HomeMy WebLinkAboutAgreement_General_07/10/2014 (3) LESSEE Site I.D.: Tequesta Flag Pole, Site No. 68510
LAND AND TOWER LEASE AGREEMENT
This Agreement, made this day of C' 2014, between The Village of Tequesta,
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Florida, a municipal corporation with its principal offices located at
345 Tequesta Drive, Tequesta, Florida 33469, hereinafter designated LESSOR, and
Verizon Wireless Personal Communications LP d/b /a Verizon Wireless, a Delaware limited
partnership, with its principal office located at One Verizon Way, Mail Stop 4AW100, Basking
Ridge, New Jersey 07920 (telephone number 866 - 862 - 4404), hereinafter designated LESSEE.
The LESSOR and LESSEE are at times collectively referred to hereinafter as the "Parties" or
individually as the "Party ".
WHEREAS, LESSOR owns the Property located at 901 Old Dixie Highway, Tequesta,
Florida 33469 which contains, among other things, an existing equipment shed and a
communications tower, and
WHEREAS, LESSEE desires to lease ground space comprised of portions of LESSOR'S
property located at 901 Old Dixie Highway, Tequesta, Florida 33469, including the existing
equipment shed, as well as space on the communications tower, from LESSOR in connection with
the provisions of communications services.
NOW, THEREFORE, in consideration of the mutual covenants herein set forth and other
good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the
parties hereby agree as follows:
1. PREMISES AND TOWER SPACE LESSOR hereby leases to LESSEE a portion
of that certain parcel of property (the entirety of LESSOR's property is referred to hereinafter as
the "Property") located at 901 N. Old Dixie Highway, Tequesta, Florida 33469, and being
described as a three hundred (300) square foot parcel of ground space, including the existing
equipment shed located thereon (the "Land Space "), together with the non - exclusive right (the
"Rights of Way") for ingress and egress, seven (7) days a week twenty-four (24) hours a day, on
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LESSEE Site LD.: Ted Flag Pole, Site No. 68510
foot or motor vehicle, including trucks, over the Property extending from the neatest public
right -of -way to the Land Space, as specified below, for the use and maintenance of the existing
equipment shed, and for the installation, use and maintenance of utility wires, poles, cables,
conduits, and pipe`s over, under, or along the Land Space.
LESSOR also leases to LESSEE a portion of LESSOR'S existing communications tower
(the `Tower") located on the Property, in order for LESSEE to erect, operate and maintain
communications antennas thereon. LESSEE shall have the right to locate up to six (6) antennas
on the Tower. Notwithstandmg anything in this Agreement to the contrary, the parties
acknowledge and agree that Exhibit B (as is hereafter defined) depicts the exact location of
LESSEE's initial installation of three (3) antemias on the Tower space, but that the exact location
of the entirety of the Tower space as may be used for up to three (3) future antennas may not be
shown on Exhibit B but is nonetheless included in leased Tower space. LESSEE may install up
to three (3) additional antennas, at approximately the same height levels identified in Exhibit B,
for a total of six (6) antennas upon subsequent application to LESSOR for same, as specified in
Paragraph 9 below. Notwithstanding anything contained herein, LESSOR shall maintain
exclusive ownership of the Tower and has the exclusive right to rent, lease or license all other
space on the Tower to third parties and to collect the rent from any such leases or licenses.
The Land Space, Rights of Way, and Tower space leased to LESSEE are hereinafter
referred to as the "Premises" and is more particularly described in Exhibit "A" attached hereto
and made a part hereof. The Prouty is likewise described herein in Exhibit "A" attached hereto
and made a part hereof. A site sketch depicting the location of the tower, LESSEE'S antennas
thereon, and the equipment shelter is attached hereto as Exhibit "B ".
2. ACCESS LESSEE shall have access to Premises seven (7) days a week twenty -
four (24) hours a day. Notwithstanding the foregoing, LESSEE shall give LESSOR'S plant
operator 24 hours advance notice prior to accessing the Tower at (561) - 575 -6235 during business
hours (8:00 a.m. - 5:00 p.m. Monday through Friday), and (561) - 2624326 after hours, except in
the case of an emergency. LESSEE shall comply with all reasonable security procedures
established by LESSOR to prevent unauthorized access to the Premises and the Property
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LESSEE Site I.D.: Tequala Flag Pole, Site No. 68510
generally. LESSOR and LESSEE shall each designate emergency contact personnel to notify in
case of an emergency requiring access to the Premises. LESSOR reserves the right to enter the
Premises at any time to visually inspect the Premises and/or Tower or to show the Premises and
/or Tower to prospective licensees, lenders, or purchasers.
3. SURVEY LESSOR also hereby grants to LESSEE the right to survey the
Property, and the Premises, and said survey shall then become Exhibit "C" which shall be attached
hereto and made a part hereof; and shall control in the event of boundary and access discrepancies
between it and Exhibit W. Cost for such work shall be borne by LESSEE.
4. TERM; RENTAL This Agreement shall be effective as of the date of execution
by both Parties, provided, however, the initial term shall be for five (5) years and shall
commence on the Commencement Date (as hereinafter defined) at which time rental payments
shall commence and be due annually at a rental of Thirty Six Thousand and 00/100 Dollars
($36,000.00) to be paid on the Commencement Date, and each annual anniversary of the
Commencement Date, in advance, to LESSOR or to such other person, firm or place as LESSOR
may, from time to time, designate in writing at least thirty (30) days in advance of any rental
payment date by notice given in accordance with Paragraph 24 below. The Agreement shall
commence based upon the date LESSEE is granted a building permit by the governmental agency
charged with issuing such permits, or the date of execution of the Agreement by the Parties,
whichever is later. In the event the date at which LESSEE is granted a building permit or the
date of execution of the Agreement, whichever is applicable, falls between the I" and 15 of the
month, the Agreement shall commence on the I" of that month and if such date falls between the
I e and 31" of the month, then the Agreement shall commence on the 1' day of the following
month (either the "Commencement Date - ). LESSOR and LESSEE acknowledge and agree that
initial rental payment(s) shall not actually be sent by LESSEE until thirty (30) days after the
Commencement Date. By way of illustration of the preceding sentence, if the Commencement
Date is January 1, LESSEE shall send to the LESSOR the first annual rental payment by
February 1.
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LESSEE Site LM Tequefa Flag Pole, Site No. 68510
a. Upon agreement of the Parties, LESSEE may pay rent by electronic funds transfer
and in such event, LESSOR agrees to provide to LESSEE bank routing information for such
purpose upon request of LESSEE.
b. LESSOR hereby agrees to provide to LESSEE, in c mitmction with the execution
of this Agreement, certain documentation (the "Rental Documentation") evidencing LESSOR's
interest in, and right to receive payments under, this Agreement, including without limitation: (i)
documentation, acceptable to LESSEE in LESSEE'S reasonable discretion, evidencing
LESSOR'S good and sufficient title to and/or interest in the Property and right to receive rental
payments and other benefits hereunder, (ii) a complete and fully executes Internal Revenue
Service Form W -9, or equivalent; in a form acceptable to LESSEE, for any party to whom rental
payments are to be made pursuant to this Agreement; and (iii) other documentation necessary for
evidencing LESSOR'S interest in, or right to receive rental payments and other benefits
hereunder, requested by LESSEE in LESSEE'S reasonable discretion. From time to time during
the Term of this Agreement and within thirty (30) days of a written request from LESSEE,
LESSOR agrees to provide updated Rental Documentation in a form reasonably acceptable to
LESSEE. The Rental Documentation shall be provided to LESSEE in accordance with the
provisions of and at the address given in Paragraph 24.
C. Delivery of Rental Documentation to LESSEE shall be a prerequisite for the
payment of any rent by LESSEE and notwithstanding anything to the contrary herein, LESSEE
shall have no obligation to make any rental payments until Rental Documentation has been
supplied to LESSEE as provided herein; provided, however, in the event any amounts which
would otherwise be due have not been paid by LESSEE due to the absence of Rental.
Documentation, such amounts shall be paid to LESSOR by LESSEE within forty-five (45) days
of the delivery of Rental Documentation to LESSEE.
d. Within fifteen (15) days of obtaining an interest in the Property or this
Agreement:, any assignee(s), transferees) or other successor(s) in interest of LESSOR shall
provide to LESSEE Rental Documentation in the manner set forth in the preceding paragraph.
From time to time during the Term of this Agreement and within thirty (30) days of a written
request from LESSEE, any assignee(s) or transferee(s) of LESSOR agrees to provide updated
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LESSEE Site M: Tegw%ta Flag Pole, Site No. 68510
Rental Documentation in a form reasonably acceptable to LESSEE. Delivery of Rental
Documentation to LESSEE by any assignee(s), transfbnx (s) or other successors) in interest of
LESSOR shall be a prerequisite for the payment of any rent by LESSEE to such party and
notwiding anything to the contrary herein, LESSEE shall have no obligation to make any
rental payments to any assignee(s), transferee(s) or other successor(s) in interest of LESSOR
until Rental Documentation has been supplied to LESSEE as provided herein; provided,
however, in the event any amounts which would otherwise be due have not been paid by
LESSEE due to the absence of Rental Documentation, such amounts shall be paid to LESSOR,
or any assignee(s), transferees) or other successor(s) in interest of LESSOR, as applicable, by
LESSEE within forty -five (45) days of the delivery of Rental Documentation to LESSEE.
5. EXTENSIONS This Agreement shall automatically be extended for four (4)
additional five (5) year terms unless LESSEE terminate it at the end of the then current term by
giving LESSOR written notice of the intent to terminate at last six (6) months prior to the end of
the then current term.
6. EXTENSION RENTALS For purposes of this Paragraph 5, a "Lase Year" shall be
defined as the twelve -month period which commences on the Commencement Date or ammual
anniversary thereof as applicable, and end on the day immediately preceding the next successive
anniversary of the Commencement Date. Commencing on the first annual anniversary of the
Commencement Date and on each annual anniversary thereafter during the Term of this
Agreement (including all extension terms), the annual rental fee shall increase by the greater of : (i)
an amount equal to four percent (4 %) of the monthly rental fee due for the immediately preceding
Lase Year, or (u) an increase determined by a formula as follows:
Renewal Rent = (Basic Rent)+((IR IL)/IL X Basic Rent)
Definitions: IR is the Consumer Price Index for the month
which is three (3) months immediately
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LESSEE Site ID.: Tequesta Flag Pole, Site No. 68510
Preceding the month in which the second Lase Year
and each succeeding Lase Year commence.
IL is the Consumer Price Index for the month
which is three 3 months immediately preceding
the month in which this Agreement commenced.
"Consumer Price Index" shall mean the Consumer Price Index published by the
Bureau of Labor Statistics of the United States Department of Labor for Urban Wage
Earners and Clerical Workers for All Items (CPI W) U.S. City average or shall mean the
successor thereto. In the event the Consumer Price Index is converted to a different
standard reference base or otherwise revised, the determination of the rent for the second
Lease Year and each succeeding Lease Year shall be made with the use of such conversion
factor, formula or table for converting the Consumer Price Index as may be published by
the Bureau of Labor Statistics, or if the Bureau should fail to publish the same, then with
the use of such conversion factor, formula or table for converting the Consumer Price Index
as may be published by any nationally recognized publisher of similar statistical
information. If the Consumer Price Index cases to be published and there is no successor
thereto, such other index as LESSOR and LESSEE may agree upon shall be substituted for
the Consumer Price Index, and if they are unable to agree, then such matter shall be
submitted to arbitration in accordance with the then existing commercial rules of arbitration
of the American Arbitration Association at the American Arbitration Association office
nearest the LESSEE.
7. ADDITIONAL EXTENSIONS If at the end of the fourth (4th) five (5) year
extension term this Agreement has not been terminated by either Party by giving to the other
written notice of an intention to terminate it at last three (3) months prior to the end of such term,
this Agreement shall continue in force upon the same covenants, terms and conditions for a fiuther
term of five (5) years and for five (5) year terms thereafter until terminated by either Party by
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LESSEE Sibs I.D.: Taquests Flag Pole, Site No. 68510
giving to the other written notice of its intention to so terminate at least three (3) months prior to
the end of such term. Annual rental for each such additional five (5) year term shall be calculated
pursuant to Paragraph 6 above. The initial term and all extensions shall be collectively referred to
herein as the "Tema".
8. TAXES LESSEE shall have the responsibility to pay any personal property, real
estate taxes, assessments, or charges owed on the Property which LESSOR demonstrates is the
result of LESSEE'S use of the Premises and/or the installation, maintenance, and operation of
the LESSEE'S improvements, and any sales tax imposed on the rent (except to the extent that
LESSEE is or may become exempt from the payment of sales tax in the jurisdiction in which the
Property is located), including any increase in real estate taxes at the Property which LESSOR
demonstrates arises from the LESSEE'S improvements and/or LESSEE'S use of the Premises.
LESSOR and LESSEE shall each be responsible for the payment of any taxes, levies,
assessments and other charges imposed including franchise and similar taxes imposed upon the
business conducted by LESSOR or LESSEE at the Property. Notwithstanding the foregoing,
LESSEE shall not have the obligation to pay any tax, assessment, or charge that LESSEE is
disputing in good faith in appropriate proceedings prior to a final determination that such tax is
properly assessed provided that no lien attaches to the Property. Nothing in this Paragraph shall
be construed as making LESSEE liable for any portion of LESSOR'S income taxes in
connection with any Property or otherwise. Except as set forth in this Paragraph, LESSOR shall
have the responsibility to pay any personal ply, real estate taxes, assessments, or charges
owed on the Property and shall do so prior to the imposition of any lien on the Property.
