HomeMy WebLinkAboutContract 57222-CA1CSC No. 57222-CAI
CITY OF FORT WORTH
ASSIGNMENT
For value, received Country World Productions Inc. dba US Captioning Company
("Assignor"), hereby assigns to VITAC Corporation ("Assignee"), all of its right, title and
interest in and to any and all sums of money now due or to become due from the City of Fort
Worth to Assignor under CSCO 57222 (the "Contracts") and Assignee agrees to assume and
perform all duties and obligations required by Assignor under the terms of the Contracts.
This Assignment constitutes the entire agreement between Assignor and Assignee with
respect to the subject matter hereof. No modification of any provision of this Assignment shall
be effective unless in writing and signed by Assignor and Assignee. This Assignment shall inure
to the benefit of and be binding upon Assignor and Assignee and their respective successors and
assigns. This Assignment shall be governed by the terms of the original Contracts between
Assignor and various other entities and the City of Fort Worth and the laws of the State of Texas,
without application of principles of conflicts of law.
This Assignment may be executed in one or more counterparts each of which shall be
deemed an original but all of which together shall constitute one and the same instrument.
Signed signature pages may be transmitted by facsimile or e-mail, and any such signature shall
have the same legal effect as an original.
Dated the day of 2p2.).
Country World Productions Inc. dba US Captioning
Company
CRYSTAL JOSKI (Assignor)
Notary Public
State of Wisconsin
By:
Print:
Title: Chief Operating Officer
VITAC Corporation
---.... _ (Assignee)
KEVIN WAYNE S1r0CKWELL
NOTARY PUBLIC
STATE OF COLORADO By:
NOTARY ID 20234002S49 print:
MY lug savotJc+-y
Title: Chief Financial Officer
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 1 of
NOTARY ACKNOWLEDGEMENT
On ,611 -1 k tithe day of 2023, personally appeared
rc ,x wh�o'`�` acknowledged to met (s)he is the Chief Operating Officer of
Country World ProduCtl&At Inc. dba US Captioning Companyf, ("Assignor"), and that (s)he
executed this document for the purposes and consideration contained herein.
Country World Productions Inc. dba US Captioning
Company
By.
Print:
Title: Chief Operating Officer
NOTARY ACKNOWLEDGEMENT
On the day Of --ftAA1 who acknowledged tt 2023, personally appeared
o me that (s)he is the Chief Financial Officer of
VITAC Corporation, ("Assignee"), and that (s)he executed this document for the purposes and
consideration contained herein.
KEV+N WAYNE STOCKWELL VITAC Corporation
NOTARY PUBLIC
STATE OF COLORADO By.
NOTARY ID 20234002549 Print:
Title: Chief Financial Officer
SUBSCRIBED TO before me on this Zc.> day of 111 202".
Notary Pub is in and for the State of r71,,r,
My commission Expires: i- tC11 - -
Assignment Page 2 of 3
CONSENT TO ASSIGNMENT
The City of Fort Worth consents to the assignment of Country World Productions Inc.
dba US Captioning Company, ("Assignor") to VITAC Corporation, ("Assignee"), of all its
rights, title, and obligation owing and all funds due or to become due to Assignor under CSCO
57222 as long as all terms required of Assignor in said contracts are met by Assignee.
CITY OF FORT WORTH
/A
Reginald Zeno (Apr 24, 2023 08:35 CDT)
Reginal Zeno- Chief Financial Officer
Jo Gunn Apr 24, 2023 08:28 CDT)
Jo Ann Gunn — Chief Procurement Officer
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ATTESTED BY:
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Jannette Goodall, City Secretary
APPROVED AS TO FORM AND LEGALITY:
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Andrea Phillips (Apr 20, 20 3 09:03 CDT)
City of Fort Worth Assistant City Attorney
Contract Compliance Manager:
Apr24,2023
Date
Apr24,2023
Date
Apr24,2023
Date
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including ensuring all performance and
reporting requirements.
15, --),
Aya Nomura (Apr 20, 2023 09:14 CDT)
Employee Signature/Date
Apr 20, 2023
Cable Services Supervisor
Title
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 3 of
DocuSign Envelope ID: B1997B7E-2E91-419C-BF14-09E165E05BBB
W=9
Request for Taxpayer
Give Form to the
Form
Identification Number and Certification
requester. Do not
(Rev. October2018)
Department of the Treasury
send to the IRS.
Internal
Revenue Service
► Go to www.irs.gov/F`orn1W9 for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
VITAC Corporation
2 Business name/disregarded entity name, if different from above
M
4)3
Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
0
to
following seven boxes.
certain entities, not individuals; see
a
instructions on page 3):
p
❑ Individual/sole proprietor or ® C Corporation ElS Corporation ElPartnership ❑ Trust/estate
c
single -member LLC
Exempt payee code (if any)
o. o
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) IN-
0
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check
Exemption from FATCA reporting
.9 to
c
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
code (if any)
IL °
w
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
N
❑ Other (see instructions) ►
(Applies to accounts maintained outside the U.S.)
CL
5 Address (number, street, and apt. or suite no.) See instructions.
Requester's name and address (optional)
8300 E Maplewood Ave Suite 310
co
6 City, state, and ZIP code
Greenwood Village, CO 80111
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
Social security number
backup withholding. For individuals, this is generally your social security number (SHowever, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later.
or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter. 2 5 - 115 1119 151 31 7
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later.
Sign Signature of 5ig..dby 1 /5/2023
Here I U.S. person ►? " Date ►
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
April 10, 2023
Dear City of Fort Worth,
This letter is to inform you that on May 9, 2022, Country World Productions, Inc.
dba U.S. Captioning Company was acquired by Verbit/Vitac. So, Vitac has now
attained all of USC's clients and is performing the captioning services. We are no
longer in business.
Thank you for your past business, and I hope Fort Worth prosperity and a bright
future.
Sincerely,
-A5t� L&711111t�
Beth Aschenbrenner
Past President/CEO
Country World Productions, Inc.