AMERICAN ELITE CONSTRUCTION LLC

335 Staffordshire Rd. Bldg. #5

Stafford, Texas 77477

Phone: 832-545-0921

I Perform the following facets of construction: (Please Circle) 

 

Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification Go to www.irs.gov/FormW9 for instructions and the latest information.

Give Form to the requester. Do not send to the IRS.

 

4. Exemptions ( Codes apply only to certain entities, not individuals; see instruction on page 3):

 

Part I

Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN If you do not have a number, see How to get a TIN, later.

Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.

 

Part II

Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

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

4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

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 for Part II, later.

General Instructions

Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

Purpose Of Form

An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following.

• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. 

INDEPENDENT CONTRACTOR'S AGREEMENT

It is hereby agreed by and between Company and Independent Contractor that throughout this agreement, the terms "subcontractor," "independent contractor" and/or "independent subcontractor" may be used interchangeably. However, the parties understand and agree that the legal relationship of Independent Contractor to Company shall be exclusively that of independent contractor and that no employer/employee relationship is intended or implied by the terms of this Agreement.

1.1  Whereas the Company is in the roofing and roofing repair business: and 

1.2 Whereas the Independent Contractor is in the business of providing roofing repair services as an independent subcontractor and Company has occasion from time to time to require and independent subcontractor to perform roofing repair work: and 

1.3 Whereas the Company and Independent Contractor want to define the nature and extent of their relationship. 

1.4 Company and Independent Contractor now therefore, agree, effective immediately, as follows:

2.1 "Contract Documents" The term "Contract Documents" includes this Agreement, the acknowledgement and disclosures attached hereto as Exhibits "A" and "B'. In addition, the Contract Documents also include any agreement between Company and a Property Owner or a General Contractor, if any, (including general, supplementary, and other conditions), the plans and specifications, all addenda issued prior to and all modifications and change orders issued after execution of the Agreement between Owner and Company or Owner and General Contractor, if any, in connection with any Project (see Section 2.2 It is the independent Contractor's responsibility to obtain copies of and be familiar with these documents for any Project on which Independent Contractor has agreed to provide work. Independent Contractor acknowledges that the Contract Documents are applicable to all work performed on any Project under this Agreement, and Independent Contractor assumes towards Property Owner and General Contractor, if any, all obligations, and responsibilities which the Company, by those Contract Documents, assumes towards Property Owner and General Contractor, if any, insofar as applicable and under the terms of this Agreement.

2.2 "Projects" Company shall from time to time enter into contracts or agreements to engage the services of Independent Contractor with respect to roofing projects and/or at jobsites. Such contracts are referred to as "Projects" in this Agreement. On each Project, any bid, proposal, or contract under which Independent Contractor is to supply services to Company and/or in fulfillment of Company's obligation to a Property Owner of General Contractor is expressly subject to the terms and conditions of this Agreement. If any other written document or oral representation, including terms or provisions in any bid or proposal from Independent Contractor, conflict with the terms or conditions of this Agreement, the terms of this Agreement shall take precedence over any such conflicting provision unless the parties expressly agree in a writing signed by Company that some other term or provision shall supersede particular provision(s) of this Agreement.

2.3 This Agreement supersedes and replaces any prior agreement or contract between the parties, whether written or oral; Independent Contractor hereby expressly disclaims reliance upon any other representations, whether written or oral, made prior to the execution of this Agreement. Moreover, Independent Contractor expressly waives the right to claim that any provision of this Agreement was induced by fraud or misrepresentation in any oral statement by Company or its agents, representatives or employees made prior to the execution of this Agreement.

2.4 Company and Independent Contractor agree that the terms and conditions of this Agreement, along with the Contract Documents applicable to any Project, shall govern the relationship entered between Company and Independent Contractor in the performance of Independent Contractor's work on any Project.

3.1 It is expressly agreed that Independent Contractor and its owners, officers, agents, employees, and subcontractors, if any, are not employees of the Company for any purpose whatsoever but shall be exclusively an independent contractor. 

