIER further agrees that BROKER has the discretionary right to offset any payment owed to CARRIER hereunder for liability incurred by CARRIER under this Agreement.

11. TERMINATION IN TRANSIT. If, for any reason, this Agreement is terminated

while the shipment is in transit, CARRIER agrees that it shall complete the transportation services in accordance with this Agreement, and BROKER hereby agrees that it shall compensate CARRIER for completion of such services in

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accordance with this Agreement. Should CARRIER refuse to complete the transportation services as provided herein, CARRIER expressly agrees that BROKER shall have the right to take control of the shipment and provide or complete such service and CARRIER shall forfeit any right which it may otherwise have under this Agreement to payment from BROKER in connection with the subject shipment. CARRIER hereby waives any recourse against BROKER for such action and agrees to reimburse BROKER for any costs and expenses arising out of completion of the transportation service and to pay BROKER any damages for which BROKER may be liable to its customer, consignee, or other third party arising out of the failure of CARRIER to complete transportation service. Such amount shall be deducted to the maximum extent possible from any payment otherwise due CARRIER under this Agreement, if such amount has not been repaid earlier by CARRIER. Further, such failure by CARRIER to complete transportation service shall constitute a breach of this Agreement.

12. NON-SOLICITATION AND CONFIDENTIALITY. Neither party may disclose the

terms of this Agreement to a third party without the prior written consent of the other party except (1) as required by law or regulation; (2) disclosure is made to its parent, subsidiary or affiliate company; or (3) to facilitate rating or auditing of transportation charges by an authorized agent and such agent agrees to keep the terms of the Agreement confidential. CARRIER will not solicit traffic from any shipper, consignor, consignee or customer of BROKER where (1) the availability of such traffic first became known to CARRIER as a result of BROKER's efforts, or (2) the traffic of the shipper, consignor, consignee or Customer of BROKER was first tendered to CARRIER by BROKER. If CARRIER breaches this Agreement and directly or indirectly solicits traffic from customers of BROKER and obtains traffic from such customer during the term of this Agreement or for twelve (12) months thereafter, CARRIER shall be obligated to pay BROKER, for a period of fifteen (15) months thereafter, commission in the amount of thirty-five percent (35%) of the transportation revenue resulting from traffic transported for the Customer, and CARRIER shall provide BROKER with all documentation requested by BROKER to verify such transportation revenue.

13. SUB-CONTRACT PROHIBITED. CARRIER specifically agrees that all freight

tendered to it by BROKER shall be transported on equipment operated only under the authority of CARRIER and that CARRIER shall not in any manner sub-contract, broker, or in any other form arrange for the freight to be transported by a third party without the prior written consent, approval, and knowledge of BROKER. In the event CARRIER breaches this provision and subcontracts or brokers a shipment to another entity, CARRIER agrees and acknowledges that it will remain primarily liable for any loss, damage or expense incurred during the transportation, to include warehousing, of any shipment by such third party. In addition, any breach of this Agreement will result in the forfeiture of any

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compensation otherwise payable to CARRIER by BROKER for each shipment handled by CARRIER in violation of this Paragraph 13.

14. ASSIGNMENT/MODIFICATION/BENEFIT OF AGREEMENT. This Agreement may

not be assigned or transferred in whole or in part, and supersedes all other agreements and all tariffs, rates, classifications and schedules published, filed or otherwise maintained by CARRIER. This Agreement shall be binding upon and ensure to the benefit of the parties hereto.

15. SEVERABILITY. In the event that the operation of any portion of this Agreement

results in a violation of any law, the parties agree that such portion shall be severed and that the remaining provisions of this Agreement shall continue in full force and effect.

16. DISPUTE RESOLUTION. This Agreement shall be deemed to have been drafted

in accordance with the statutes and laws of the State of Texas and, in the event of any disagreement or dispute, the laws of this state shall apply and suit must be brought in this state.

IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed in their respective names by their duly authorized representatives as of the date first above written. “BROKER” Crane Cartage Freight Service Inc. By: ______________________________ Printed: __________________________ Address: Crane Cartage, LLC 16685 Air Center Blvd. Houston, Texas 77032 Phone No.: ______________________ Fax No.: ________________________

“CARRIER” _________________________________ By: ______________________________ Printed: _________________________________ Address: _________________________________ _________________________________ Phone No.: _______________________ Fax No.: _________________________ FID No.: _________________________

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APPENDIX A

HAZARDOUS MATERIAL REQUIREMENTS:

1. CARRIER represents and warrants that it has obtained all necessary federal

permits and registration to transport hazardous materials in interprovincial, interstate commerce. Prior to transport of any shipment containing hazardous materials, CARRIER shall provide BROKER with a copy of all such federal and state permits and registration. Additionally, CARRIER agrees to notify BROKER immediately upon any revocation or suspension of CARRIER’s state or federal hazardous material permits or registration status having to do with the suspension or revocation of Carrier’s “Satisfactory” Safety Fitness Rating issued by the U.S. Department of Transportation, which satisfactory rating is a prerequisite to providing transportation for hazardous materials under this Agreement.

