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Home My WebLink AboutContract 58121-NC1CSC No. 58121-NC1 FORTWORTH MEMORANDUM Date: 9/15/2023 To: Assistant City Attorney From: Tracy Walter — FMS/Vendor Management Re: Name Change Only: Bean Electrical Inc. to Bean Electrical LLC Prior Name: Bean Electrical Inc. New Name: Bean Electrical LLC Supplier id: 0000027137 CSCO: 58121 Note: Supplier updated name only and the tax id (EIl) number remained the same. APPROVED BY: -0"4- Assistant City Attorney Sep 15, 2023 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX UCC Business Organizations Trademarks Notary Account HelplFees Briefcase Logout Filing Number: 806036102 Entity Type: Domestic Limited Liability Company (LLC) Original Date of Filing: April24, 2023 Entity Status: In existence Formation Date: May 20, 1985 Tax10: 17526417506 FEIN: Duration: Perpetual Name: Bean Electrical, LLC Address: PO BOX 40016 FORT WORTH. TX 76140-0016 USA - - FILING HISTORY View image Docarnent Humber Filing Type / 125830102C�OOI Public l nfonnalion Repod iPl R] 1 12419MSS000I Cedifrcale of Convereroa Order I Return to Search 6llSINESS ORGANIZATIONS INQUIRY -VIEW ENTITY M4HAGFMFNTASSi1MED. NAY, �SSOUATEn ENTMES] Filing Date Effective Date Eff. Cond December 31 2= June 17 2023 No April 24, 2023 April 24, 2023 plc Form W=9 Request for Taxpayer Give Form to the (Rev. October2018) Identification Number and. Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service ► Go to www.irs.gov/FormW9 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. Bean Electrical, LLC 2 Business name/disregarded entity name, if different from above CO �P 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the Y 4 Exemptions codes apply only to P� ( PP Y Y m following seven boxes. certain entities, not individuals; see o o ❑✓ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate instructions on page 3): to single -member LLC Exempt payee code (if any) a o ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► `o M.�, 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 LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is LLC that is disregarded from code (if any) a c another not the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that w is disregarded from the owner should check the appropriate box for the tax classification of its owner. m ❑ Other (see instructions) ► (Applies to accounts maintained outside the U.S.) fn 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional) al Un 821 E. Enon Ave. 6 City, state, and ZIP code Fort Worth, TX 76140 7 List account number(s) here (optional) ■�:iM 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 (SSN). However, for a I I I - m 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 Employer identification number Number To Give the Requester for guidelines on whose number to enter. FR - 2I0I4I1I7 5 OI JIM Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); 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 o m 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 d' ' nds on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secure petty, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, yo are n equired to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. Sign Signature of Here I U.S. person ► Date ► General InstruC:llons • Form 1099-DIV (dividends, including those from stocks or mutual funds) 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/F6rmW9. 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-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-g (Rev. 10-2018) BE,-,A-N EL----,E,, C-TRIC AL, LL.G. 821 F. Enon t vvi- w Fool N-V*or1h, Texas 761 -1.0 tti�►3c.1 ;un-IL•ru•ical.t•nno c June 15, 2023 City of Fort Worth Clint Hoover Engineering Manager 200 Texas Street Fort Worth, Texas 76102-6314 Facsimile: (817) 392-8654 P 8 17-i61-7.1.00 N 817-.561-7-103 I am sending this notice pursuant to our contracts with the City of Forth Worth CSN #55733 Area 1, CSN #53451 Area 2, CSN #53376 Area 3, CSN #55732 Area 4. On May 1, 2023, Bean Electrical, Inc. (the "Company") entered into a transaction which resulted in a change of ownership pursuant to which all of the equity of the Company was acquired by Lumin8 Transportation Technologies, LLC ("Lumin8"), a Colorado -based intelligent transportation systems, traffic signal, and street lighting provider (httDs://Iumin8.com/). As part of the acquisition, Bean Electrical, Inc. converted into Bean Electrical, LLC through the filing of a certificate of conversion with the Secretary of State of Texas. While the ownership and name have changed, the Company's operations and EIN remain the same as before. Please find attached an updated W9 for your records. Let me know if you have any questions. We look forward to continue providing the best service to the City of Fort Worth and expanding our offerings with the support of Lumin8. Sincerely Chip Bea " V.P. SW Region CC: Fort Worth City Attorney's Office 200 Texas Street Fort Worth, Texas 76102 Bean Electrical, LLC. TECL17979 Regulated by The Texas Department of Licensing and Regulations, P.O. Box 12157, Austin, Texas 78711, 1 800 803 9202, 512 463 6599, website www,llcense,state,tx,us/comolalnts