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Town of Wickenburg Commercial Facade Grant Application Organization Name: Prubcee Jae LLO (Johnson's Build ng ) Address: (AOS, 322% Ave Wukenburg, AZ 35390 Phone: (002-677-Allos 2" Phone: Email: Veal cindy @ Ua hoo.com Contact Name and Title: Cindy Cncishang Real Owne — Scope of Work: Viease. eo gtacheol Grant Reguest/ Scwee of Work Document. Funding Amount Requested: $ } O, 000 CAML Owner 731125 Authorized Agency Representative Cindy CheeStran Bea/ Title Date Wickenburg Downtown Revitalization Grant Request Aubreejeane LLC Johnsons Building As a property owner in the heart of historic downtown Wickenburg, | am requesting grant support to restore and improve the exterior of my building, which recently sustained significant damage after being struck by a semi-truck. These repairs will not only restore the structure of the building but also improve the visual aesthetic of a prominent property in the heart of downtown Wickenburg. Using high-quality, durable materials and design that reflects the town's heritage, this project will contribute to Wickenburg's ongoing beautification efforts while ensuring the building remains resilient for years to come. Investing in this restoration strengthens the character of our community and helps maintain a vibrant, welcoming atmosphere for everyone who experiences downtown Wickenburg. Scope of Work The planned project will involve restoration of the building’s exterior, beginning with the implementation of traffic and pedestrian safety measures. Barriers and signage will be installed to safely redirect foot and vehicle traffic during construction. The initial phase will include demolition of the damaged exterior wall and removal of all compromised materials. Following demolition, new framing will be constructed to restore the structural integrity of the building. Once framed, the wall will be re-covered with stucco to match the original texture and finish. After the stucco application and curing, the exterior will be repainted to match the existing exterior color. Additionally, the existing metal roof will be repaired or replaced as needed to ensure full weatherproofing and structural safety. A dumpster will be rented and placed on-site throughout the duration of the project to manage construction debris responsibly and maintain a clean and organized work area. Town of Wickenburg 155 N Tegner Street, Suite A Wickenburg, AZ 85390 utilities@wickenburgaz.GOV Office hours are Monday - Thursday 7:00am - 6:00pm Remove Account Have your bill paid automatically each month with Xpress Bill Pay's hassle-free Auto Pay feature. Billing Address Service Address Account Information Aubreejeane LLC 1340 S. 323rd Avenue Due Date 03/15/2025 PO Box 931 Wickenburg AZ 85380 Account Number Wickenburg, AZ 85358 ae = Select Billing Period 3/15/2025 LICENSE NUMBER LICENSE DESCRIPTION STARTDATE END DATE | Total Charges 7743 Standard License | 1/1/2025 12/3/2025 ~ Standard Business - One Year $50.00 License Charges $50.00 Previous Balance -$50.00 Statement Balance $0.00 Total Amount Due $0.00 The information displayed here is provided by Town of Wickenburg. if there is a discrepancy, please contact Town of Wickenburg. Please note that this bill is only displaying payments made on or after 02/19/2025. Payments made directly to Wickenburg may or may not be displayed here. Request for Taxpayer Identification Number and Certification Go to www.irs.gov/FormW39 for instructions and the latest information. Give form to the requester. Do not send to the IRS. Form W i) (Rev. March 2024) Department of the Treasury Internal Revenue Service Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. 4 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded entity's name on line 2.) wD cee. \ean'e LLC 2 Business name/disregarded entity name, if different from above. 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes. Oo Individual/sole proprietor | C corporation oO S corporation Oo Partnership Oo Trust/estate Pre. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) ee Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner. oO Other (see instructions) Exempt payee code (if any) Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) Print or type. See Specific Instructions on page 3. ‘3b If on line 3a you checked “Partnership” or “Trust/estate,” or checked “LLC” and entered “P” as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries, See instructions . - eo te ee & (Applies to accounts maintained outside the United States.) 5 Address (number, street, and apt. or suite no.). See instructions, Requester's name and address (optional) 1B4O S, BU2S Ave 6 City, state, and ZIP code Wicker burma AZ 35340 7 List account number(s) here (optional) v Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part |, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or TIN, later. | Social security number [Employer identification number ] Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. 5) b i 4 9 g L} oO d a sie Certification Under penalties of perjury, | certify that: 4. The number shown on this form is my correct taxpayer identification number (or | am waiting for a number to be issued to me); and 2. 1am not subject to backup withholding because (a) | am exempt from backup withholding, or (b) | have not been notified by the Internal Revenue Service (IRS) that | 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 | am no longer subject to backup withholding; and 3. lam aU.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that | 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 Il, later. Sign CAMARLP owe OS |125 Signature of U.S, person Here General Instructions New line 3b has been added to this form. A flow-through entity is 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, What’s New Line 3a has been modified to clarify how a disregarded entity completes this line, An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the “LLC” box and enter its appropriate tax classification. required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065). Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat. No. 10231X Form W-9 (Rev. 3-2024) Estimate US WEST LLC ESTIMATE NO. 068 ISSUE DATE 7130/2025 VALID UNTIL 8/30/2025 FROM FOR US WEST LLC Cindy Christian-Aubreejeane LLC Johnson 4934 W Saint Exupery Drive Building Anthem AZ 85086 72.N. Tegner Street United States Wickenburg AZ 85390 United States DESCRIPTION QUANTITY UNIT PRICE ($) DISCOUNT % AMOUNT ($) Traffic/Pedestrian Control & Safety 1 4,367.59 0.00 4,367.59 Includes Labor, Labor Burden, Equipment, and Materials: «Build temporary ADA approved sidewalk path using concrete barriers. «Block off four parking spaces directly in front of work area. +Pedestrian & vehicular signage. Demolition 1 4,381.76 0.00 4,381.76 Includes Labor, Labor Burden, Equipment, and Materials: *Remove damaged metal roof panels (6}, metal roof trim, fasteners, and underlayment. «Remove damaged wood framing (fractured facia and rafters). *Remove damaged stucco (soffit). *Ciean up debris and haul off. Framing 1 3,459.86 0.00 3,459.86 Includes Labor, Labor Burden, Equipment, and Materials: +Rebuild framing at damage area (rafters, facia, and soffit sheathing). Stucco 1 3,948.27 0.00 3,948.27 Includes Labor, Labor Burden, Equipment, and Materials: Replace lathe at damaged soffit area «Install stucco over lathe at damaged soffit area. Painting 1 2,473.98 0.00 2,473.98 Includes Labor, Labor Burden, Equipment, and Materials: +*Repaint damaged area with one coat of primer and two coats of exterior paint. Paint color to match existing building as close as reasonable. Metal Roof 1 3,592.54 9.00 3,592.54 Includes Labor, Labor Burden, Equipment, and Materials: «Install new roofing underlayment at damaged area. «Install new metal facia and drip edge trim. «Install new metal roof panels (6). «Install new fasteners and sealant. Dumpster 1 1,479.20 0.00 1,479.20 14 day rental for a 20 yard dumpsterr Total (USD): Attachment 1 Attachment 2 $23,703.20 PZ 4 7 ye y iy