2. CARRIER represents and warrants that all drivers used to transport hazardous

material shipments have undergone the necessary training requirements of state and federal laws, including, but not limited to, the training requirements under 49 C.F.R. Part 126(F). CARRIER further warrants and certifies that all drivers used to transport hazardous material have the proper endorsements on their Commercial Driver’s License to legally transport such shipments. CARRIER further agrees to comply with all federal, state, and local laws regarding the transportation of hazardous material, including, but not limited to, the requirements specified under 49 C.F.R. Part 397

3. CARRIER represents and warrants that it is in compliance with the requirements

of form MCS-90. Prior to transport of any shipment containing hazardous materials, CARRIER shall provide BROKER with a completed and executed copy of form MCS-90.

4. CARRIER shall procure and maintain at its sole cost and expense, public liability

and property damage insurance with a reputable and financially responsible insurance company-insuring CARRIER in an amount not less than ONE MILLION DOLLARS (1,000,000) per occurrence or such higher amounts as may be required by the U.S. Department of Transportation. Such insurance policy shall include “CRANE CARTAGE and its subsidiary companies” as additional insured with respect to any and all liabilities for personal injuries (including death) and property damage, including environmental damage due to the release of a hazardous material or waste, arising out of the ownership, maintenance, use or operation, including loading and unloading, or the equipment operated by CARRIER under this Agreement

16685 Air Center Blvd

Houston, Texas 77032

Form C P a g e | 1

Certification Regarding Debarment, Suspension, or Ineligibility for Award

(Executive Order 12689)

TCC Use Only Today’s Date: TCC Rep. Initials:

Today’s Date: Terminal:

Vendor Name FIN/EIN

Physical Address Telephone No.

Independent Contractor City, State, Zip code Agent/Vendor

I certify, to the best of my knowledge and belief, that

and/or any of its principals: (Enter company or vendor name here)

Read each statement and place a check mark on the one that applies to you and/or your company. 1.

Are presently debarred, suspended, or otherwise excluded (to the extent specified in the exclusion agreement) that party from participation in a procurement or nonprocurement activity by any Federal agency. If excluded under what exclusion type?

Nonprocurement List Reciprocal List Procurement List

Are not Are presently debarred, suspended, or otherwise excluded (to the extent specified in the exclusion agreement) that party from participation in a procurement or nonprocurement activity by any Federal agency; and

2.

Have, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property; and

Have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property; and

3.

Are presently under indictment for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses.

Are not presently under indictment for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses.

I certify that will immediately notify Crane if becomes debarred, suspended, proposed for debarment, or

declared ineligible for the award of contracts by any Federal agency. Print Name Title Signature Today’s Date

16680 Central Green Boulevard

Houston, TX 77032

Form F R-11/29/10 P a g e | 1

EEO Compliance Certification Status

Crane Cartage Freight Services Inc. (“CCFS”) does business with the Federal Government or with companies that do business with the federal government. As a result, CCFS must collect certain information from companies we do business with as it relates to the size of company and type of EEO business. The below EEO Category Types describes the type of businesses that CCFS works with and we need each company to select the one that best describes their company. This is especially important to your company if your average gross income per year for the last three (3) years was less than $21.5M. Be aware, that if you meet the previously mentioned criteria, your company could be deemed a small business.

Please read the below EEO business descriptions and mark the ones that applies to your company:

LGB

Large Business: We are a large business making more than $21.5M average per year.

SBC Small Business Concern: Is a business that makes less than $21.5M per year, over a three-year average.

SDB Small Disadvantaged Business: A small business must be at least 51% owned and controlled by a socially and economically disadvantaged individual or individuals. African Americans, Hispanic Americans, Asian Pacific Americans, Subcontinent Asian Americans, and Native Americans are presumed to quality. Other individuals can qualify if they show by a " preponderance of the evidence" that they are disadvantaged. All individuals must have a net worth of less than $750,000, excluding the equity of the business and primary residence. Small businesses wanting to take advantage of the SDB Program must be certified by the SBA. You can obtain more information about the SDB Program by contacting any SBA district office , or reviewing the SDB home page, http://www.sba.gov/sdb or taking the online training course on SBA certifications http://www.sba.gov/training/certprograms.html . For more information or questions, call (202) 619-1850. Additionally, you must be registered with the Government’s Central Contractor Registration, which also registers you as a small business if you meet requirements. Please register at www.ccr.gov

HUB Hub Zone Small Business: The HUB Zone Empowerment Contracting Program stimulates economic development and creates jobs in urban and rural communities by providing Federal contracting preferences to small businesses. These preferences go to small businesses that obtain HUB Zone (Historically Underutilized Business Zone) certification in part by employing staff who live in a HUB Zone. The company must also maintain a "principal office" in one of these specially designated areas. [A principal office can be different from a company headquarters, as explained in our section dedicated to Frequently Asked Questions.] The program resulted from provisions contained in the Small Business Reauthorization Act of 1997.

o It must be a small business by SBA size standards; o Its principal office must be located within a HUB Zone, which includes lands on

federally recognized Indian reservations; o It must be owned and controlled by one or more U.S. citizens (N.B.-this means

any level of ownership in an applicant small business by another company would

http://www.sba.gov/sdb/nondesig.html�

http://www.sba.gov/regions/states.html�

http://www.sba.gov/sdb�

http://www.sba.gov/training/certprograms.html�

http://www.ccr.gov/�


Houston, TX 77032

Form F R-11/29/10 P a g e | 2

EEO Compliance Certification Status

result in a decline). Approved ownership can also be by a Community Development Corporation or Indian tribe; and

o At least 35% of its employees must reside in a HUB Zone.