LESSEE shall have the right, at its sole option and at its sole cost and expense, to appeal,
challenge or seek modification of any tax assessment or billing for which LESSEE is wholly or
partly responsible for payment. LESSOR shall reasonably cooperate with LESSEE at
LESSEE'S expense in filing, prosecuting and perfecting any appeal or challenge to taxes as set
forth in the preceding sentence, including but not limited to, executing any consent, appeal or
other similar document. In the event that as a result of any appeal or challenge by LESSEE,
there is a reduction, credit or repayment received by the LESSOR for any taxes previously paid
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LESSEE Site I.D.: Tegneste Flog Pole, Site No. 68510
by LESSEE, LESSOR agrees to promptly reimburse to LESSEE the amount of said reduction,
credit or repayment In the event that LESSEE does not have the standing rights to pursue a
good faith and reasonable dispute of any taxes under this paragraph, LESSOR will pursue such
dispute at LESSEE'S sole cost and expense upon written request of LESSEE.
9. USE: GOVERNMENTAL APPROVALS LESSEE shall use the Premises for the
purpose of constructing, maintaining, repairing and operating a communications facility and uses
incide�al
thereto. LESSEE shall maintain, at its sole cost and expense, its equipment in good
condition, reasonable wear and tear excepted. All work performed on the Premises shall be
performed by licensed contractors specializing in such work, shall be performed in a good and
worlonanhlce manner, and shall be prosecuted to completion in accordance with the plans,
specifications and issued permits. Any damage caused to the Property, including the Premises, due
to the acts or omissions of LESSEE or its agents, contractors or employees, shall be repaired by
LESSEE at LESSEE'S sole cost and expense, excepting normal wear and bear and casualty
damage.
LESSEE shall, prior to any use of the Premises, relate the existing generator located on
the Premises to a location depicted in Exhibit B or any location mutually agreed upon between the
parties.
LESSEE shall have the right to replace, repair, or otherwise modify its utilities, equipment,
antennas and/or conduits or any portion thereof and the frequencies over which the equipment
operates, whether the equipment, antennas, conduits or frequencies are specified or not on any
exhibit attached hereto, during the Term. With respect to Lessee's ground space, the equipment
specified in Exhibit B may be repaired, replaced or added to by Lessee without Lessor's consent,
provided Lessee does not use any space beyond that which is designated in Section 1(c) above.
However, with respect to LESSEE space on the Tower, LESSEE shall not at any time construct
or install any additional antennas or equipment or make any improvements, additions,
modifications or alterations other than those approved by LESSOR, without the written consent
of LESSOR, which will not be unreasonably withheld, conditioned or delayed. Notwithstanding
the foregoing, LESSEE acknowledges that the ice of the Tower and its compatibility
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LESSEE Site LD.: Tequeft Flag Pole, Site No. 68510
with the surrotmding areas is a sigaific ant and major concern of LESSOR. The equipment
shelter shall be landscaped, fenced and secured by, and at the sole expense of the LESSEE using
an eight foot high security fence and vegetation approved by the LESSOR. LESSOR grants
LESSEE any additional ground space necessary to comply with the landscaping, fencing and
security requirements above. Additionally, LESSOR shall have the sole and exclusive discretion
to approve or deny a request for the installation of additional equipment and/or antennas located
on LESSEE' Tower space, based solely on aesthetics. In no event shall LESSEE be permitted to
make changes or modifications which: (i) expand or materially change or alter the LESSEE'S
use of the Premises; (ii) are installed outside of the boundaries of the Premises; or (iir) may
Otherwise adversely affect the structure or appearance of the Premises or Tower.
Whenever LESSEE desires to make alterations, improvements, modifications, additions
or other changes to the equipment or antennae on LESSEE's Tower space, designated on Exhibit
B, then LESSEE, prior to making said changes, shall provide LESSOR with plans and
specifications which fully describe the equipment and/or antennae to be installed. The plans and
specifications shall be reviewed by LESSOR and approved prior to the commencement of any
Proposed changes or improvements. After LESSOR'S approval of the plans and specifications,
an updated Exhibit B to this Agreement shall be prepared. by LESSEE and signed by both
LESSOR and LESSEE; thereafter, LESSOR and LESSEE shall amend the Agreement to
substitute the updated Exhibit B for the prior Exhibit B.
It is understood and agreed that LESSEE'S ability to use the Premier is contingent upon
its obtaining after the execution date of this Agreement all of the certificates, permits and other
approvals (collectively the "Governmental Approvals") that may be required by any Federal, State
or Local authorities as well as satisfactory soil boring tests and structural analysis which will
permit LESSEE use of the Premises as set forth above which will permit LESSEE use of the
Premises as set forth above. LESSOR shall cooperate with LESSEE in its effort to obtain such
approvals and shall take no action which would adversely affect the status of the Property,
including the Premises, with respect to the proper use thereof by LESSEE. In the event that (i)
any of such applications for such Governmental Approvals should be finally rejected; (ir) any
Governmental Approval issued to LESSEE is canceled, expires, lapses, or is otherwise
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LESSEE Site I.D.: Tequem Flag Pole, Site No. 68510
withdrawn or terminated by governmeirtal authority, (iii) LESSEE determines that such
Governmental Approvals may not be obtained in a timely manner, (iv) LESSEE determines that
any soil boring tests or structural analysis is unsatisfactory; (v) LESSEE determines that the
Premises is no longer technically compatible for its use, or (vi) LESSEE, in its sole discretion,
determines that the Premises is obsolete or unnecessary, LESSEE shall have the right to
teriminate this Agreement. Notice of LESSEE's exercise of its right to terminate shall be given to
LESSOR in writing by certified mail, return receipt requested, and shall be effective upon the
mailing of such notice by LESSEE, or upon such later date as designated by LESSEE. All rentals
Paid to said termination date shall be retained by LESSOR. Upon such termination, this
Agreement shall be of no further force or effect except to the extent of the representations,
W tanties and indemnities made by each Party to the other heretmder. Otherwise, the LESSEE
shall have no further obligations for the payment of rent to LESSOR.
10. INDEMNIFICATION Each Party shall indemnify and hold the other harmless
against any claim of liability or loss from personal injury or property damage resulting from or
arising out of the negligence or willful misconduct of the indemnifying Party, its employees,
contractors or agents, except to the extent such claims or damages may be due to or caused by
the negligence or willful misconduct of the other Party, or its employees, contractors or agents.
Notwithstanding anything in this Agreement to the contrary, LESSOR'S liability shall be limited
by the statutory amounts set forth in SEC. 768.28, Florida Statutes, including the limits
regarding attorney's fees. Nothing contained in this Agreement shall be construed as a waiver of
LESSOR's sovereign immunity beyond the waivers set forth in Sec. 768.28, Florida Swalu e.s.
Nothing contained in this Agreement shall be construed as LESSOR'S consent to be sued.
11. INSURANCE LESSOR shall, at its own cost and expense, maintain broad form
property insurance of at least One Million Dollars ($1,000,000.00). At its sole discretion,
LESSOR may be self-insured for such coverage LESSEE shall, at its own cost and expense,
maintain commercial general liability insurance with limits not less than $1,000,000 for injury to
or death of one or more persons in any one occurrence and $500,000 for damage or destruction
to property in any one occurrence. LESSEE shall include LESSOR as an additional insured.
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LESSEE Site I.D.: Tequesta Flag Pole, Site No. 68510
12. I.IIVETATION OF LIABILITY Except for indemnification pursuant to Paragraphs
10 and 30, neither Party shall be liable to the other, or any of their respective agents,
representatives, employees for any lost revenue, lost profits, loss of technology, rights or
services, incidental, punitive, indirect, special or consequential damages, loss of data, or
interruption or loss of use of service, even if advised of the possibility of such damages, whether
under theory of contract, tort (including negligence), strict liability or otherwise.
Notwithstanding anything in this Agreement to the contrary, LESSOR'S liability shall be limited
by the statutory amounts set forth in SEC. 768.28, Florida Statutes, including the limits
regarding attorney's fees. Nothing contained in this Agreement shall be construed as a waiver of
LESSOR's sovereign immunity beyond the waivers set forth in Sec. 76818, Florida Statutes.
Nothing contained in this Agreement shall be construed as LESSOR'S consent to be sued.
13. ANNUAL TERMIlVATION Notwithstanding anything to the contrary contained
herein, provided LESSEE is not in default hereunder beyond applicable notice and cure periods,
LESSEE shall have the right to terminate this Agreement upon the annual anniversary of the
Commencement Date provided that six (6) months prior notice is given to LESSOR In the
event LESSEE chooses to terminate the Agreement pursuant to this section, it shall pay to
LESSOR a termination fee equal to three (3) times the preceding month's rent
14. INTERFERENCE LESSEE agrees to install equipment of the type and frequency
which will not adversely affect or cause harmful interference which is measurable in accordance
with then existing industry standards to any equipment of LESSOR or other lessees of the
Property which equipment existed on the Property prior to the date this Agreement is executed
by the Parties. In the event any after-installed LESSEE'S equipment causes such interference,
and after LESSOR has notified LESSEE in writing of such interference, LESSEE will take all
commercially reasonable steps necessary to correct and eliminate the interference, including but
not limited to, at LESSEE'S option, powering down such equipment and later powering up such
equipment for intermittent testing. In no event will LESSOR be entitled to terminate this
Agreement or relocate the equipment as long as LESSEE is making a good faith effort to remedy
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LESSEE Site I.D.: Tegaesta Flag Pole, Site No. 68510
the interference issue. LESSOR agrees that LESSOR and/or any other tenants of the Property
who currently have or in the future take possession of the Property will be permitted to install
only such equipment that is of the type and frequency which will not adversely affect or cause
harmful interference which is measurable in accordance with then existing industry standards to
the then existing equipment of LESSEE. The Parties aclmowledge that there will not be an
adequate remedy at law for noncompliance with the provisions of this Paragraph and therefore,
either Party shall have the right to equitable remedies, such as, without limitation, injunctive
relief and specific performance.
15. TOWER COMPLIANCE LESSOR covenants that it will keep the Tower in good
repair as required by all Laws (as defined in Paragraph 35 below). The LESSOR shall also
comply with all rules and regulations enforced by the Federal Communications Commission with
regard to the lighting, marking and painting of towers. If the LESSOR fails to make such
repairs including maintenance the LESSEE may make the repairs and the costs thereof shall be
payable to the LESSEE by the LESSOR on demand together with interest thereon from the date
of payment at the greater of (i) ten percent (10 1 /6) per annum, or (ii) the highest rate permitted by
applicable Laws. If the LESSOR does not make payment to the LESSEE within ten (10) days
after such demand, the LESSEE shall have the right to deduct the costs of the repairs from the
suing monthly rental amounts normally due from the LESSEE to the LESSOR.
No materials may be used in the installation of the antennas or transmission lines that will
cause corrosion or rust or deterioration of the Tower structure or its app urten; am.
All antenna(s) on the Tower must be identified by a marking fastened seemly to its
bracket on the Tower and all transmission lines are to be tagged at the conduit opening where it
enters any users equipment space.
Not later than fifteen (15) days following the execution of this Agreement, LESSOR shall
supply to LESSEE copies of all structural analysis reports that have been done, if any, with
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LESSEE Site ID.: Tequem Flag Pole, Site No. 68510
respect to the Tower and throughout the Term, LESSOR shall supply to LESSEE copies of all
structural analysis reports that are done with respect to the Tower promptly after the completion
of the same.
16. REMOVAL AT END OF TERM LESSEE shall, upon expiration of the Term, or
within ninety (90) days after any earlier termination of the Agreement, remove its building(s),
antennas, equipment, conduits, fixtures and all personal property and restore the Premises to its
original condition, reasonable wear and tear and casualty damage excepted. The existing
equipment shed is the property of LESSOR and shall not be removed except with the express
written consent of LESSOR. LESSOR agrees and acknowledges that all of the equipment,
conduits, fixtures and personal property of LESSEE shall remain the personal property of
LESSEE and LESSEE shall have the right to remove the some at any time during the Term,
whether or not said items are considered fixtures and attachments to real property under
applicable Laws (as defined in Paragraph 35 below). If such time for removal causes LESSEE to
remain on the Premises after termination of this Agreement, LESSEE shall pay rent at the then
existing monthly rate or on the existing monthly pro -rata basis if based upon a longer payment
term, until such time as the removal of the building, antenna structure, fixtures and all personal
property are completed. LESSOR expressly waives all rights of levy, distraint or execution with
respect to LESSEE's property, including without limitation any statutory or common law security
interest or landlord's lien for rent.
17. HOLDOVER LESSEE has no right to retain possession of the Premises or any part
thereof beyond the expiration of that removal period set forth in Paragraph 16 herein, unless the
Parties are negotiating a new lease or lease extension in good faith. In the event that the Parties
are not in the process of negotiating a new lease or lease extension in good faith, LESSEE holds
over in violation of Paragraph 16 and this Paragraph 17, then the rent then in effect payable from
and after the time of the expiration or earlier removal period set forth in Paragraph 16 shall be
equal to the rent applicable during the month immediately preceding such expiration or earlier
termination.