3.2 Company shall have no control over the manner or details of Independent Contractor's work or that of Independent Contractor's owners, officers, agents, employees, or subcontractors other than the general right to ensure that Independent Contractor performs the duties and obligations imposed upon Independent Contractor under this Agreement and the Contract Documents applicable to any Project on which Independent Contractor has agreed to perform work. Nothing in this Agreement shall be regarded as creating any relationship by and between Company and Independent Contractor, such as an employer/employee, joint venture, partnership, single business enterprise, or shareholder relationship. 

3.3 Company shall provide no health insurance, retirement plans, thrift plans or any other employee benefits to Independent Contractor. Company will not cover Independent Contractor or its owner, employees, agents or subcontractors under any Workers' Compensation Insurance Policy or any other insurance policy and Independent Contractor expressly elects not to be covered by any Workers' Compensation Insurance Policy or any other insurance policy purchased by Company. Moreover, Independent Contractor expressly rejects any such insurance coverage. 

3.4 Company will not withhold social security, federal or state income taxes or any other state or federal withholding from the Independent Contractor's compensation. It is expressly understood that Independent Contractor shall pay all such taxes or social security directly and on its own behalf.

3.5 All expenses and disbursements, including, but not limited to, those for travel and maintenance, entertainment, insurance, license fees, legal fees, membership dues, taxes, educational expenses and any and all other general selling and/or personal expenses that may be incurred by Independent Contractor except as otherwise noted or provided for in writing shall be borne wholly and completely by Independent Contractor, and Company shall not be in any way responsible or liable therefore.

3.6 Independent Contractor shall be solely responsible for supplying all necessary tools and equipment, including safety equipment, necessary to complete its work on any Project subject to this Agreement and in accordance with the terms of the Contract Documents.

3.7 Independent Contractor does not have, nor will it hold itself out as having, any right, power or authority to create any contract or obligation, either expressed or implied, on behalf, in the name of, or binding on Company, or to pledge Company's credit, or to extend credit in Company's name, or to amend, supplement or alter the terms of any contract to which Company is a party, unless Company shall consent thereto in advance in a writing expressly referencing this Section 3.7.

3.8 Company shall not be responsible for ensuring that Independent Contractor, or its owners, officers, employees, agents, or subcontractors, perform Independent Contractor's work in a safe manner. Likewise, the Company shall not be responsible for supplying any training, supervision, or equipment (including safety equipment or fall protection) to Independent Contractor. As between Company and Independent Contractor, Independent Contractor shall assume all responsibility to training, supervision and provision of equipment necessary to perform Independent Contractor's work in compliance with the Contract Documents applicable to any Project. If any equipment, including safety equipment or fall protection equipment, is supplied by Company, it will not be out of any duty or obligation imposed upon Company under this Agreement or the Contract Document, but only under separate sales or lease terms to be negotiated by the parties should the need arise.

4.1 Independent Contractor and its owners, officers, and employees, in addition to any other obligation set forth in the Contract Documents, shall strictly comply with all applicable laws, rules, and regulations of duly constituted governmental authorities including all applicable state and federal occupational safety regulations and shall obtain all licenses, registrations or other approvals required by law in connection with the services to be rendered.

4.2 Independent Contractor is required to obey all federal, state, and local laws, rules, and regulations, as well as any rules or obligations imposed under the Contract Documents. Independent Contractor shall report any accidents to Company and Premises Owner within twenty-four (24) hours of the incident.

 

Company shall pay independent Contractor weekly progress payments in accordance with the terms of this Agreement, Applications for weekly progress payments shall be in writing and shall be submitted to the Company on or before Wednesday of each week. Company shall pay the Independent Contractor weekly progress payments by the following Friday, subject to other provisions of the Agreement. Payment to the hiring company must be received in full before any payment is issued to the party listed above (subcontractor) Invoices must be turned in every WEDNESDAY evening for our office to post and pay out two days later (Friday) for work 100% completed or progress payments discussed prior to the start of any work. Invoices received after Wednesday will be paid the following week. WE WILL ALSO NEED LIEN RELEASE ON PAYMENTS BEFORE CHECKS ARE ISSUED. Shingle jobs we will pay ONLY up to 5% waste.