To register or find more information, please go to http://www.sba.gov/hubzone on the internet. Additionally, you must be registered with the Government’s Central Contractor Registration, which also registers you as a small business if you meet requirements. Please register at www.ccr.gov.

WSB Women Owned Small Business: A woman must have a 51% ownership in the company.

VSB Veteran Owned Small Business: The term "veteran" means a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable.

DSB Disabled Owned Veteran Small Business: A Service-Disabled Veteran is a person who served in the active military, naval, air service, and who was discharged or released under conditions other than dishonorable, and whose disability was incurred or aggravated in line of duty in the active military, naval, or air service. To be considered a Service-Disabled Veteran, the veteran must have an adjudication letter from the Veterans Administration (VA), a Department of Defense Form 214, Certificate of Release or Discharge from Active Duty, or a Statement of Service from the National Archives and Records Administration, stating that the veteran has a service-connected disability. Please ensure you have selected all that apply as you can be identified in one or more categories if your company meets the criteria shown.

What is your status with CCFS? Mark only one. I wish to be CCFS independent contractor/vendor. I wish to be an CCFS agent/vendor I am/we are a business other than the two preceding categories (please specify):

Signature required below. Upon execution and return of Form E, the undersigned agrees that the EEO Compliance Certification Status above is incorporated by reference in all purchases and service contracts with CCFS and its subsidiaries.

Print Agent/Contractor’s Name or DBAN Agent/Contractor’s Title

Agent/Contractor’s Signature Today’s Date

http://www.sba.gov/hubzone�

http://www.ccr.gov/�



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0020 - Business Conduct Guidelines for Vendors

1.0 Scope. This policy establishes the general business conduct guidelines for each Crane Freight Services ("CCFS") Vender/Supplier and its employees. The Vendor/Supplier and its employees will perform services for CCFS and act in such a manner to maintain CCFS reputation for integrity and good corporate citizenship and abide by basic principles of ethical and lawful business conduct. The business conduct guidelines set out herein (the "Business Conduct Guidelines") outline the standards expected of the Vendor/Supplier and its employees in their dealings with the public and with customers, clients, vendors, volunteers and employees of CCFS.

2.0 Policy. The following is the, policy of CCFS:

a) The Vendor/Supplier hereby agrees to the Business Conduct Guidelines as a condition of conducting business with CCFS.

b) Failure to adhere to the Business Conduct Guidelines shall result in denial or termination of any business relationship with CCFS and/or legal action.

3.0 Adherence to the Law. The Vendor/Supplier and its employees must comply with all the laws applicable to CCFS and all the laws applicable to the services performed by the Vendor/Supplier. If in doubt as to the legality of a particular course of action, the Vendor/Suppler and its employees shall discuss the proposed activity with the relevant manager at CCFS. The manager shall consult with CCFS Corporate Safety & Compliance Department.

4.0 Respect and Dignity in the Workplace. The Vender/Supplier and its employees shall treat all CCFS employees, vendors, business associates, volunteers, and customers of CCFS and the public with respect and dignity. The Vendor/Supplier and its employees shall not engage in harassment and/or discriminatory acts or practices. CCFS has the right to request a Vendor/Supplier and/or its employee(s) be removed from a CCFS project if the conduct of the Vendor/Supplier and/or its employee(s) requires, and the Vendor/Supplier will fulfill the request immediately after receiving written notification from CCFS.

5.0 Health and Safety. The Vendor/Supplier and its employees shall perform the services for CCFS in a safe and compliant manner as required by law.

6.0 Alcohol and Drugs. The Vendor/Supplier and its employees shall not possess. consume and/or traffic in alcoholic beverages, illegal drugs or restricted substances while performing the relevant services for CCFS.

7.0 Environment. The Vendor/Supplier and its employees shall obey all environmental laws applicable in the jurisdictions in which CCFS operates while performing the relevant services for CCFS.



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8.0 Professional Image. The Vendor/Suppler and its employees shall consistently present a

professional image in attire, personal demeanor. communications and actions in all contacts with CCFS customers and the public at large.