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LESSEE Site I.D.: Tegwm Flag Pole, Site No. 68510
18. ELECTRICAL SERVICE LESSEE shall install an electrical meter at the Premises
for the measurement of electrical power used by LESSEE'S operations. LESSEE is responsible
for paying the costs of such electrical usage directly to the local utility provider. If it is
determined that LESSEE has consumed electrical service or other utilities which are in addition
to those metered by LESSEE'S separate meter, LESSOR shall have the right to invoice LESSEE
for any such charges, which shall be in addition to the rent and other payments required to be
made by LESSEE under this Agreement. LESSOR will not be liable for any interruption or
stoppage of electrical service to the Premises or for any damage to persons or property resulting
from that interruption or stoppage, unless caused by the negligence or willful misconduct of
LESSOR, its employees, servants or agents.
19. RIGHTS UPON SALE Should LESSOR, at any time during the Term decide (i) to
sell or transfer all or any part of the Property or the Tower thereon to a purchaser other than
LESSEE, or (ii) to grant to a third party by easement or other legal instrument an interest in and
to that portion of the Tower and or Property occupied by LESSEE, or a larger portion thereof; for
the purpose of operating and maintam� communications facilities or the management thereof,
such sale or grant of an easement or interest therein shall be under and subject to this Agreement
and any such purchaser or transferee shall recognize LESSEE'S rights hereunder under the terms
of this Agreement. To the extent that LESSOR grants to a third party by easement or other legal
instrument an interest in and to that portion of the Tower and/or Property occupied by LESSEE
for the purpose of operating and maintaining communications facilities or the management
thereof and in conjunction therewith, assigns this Agreement to said third party, LESSOR shall
not be released from its obligations to LESSEE under this Agreement, and LESSEE shall have
the right to look to LESSOR and the third party for the full performance of this Agreement.
Nothing contained in this Paragraph 18 shall in any way impact LESSOR'S right to lease
additional Tower space or additional ground space on the Property which does not interfere with
LESSEE'S use of the Premises, including Tower space as described in Paragraph 1.
14
LESSEE Site LD.: TeVesta Flag Pole, Site No. 68510
20. QUIET ENJOYMENT LESSOR covenants that LESSEE, on paying the rent and
Performing the covenants herein, shall peaceably and quietly have, hold and enjoy the Premises.
21. TITLE LESSOR represents and warrants to LESSEE as of the execution date of
this Agreement, and covenants during the Term that LESSOR is seized of good and sufficient
title and interest to the Property and has full authority to enter into and execute this Agreement.
LESSOR further covenants during the Term that them are no liens, judgments or impediments of
tide on the Property, or affecting LESSOR'S title to the same and that there are no covenants,
casements or restrictions which prevent or adversely affect the use or occupancy of the Premises
by LESSEE as set forth above.
22. INTEGRATION It is agreed and understood that this Agreement contains all
agreements, promises and understandings between LESSOR and LESSEE and that no verbal or
oral agreements, promises or understandings shall be binding upon either LESSOR or LESSEE
in any dispute, controversy or proceeding at law, and any addition, variation or modification to
this Agreement shall be void and ineffective unless made in writing signed by the Parties. In the
event any provision of the Agreement is found to be invalid or unenforceable, such finding shall
not affect the validity and enforceability of the remaining provisions of this Agreement. The
failure of either Party to insist upon strict performance of any of the terms or conditions of this
Agreement or to exercise any of its rights under the Agreement shall not waive such rights and
such Party shall have the right to enforce such rights at any time and take such action as may be
lawful and authorized under this Agreement, in law or in equity.
23. GOVERNING LAW This Agreement and the performance thereof shall be
governed, interpreted, construed and regulate by the Laws of the State in which the Property is
looted.
24. ASSIGNMENT, SUBLETTING This Agreement may be sold, assigned or
transferred by LESSEE without any approval or consent of LESSOR to LESSEE's principal,
15
LESSEE Site LD.: Tequesta Flog Pole, Site No. 68510
affiliates, subsidiaries of its principal or to any entity which acquires all or substantially all of
LESSEE'S assets in the market defined by the Federal Communications Commission in which
the Property is located by reason of a merger, acquisition or other business motion. As to
other parties, this Agreement may not be sold, assigned, subleased or transferred without the
written consent of LESSOR, which such consent will not be unreasonably withheld, delayed or
conditioned No change of stock ownership, partnership interest or control of LESSEE or
transfer upon partnership or corporate dissolution of LESSEE shall constitute an assignment
hereunder.
The parties expressly understand and agree that LESSOR shall have the sole and
exclusive right to lease additional space on the Tower and on the Property for the installation of
additional antennas, cables and equipment. All rent or other compensation derived from the rent
of additional Tower and/or Property space shall belong exclusively to LESSOR, and LESSEE
shall have no rights or claims to any such revenues. The sale, assignment, subletting or
transfen ing of any rights or space conferred hereunder in violation of the terms of this Paragraph
23 shall constitute a material breach of this Agreement by LESSEE and LESSOR shall have the
right to terminate this Agreement effective immediate and to pursue all legal and equitable
remedies available to it under this Agreement and applicable law.
25. NOTICES All notices hereunder must be in writing and shall be deemed validly
given if sent by certified mail, return receipt requested or by commercial courier, provided the
courier's regular business is delivery service and provided further that it guarantees delivery to
the addressee by the end of the next business day following the courier's receipt from the sender,
addressed as follows (or any other address that the Party to be notified may have designated to
the sender by like notice):
16
LESSEE Site I.D.: Tequesta Flag Pole, Site No. 68510
LESSOR Village of Tequesta, Florida
345 Tequesta Drive
Tequesta, Florida 33469
LESSEE: Verizon Wireless Personal Communications LP
d/b /a Verizon Wireless
180 Washington Valley Road
Bedminster, New Jersey 07921
Attention: Network Real Estate
Notice shall be effective upon actual receipt or refusal as shown on the receipt obtained
pursuant to the foregoing.
26. SUCCESSORS This Agreement shall extend to and bind the heirs, personal
representative, successors and assigns of the Parties hereto.
27. SUBORDINATION AND NON - DISTURBANCE At LESSOR'S option, this
Agreement shall be subordinate to any fimue master lease, ground lease, mortgage, deed of trust
or other security interest (a "Mortgage'l by LESSOR which from time to time may encumber all
or part of the Property, provided, however, as a condition precedent to LESSEE being required
to subordinate its interest in this Agreement to any future Mortgage covering the Properly,
LESSOR shall obtain for LESSEE'S benefit a non - disturbance and attornment agreement for
LESSEE'S benefit in the form reasonably satisfactory to LESSEE, and containing the terms
described below (the `Non- Disturbance Agreement'), and shall recognize LESSEE'S right to
remain in occupancy of and have access to the Premises as long as LESSEE is not in default of
this Agreement beyond applicable notice and cute periods. The Non - Disturbance Agreement
shall include the encumbering party's ( "Lender's') agreement that, if Lender or its
successor- in - interest or any purchaser of Lender's or its successor's interest (a "Purchaser")
acquires an ownership interest in the Property, Lender or such successor-in- interest or Purchaser
will (1) honor all of the terms of the Agreement, (2) fiM LESSOR'S obligations under the
Agreement, and (3) promptly cure all of the then - existing LESSOR defaults under the
Agreement. Such Non-Disturbance Agreement must be binding on all of Lender's participants
in the subject loan (if any) and on all successors and assigns of Lender and/or its participants and
on all Purchasers. In return for such Non - Disturbance Agreement, LESSEE will execute an
17
LESSEE Site LD.: Tegwm Flag Pole, Site No. 68510
agreement for Lender's benefit in which LESSEE (1) confirms that the Agreement is subordinate
to the Mortgage or other real property interest in favor of Lender, (2) agrees to attom to Lender if
Lender becomes the owner of the Property and (3) agrees to accept a cure by Lender of any of
LESSOR'S defaults, provided such cure is completed within the deadline applicable to LESSOR.
In the evert LESSOR defaults in the payment and/or other performance of any mortgage or other
real property interest encumbering the Property, LESSEE, may, at its sole option and without
obligation, cure or correct LESSOR'S default and upon doing so, LESSEE shall be subrogated to
any and all rights, titles, liens and equities of the holders of such mortgage or other real property
interest and LESSEE shall be entitled to deduct and setoff against all rents that may otherwise
become due under this Agreement the sums paid by LESSEE to cure or correct such defaults.
28. RECORDING LESSOR agrees to execute a Memorandum of this Agreement
which LESSEE may record with the appropriate recording officer. The date set forth in the
Memorandum of Lease is for recording purposes only and bears no reference to commencement
of either the Term or rent payments.
29. DEFAULT
a. In the event there is a breach by LESSEE with respect to any of the
provisions of this Agreement or its obligations under it, including the payment of rent, LESSOR
shall give LESSEE written notice of such breach. After receipt of such written notice, LESSEE
shall have fifteen (15) days in which to cure any monetary breach and thirty (30) days in which
to cure any non - monetary breach, provided LESSEE shall have such extended period as may be
required beyond the thirty (30) days if the nature of the cure is such that it reasonably regaires
more than thirty (30) days and LESSEE commences the cure within the thirty (30) day period
and thereafter continuously and diligently pursues the cure to completion. LESSOR may not
maintain any action or effect any remedies for default against LESSEE unless and until LESSEE
has failed to cure the breach within the time periods provided in this Paragraph.
b. In the event there is a breach by LESSOR with respect to any of the
provisions of this Agreement or its obligations under it, LESSEE shall give LESSOR written
notice of such breach. After receipt of such written notice, LESSOR shall have thirty (30) days
18
LESSEE Site LD.: Tequft Flag Pole, Site No. 68510
in which to an any such breach, provided LESSOR shall have such extended period as may be
required beyond the thirty (30) days if the nature of the cure is such that it reasonably requires
more than thirty (30) days and LESSOR commences the cure within the thirty (30) day period
and thereafter continuously and diligently pursues the cure to completion. LESSEE may not
maintain any action or effect any remedies for default against LESSOR unless and until
LESSOR has failed to cue the breach within the time periods provided in this Paragraph.
Notwithstanding the foregoing to the contrary, it shall be a default under this Agreement if
LESSOR fails, within ten (10) days after receipt of written notice of such breach, to perform an
obligation required to be performed by LESSOR if the failure to perform such an obligation
interferes with LESSEE'S ability to conduct its business on the Property, provided, however,
that if the nature of LESSOR'S obligation is such that more than ten (10) days after such notice
is reasonably required for its performance, then it shall not be a default under this Agreement if
performance is commenced within such ten (10) day period and thereafter diligently pursued to
completion.
30. REMEDIES Upon a default, the non - defaulting Party may at its option (but
without obligation to do so), perform the defaulting Party's duty or obligation on the defaulting
Party's behalf, including but not limited to the obtaining of reasonably required insurance
policies. The costs and expenses of any such performance by the non - defaulting Party shall be
due and payable by the defaulting Party upon invoice therefor. In the event of a default by either
Party with respect to a material provision of this Agreement, without limiting the non - defaulting
Party in the exercise of any right or remedy which the non- defnilting Party may have by reason
of such default, the non - defaulting Party may terminate the Agreement and/or pursue any remedy
now or hereafter available to the non - defaulting Party under the Laws or judicial decisions of the
state in which the Premises are located; provided, however, LESSOR shall use reasonable efforts
to mitigate its damages in connection with a default by LESSEE. If LESSEE so performs any of
LESSOR'S obligations hereunder, the full amount of the reasonable and actual cost and expense
incurred by LESSEE shall immediately be owing by LESSOR to LESSEE, and LESSOR shall
lay to LESSEE upon demand the full undisputed amount thereof with interest thereon from the
date of payment at the greater of (i) ben percent (10%) per aimum, or (ii) the highest rate
19
LESSEE Site I.D.: Tequem Flag Pole, Site No. 68510
permitted by applicable Laws. Notwithstanding the foregoing, if LESSOR does not pay
LESSEE the full undisputed amount within thirty (30) days of its receipt of an invoice setting
forth the amount due from LESSOR, LESSEE may offset the full undisput d amount, including
all accrued interest, due against all fees due and owing to LESSOR until the full undisputed
amount, including all accrued interest, is fully reimbursed to LESSEE.
31. ENVIRONNU*4TAL
a. LESSOR will be responsible for all obligations of compliance with any
and all environmads and industrial hygiene laws, including any regulations, guidelines,
standards, or policies of any governmental authorities regulating or imposing standards of
liability or standards of conduct with regard to any environmental or industrial hygiene
conditions or concerns as may now or at any time hereafter be in effect, that are or were in any
way related to activity now conducted in, on, or in any way related to the Tower or Property,
unless such conditions or concerns are caused by the specific activities of LESSEE in the
Premises.
b. LESSOR shall hold LESSEE harmless and indemnify LESSEE from and
assume all du ties, responsibility and liability at LESSOR'S sole cost and expense, for all duties,
responsibilities, and liability (for payment of penalties, sanctions, forfeitures, losses, costs, or
damages) and for responding to any action, notice, claim, order, summons, citation, directive,
litigation, investigation or proceeding which is in any way related to: a) failure to comply with
any environmental or industrial hygiene law, including without limitation any regulations,
guidelines, standards, or policies of any governmental authorities regulating or imposing
standards of liability or standards of conduct with regard to any or industrial
hygiene concerns or conditions as may now or at any time hereafter be in effect, unless such non-
compliance results from conditions caused by LESSEE; and b) any environmental or industrial
hygiene conditions arising out of or in any way related to the condition of the Tower or Property
or activities conducted thereon, unless such environmental conditions are caused by LESSEE.