6.1 Either party may terminate this Agreement at any time by giving written notice to the other party. Written notice of termination by Independent Contractor shall not be effective to alter the terms of this Agreement with reference to any work then in progress or any work completed prior to such termination.

Independent Contractor agrees to defend. indemnify and hold Company harmless from and against any and all claims, lawsuits, demands, losses, damages, costs, liabilities, and expenses (including. but not limited to. attorney's fees, liability or potential liability, and costs of suit) of whatever kind or character, on account of any actual or alleged loss, injury or damage to any person. firm or corporation (including Independent Contractor. its owners. officers. agents, employees or subcontractors or any third party) and for any damage to property arising out of or in connection with work performed by Independent Contractor under this Agreement or on any Project. This indemnification provision specifically applies to any claim brought against Company or its owners. officers. agents or employees based on the negligence of Company or its owners. officers. agents or employees in supervising, training or otherwise in any way controlling or directing the work of Independent Contractor or Independent Contractor's owners, officers. employees, agents or subcontractors. This indemnification agreement also specifically applies to any claim brought against Company or its owners, officers or employees based on any act or omission in the provision or non- provision of any equipment (including safety equipment and fall protection) or adequate training. supervision or warnings in connection with the provision of any equipment ( including safety equipment and fall protection) and also applies to any claim against Company or its owners. officers or employees based on negligence in the maintenance or control of premises or failure to maintain a safe workplace.

8.1 This agreement shall be deemed to have been made in the State of Texas and shall be construed according to the laws of that state. The parties hereby agree that any and all disputes, claims or suits arising out of this suit shall be venued in the State of Texas and shall be venued in Harris County, Texas.

8.2 The parties further agree that all disputes arising out of the terms of this Agreement, including disputes related to work performed on any Project, shall be resolved in mandatory arbitration before the American Arbitration Association ("AAA") and pursuant to the rules of the AAA. Any such arbitration shall occur in Houston, Harris County, Texas and shall also be subject to the Texas General Arbitration Act.

9.1 Nothing contained in this Agreement shall be construed as requiring the commission of any actcontrary to law. Whenever there is any conflict between any provisions of this Agreement and anypresent or future statute, law, ordinance, or regulation contrary to which the parties have no legal rightto contract, the latter shall prevail, but in such event the provision of the Agreement thus affected shallbe curtained and limited only to the extent necessary to bring it within the requirement of the law. Ifany part, article, paragraph, or clause of this Agreement shall be held to be indefinite, invalid, orotherwise unenforceable, the entire Agreement shall not fail on account thereof, and the balance of thisAgreement shall continue in full force and effect. If any tribunal or court of appropriate jurisdictiondeems any provision hereof (other than for the payment of money) unreasonable, said tribunal or courtmay declare a reasonable modification hereof, and this Agreement shall be valid and enforceable, andthe parties hereto agree to be bound by and perform same, as thus modified

10.1 The use of a torch or the issuance of a purchase order for a torch by Independent Contractor or its owners, officers, agents, employees, or subcontractors in connection with any Project shall be grounds for immediate termination of this Agreement and all Projects subject to this Agreement. Independent Contractor shall completely indemnify and hold harmless Company for any and all damages or injuries claimed by any person or entity arising out of the use of a torch by Independent Contractor. or its owners, officers, agents, employees or subcontractors in connection with any work performed subject to this Agreement and/or subject to the terms and conditions specified in Section 7.1 above, including any claim against Company or its owners, officers, or employees for their own alleged negligence.

11.1 Independent Contractor shall purchase Comprehensive Commercial General Liability & Workman's Comp Insurance ("CGL Policy") naming Company as an "Additional Insured" and covering any occurrence arising out of work performed on any Project. The CGL Policy shall provide at least $1,000,000.00 per occurrence limits, $2,000,000.00 general aggregate limits, and $1,000,000.00 products/completed operations coverage limits. The Independent Contractor shall provide current documentation from its insurer or insurance agent to the Company demonstrating that a CGL Policy that meets the above conditions has been procured and maintained. 