9.0 Appropriation of Company Assets. The Vendor/Supplier and its employees must not borrow or make use of CCFS name, property, goodwill, finds, data or other assets for their personal gain or benefit, or for the benefit of others, except as part of a CCFS-authorized compensation or benefit program. Upon termination of the CCFS Agreement, the Vendor/Supplier and its employees must relinquish or return all of CCFS records and equipment. CCFS assets owned by CCFS are intended to be used solely for CCFS business.

10.0 Conflict of Interest. The Vendor/Supplier and its employees must avoid activities or situations that involve real or perceived conflicts of interest with CCFS and/or openly declare that a conflict of interest exists.

11.0 Confidentiality. The Vender/Supplier and its employees shall maintain the confidentiality of all confidential information belonging to CCFS.

12.0 Gifts, Bribes, Kickbacks, and Other Inducements. The Vendor/Supplier is herby advised of and bound to honor the following CCFS policy on giving and receiving gifts, bribes, kickbacks and other inducements:

a) The Vendor/Supplier will not give or encourage anyone else to give gifts, bribes, kickbacks or inducements of any kind to any (i) government employee, (ii) vendor/supplier or (iii) higher tier contractor under government or nongovernment contracts or subcontracts, in order to gain any business advantage or contract.

b) Vendor/Supplier shall neither give to nor accept from CCFS personnel gifts or anything of value, including an item, service, hospitality, use of a vacation home, lavish entertainment, etc. Exceptions to this general gift policy may be made for infrequent gifts of nominal value (US $20 or less per item, aggregate value up to US $50 per year), as long as the gift was not given or received with corrupt intent and could not be perceived as such. In no event should a gift be give to or accepted from CCFS personnel during, or in connection with, contract negotiations. Any gifts offered or accepted should be reported to CCFS management.

The nominal value amount referred to in the previous paragraph is applicable in Africa, Argentina, India, Indonesia, Philippines, and America. Please consult with CCFS Corporate Safety & Compliance Department for the nominal value amount for other locations.

13.0 Report Violations of Business Conduct Guidelines. The Vendor/Supplier should report any violation or suspected violation of the Business Conduct Guideline to Committee on Corporate Conduct, ____________________or by facsimile to Committee on Corporate Conduct ______________________.



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14.0 Adherence to CCFS Code of Conduct. The Vendor/Supplier agrees to abide by CCFS

Code of Conduct.

15.0 Report Violations of Code of Conduct. The Vendor/supplier should report any violation or suspected violation of the CCFS Code of Conduct by contacting the toll-free compliance line ( ). If calling from outside the U.S., first dial the applicable AT&T local county access code. A representative is available to report problems under, or ask questions about, the Code of Conduct. The compliance line is staffed 24 hours a day. seven days a week. Calls may be made anonymously.

The Vendor/Supplier may also report any violation or suspected violation of the Code of Conduct by mail to Committee on Corporate Conduct, _____________________________, or by facsimile to Committee on Corporate Conduct (____________ ).

Acknowledgement

Vendor’s Name (print) Terminal Code

Vendor’s Signature Vendor# Today Date

INSTRUCTIONS TO PRINTERSFORM W-9, PAGE 1 of 4MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES. PRINTS: HEAD to HEADPAPER: WHITE WRITING, SUB. 20. INK: BLACKFLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")PERFORATE: (NONE)

Give form to therequester. Do notsend to the IRS.

Form W-9 Request for TaxpayerIdentification Number and Certification

(Rev. October 2007) Department of the TreasuryInternal Revenue Service Name (as shown on your income tax return)

List account number(s) here (optional)

Address (number, street, and apt. or suite no.)

City, state, and ZIP code

Pri

nt o

r ty

pe

See

Sp

ecifi

c In

stru

ctio

ns o

n p

age

2.

Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoidbackup withholding. For individuals, this is your social security number (SSN). However, for a residentalien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it isyour employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

Social security number

or

Requester’s name and address (optional)

Employer identification number Note. If the account is in more than one name, see the chart on page 4 for guidelines on whosenumber to enter. Certification

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 I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the InternalRevenue 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 hasnotified me that I am no longer subject to backup withholding, and

2.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backupwithholding 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 retirementarrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you mustprovide your correct TIN. See the instructions on page 4. SignHere

Signature ofU.S. person ©

Date ©

General Instructions

Form W-9 (Rev. 10-2007)

Part I

Part II

Business name, if different from above

Cat. No. 10231X

Check appropriate box:

Under penalties of perjury, I certify that:

13 I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

TLS, have youtransmitted all R text files for this cycle update?

Date

Action

Revised proofsrequested

Date

Signature

O.K. to print

Use Form W-9 only if you are a U.S. person (including aresident alien), to provide your correct TIN to the personrequesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you arewaiting 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 aU.S. person, your allocable share of any partnership income froma U.S. trade or business is not subject to the withholding tax onforeign partners’ share of effectively connected income.

3. I am a U.S. citizen or other U.S. person (defined below).

A person who is required to file an information return with theIRS must obtain your correct taxpayer identification number (TIN)to report, for example, income paid to you, real estatetransactions, mortgage interest you paid, acquisition orabandonment of secured property, cancellation of debt, orcontributions you made to an IRA.