Notwithstanding anything in this Agreement to the contrary, LESSOR'S liability shall be limited
by the statutory amounts set forth in Sec. 768.28, Florida Statutes, including the limits regarding
20
LESSEE Site I.D.: Tegaesta Flag Pole, Site No. 68510
attorney's fees. Nothing contained in this Agreement shall be construed as a waiver of
LESSOR's sovereign immunity beyond the waivers set forth in Sec. 768.28, Florida Statutes.
Nothing contained in this Agreement shall be construed as LESSOR'S consent to be sued.
32. CASUALTY In the event of damage by fire or other casualty to the Tower or
Premises that cannot reasonably be expected to be repaired within forty-five (45) days following
same or, if the Properly is damaged by fire or other casualty so that such damage may reasonably
be expected to disrupt LESSEE'S operations at the Premises for more than forty-five (45) days,
then LESSEE may, at any time following such fire or other casualty, provided LESSOR has not
completed the restoration required to permit LESSEE to resume its operation at the Premises,
terminate this Agreement upon fifteen (15) days prior written notice to LESSOR. Any such
notice of termination shall cause this Agreement to expire with the same force and effect as
though the date set forth in such notice were the date originally set as the expiration date of this
Agreement and the Parties shall make an appropriate adjustment, as of such termination date,
with respect to payments due to the other under this Agreement. Notwithstanding the foregoing,
the rent shall abate during the period of repair following such fire or other casualty in proportion
to the degree to which LESSEE'S use of the Premises is impaired.
33. CONDEMNATION In the event of any condemnation of all or any portion of the
Property, this Agreement shall terminate as to the part so taken as of the date the condemning
authority takes title or possession, whichever occurs first. If as a result of a partial condemnation
of the Premises or Tower, LESSEE, in LESSEE'S sole discretion, is unable to use the Premises
for the purposes intended hereunder, or if such condemnation may reasonably be expected to
disrupt LESSEE'S operations at the Premises for more than forty-five (45) days, LESSEE may,
at LESSEE'S option, to be exercised in writing within fifteen (15) days after LESSOR shall have
given LESSEE written notice of such taking (or in the absence of such notice, within fifteen (15)
days after the condemning authority shall have taken possession) terminate this Agreement as of
the date the condemning authority takes such possession. LESSEE may on its own behalf make
a claim in any condemnation proceeding involving the Premises for losses related to the
21
LESSEE Site M: Tequesta Flag Pole, Site No. 68510
equipment, conduits, fixtures, its relocation costs and its damages and losses (but not for the loss
of its leasehold interest). Any such notice of termination shall cause this Agreement to expire
with the same force and effect as though the date set forth in such notice were the date originally
set as the expiration date of this Agreement and the Parties shall make an appropriate adjustment
as of such termination date with respect to payments due to the other under this Agreement. If
LESSEE does not terminate this Agreement in accordance with the foregoing, this Agreement
shall remain in fall force and effect as to the portion of the Premises remaining, except that the
rent shall be reduced in the same proportion as the rentable area of the Premises taken bears to
the total rentable area of the Premises. In the event that this Agreement is not terminated by
reason of such condemnation, LESSOR shall promptly repair any damage to the Premises caused
by such condemning authority.
34. SUBML4SION OF AGREEMENT/PARTIAL INVAUMMAUTHORNY The
submission of this Agreement for examination does not constitute an offer to lease the Premises
and this Agreement becomes effective only upon the full execution of this Agreement by the
Parties. If any provision herein is invalid, it shall be considered deleted from this Agreement and
shall not invalidate the remaining provisions of this Agreement. Each of the Parties hereto
warrants to the other that the person or persons executing this Agreement on behalf of such Party
has the full right, power and authority to enter into and execute this Agreement on such Party's
behalf and that no consent from any other person or entity is necessary as a condition precedent
to the legal effect of this Agreement.
35. APPLICABLE LAWS During the Term, LESSOR shall maintain the Property and
all structural elements of the Premises in compliance with all applicable laws, rules, regulations,
ordinances, directives, covenants, easements, zoning and land use regulations, and restrictions of
record, permits, building odes, and the requirements of any applicable fire insurance
underwriter or rating bureau, now in effect or which may hereafter come into effect (mchiding,
without limitation, the Americans with Disabilities Act and laws regulating hazardous
substances) (collectively "Laws"). LESSEE shall, in respect to the condition of the Premises and
22
LESSEE Site LD.: Tequem Flag Pole, Site No. 68510
at LESSEE'S sole cost and expense, comply with (a) all Laws relating solely to LESSEE'S
specific and unique nature of use of the Premises (other than general office use); and (b) all
building cis requiring modifications to the Premises due to the improvements being made by
LESSEE in the Premises.
36. SURVIVAL The provisions of the Agreement relating to indemnification from one
Party to the other Party shall survive any termination or expiration of this Agreement.
Additionally, any provisions of this Agreement which require performance subsequent to the
tem»na . on or expiration of this Agreement shall also survive such termination or expiration.
37. CAPTIONS The captions contained in this Agreement are inserted for convenience
only and are not intended to be part of the Agreement. They shall not affect or be utilized in the
construction or interpretation of the Agreement.
23
LESSEE Site I.D.: TequesW Flag Pole, Site No. 68510
IN WITNESS WHEREOF, the Parties hereto have set their hands and affixed their respective seals
the day and year first above written.
LESSOR:
SS Villag a uesta, Florida
Y. '
Name: e: b
Title r
Date: �1 -1
Name:
LESSEE:
Verizon Wireless Personal Communications LP
d/b /a Verizon Wireless
WITNESS
BY:
Name: Name: Aparna Khurjekar
Area Vice President Network
Date:
Name:
24
LESSEE Site I.D.: Tequesta Flag Pole, Site No. 66510
Exhibit "A"
(Description of Premises and of Property)
(Lessee is referred to in this Exhibit as "Verizon Wireless")
Description of Property:
The South 600.79 feet (measured at right angles to the South line thereof), of
the Northwest Quarter (NW 1/4) of the Northwest Quarter (NW 1/4) of Section
30, Township 40 South, Range 43 East, Palm Beach County, Florida. lying East
of the Easterly Right of Way line of Old Dixie Highway as described In Order
of Taking recorded in Official Records Book 6548, Page 1319, of the Public
Records of Palm Beach County. Florida.
Description of portion and Space:
A parcel 4 S outh. land b . e43� s
Tomah 40 Eaet. Palm Beach County, Florida. said P=vd more partteul e fall
COMWNCI at the Southeast comer of sold Northwest 1/4 of the Northwest 1/4 of Section 30. proud North 89'
57' 03' West along the South Me of said Northwest 1/4 of the Narthweat 1/4 a distance of 230.56 That thence
depmtbW last said Ihm North 00' 02' 57' East a distance of 412.58 feet to the POINT OF BEGINNING; thence
North 35' Zr 48' West a distance of 25.00 feet thence North 54' 32' 14' East o dista of 12.00 feet; thence
South 35' 27' 48' East a distance of 25.00 feet thence South 54' 32' 14 West a distance of 12.00 feet to
the POINT OF BEG N NUi6.
Containing an area of 300 square feet.
Description of Rights of Way:
DESCRIPTION OF VERIZON WIRELESS GROUND RING EASEMENT
A 3.00 foot aide strip of land being a portion of the South 600.79 feet of the Northwest 1/4 of the Northwest 1/4 of Section
30, Township 40 South. Range 43 East, Palm Beach County, Florida, add parcel more particularly described as follows:
COMMENCING at the Southeast comer of said Northwest 1/4 of the Northwest 1/4 of Section 30. proceed North M'
57' 03' West along the South One of said Northwest 1/4 of the Northwest 1/4 a distance of 230.E feet thence
deporting last said Me. North OW 02' 57' East a distance of 412.56 feet; thence South 09' 32' 14' West a distance
of 4.24 feet to the POINT OF BEGINNING; thence North 35' 27' 48' West a distance of 31.00 feet thence North 54'
32' 14' East a distance of 1 &00 feet; thence South 35 27 46' East a distance of 31.00 feet; thence South 54' 32'
14' West a distance of 18.00 feet to the POINT OF BEGINNING.
LESS AND EXCEPT THE 1`01.10IING DESCROW PARCEL:
A parcel of land being a portion of the South 800.79 feet of the Northwest 1/4 of the Northwest 1/4 of Section 30.
Township 40 South. Range 43 East, Palm Beach County. Florida, said parcel more particularly described as follows:
COMMENCING at the Southeast earner of said Northwest 1/4 of the Northwest 1/4 of Section 30, proceed North BW
57' 03' West along the South Me of sold Northwest 1/4 of the Northwest 1/4 a distance of 230.58 feet thence
departing lost said line. North 00' 02' S7' East a distance of 412.56 feet to the POINT OF BEGINNING; thence
North 35' 27' 48' West a distance of 23.00 feet; thence North 54' 32' 14' East a distance of 12.00 feet thence
South 35' 27' 46' East a distance of 25.00 feet; thence South 54' 32' 14' West a distance of 1100 feet to
the POINT OF BEGINNING.
Sold 3.00 foot wide strip containing a not area of 256 square fast.
25
LESSEE Site 1.D.: Tegoesta Flag Pole, Site No. 68510
DESCRIPTiON OF VERiZON WIRELESS STOOP EASEMENT
A pared of land bdrtg a portion of the South 900.79 feet of the Nartlrwest 1/4 of the Ncrlhwest 1/4 of Section 30,
Towmh1p 40 South, Flange 43 East, Palm Beach County. Florida, gold pared more particularly did as follower
SIG at the Southeast comer of gold Northwest 1/4 of the Northwest 1/4 of Section 30. proceed North 9'9'
57' 03' West along the South Ilse of said Northwest 1/4 of the Northwest 1/4 a dhitance of 230.99 feet thence
duty.- lest said Ine. North Oo' 02' 57' East a distance of 41299 feet; am= North 54' 32' 14' East a distance
Of 1200 feel: thence North 35' 27' 49' !vast a distance of 19.49 test to the POINT OF BEGINNING; thanes continue
North 38' 27' 49' West a distance of 4.00 feet; thence Norte 54' 32' 14' East a distance of .175 tech thence
South 38' 27' 49' East a distance of 4.00 That thence South 54' 32' 14' West a dWanoe of 3.78 feet to
the POINT of BEGINNING.
Containing an arm of 15 square feet.
DESCRIPTION OF VERIZON YRELESS 3' ICE BRIDGE EASEMENT
A 300 float wide strip of land being a portion of the South 900.79 feet of tic Nortlanot 1/4 of the Northwest 1/4 of Section
30, Tosmahip 40 South. Range 43 East, Palm Beach County. Flardda, the sidelbres of add ship Ivtng 1.50 feet on each
dde of the following described eenteAm
001 N0 of the Southeast comer of said Northwest 1/4 of the Nartlurest 1/4 of Section 30, proceed North W
57' 03' West along the South Ine of said Northwest 1/4 of the Northwest 1/4 a distance of 230.59 feet thence
departinng last said line. North 00' 02' 57' East a distance of 41259 feet thence North W 32' 14' East a distance
of 1200 feet; thence North 35' 27' 48' West a distance of 5.81 feet to the POINT OF BEGINNING of the hereh
dewtted contefte; thence North 5W 10' 32' East a distance of 481 feet to the POINT OF NA71ON of the
herein deswibad centerline.
The sidelines of said ship to be a or l rimmed, as new to fmm we contiguous shape and to mast a bearing
of North 38' 27' 49' West at the Point of Begs I g.
Contafiing an area of 14.4 spoors feet, more or less.
In addition to the above, Lessee shall have non - exclusive access and utility rights across the
Property as necessary to connect the Premises to the nearest public right of way.
Tower Space: Space at the 105' level on the Tower, as depicted in Exhibit B attached hereto.
26
LESSEE Site I.D.: Tequesla Flag Pole, Site No. 68510
Exhibit "W'
(Site Sketch)
(LESSEE may be referred to as Weriz in this Exhibit)
(See Attached)
27
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i .
LESSEE Site I.D.: Tequaft Flag Pole, Site No. 68510
Exhibit "C"
(LESSEE'S Survey)
(LESSEE is referred to in this depiction as Nadzon Wireless')
(See Attached)
28
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Prepared By and Upon Recording, Return to:
Nitin Datt, Esq.
c/o Maria Martella, Florida Registered Paralegal
Holland & Knight LLP
515 E. Las Olas Boulevard
Suite 1200
P.O. Box 14070
Fort Lauderdale, Florida 33301
STATE OF FLORIDA )
COUNTY OF PALM BEACH )
Lessee Site ID: Tequesta Flag Pole, Site No. 68510
MEMORANDUM OF LAND AND TOWER LEASE AGREEMENT
This MEMORANDUM OF LAND AND TOWER LEASE AGREEMENT
( "Memorandum ") is made this 10 day of , 20_, between THE
VILLAGE OF TEQUESTA, FLORIDA, a Florid arfiuniapa I corporation with its principal
offices located at 345 Tequesta Drive, Tequesta, Florida 33469, hereinafter referred to as
"LESSOR ", and VERIZON WIRELESS PERSONAL COMMUNICATIONS LP d/b /a
Verizon Wireless, a Delaware limited partnership with its principal office located at One
Verizon Way, Mail Stop 4AW100, Basking Ridge, New Jersey 07920, hereinafter referred
to as "LESSEE ". LESSOR and LESSEE are at times collectively referred to hereinafter as
the "Parties" or individually as the "Party".