11.2 In the event that Independent Contractor elects not to purchase a CGL / WC Policy with the coverage limits identified above, or if Independent Contractor fails to provide documentation to Company demonstrating that such a CGL Policy has been procured and maintained, Independent Contractor hereby authorizes a 5% deduction on all gross payments made to Independent Contractor. This deduction will be used to offset the expense of the Company's own liability insurance and shall not be used to purchase any additional insurance coverage for Independent Contractor.

12.1 If Independent Contractor has elected not to obtain coverage for itself or its owners, officers, agents, employees or subcontractors made available by the Texas Workers' Compensation Act, the decision to forego such coverage was made by Independent Contractor voluntarily with full knowledge by Independent Contractor of the risks involved in working without Workers' Compensation coverage, and Independent Contractor has voluntarily assumed all such risks and does not expect or intend such risks be shared by Company or any Property Owner.

12.2 Independent Contractor hereby waives for itself and for anyone claiming by or through it any cause of action, suit, debt, sum of money, damages, judgment, claims or demands, in law or in equity, that may arise out of or in connection with any injury, loss or damage incurred by Independent Contractor or its owners, officers, agents, employees or subcontractors on or about the Property Owner's property and hereby releases Company and any property owner from any such claims, causes of action, suits, demands or other proceedings arising out of a claim that is or would be subject to the Workers' Compensation Act or any Workers' Compensation Insurance.

12.3 Independent Contractor fully understands that Workers' Compensation coverage will not be provided to Independent Contractor or its owners, officers, agents, employees, or subcontractors. Any expenses, medical or otherwise, incurred shall be the exclusive responsibility of Independent Contractor and/or its owners, officers, agents, employees, or subcontractors and not the responsibility of the Company or any Property owner.

AUTHORIZATION AND RELEASE TO OBTAIN INFORMATION

Under the provisions of the Fair Credit Reporting Act, 15 USC, Section 1681 et seq., the Americans with Disabilities Act and all applicable federal, state and local laws, I hereby authorize and permit American Elite Construction, LLC., to obtain a consumer report and/or an investigative consumer report which may include the following.

1. My employment records.

2. Records concerning any driving, criminal history, credit history, civil records, worker's compensation (post-offer only) and drug testing.

3.(For truck drivers only) In accordance with the Department of Transportation Motor Carrier Safety Regulation, Section 382,413, information concerning alcohol and controlled substances for the past two years.

4. Verification of my academic and/or professional credentials; and information and/or copies of documentation from any military service records

I understand that an "investigative consumer report" may include information as to my character, general reputation, personal characteristics, and mode of living which may be obtained by interviews with individuals with whom I am acquainted or who may have knowledge concerning any such items of information.

I agree that a copy of this authorization has the same effect as the original.

I hereby release and hold harmless any person, firm, or entity that discloses matters in accordance with this authorization, as well as American Elite Construction, LLC., from liability that might otherwise result from the request for use of and/or disclosure of any or all the foregoing information.

I understand and acknowledge that under the provision of the Fair Credit Reporting Act I may request a copy of any consumer report from the consumer reporting agency that compiled the report, after I have provided proper identification.

I hereby authorize American Elite Construction, LLC., to obtain and prepare an investigative consumer report as set forth above, as part of its investigation of my employment application. This authorization shall remain in effect over the course of my employment. Reports may be ordered periodically during my employment.

 CERTIFICATION UNDER THE IMMIGRATION REFORM AND CONTROL ACT OF 1986

On This day of hereby certified that I and all of my agents, employees and subcontractors, if any, and those owners, officers, agents, employees and subcontractors, if any, employed by the company or partnership for which I represent are all legally authorized to work in the United States, and those owners, officers, agents, employees and subcontractors, if any, employed after November 6, 1986, have been properly certified under the Immigration Reform and Control Act of 1986.