Individual/Sole proprietor

Corporation

Partnership

Other (see instructions) ©

Note. If a requester gives you a form other than Form W-9 torequest your TIN, you must use the requester’s form if it issubstantially similar to this Form W-9.

● 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 UnitedStates, ● An estate (other than a foreign estate), or

Definition of a U.S. person. For federal tax purposes, you areconsidered a U.S. person if you are:

Special rules for partnerships. Partnerships that conduct atrade or business in the United States are generally required topay a withholding tax on any foreign partners’ share of incomefrom such business. Further, in certain cases where a Form W-9has not been received, a partnership is required to presume thata partner is a foreign person, and pay the withholding tax.Therefore, if you are a U.S. person that is a partner in apartnership 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 partnershipincome. The person who gives Form W-9 to the partnership forpurposes of establishing its U.S. status and avoiding withholdingon its allocable share of net income from the partnershipconducting a trade or business in the United States is in thefollowing cases: ● The U.S. owner of a disregarded entity and not the entity,

Section references are to the Internal Revenue Code unlessotherwise noted.

● A domestic trust (as defined in Regulations section301.7701-7).

Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) ©

Exempt payee

Purpose of Form

INSTRUCTIONS TO PRINTERSFORM W-9, PAGE 2 of 4MARGINS: TOP 13 mm (1⁄ 2"), CENTER SIDES. PRINTS: HEAD to HEADPAPER: WHITE WRITING, SUB. 20. INK: BLACKFLAT SIZE: 216 mm (81⁄ 2") 3 279 mm (11")PERFORATE: (NONE)

Form W-9 (Rev. 10-2007) Page 2

Sole proprietor. Enter your individual name as shown on yourincome tax return on the “Name” line. You may enter yourbusiness, trade, or “doing business as (DBA)” name on the“Business name” line.

13 I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING


Other entities. Enter your business name as shown on requiredfederal tax documents on the “Name” line. This name shouldmatch the name shown on the charter or other legal documentcreating the entity. You may enter any business, trade, or DBAname on the “Business name” line.

If the account is in joint names, list first, and then circle, thename of the person or entity whose number you entered in Part Iof the form.

Specific Instructions Name

Exempt Payee

5. You do not certify to the requester that you are not subjectto backup withholding under 4 above (for reportable interest anddividend accounts opened after 1983 only). Certain payees and payments are exempt from backupwithholding. See the instructions below and the separateInstructions for the Requester of Form W-9.

Civil penalty for false information with respect towithholding. If you make a false statement with no reasonablebasis that results in no backup withholding, you are subject to a$500 penalty. Criminal penalty for falsifying information. Willfully falsifyingcertifications or affirmations may subject you to criminalpenalties including fines and/or imprisonment.

Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to arequester, you are subject to a penalty of $50 for each suchfailure unless your failure is due to reasonable cause and not towillful neglect.

Misuse of TINs. If the requester discloses or uses TINs inviolation of federal law, the requester may be subject to civil andcriminal penalties.

If you are an individual, you must generally enter the nameshown on your income tax return. However, if you have changedyour last name, for instance, due to marriage without informingthe Social Security Administration of the name change, enteryour first name, the last name shown on your social securitycard, and your new last name.

If you are exempt from backup withholding, enter your name asdescribed above and check the appropriate box for your status,then check the “Exempt payee” box in the line following thebusiness name, sign and date the form.

4. The IRS tells you that you are subject to backupwithholding because you did not report all your interest anddividends on your tax return (for reportable interest anddividends only), or

3. The IRS tells the requester that you furnished an incorrectTIN,

2. You do not certify your TIN when required (see the Part IIinstructions on page 3 for details),

You will not be subject to backup withholding on paymentsyou receive if you give the requester your correct TIN, make theproper certifications, and report all your taxable interest anddividends on your tax return.

1. You do not furnish your TIN to the requester,

What is backup withholding? Persons making certain paymentsto you must under certain conditions withhold and pay to theIRS 28% of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding includeinterest, tax-exempt interest, dividends, broker and barterexchange transactions, rents, royalties, nonemployee pay, andcertain payments from fishing boat operators. Real estatetransactions are not subject to backup withholding.

Payments you receive will be subject to backupwithholding if:

If you are a nonresident alien or a foreign entity not subject tobackup withholding, give the requester the appropriatecompleted Form W-8.

Example. Article 20 of the U.S.-China income tax treaty allowsan exemption from tax for scholarship income received by aChinese student temporarily present in the United States. UnderU.S. law, this student will become a resident alien for taxpurposes if his or her stay in the United States exceeds 5calendar years. However, paragraph 2 of the first Protocol to theU.S.-China treaty (dated April 30, 1984) allows the provisions ofArticle 20 to continue to apply even after the Chinese studentbecomes a resident alien of the United States. A Chinesestudent who qualifies for this exception (under paragraph 2 ofthe first protocol) and is relying on this exception to claim anexemption from tax on his or her scholarship or fellowshipincome would attach to Form W-9 a statement that includes theinformation described above to support that exemption.