1. LESSOR and LESSEE entered into a Land and Tower Lease Agreement (the
"Agreement") on Q--� � o , 20_ for an initial term of five (5) years,
commencing on the Commencement Date (as defined below). The Agreement
shall automatically be extended for four (4) additional five (5) year terms unless
the LESSEE terminates it at the end of the then current term by giving the
LESSOR written notice of the intent to terminate at least six (6) months prior to
the end of the then current term. If at the end of the fourth (4th) five (5) year
extension term the Agreement has not been terminated by either Party by giving
to the other written notice of an intention to terminate it at least three (3) months
prior to the end of such term, the Agreement shall continue in force upon the
same covenants, terms and conditions for a further term of five (5) years and for
1
fire (5) year terms thereafter until terminated by either Party by giving to the
other written notice of its Intention to so terminate at least three (3) months prior
to the end of such term.
2. LESSOR hereby leases to LESSEE a portion of that certain parcel of property
(the entirety of LESSOR' property Is referred to hereinafter as the "Property")
located at 901 N. Old Dixie Highway, Tequeste, Florida 33469, and being
described as a three hundred (300) square foot parcel of ground space, Including
the existing equipment shed located thereon (the "Land Space "), together with
the non exclusive right (the "Rights of Way") for Ingress and egress, seven (7)
days a week twenty four (24) hours a day, on foot or motor vehicle, including
trucks, over the Property extending from the nearest public right of way to the
Land Space, as specified below, for the use and maintenance of the existing
equipment shed, and for the Installation, use and maintenance of utility wires,
poles, cables, conduits, and pipes over, under, or along the Land Space.
LESSOR also leases to LESSEE a portion of LESSOR'S existing
communications tower (the "Tower") located on the Property, in order for
LESSEE to erect, operate and maintain communications antennas thereon. The
Land Space, Rights of Way, and Tower space leased to LESSEE are hereinafter
referred to as the "Premises" and Is more particularly described in Exhibit "A"
attached hereto and made a part hereof. The Property is likewise described
herein in Exhibit "A" attached hereto and made a part hereof. A site sketch
depicting the location of the Tower and equipment shed is attached hereto as
Exhibit "B ".
3. The Commencement Date of the Agreement, of which this Is a Memorandum, Is
based upon the date LESSEE is granted a building permit by the governmental
agency charged with Issuing such permits, or the date of execution of the
Agreement by the Parties, whichever Is later. In the event the date at which
LESSEE is granted a building permit or the date of execution of the Agreement,
whichever is applicable, falls between the 1st and 15th of the month, the
Agreement shall commence on the 1 st of that month and if such date falls
between the 16th and 31 st of the month, then the Agreement shall commence on
the 1st day of the following month (either the "Commencement Date ").
4. Should LESSOR, at any time during the Term decide (f) to sell or transfer all or
any part of the Property or the Tower thereon to a purchaser other than LESSEE,
or pi) to grant to a third party by easement or other legal instrument an interest in
and to that portion of the Tower and or Property occupied by LESSEE, or a larger
portion thereof, for the purpose of operating and maintaining communications
facilities or the management thereof, such sale or grant of an easement or
2
interest therein shall be under and subject to this Agreement and any such
purchaser or transferee shall recognize LESSEE'S rights hereunder under the
terms of this Agreement. To the extent that LESSOR grants to a third party by
easement or other legal instrument an interest in and to that portion of the Tower
and/or Property occupied by LESSEE for the purpose of operating and
maintaining communications facilities or the management thereof and in
conjunction therewith, assigns this Agreement to said thins party, LESSOR shall
not be released from its obligations to LESSEE under this Agreement, and
LESSEE shall have the right to look to LESSOR and the third party for the full
performance of this Agreement. Nothing contained in this Paragraph 4 shall in
any way Impact LESSOR'S right to lease additional Tower space or additional
ground space on the Property which does not interfere with LESSEE'S use of the
Premises, including Tower space as described in Exhibit A.
5. The terms, covenants and provisions of the Agreement, the terms of which are
hereby incorporated by reference into this Memorandum, shall extend to and be
binding upon the respective executors, administrators, heirs, successors and
assigns of LESSOR and LESSEE.
Remainder of Page Intentionally Blank
Signature Page to Follow
3
IN WITNESS WHEREOF, hereunto and to a duplicate hereof, LESSOR and
LESSEE have caused this Memorandum to be duly executed on the date first written
hereinabove.
LESSOR:
WITNESS ��yu: ge Tequesta, Flori
Name:
N e:
Title:
Date: `
Name: _ L oe, tl,,.) • l C 4yk S
LESSEE:
Verizon Wireless Personal Communications LP
d/b /a Verizon Wireless
WITNESS
BY:
Name: Name: Apanna Khurjekar
Area Vice President Network
Date:
Name:
4
STATE OF FLORIDA )
LESSOR ACKNOWLEDGMENT
COUNTY OF PALM BEACH )
I, LD (i [ C i It a.rn5 , do hereby certify that �1 � /�wk't personally
came before me this day and acknowledged that s/he is the of THE
VILLAGE OF TEQUESTA, FLORIDA, a municipal corporatid , and s /he, being
authorized to do so, executed the foregoing MEMORANDUM OF LAND AND TOWER
LEASE AGREEMENT as his /her own act and deed on behalf of THE VILLAGE OF
TEQUESTA, FLORIDA. He /She is personally known to me or has produced
as identification.
E Rd mad otarial Seal, this _ day of 20_
tia° °�e ORI MCWILLIAMS
Notary Public -State of Florida
• c My Comm. Expires Oct 18, 2016
;•F °v�;: Commission # EE 217256 Notary Public
Bonded Through Nat onal Notary Assn
My Commission Expires:
STATE OF NORTH CAROLINA )
LESSEE ACKNOWLEDGMENT
COUNTY OF MECKLENBURG )
I, , do hereby certify that Aparna Khudekar personally came
before me this day and acknowledged that she is the Area Vice President Network of
VERIZON WIRELESS PERSONAL COMMUNICATIONS LP d /b /a Verizon Wireless, a
Delaware limited partnership, and that she, as Area Vice President Network, being
authorized to do so, executed the foregoing MEMORANDUM OF LAND AND TOWER
LEASE AGREEMENT on behalf of VERIZON WIRELESS PERSONAL
COMMUNICATIONS LP d /b /a Verizon Wireless. She is personally known to me.
WITNESS my hand and official Notarial Seal, this _ day of 1 20_.
Notary Public
My Commission Expires:
5
II$IT A
(Description of Premises and of Property)
(Lessee is referred to in this Exhibit as "Ve'rizon Wireless ")
Description of Property:
The South 600.79 feet (measured at right angles to the South tine thereof). of
the Northwest Quarter (NMI 1/4) of the Northwest Quarter (NW 1/4) of Section
30, Township 40 South, Range 43 East, Palm Beach County, Florida. lying East
of the Easterly Right of Way line of Old Dixie Highway as described In Order
of Taking recorded in Official Records Book 6548, Page 1319, of the Public
Records of Palm Beach County. Florida.
Description of Land Space:
A parcel of land belrhg a portion of the Smyth 800.70 feet of the Northwest 1/4 of the Northwest 1/4 of Section 30,
Township 40 Smyth. Range 43 East, Palm Beach County, Florldo, said parcel more partIzAarly deaorUnd as follow
COMMENCING at the Southeast corner of sold Northwest 1/4 of the Nathwmt 1/4 of Section 30, proceed North 89'
57 03' west along the South line of sold Northwest 1/4 of the Northwest 1/4 a distance of 230.58 feet; then
departing last said line. North O' 02' 57' East a distance of 412.88 feet to the POINT OF BEGINNING; thence
North 35' 27' 48' Vilest a distance of 25.00 feet then North 54 32' 14' East a dietonce of 12.00 feet; then
South 35' 27' 48' East a distance of 28.00 feet; thence South 54' 32' 14' west a distance of 12.00 feet to
the POINT OF BEGINNING.
Contcining on area of 300 square feet
Description of Rights of Way:
DESCRIPTION OF VERIZON WIRELESS GROUND RING EASEMENT
A 3.00 foot wide strip of land being a portion of the South 800.78 feet of the Northwest 1/4 of the Northwest 1/4 of Section
30. Township 40 South. Range 43 East, Palm Beads County. Florida, odd parcel more particularly described as follow
COMMENCiNG at the Southeast comer of said Northwest 1/4 of the Northwest 1/4 of Seaton 30, proceed North 88'
87 03' west clang the South Iine of said Northwest 1/4 of the Northwest 1/4 a distance of 230.58 foot; thence
departing last said line. North Ol' 02' 57' East a distance of 412.58 feet; thence South 08' 32' le west a distance
of 4.24 feet to the POINT OF BEGINNING; thence North 35' 27' 48' west a distance of 31.00 feet; thence North 54'
32' 14' East a distance of 18.00 feet: thence Smith 38' 27 48' East a distance of 31.00 feet thence South 54' 32'
14' west a distance of 1t1OO feet to the POINT OF BEGINNING.
LESS AND EXCEPT THE FOLLOWING OESCRIBEO PARCEL:
A parcel of land being a portion of the South 800.79 feet of the Northwest 1/4 of the Northwest 1/4 of Section 3%
Township 40 South, Range 43 East, Palm Beach County, Florida, sold parcel more particularly described as falimc
COMMENCING at the Southeast caner of said Northwest 1/4 of the Northwest 1/4 of Section 3% Proceed North or
57' 03' west along the South line of sold Northwest 1/4 of the Northwest 1/4 a distance of 230.58 feet; thence
departing last sold line. North 00' 02' 87' East a distance of 412.98 feet to the POINT OF BEGINNING; thence
North 35' 27 4 ' west a distance of 28.00 That thence North 84 32' 14' East a distance of 12OO feet; thence
South 35' 27' 48' East a distance of 26.00 feet; then South 54 32' 14' west a distance of 1200 feet to
the POINT OF BEGINNING.
Said 3.00 feat bride strip containing a net am of 258 square feet
6
DESCRIPTION OF VERIZON WIRELESS STOOP EASEMENT
A parcel of land big a portico of the South 800.79 feet of the Northwad 1/4 of the Northwest 1/4 of Section 30,
Township 40 Southh, F�ango 43 East, Palm Beach County. Flarfda odd parcel mom particularly described as follows:
COMMENCING at the Southeast caner of add Northwest 1/4 of the Northwest 1/4 of Scotian 3% North tom'
87' 03' West clang the S Tine of add Nor 1/4 of the Northwes 1/ 4 a dlet arm of 230.56 fast; thence
d � tlrence North 27' 48' Watt a distance of 1 distance
9.49 fed to the POINT OF BEWMG; thence
of 120 continue
North 39 27' 48' West a distance of 4.00 foal; thence Nag 84 32' 14' East a dh taros of 378 That thence
South 38' 27' 48' East a distance of 4.00 feet; thence South W 32' 14' West a distance of 3.78 feet to
the POINT OF BEGINNING.
Containing an area of 19 aquare feet.
DESCRIPTION OF VERIZON WIRELESS X ICE BRIDGE EASWENT
A 100 foot wide strV of land being a portion of the South 800.79 feet of the Nertlrsest 1/4 of the Norhwmt 1/4 of Sec4lae
30. TownshIp 40 South. Range 43 East, Palm Beach County. Flarkla, the aidd6ws of acid abip 171ng 1.90 fast an each
side of the following dembed oahternnc
COWAENCM at the Southeast comer of odd Northwest 1/4 of the Northwest 1/4 of Section 30, proceed North 89'
Sr 03' Wort along the South Une of sold Northwest 1/4 of the Northwest 1/4 a distance of 230.W feet; thence
depattrhg last said sine, North 00' 02' 87' East a distance of 412.98 foot; than= North 94' 32' 14' East a distance
of 12.00 feet; thence North 38' 27' 48' West a distance of 9.61 feet to the POINT OF BEGINNING of the herein
deemed aentefte; thence North 88' 10' 32' East a distance of 4.81 feet to the POINT OF 7EFUNA710N of the
herein described contallne.
The d ddirm of said a" to be artasded or trtr ww4 ce nocnoa% to fom one oahtlguass shape and to most a baohhg
of North 3W 27' 48' West at the Point of Beginning.
Containing an area of 14.4 square feet, more or late
In addition to the above, Lessee shall have non - exclusive access and utility rights across the
Property as necessary to connect the Piemim to the nearest public right of way.
Tower Space: Space at the 105' level an the Tower
7
E1 H I BIT B
(Site Sketch)
(See attached)
8
II IIfIll,�
d
a 16
a l l
kk
pf
4
Fo� ��9 Request for Taxpayer Give Form to the
(Hev.August 2013) Identlflcation Number and Certifilcation r�uester.��ot
Departrnent of the Treasury send to the IRS.
Irrtemal Revenue Servica
Name(as shown on your income tax rettun)
Village of Tequesta,Florida
N Bustn�s name/disregerded errtity name,if differerrt from above
m
rn
m
� Check appropriata box for federal tex classiflcation: Exemptlons(see instructlons):
� ❑IndividueVsole propNetor ❑ C Corporation ❑ S Corporatlon ❑ Pertnership ❑TrusV�tete
�o ExemPt PaYee c�de(if any) 3
� c�i � Llmfted Iiabllity compeny.Errter the tax classiflcation(C=C corporation,S=S corporation,P=partnership)► Exemptlon from FATCA reportlng
° � c;ode(tf anY) C
� e
a� ❑� Other(see instructlons)► Municipal Govemment
g Address(number,street,and apt.or sufte no.) Requester's neme and address(optiona�
� 345 Tequesta Drive
City,state,and ZIP c�de
� Tequesta,Florida 33469
L1st acxourrt number(s)here(optionel)
Taxpayer ldentification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line ���+�number
to avoid backup wfthholding.For individuals,this is your social security number(SSN).However,for a � -m -�
resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other
entiti�,k is your employer identiflcation num�r(EII�.If you do not have a number,see How to get a
TIN on page 3.
Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer ident�ncatlon number
number to enter.
CertificatiOn
Under penalties of peryury,I certiiy 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 notfied by the Intemal Revenue
Service QRS)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(ff any)indicating that I am exempt from FATCA reporting is correct.
Certlflcatlan Instructlons.You must cross out item 2 above if you have been notifled by the IRS that you ere currently subJect to backup withholding
because you have failed to report all irrterest and dividends on your tax retum.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 arrangemerrt(IRA),and
generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the
instructions on page 3.
Si n
He e us�n► �� � oate► 7.7"Y•Y�/� �
General Instructions wfthholding tax on foreign partners'shere of effecdvely connected income,and
Section references are to the Intemal Revenue Code unl�s otherwise noted. 4•CertifY that FATCA code(s)errtered on this form(ff arry)Indicating that you ere
exempt from the FATCA reportlng,Is correct.
Futur�e developmerns.The IRS has created a page on IRS.gov for irrfortnation Note.If you are a U.S.person arid a requester gNes you a form other than Form
about Form W-9,at wwwJrs.gov/w9.Information ebout arry firture developments yy-g to request your TIN,you must use the requester's form ff R Is substarrtially
affecting Fortn W-9(such as legislatlon enacted aker we release it)will be posted slmllar to this Form W-9.
on thet page.
Deflnitlon of a U.S.person.For federel tex purpoges,you are considered a U.S.
Purpose of Form person ff you are:
A person who is requlred to flle en Informetlon retum w(th the IRS must obtaln your '��ndividual who is a U.S.c(tizen or U.S.residerrt alien,
correct taxpayer ldentiflceUon number(TIN)ta report,for example,irn�me pald to •A partriership,corporatlon,company,or essoclatlon created or organb�d in the
yau,paymerrts made to you In settlement of paymerrt card end third party nehvork United States or under the laws of the Unfted States,
transacdons,real estate transectlons,mortgege irrterest you peld,acquis(tion or .q��e(other than a forelgn estate),or
abandonmerrt of seaued properly,cancellatlon of debt,or contributlons you made .A domestic trust(as deflned In Regulatlons section 301.7701-�.
ro an�Ra
Use Form W-9 only If you are a U.S.person pncluding a r�iderrt alien),to SPec�a�ru��for parhnerahipa Pertnerships that conduct e trade or business in
provide your cortect TIN to the person requestlng tt(the requ�te�end,when the United States are generally requtred to pay a withholding tax under sec:tlon
applicable,to: 1446 on any foreign partners'share of effectively connected texabte income from
1.Certify that the 11N yau are gNing is correct(or you are waidng for e number such business.F�uther,in certain cases where a Fortn W-9 has not been received,
to be f�uec�, the rules under sectlon 1446 requhe a partnership to presume that a partner Is a
foreign person,and pay the sectlon 1446 wfthholdfng taz.Therefore,tf you are a
2.Certffy that yau are not subject to backup wfthholding,or U.S.person that is a partner in a pertnership conducting a trade or business in the
3.Claim exemptlon from backup withholding if you are a U.S.exempt payee.If United States,provide Form W-9 to the partnership to esteblish yo�u U.S.status
appliceble,you are alsa certliying that as a U.S.person,your allocable share of ��oid section 1446 withholding on your ahare of partnership Income.
any partnership income from a U.S.trade or business Is not subject to the
Cat.No.10231X Fortn W-9(Rev.&2013)
Form W-9(Rev.8-2013) p�e Q
In the cases below,the following person must give Form W-9 to the partnership Updating Your Ir�formation
for purposes of establishing fts U.S.status and avolding wlthholding on fts
allxable shere of net incame from the partriership conductlng e trade or busln�s You must provide updated Informatlon to eny person to whom you clalmed to be
in the Unfted States: en exempt payee if you are no longer en exempt peyee arid anticlpate recelving
•In the case of a disregarded entlty with a U.S.owner,the U.S.owrrer of the reportable paymerrts In the future from this person.For exemple,you may rreed to
disregerded enHty arid rrot the endty, provide updated irrformation if you ere a C corporatlon that elects to be an S
corporatlon,or if you rro longer ere tex exempt.In add�lon,you must fumish a new
•In the case of a grarrtor trust with a U.S.grantor or other U.S.owner,generally, Form W-9 ff the name or TIN chang�for the acxourrt,for exemple,if the grantor
the U.S.grantor or other U.S.owrrer of the grantor trust and not the trust,end of a grentor trus[dies.
•In the case of a U.S.trust(other than a grantor trvst),the U.S.trust(other than a penalties
grarrtor trust)and not the beneflciaries of the trusL
Forelgn peraon.If you are a forelgn person or the U.S.branch of a foreign benk Fellure to fumish TIN.If you fail to fumish your correct TIN to a requester,you are
that has elected to be treated as a U.S.person,do rrot use Form W-9.Instead,use subject to a penatty of$50 for each such fallure unl�s yoiu feiline Is due to
the appropriate Form W-8 or Form 8233(see Publication 515,Withholding of Tax reasoneble cause and not to wlllful neglect
on Nonresider�t Aliens and Forelgn Entitles). Clvil penelly tor felse IrHormetlon with r�pect to withholding.If you meke a
Nonr�ident ellen who becom�a reslderrt allen.Generally,only a nonresiderrt felse statemerrt wfth rro reasonable besis that results in no backup wlthholding,
allen Individual may use the terms of a tax treaty to reduce or eliminate U.S.tax on you ere subject to a$500 penelty.
certain types of Income.However,most tex treatles conteln a provision Imown es
a"saving clause."Exceptlons specifled In the saving clause may permft an Criminel penaHy tor TalsHying hMormetion.VNllfully fals(Tying certlflcatlons or
exemptlon from tax to corrtinue for certeln types of income even after the payee ���ons may subject you to criminal penaltl�Including fln�end/or
has otherwise become a U.S.residerrt allen for tax purpos�. �mprisonment.
If you are a U.S.residerrt alien who is relying on an exceptlon corrtained in the ��+Se of TINs.If the requ�ter disclos�or uses TINs in violation of federel lew,
seving ctause of a tax treaty to deim en exemption from U.S.tax on certein types the requester may be sub)ect to clvil end criminel penalties.
of income,you must attach a statemerrt to Form W-9 that speclfles the following
r�e he�: Specif c Instructions
1.The treaty country.Generelly,this must be the seme Veaty under which you
claimed exemptlon from tex as a nonresident elien. Nam@
2.The treaty article addressing the income. If you are an Individual,you must generelly enter the name shown on your Income
3.The article number(or location)in the tax treaty that contains the saving taz retum.However,if you have changed your lest name,for instance,due to
clause and its exceptions. merriage without informing the Sxlal Security Administratlon of the name chenge,
4.The type and amount of inc:ome thet qualifles for the exemptlon from tax. errter your flrst name,the lest neme shown on your social security card,and your
new last neme.
5.Sufficlerrt fac[s to justify the exemptlon from tax under the terms of the treaty If the account is in Jolnt nemes,Ilst flrst,end then circle,the name of the person
article. or entlty whose number you entered in Pert I of the form.
Exemple.Article 20 of the U.S:China Income tex treaty allows an exemption ��e proprietor.Errter your individual neme as shown on your Income tax retum
from tax for scholarship income recelved by a Chinese student temporarily pr�errt on the"Name"Ilrre.You may enter your buslness,trade,or"doing business as
in the UnRed States.Under U.S.law,this studerrt will�me a residerrt ellen for gq �e on the"Busirress name/disregerded eritlty name"Iine.
tax purpos�ff his or her stay in the United States exc�eds 5 calendar y�rs. � ��
However,paragraph 2 of the first Protocol to the U.S.-China treaty(dated April 30, PerinershiR C Corporetlon,or S Corporatlon.Fster the entity's name on the
1984)allows the provisions of Article 20 to corrtinue to apply even after the °Neme"Iine and erry business,trade,or"doing business as(DBP�neme°on the
Chinese studeM becom�a residerrt alien of the United States.A Chin�e studerrt "Business name/disregarded entfty name°Ilne.
who qualifles for this exception(under paragreph 2 of the first pratoco�and is Dlsregarded erRHy.For U.S.federel tax purposes,an errtity that is disregarded as
relying on this exceptlon to claim an exemption irom tax on his or her scholership an enttty separate from ffs owner Is treated es a"dfsregarded errtfty." See
or fellowship income would attach to Form W-9 e statemerrt that includes the Regulation sectlon 3D1.7701-2(c)(2)(II�.Errter the owner's name on the"Neme"
informatlon described above to support that exemptlon. Ilne.The name of the entity ert[ered on the"Neme"Iine should never be a
If you are e rronresiderrt eiien or a foreign entity,give the requester the disregerded enUty.The name on the"Name°Ilne must be the name shown on the
appropriate completed Fortn W-8 or Form 8233. income tex retum on which the Income should be reported.For exemple,if a
What is beckup wkhholding?Persons making certaln peyments to you must foreign LLC that is treated as a disregerded errtity for U.S.federal tax purposes
under certain condfiior�s withhold end pay to the IRS a percerrtage of such has a single owrrer that Is a U.S.person,the U.S.owner's name is requlred to be
peymerrts.This Is called"backup withholding.° Payments that may be subject to Provided on the"Name"Iine.If the direct owner of the eritlly is elso a disregarded
backup w(thholding Include irrterest,tex-exempt Interest,dividends,broker and errt(ty,errter the flrst owrrer that Is not dlsregarded for federal tex purposes.Errter
barter exchange transactions,rerrts,royaltles,nonemployee pay,paymerrts made �e disregarded errt(ty's name on the"Business neme/disregarded entlty name"
in settlemerrt of payment card and thlyd party network trensactlons,and certain Ilne.If the owner of the disregarded entlty is a foreign person,the owner must
paymerrts from flshing boat operators.Real estate transactions are not subJect to �mplete an appropriate Form W-8 instead of a Form W-9. Thfs is the case even if
backup wRhholding. the foreign person has a U.S.TIN.
You will not be subject to backup withholding on paymertfs you recelve if you Note.Check the appropriete box for the U.S.federal tex clessiflcatlon of the
give the requester yo�u conect TIN,make the proper certiflcatlons,and report ell Pe�n whage name is errtered on the"Neme"Iirre(IndividuaVsole proprietor,
your texable Interest and dNidends on your tax retum. Partnership,C Corporatlon,S Corporetion,TrusVestate).
Llmlted Llabflity Com�rry(LLC).If the person Iderrtlfled on the"Name"Iine is an
Paymerrts you receive will be subject to backup LLC,check the"Limfted Ilability company"box only arid eriter the appropriate
withholding ff: code for the U.S.federal tex classiflcetlon In the space provided.If you are an LLC
1.You do rrot fumish our TIN to the r uester, that is treated es a pertnership for U.S.federal tax purposes,errter"P"for
y � partnershlp.If you are en LLC that hes flled a Form 8832 or a Fortn 2553 to be
2.You do not certliy your T1N when required(see the Part II instructlons on pege texed es e corporatlon,errter"C°for C corporetion or"S"for S corporetlon,as
3 for details), appropriate.If you are an LLC that Is disregarded as an enUty separate from its
3.The IRS tells the requester that you fumished an incorrect T1N, owrrer under Regulatlon sectlon 301.7701-3(except for employmerrt and excise
tax),do not check the LLC box unlesa the owner of the LLC(required to be
4.The IRS tells you that you are subJect to backup wRhholding because you did iderrtifled on the"Name"Iine)Is another LLC thet is not disregarded for U.S.
not report all your irrterest and dividends on your tax retum(for reportable Irrterest federal tax purposes.If the LLC Is disregarded es an entlty separate from tts
end dNidends only),or owner,errter the appropriate tax classiflcaHon of the owner iderrtifled on the
5.You do not certHy to the requester that you are not subject to backup "Neme"Iine.
withholding under 4 above(for reporteble IMterest and dividend accourrts opened Ofher er�tltltlea Errter your business neme es shown on required U.S.federal tex
after 1983 only). documerrts on the"Name"Iine.This name should match the name shown on the
Certein payees and paymerrts are exempt from backup wrlthholding.See Exempt charter or other legal documerrt creaUng the entlty.You may errter any business,
payee code on page 3 and the separate Instructions for the Requester of Form �de,or DBA name on the"Buslness neme/disregarded errtity name"Iirre.
W-9 for more Informatlon.
Also see Speclel rules for partnershlps on page 1. �7Cem(�t10�1S
Whet la FATCA reportlng?The Forelgn Accourrt Tax Compllance Act(FATC� If you are exempt from backup w(thholding and/or FATCA reportlng,errter In the
requires e perticlpating foreign flnanclal Instkutlon to report all Unfted States ��Pffons box,any code(s)that may apply to you.See Exempt payee code and
acxouM holders that are specifl�Unked States persons.Certe(n payees are ��Ption from FATCA report/ng code on page 3.
exempt from FATCA reporting.See ExempUon fiom FATCA reportlng code on
page 3 and the Instructlons for the Requester of Form W-9 for more Irrtormetion.
