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AP Email * Require PO for Payment Agreement
Airlogix Terms of Service: Thank you for choosing Airlogix. In order to dispatch a technician to your location, please fill out this form and return to us at your earliest convenience. By completing this form, you agree to the following terms. Airlogix will not be responsible for any equipment services performed by any Company other than Airlogix after the date of last service. Payment terms are Net 30 days. Invoices are due within 31 days of date of service. Payment can be made via Check, Money Order, Credit Card or ACH. Credit Card transactions are subject to a 3% convenience fee. Airlogix agrees to provide service to customer on an As-Needed basis at the agreed upon rates for labor provided. Please note the following categories for labor rates: Regular Time is considered Monday-Friday from 8:00am to 3:59pm; Overtime is considered Monday-Friday from 4:00pm to 7:59am and Saturdays; Double Time is considered Sundays and Holidays from 12:01am to 7:59am.The minimum charge for every service is (2) hours of labor plus a Trip Charge.
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Card Holder Name
Request for Taxpayer Identification Number and Certification. Go to www.irs.gov/FormW9 for instructions and the latest information.
Tax Payer Name *
As shown on your tax return
tax_classification * Tax Payer Address
* List Account Numbers Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.
Under penalties of perjury, I certify that:
1.The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2.I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal RevenueService (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 amno longer subject to backup withholding; and
3.I am a U.S. citizen or other U.S. person (defined below); and
4.The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
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 mutualfunds)
•Form 1099-MISC (various types of income, prizes, awards, or grossproceeds)
•Form 1099-B (stock or mutual fund sales and certain othertransactions 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 residentalien), 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.