Note. You are requested to check the appropriate box for yourstatus (individual/sole proprietor, corporation, etc.).

4. The type and amount of income that qualifies for theexemption from tax. 5. Sufficient facts to justify the exemption from tax under theterms of the treaty article.

Nonresident alien who becomes a resident alien. Generally,only a nonresident alien individual may use the terms of a taxtreaty 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 maypermit an exemption from tax to continue for certain types ofincome 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 exceptioncontained in the saving clause of a tax treaty to claim anexemption from U.S. tax on certain types of income, you mustattach a statement to Form W-9 that specifies the following fiveitems: 1. The treaty country. Generally, this must be the same treatyunder which you claimed exemption from tax as a nonresidentalien. 2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty thatcontains the saving clause and its exceptions.

Also see Special rules for partnerships on page 1.

Foreign person. If you are a foreign person, do not use FormW-9. Instead, use the appropriate Form W-8 (see Publication515, Withholding of Tax on Nonresident Aliens and ForeignEntities).

● The U.S. grantor or other owner of a grantor trust and not thetrust, and ● The U.S. trust (other than a grantor trust) and not thebeneficiaries of the trust.

Limited liability company (LLC). Check the “Limited liabilitycompany” box only and enter the appropriate code for the taxclassification (“D” for disregarded entity, “C” for corporation, “P” for partnership) in the space provided. For a single-member LLC (including a foreign LLC with adomestic owner) that is disregarded as an entity separate fromits owner under Regulations section 301.7701-3, enter theowner’s name on the “Name” line. Enter the LLC’s name on the“Business name” line. For an LLC classified as a partnership or a corporation, enterthe LLC’s name on the “Name” line and any business, trade, orDBA name on the “Business name” line.


I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING



13

Part I. Taxpayer IdentificationNumber (TIN) Enter your TIN in the appropriate box. If you are a residentalien and you do not have and are not eligible to get an SSN,your TIN is your IRS individual taxpayer identification number(ITIN). Enter it in the social security number box. If you do nothave an ITIN, see How to get a TIN below.

How to get a TIN. If you do not have a TIN, apply for oneimmediately. To apply for an SSN, get Form SS-5, Applicationfor a Social Security Card, from your local Social SecurityAdministration office or get this form online at www.ssa.gov. Youmay also get this form by calling 1-800-772-1213. Use FormW-7, Application for IRS Individual Taxpayer IdentificationNumber, to apply for an ITIN, or Form SS-4, Application forEmployer Identification Number, to apply for an EIN. You canapply for an EIN online by accessing the IRS website atwww.irs.gov/businesses and clicking on Employer IdentificationNumber (EIN) under Starting a Business. You can get Forms W-7and SS-4 from the IRS by visiting www.irs.gov or by calling1-800-TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN,write “Applied For” in the space for the TIN, sign and date theform, and give it to the requester. For interest and dividendpayments, and certain payments made with respect to readilytradable instruments, generally you will have 60 days to get aTIN and give it to the requester before you are subject to backupwithholding on payments. The 60-day rule does not apply toother types of payments. You will be subject to backupwithholding on all such payments until you provide your TIN tothe requester.

If you are a sole proprietor and you have an EIN, you mayenter either your SSN or EIN. However, the IRS prefers that youuse your SSN. If you are a single-member LLC that is disregarded as anentity separate from its owner (see Limited liability company(LLC) on page 2), enter the owner’s SSN (or EIN, if the ownerhas one). Do not enter the disregarded entity’s EIN. If the LLC isclassified as a corporation or partnership, enter the entity’s EIN. Note. See the chart on page 4 for further clarification of nameand TIN combinations.

Note. Entering “Applied For” means that you have alreadyapplied for a TIN or that you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign ownermust use the appropriate Form W-8.

9. A futures commission merchant registered with theCommodity Futures Trading Commission, 10. A real estate investment trust,

11. An entity registered at all times during the tax year underthe Investment Company Act of 1940, 12. A common trust fund operated by a bank under section584(a), 13. A financial institution,

14. A middleman known in the investment community as anominee or custodian, or 15. A trust exempt from tax under section 664 or described insection 4947.

THEN the payment is exemptfor . . .

IF the payment is for . . .

All exempt payees except for 9

Interest and dividend payments

Exempt payees 1 through 13.Also, a person registered underthe Investment Advisers Act of1940 who regularly acts as abroker

Broker transactions

Exempt payees 1 through 5

Barter exchange transactionsand patronage dividends

Generally, exempt payees 1 through 7

Payments over $600 requiredto be reported and directsales over $5,000 See Form 1099-MISC, Miscellaneous Income, and its instructions. However, the following payments made to a corporation (including grossproceeds paid to an attorney under section 6045(f), even if the attorney is acorporation) and reportable on Form 1099-MISC are not exempt frombackup withholding: medical and health care payments, attorneys’ fees, andpayments for services paid by a federal executive agency.