Form W-9(Rev.8-2013) pege$
Exempt payee code.Generally,individuals pncluding sole proprietors)ere not G—A real es[ate investmerrt trust
exempt from backup wlthhoiding.Corporatioris are ezempt from backup `
withholding for certein paymerrts,such as interest and dividends.Corporatlons ere H—A reguleted inv�trnerrt comparry as defined in section 851 or an entlty
not exempt irom backup withholding for paymerAs made in settlemerrt of paymerrt 1�����I Um�dtuing the tax year under the Investrrierrt Compeny Act of
card or third party network trensactions.
Note.If you are exempt from backup w(thholding,you should still complete this I—A common trust fund as deflnetl In sectlon 584(a)
form to avold possible enoneous backup withholding. J—A bank es deflned in sectlon 581
The following codes IdentKy payees that are exempt from backup wRhholding: K—A broker
1—An organizetion exempt from tax under sectlon 501(a),any IRA,or a L—A trust exempt from tax under sectlon 664 or described In sectlon 4947(�(1)
custodial account under sectlon 403(b)(�if the acxourrt satfsfles the requlrements M—A tex ezempt trust under a sectlon 403(b)plan or sectlon 457(g)plen
of sectlon 401(�(2)
2—The UnRed States or erry of its agencies or Instrumerrtalftles Part I.Taxpayer ldentification Mumber(TIN)
3—A state,the DlsUict of Columbia,a possession of the UnRed States,or eny of Enter your TIN In tlte appmpriete box.If you are a resideM alien end you do not
their political subdlvisions or instrumeritalitles have and are not eligible to get en SSN,yoiu TIN ts your IRS Individual taxpayer
4—A foreign govemmerrt or any of its polRical subdlvisions,agenci�,or lderrtiflcation number(ITII�.Enter ft In tha soclal security number box.If you do not
instrumentalitles have an ITIPI,see How to get a TIN below.
5—A corporation If you are a sole proprietor and you have an EIN,you may errter efther your SSN
6—A dealer in securiUes or commodities or EIN.However,the IRS prefers that you use your SSN.
required to register in the UnRed if you are a single-member LLC that is disr�erded es an entity separate from tts
States,the District of Columbla,or a possession of the UnRed States owner(see Llmlted L/abllity Company(L.LC)on paga 2),errter the owner's SSN(or
7—A futures commission merchant registered with the Commodity Futur� EIN,If the owner hes one).Do rrot errter the disregarded errtity's EIN.If the LLC is
Treding Comml�lon classifled es a corporatlon or partnership,errter the enUty's EIN.
8—A real estate Investment trust Note.See the chert on page 4 for ftuther clariflcatlon of name and TIN
9—M entity registered at all tim�d�uing the tex year under the Investment combinations.
Company Ac[of 1940 How to get a TIN.If you do not have a TIN,apply for one Immediately.To apply
10—A common trust fund operated by a bank under section 584(a) for an SSN,get Form SS-5,Applicatlon for a Sociai Security Cerd,from your local
11—A flnencial institutlon Soclal Security Administration offlce or get this form online at www.sse.gov.You
may also get this fortn by calling 1-800-772-1213.U�Form W-7,Application for
12—A middleman Imown in the inveshnerrt community as e nominee or IRS Individual Taxpayer ldentlflcatlon Number,to apply for an(11N,or Form SS-4,
custod�en Applicatlon for Employer ldentlflcatlon Number,to apply for en EIN.You can apply
13—A trust exempt from tex under sectlon 664 or d�cribed In section 4947 for an EIN online by accessing the IRS websfte at www.irs.gov/buslnesses arid
clicMng on Employer ldentlflcatlon Number(Eil�under Stertlng a Business.You
The following chart shows types of paymerrts that may be exempt from backup �9�Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-
wlthholding.The chart applies to the exempt payees Iisted above,1 through 13. TAX-FOHM(1-800-829-3676).
IF the peyment is tor... THEN fhe paymeM Is exempt for... If you ere esked to complete Form W-9 but do not have a TIN,apply for a TIN
and write"Applied For"In the space for the T1N,sign and date the form,end gNe R
to the requester.For irrterest arid dividend peymerits,and certein peymertts made
Irrterast end dividend paymerrts All exempt payees except w(th respect to readily tradable Instruments,generally you will have 60 days to get
for 7 a TIN and gNe ft to the requ�ter before you are subJect to backup wlthholding on
paymerrts.The 60-day ruls does not apply to other types of paymer�ts.You wlll be
Broker transactions Exempt paye�1 through 4 and 6 subject to backup w(thholding on all such paymerrts until you provide yaur TIN to
through 11 and all C corporatlons.S the requ�ter.
corporations must not eMer en exempt Note.Errtering"Applied For"means that you have already applied for e TIN or that
payee code because they are exempt you intend to apply for one soon.
only for sales of noncovered securities
acquired prlor to 2012. Cautlon:A dlsregarded U.S.errtity that hes a foielgn owner must use the
approprJate Form W-8.
Barter exchange transactions and Exempt payees 1 through 4
patronage d(vidends Part I I.Certfication
Paymerrts over$600 required to be Generally,exempt payees To establish to the withholding agent that you are a U.S.person,or r�iderrt elien,
� Z slgn Form W-9.You may be requested to sign by the withholding agent even If
reported and dlrect sales over$5,000 1 through 5 items 1,4,or 5 below Indicate otherwise.
For a jolrrt axourrt,only the person whose TIN is shown In Part I should sign
Paymerrts made in settlement of Exempt payees 1 through 4 (when required).In the case of a dlsregerded entlty,the person Iderrtifled on the
paymerrt card or third party network "Neme"Ilrre must sign.Exempt payees,see Ezempt peyee code earlier.
trensectlons
Signetrire requlremerHg.Complete the certiflcation as indicated In Rems 1
'See Form 1098-MISC,Miscellaneous Income,end Its Instructlons. through 5 below.
Z However,the following paymerrts made to a corporatlon and reportable on Form 1.Intereaf,dhridend,end berter exchange ecxounts opened before 1�4
1099-MISC ere not exempt from backup withholding:medical and health care and broker accouMs considered ecdve d�uing 18�1.You must gNe your
payments,attomeys'fees,gross proceeds peid to an attomey,and peyments for �Rect T�N,but you do rrot have to sign the certlflcation.
services peid by a federal executive agency. 2 Irrter�t,dhridend,broker,end baRer e:chenge accou�rts operred efter
Exemptlon from FATCA reportlng cbde.The following c�des identlTy payees ���d broker aaxiu�consider�i Inective d�uing 1983.You must sign the
that are exempt from reportlng under FATCA These codes apply to persons oertiflcetlon or backup withholding will apply.If you ere subJect to backup
submitting this form for acxounts maintairred outside of the Unfted Stetes by wRhholding and you ere merely providing your correct TIN to the requester,you
certain foreign flnenclal institutions.Therefore,if you ere only submitting this torm must cross out kem 2 In the certiflceUon before signing the form.
for an account you hold In the United States,you may leave this fleld blank. 3.R�I estate tra�ectlona.You must sign the certiflcatlon.You mey cross out
Consuft w(th the person requ�tlng this form if you are uncertaln If the flnencial Rem 2 of the certiflcatlon.
instkution is subJect to these requiremerds.
4.Other paymerrts.Yau must give yo�u correct TIN,but you do not have to sign
A—An organization exempt from tex under sectlon 501(a)or eny Individual the certiflcatlon unless you have been notifled that you have prevlousy gNen en
reUrement plen as deflned in sectlon 7701(�(3� Incorrect TIIV."Other paymerrts"include paymerrts made in the course of the
B—The United Stet�or any of ifs agencles or Instrumentelftl� requester's trade or businass for rerrts,royaitles,goods(other than bills for
merchandise),medical and heakh care services(Including payments to
C—A state,the District of Columbia,a pos�ssion of the Unfted States,or eny cprpprations),paymerds to a nonemployee for services,paymerrts made In
of their pol(tical subdivisions or instrumentalitles settlemerrt of peymerrt card and third party rietwork transactlons,peymerrts to
D—A corporetlon the stock of which is regularly traded on orre or more oe►taln flshing boat crew members end tishermen,and gross proc�eds pald to
establish�securitias markets,as described In Reg.sectlon 1.1472-1(c)(i)m attomeys Qncluding paymerrts to corporatlons).
E—A corporation that is a member of the same expanded afflliated group as a 5.Mortgage IrKerest pald by you,acqulsitlon or abandonment of�cured
corporaUon described in Reg.sectlon 1.1472-1(c)(1)m properLY,cance��edon of debt,qualHied hdfion program�ymerrts(�mder
F—A dealer in securitles,commoditles,or derNative flnancial instrumerrts �on 529),IRA,Coverde0 ESoA,Archer MSA or HSA coMributlona or
pnclud(ng notlonel principal contrects,fuhues,forwards,and opdons)that is distributlons,end penslon matributlons.You must gNe yo�u correct TIN,but you
registered as such under the laws of the UnRed Stat�or any state do rrot have to sign the certlflcation.
.
Form W-9(Rev.8-2013) Page 4
What Name and Number To Give the Requester No�.If rro name Is circled when more then one name is Iis[ed,the number will be
considered to be that of the flrst neme Ilsted.
For thla type of acxourrt Give neme end SSN ot
1.Individual The Individual �ure Your Tax Records from Identity Theft
2.Two or more individuals Qolrrt The actual owner of the accourrt or, Iderrtity theft occurs when someorre uses your personal Informatlon such as your
acxourrt) if combined funds,the flrst name,social security number(SSI�,or other ide�ng informetlon,wRhout your
indivldual on the account' Permiss�on,to commit fraud or other crimes.An ideritlty thief may use your SSN to
get a Job or may flle a tax retum using your SSN to receive a refund.
3.Custod(an acxourrt of a minor The minor'
(Uniform Gift to Minors Act) To reduce your risk:
4.a.The usual revocable savings The grentor-trustee' '��Yotu SSN,
trvst(grantor Is also trvstee) •Ensure your employer is protecting yo�u SSN,end
b.So-called trust account that is 7}�a�l owrrer' •Be careful when choosing a tex preparer.
not a legal or velid trust under
�e� If your tex records are affected by Identlty theft end you recefve a notice from
5.Sole proprletorship or disregarded The owner' the IRS,respond�IgM away to the name and phone number prirtted on the IRS
erdity owned by an tndlvidual notice or letter.
6.Grantor trust fliing under OpHonal The grentoP �f your tax records are rrot currerrtly affected by Identlty theft but you think you
Fortn 1099 Filing Method 1(see are at risk due to a los[or stolen purse or wallat,questlonable credlt c�d activity
or credft repoR,contact the IRS Ideritlty Theft Hotline at 1-8U0-908-4490 or submit
Regulatlon section 1.671-4(b)(2)m(A)) Form 14Q39.
For thls type oi eccou� �ive name arrcl�N of. For more IniormaUon,see Publicatlon 4535,Iderrtity Theft Preverrtion and Victlm
7.Disregerded entity not owned by an The owner ����e•
�^dividual Victims of identlty theft who are experiencing economlc hartn or a system
8.A valid trust,estete,or penslon trust Legal entlty° problem,or are seeMng help In resolving tax problems that have not been resolved
9.Corporatlon or LLC electlng The cor�mraUon through rmrmal chennets,may be eligible for Taxpayer Advacate Service(fAS)
corporate status on Fortn 8832 or ass�stence•You cen reach TAS by calling the TAS toll-free case inteke Ilne at
Fortn 2553 1-877-777-4778 or TTY/TDD 1-800-829-4059.
10.AssociaUon,club,religious, The organbation ��t Yo�eH from susplclous emails or phlshing schemes. Phishing is the
chariteble,educaUonal,or other creation end use of emeil arM webskes designed to mimic legitlmate business
tex-exempt organizatlon emalls and websRes.The most common act Is sending an email to a user falsely
11.Partnershi or muYtl-member LLC The artnershi clalming to be an esteblished legitlmete errterprise in en attempt to scem the user
P P P irrto surrendering private informatlon thet will be used for iderttity theft.
12.A broker or registered nominee The broker or nominee The IRS does not Initlate contacts wfth taxpayers via emeils.Also,the IRS does
13.Acxount with the Departmerrt of The public entity not request personel deTelled Infomietion through email or ask taxpayers for the
Agricufture in the name of a public PIN numbers,passwords,or similer secret access irrfortnetlon for thelr credft card,
erdity(such as a state or local bank,or other flnanclal accourrts.
govemmerrt,school district,or If you receNe an ur�solicfted emall clalming to be Trom the IRS,forvvard this
prison)that receives agricuRural message to phlshing�Irs.gov.You may also report misuse of the IRS name,logo,
program paymenis or other IRS properly to the Treasury Inspector General for Tax Administratlon at
14.Grantor trust flling under the Form The trust 1-80D-366-4484.You can forward suspicious emalls to the Federal Trade
1041 Flling Method or the OpUonal Commisslon at:spem�uce.gov or conffid them et www.ftc.gov/ldtheft or 1-877-
Form 1099 Flling Method 2(see IDTHEFT(1�77-438-4338).
RegulaHon section 1.671-4@)(2)(i)(B)) Visft IRS.gov to leam more about iderrtity theR ar�d how to reduce your risk.
'Llst flrat end drole the neme of the person whose numbm you Mnish.If only ane peraon on e
Joirrt accourrt Fms an SSN.thet person's numbar mimt be fiunlshed.
Z Clrcte the minor's neme erni fiunlah the minor's SSN.
9 You must show your Indfvidual neme and you may etso�ter your buslrress or"DBA"neme on
the"Buslrress neme/dleregarded entlry"neme Iine.You mey use elther yoiu SSN or EIN(It you
heve orre),bu[the IRS encaueg�you to use your SSN.
'Llet flrs[ar�d circle the name of the truet,estete,or permlon truat(Do not hunlsh the TIN of the
persorrel represerrtetive or truvtee iml�the legel entlty ilaelf Is rrot deslgne[ed In the eccourrt
tltle.)Also aee Speclel�ules(or pertnershlps on page 1.
'Note.Grarrtar also muet provide a Form W-9 to tr�tee af trust.
Privacy Act Notice
Section 6109 of the Irrtemal Revenue Code requlres you to provide your correct TiN to persons Qncluding federel egencl�)who are requlred to flle informetlon retums with
the IRS to report Irrterest,dtvidends,or c�rtain other income paid to you;mortgage irrterest you peld;the acquisRion or abaridonment of secured property;the cancellation
of debt;or contributlons you made ta an IRA,Archer MSA,or HSA.The person collecting thls form uses the Informetion on the form to flle Information retums with the IRS,
reporting the ebove Infarmatlon.Routlne uses of this Informetlon include giving ft to the Depertment of Justice for civil and criminel Iklgation and to ciU�,states,the District
of Columbia,and U.S.commonweatths and possessions for use in administering thelr laws.The Informatlon also may be disclosed to other courmi�under a treaty,to
federal and stete agencies to enforce civll and criminal laws,or to federal law enforcement end intelligence agencles to combat terrorism.You must provide your TIN
whether or not you ere requlred to flle a tax retum.Under secdon 3406,payers must gerrerelly wRhhold a percerrtage of taxable Irrterest,dividend,and certeln other
paymerrts to a peyee who does not gNe a TIN to the peyer.Certeln penalties may also apply for provlding felse or fraudulerrt Informetlon.
.
TAXABLE YE4R Nonresident Withholding ■ CALIFORNIA FORM
2014 Allocation Worksheet 587
The payee completes this form and returns it to the writhholdin a erK.
Part 1 Wlthholding Age�
Withholdfng egenYs name
CELLCO PARTNERSHIP-DBA VERIZON WIRELESS
Addresa(apt/ste.,room,PO Bo�or PMB no.)
ONE VERIZON PLACE,ATTN: TAX
Cit�r(If you have a foreign address,sea inatrudions.) State ZIP Code
ALPHARETTA GA 3 0 0 0 4
Part 11 Nonreslde�Payee
Payee's name ❑SSN or ITIN❑FEIN 0 CA Corp no.❑CA SOS flle no.
Village of Tequesta, Florida
Addreas(ept/ste.,room,PO Box,or PMB no.)
345 Tequesta Drive
City(If you heve a foreign address,see instructions.) Stete ZIP Code
Tequesta FL 3 3 4 6 9
Nonresident payee's entity type:(Check one)
❑IndividuaVsole proprietor �Corporation ❑Partnership ❑Limited liability comparry(LLC) ❑Estate or trust
Pa�t 111 PaymeM Type
Nonresident payee:(Check one)
mPertorms services tohlly outside Cal'rfomia(no withholding required,skip to ❑Provldes goods and services In Califomia(see Part IV,Income Allocatlon)
Certiflcation of Nonresident Payee) ❑Provides services within and outside Callfornia(see Part IV,Income Allocation)
❑Provldes onry goods or materials(no withholding required,sldp to ❑Other(Describe)
Certification of Nonresident Payee)
If the nonresident payee pertorms all the services within Cal'rfomia,withholding is required on the entire payment for services unless the payee is granted a
withholding waiver from the Franchise Tax Board(Ff6).For more information,get FfB Pub.1017,Resident and Nonresident Withholding Guidelines.
Part IV Income Allocatlon
Gross payments expected from the withholding agent during the calendar year for:
(a) Within California (b) Outside Callfomfa (c) Total payments
1 Goods and services:
Goods/materials(no withholding required) ............................................................
Services(withholding required)............
2 Rents or lease payments...................
3 Royalty payments ........................
4 Prizes and other winnings ...............
5 Other payments..........................
6 Total payments subject to withholding.
Add column(a),line 1 through line 5 .......
NonresldeM wlthholding threshold amour�: ... $1.500.00
Backup wlthholdlnp threshold amouM: ....... $0.00
Certl�cation of Nonreslde�Pa ee
Under penalties of perjury,I cert'rfy that the ir�ormation provided on this documem is true and correct.If the reported facts change,I will promptly inform ,
the withholding agent.
P' or type payee's name Telephone
�t�► . �o td Zz� � > �v -O70 O
Sign �Y�'s signa�re Dete
Here � � '"� ���
Print or typa representative's neme a tltle Telephone
( )
Authorized rapresenfetive's slgnature Dete
�
For Prlvaq Notice,get FTB 1131 ENGlSP. � 7 0 4114 3 � Form 587 cz 2013
Instructions for Form 587
Nonresident Withholding Allocation Worksheet
Referen�a in th�e instructions are to tlie Catifomia Revenue and Ta�mtion Code(R&TC).
General Information in California.Foreign corporations • Payments made in connection with a
Backup Withholding—With certain limited must be qualified to transact intrastate California pertormance.
exceptions,payers that are required to business. Use Form 590. � Rent paid to nonresidents if the rent is
withhold and remit backup withholding • The payment is to an estate and the paid in the course of the withholding
to the Internal Revenue Service(IRS) decedent was a Cal'rfomia resident. Use agents business.
are also required to withhold and remit Form 590. • Royalties from natural resources
to the Franchise Tax Board (FTB)on Form 587 does not apply to payments for paid to nonresidents from business
income sourced to California.The wages to employees.Wage withholding activities in Califomia.
Cal'rfomia backup withholding rate is 7% is administered by the Califomia • Payments of prizes for contests
of the payment. For California purposes, Employment Development Department entered in Cal'rfomia.
dividends, interests,and any financial (EDD).For more information,go to � Distributions of California source
institutions release of loan funds made in edd.ca.gov or call 888.745.3886. income to nonresident beneficiaries
from an estate or trust.
the normal course of business are exempt • Endorsement payments received for
from backup withholding.For additional B When to Complete services pertormed in Califomia.
information on California backup The withholding agent requests that the • Other payments of Cal'rfomia source
withholding,go to ftb.ca.gov and search nonresident payee completes,signs, income made to nonresidents.
for backup withholding. and returns Form 587 to the withholding
If a payee has backup withholding,the agent when a contract is entered into Payments not subject to withholding
payee must contact the FTB to provide a and before a payment is made to the include payments:
valid Taxpayer ldentification Number IN • To a resident of Cal'rfomia or to a
� ) payee.The withholding agent relies on corporation,LLC,or partnership,with
before filing a tax return.The following are the certification made by the payee to a permanent I
acceptable TINs:social securit�r number determine the amount of withholding p ace of business in
(SSN);individual taxpayer identification required,provided the completed and California.
number(ITIN);federal employer signed Form 587 is accepted in good faith. • To a corporation qualified to do
identification number(FEIN);California business in California.
Form 587 remains valid for the duration . For sale of oods.
corporation number(CA Corp no.);or of the contract(or term of payments), . For income9 rom intangible personal
Cal'rfomia Secretary of State(CA SOS) provided there is no material change in
file numbec Failure to provide a valid property,such as interest and
TIN will result in the denial of the backup the facts.By signing Form 587,the payee dividends,unless the properry has
withholding credit. agrees to promptly notify the withholding acquired a business situs in California.
agent of any changes in the facts. • For services pertormed outside
A Pu OSe The withholding agent retains Form 587 of California.
� for a minimum of four years and must • To a payee that is a tax-exempt
Use Form 587,Nonresident Withholding provide it to the FTB upon request. organization under either California or
Allocation Worksheet,to determine'rf federal law, use Form 590.
withholding is required,and the amount • To a a ee that is a government enti
of California source income subject to C Income Subject to . To relmburse a payee for expenses �
withholding. Wlthholding relating to services pertormed in
Withholding is not required if payees are California Revenue and Taxation Code California if the reimbursement is
residents or have a permanent place of (R&TC)Section 18662 and the related separately accounted for and not
business in California.Get FTB Pub.1017, regulations require withholding of income subject to federal Form 1099 reporting.
Resident and Nonresident Withholding or franchise tax on certain payments made Corporate payees,for purposes
Guidelines,for more information. to nonresidents(including individuals, of this exception,are treated as
Do not use Form 587 if any of the corporations,partnerships, LLCs,estates, individual persons.
following applies: and trusts)for income received from
California sources.
• You sold California real estate. D Waivers/Reductions
Use Form 593-C,Real Estate Withholding is required if total payments A nonresident payee may request that
Withholdin Certificate. of California source income to the
• The payee is a resident of California nonresident payee during the calendar year W�hholding be waived.To apply for
or is a non- rantor trust that has exceed$1,500.The withholding rate is 7% a withholding waiver,use Form 588,
9 unless the FTB grants a waivec See General Nonresident Withholding Waiver Request.
at least one California resident A nonresident taxpayer has the option
trustee. Use Form 590,Withholdin Information D,Waivers/Reductions.
9 to request a reduction in the amount to
Exemption Certificate. Payments subject to withholding include be withheld.To apply for a withholding
• The payee is a corporation,partnership, the following: reduction,use Form 589,Nonresident
or limited liability company(LLC)that . payments for services pertormed in Reduced Withholding Request. FTB does
has a permanent place of business in California by nonresidents. not grant reductions or waivers for backup
Cal'rfomia or is qualified to do business withholding.
Form 587 Instructions 2013 Page 1
E Requirement to File a California in column (b).Enter the total OR write to:
California Tax Return amount paid for services in column(c). WITHHOLDING SERVICES AND
A payee's exemption cert'rfication on If the payee's trade,business,or COMPLIANCE MS F182
Form 587,Form 590,or a determination Profession carried on in California is FRANCHISE TAX BOARD
letter from the Ff6 waiving withholding an integral part of a unitary business PO BOX 942867
carried on within and outside California, SACRAMENTO CA 94267-0651
does not eliminate the requirement to the amounts included on line 1 through You can download,view,and print
file a California tax return and pay the tax line 5 should be com uted b a I in
due. For tax retum filing requirements, , p Y pp y 9 California tax forms and publications at
see the instructions for Long or Short the payee s California apportionment ftb.ca.gov.
Form 540NR,California Nonresident or percentage(determined in accordance OR to get forms by mail write to:
Part-Year Resident Income Tax Retum; With the provisions of the Uniform
Form 541,California Fiduciary Income Tax Division of Income forTax Purposes TAX FORMS REQUEST UNIT
Return;Form 100,Califomia Corporation Act)to the payment amounts.For more FRANCHISE TAX BOARD
information on apportionment,get PO BOX 307
Franchise or Income Tax Return;or Schedule R,Apportionment and Allocation RANCHO CORDOVA CA 95741-0307
Form 100S,Califomia S Corporation of Income. For all other questions unrelated to
Franchise or Income Tax Return. withholding or to access the TTY/TDD
Withholding Ageat numbers,see the information below.
Specific Instructions W�hholding,excluding backup
Defloitioos—For withholding terms and withholding,is optional at the discretion of �mernef and Telephone Assistance
definitions,go to itb.ca.gov and sea�ch the withholding agent on the first$1,500 Website: ftb.ca.gov
for withholding terms. in payments made during the calendar Telephone: 800.852.5711 from within the
Private Mail Box(PMB)—Include the Year.Withholding must begin as soon as United States
PMB in the address field.Write"PMB" the total payments of California source 916.845.6500 from outside
first,then the box number. Example:111 income for the calendar year exceed the United States
Main Street PMB 123. $1,500. If backup withholding is required, n1'lfDD: 800.822.6268 for persons
Foreign Address—Enter the information there is no set minimum threshold and it with hearing or speech
supersedes all types of withholding. impairments
in the following order:City,Country, If circumstances change during the year Asistencia Por Imernet y Tel�fono
Province/Region,and Postal Code.
Follow the country's practice for entering �h ch would change the amount on line�6, Sitio web: ftb.ca.gav
the postal code. Do not abbreviate the the payee must submit a new Form 587 Tel�fono: 800.852.5711 dentro de los
country's name. to the withholding agent reflecting those Estados Unidos
Part I—Withholdin A eot changes.The withholding agent should 916.845.6500 fuera de los
g g evaluate the need for a new Form 587 Estados Unidos
Enter the withholding agent's business or When a change in facts occurs. mRDD: 800.822.6268 personas con
individual information,not both. discapacidades auditivas y del
Part 11—Noareside�Payee Certi�cation of Nooresideot Payee habla
Enter the payee's business or individual The payee and/or the authorized
information, not both.Check the representative must complete,sign,
appropriate TIN box and provide the ID date,and return this form to the
number. withholding agent.
Authorized representatives include
����—P��� those persons the payee authorized to
The nonresident payee must check the act on their behalf through a power of
box that identifies the type of payment attorney,a third pariy designee,or other
being received. individual taxpayers authorized to view
Part IV—Income Nlocatioo their confidential tax data via a waiver
or release.
Use Part IV to idenfrfy payments that are
subject to withholding.Only payments Additional Information
sourced within Cal'rfornia are subject For additional information or to speak to
to withholding.Services pertormed in a representative regarding this form,call
Califomia are sourced in California. In the the Withholding Services and Compliance
case of payments for services pertormed telephone service at:
when part of the services are pertormed Telephone: 888.792.4900
outside California,enter the amount paid
for pertorming services within California 916.845.4900
in column (a).Enter the amount paid Fax: 916.845.9512
for pertorming services while outside
Pape 2 Form 587 Instructions 2013