The chart below shows types of payments that may beexempt from backup withholding. The chart applies to theexempt payees listed above, 1 through 15.

1 2

7. A foreign central bank of issue, 8. A dealer in securities or commodities required to register in

the United States, the District of Columbia, or a possession ofthe United States,

2

The following payees are exempt from backup withholding: 1. An organization exempt from tax under section 501(a), any

IRA, or a custodial account under section 403(b)(7) if the accountsatisfies the requirements of section 401(f)(2), 2. The United States or any of its agencies orinstrumentalities, 3. A state, the District of Columbia, a possession of the UnitedStates, or any of their political subdivisions or instrumentalities, 4. A foreign government or any of its political subdivisions,agencies, or instrumentalities, or 5. An international organization or any of its agencies orinstrumentalities. Other payees that may be exempt from backup withholdinginclude: 6. A corporation,

Generally, individuals (including sole proprietors) are not exemptfrom backup withholding. Corporations are exempt from backupwithholding for certain payments, such as interest and dividends. Note. If you are exempt from backup withholding, you shouldstill complete this form to avoid possible erroneous backupwithholding.

1

1. Interest, dividend, and barter exchange accountsopened before 1984 and broker accounts considered activeduring 1983. You must give your correct TIN, but you do nothave to sign the certification. 2. Interest, dividend, broker, and barter exchangeaccounts opened after 1983 and broker accounts consideredinactive during 1983. You must sign the certification or backupwithholding will apply. If you are subject to backup withholdingand you are merely providing your correct TIN to the requester,you must cross out item 2 in the certification before signing theform.

Part II. Certification

For a joint account, only the person whose TIN is shown inPart I should sign (when required). Exempt payees, see ExemptPayee on page 2.

To establish to the withholding agent that you are a U.S. person,or resident alien, sign Form W-9. You may be requested to signby the withholding agent even if items 1, 4, and 5 below indicateotherwise.

Signature requirements. Complete the certification as indicatedin 1 through 5 below.



I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING


Give name and EIN of:

For this type of account:

3. Real estate transactions. You must sign the certification.You may cross out item 2 of the certification.

A valid trust, estate, or pension trust

6.

Legal entity 4

4. Other payments. You must give your correct TIN, but youdo not have to sign the certification unless you have beennotified that you have previously given an incorrect TIN. “Otherpayments” include payments made in the course of therequester’s trade or business for rents, royalties, goods (otherthan bills for merchandise), medical and health care services(including payments to corporations), payments to anonemployee for services, payments to certain fishing boat crewmembers and fishermen, and gross proceeds paid to attorneys(including payments to corporations).

The corporation

Corporate or LLC electingcorporate status on Form 8832

7.

The organization

Association, club, religious,charitable, educational, or othertax-exempt organization

8.

5. Mortgage interest paid by you, acquisition orabandonment of secured property, cancellation of debt,qualified tuition program payments (under section 529), IRA,Coverdell ESA, Archer MSA or HSA contributions ordistributions, and pension distributions. You must give yourcorrect TIN, but you do not have to sign the certification.

The partnership

Partnership or multi-member LLC

9.

The broker or nominee

A broker or registered nominee

10.

The public entity

Account with the Department ofAgriculture in the name of a publicentity (such as a state or localgovernment, school district, orprison) that receives agriculturalprogram payments

11.

Privacy Act Notice

List first and circle the name of the person whose number you furnish. If only one personon a joint account has an SSN, that person’s number must be furnished. Circle the minor’s name and furnish the minor’s SSN. You must show your individual name and you may also enter your business or “DBA” name on the second name line. You may use either your SSN or EIN (if you have one),but the IRS encourages you to use your SSN. List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TINof the personal representative or trustee unless the legal entity itself is not designated inthe account title.) Also see Special rules for partnerships on page 1.

Note. If no name is circled when more than one name is listed,the number will be considered to be that of the first name listed.

Disregarded entity not owned by anindividual

The owner

12.

13

You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain otherpayments to a payee who does not give a TIN to a payer. Certain penalties may also apply.

Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest,dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, orcontributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return.The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S.possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federalnontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

1

2 3

4

Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personalinformation such as your name, social security number (SSN), orother identifying information, without your permission, to commitfraud or other crimes. An identity thief may use your SSN to geta job or may file a tax return using your SSN to receive a refund.

What Name and Number To Give the Requester Give name and SSN of:

For this type of account:

The individual

1.

Individual The actual owner of the account or,

if combined funds, the firstindividual on the account

2.

Two or more individuals (jointaccount)

The minor 2

3.

Custodian account of a minor(Uniform Gift to Minors Act) The grantor-trustee

1

4.

a. The usual revocable savingstrust (grantor is also trustee) The actual owner

1

b. So-called trust account that isnot a legal or valid trust understate law The owner

3

5.

Sole proprietorship or disregardedentity owned by an individual

Call the IRS at 1-800-829-1040 if you think your identity hasbeen used inappropriately for tax purposes.

1

To reduce your risk: ● Protect your SSN, ● Ensure your employer is protecting your SSN, and ● Be careful when choosing a tax preparer.

Victims of identity theft who are experiencing economic harmor a system problem, or are seeking help in resolving taxproblems that have not been resolved through normal channels,may be eligible for Taxpayer Advocate Service (TAS) assistance.You can reach TAS by calling the TAS toll-free case intake lineat 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishingschemes. Phishing is the creation and use of email andwebsites designed to mimic legitimate business emails andwebsites. The most common act is sending an email to a userfalsely claiming to be an established legitimate enterprise in anattempt to scam the user into surrendering private informationthat will be used for identity theft. The IRS does not initiate contacts with taxpayers via emails.Also, the IRS does not request personal detailed informationthrough email or ask taxpayers for the PIN numbers, passwords,or similar secret access information for their credit card, bank, orother financial accounts. If you receive an unsolicited email claiming to be from the IRS,forward this message to [email protected]. You may also reportmisuse of the IRS name, logo, or other IRS personal property tothe Treasury Inspector General for Tax Administration at1-800-366-4484. You can forward suspicious emails to theFederal Trade Commission at: [email protected] or contact them atwww.consumer.gov/idtheft or 1-877-IDTHEFT(438-4338).

Visit the IRS website at www.irs.gov to learn more aboutidentity theft and how to reduce your risk.

Form W-8BEN(Rev. February 2006)

Department of the TreasuryInternal Revenue Service

Certificate of Foreign Status of Beneficial Ownerfor United States Tax Withholding

� See separate instructions.� Give this form to the withholding agent or payer. Do not send to the IRS.

OMB No. 1545-1621

Do not use this form for: Instead, use Form:

● A foreign partnership, a foreign simple trust, or a foreign grantor trust (see instructions for exceptions) W-8ECI or W-8IMY● A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization,

foreign private foundation, or government of a U.S. possession that received effectively connected income or that isclaiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) (see instructions) W-8ECI or W-8EXP

● A person acting as an intermediary W-8IMY

● A person claiming that income is effectively connected with the conductof a trade or business in the United States W-8ECI

Part I

Part II

Identification of Beneficial Owner (See instructions.)1

3

2

4

5

6 7

Name of individual or organization that is the beneficial owner

Type of beneficial owner:

Country of incorporation or organization

Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.

City or town, state or province. Include postal code where appropriate. Country (do not abbreviate)

U.S. taxpayer identification number, if required (see instructions) Foreign tax identifying number, if any (optional)

Individual Corporation Partnership Simple trust

Mailing address (if different from above)

City or town, state or province. Include postal code where appropriate. Country (do not abbreviate)

Claim of Tax Treaty Benefits (if applicable)I certify that (check all that apply):

The beneficial owner is a resident of within the meaning of the income tax treaty between the United States and that country.

If required, the U.S. taxpayer identification number is stated on line 6 (see instructions).

The beneficial owner is not an individual, derives the item (or items) of income for which the treaty benefits are claimed, and, ifapplicable, meets the requirements of the treaty provision dealing with limitation on benefits (see instructions).

The beneficial owner is not an individual, is claiming treaty benefits for dividends received from a foreign corporation or interest from aU.S. trade or business of a foreign corporation, and meets qualified resident status (see instructions).

The beneficial owner is related to the person obligated to pay the income within the meaning of section 267(b) or 707(b), and will fileForm 8833 if the amount subject to withholding received during a calendar year exceeds, in the aggregate, $500,000.

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. Ifurther certify under penalties of perjury that:1 I am the beneficial owner (or am authorized to sign for the beneficial owner) of all the income to which this form relates,2 The beneficial owner is not a U.S. person,3 The income to which this form relates is (a) not effectively connected with the conduct of a trade or business in the United States, (b) effectively connected but isnot subject to tax under an income tax treaty, or (c) the partner’s share of a partnership’s effectively connected income, and4 For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.

Sign Here � Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY)

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25047Z Form W-8BEN (Rev. 2-2006)

� Section references are to the Internal Revenue Code.

a

b

c

d

e

SSN or ITIN EIN

Capacity in which acting

Disregarded entity

Certification

9

Special rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of Article of the

treaty identified on line 9a above to claim a % rate of withholding on (specify type of income): .

Explain the reasons the beneficial owner meets the terms of the treaty article:

10

Government International organization

Central bank of issue Tax-exempt organization

Part IV

Part III Notional Principal Contracts11 I have provided or will provide a statement that identifies those notional principal contracts from which the income is not effectively

connected with the conduct of a trade or business in the United States. I agree to update this statement as required.

● A U.S. citizen or other U.S. person, including a resident alien individual W-9

Private foundation

Note: These entities should use Form W-8BEN if they are claiming treaty benefits or are providing the form only toclaim they are a foreign person exempt from backup withholding.

Note: See instructions for additional exceptions.

Grantor trust EstateComplex trust

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner orany withholding agent that can disburse or make payments of the income of which I am the beneficial owner.

8 Reference number(s) (see instructions)

Printed on Recycled Paper

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