167-944-580
Name and Mailing Address / Nom et adresse postale
2173659 ONTARIO INC. O/A: FOREVER CARRIER 13 - 5225 ORBITOR DR MISSISSAUGA ON L4W4Y8 ATTENTION:JASKARANJIT SINGH
The CVOR Certificate or a copy must be surrendered on demand of a police officer. Not to do so is an offence.
Le certificat d'immatriculation IUVU ou une copie conforme de celui-ci doit ?tre pr?sente ? l'agent de police qui en fait la demande. Quiconque ne respecte pas cette directive commet une infraction.
Detach here / D?tachez ic
Issued pursuant to the Highway Traffic Act / D?livr? en vertu du Code de Ia route
Commercial Vehicle Operator's Registration Certificate Certificat d'immatriculation d'utilisateur de v?hicule utilitaire
Commercial Vehicle Operator`s Registration No. N? d'immatriculation d'utilisateur de v?hicule utilitaire
167-944-580
Name / Nom 2173659 ONTARIO INC.
O/A FOREVER CARRIER
Expiry Date / Date D'expiration
Y/A M D/J 2021 06 17
This certificate or a copy must be carried in each commercial motor vehicle being operated under the Commercial Vehicle Operator's Registration.
For a replacement, of a CVOR Certificate complete and submit a Commercial Vehicle Operator's Registration (CVOR) Replacement Application form. For corrections or information changes, complete and submit a Commercial Motor Vehicle Operator's Registration (CVOR) Update Application form. Application forms are to be submitted to: Ministry of Transportation, Carrier Sanctions & Investigation Office, 301 St. Paul St., 3rd floor, St. Catharines. ON L2R 7R4.
Pour le remplacement d'un certificat d'immatriculation IUVU , remplir et soumettre le formulaire de demande de remplacement d'un utilisateur de v?hicule utilitaire (IUVU ). Pour des corrections ou bien des demandes de mises ? jour de l'information, remplir et soumettre un formulaire de demande de mise ? jour d'un utilisateur de v?hicule utilitaire (IUVU ).
Les formulaires de demandes doivent ?tre soumis au: Minist?re du transport, Bureau de la s?curit? des transporteurs et de l'application des lois , 301 rue St. Paul, 3 ?me ?tage, St. Catharines On L2R 7R4
167-944-580 WB
U.S. Department of Transportation Federal Motor Carrier Safety Administration
1200 New Jersey Ave., S.E. Washington, DC 20590
SERVICE DATE September 27, 2010
CERTIFICATE
MC-717433-C 2173659 ONTARIO INC D/B/A FOREVER CARRIER BRAMPTON, ON, CA
This Certificate is evidence of the carrier's authority to engage in transportation as a common carrier of property (except household goods) by motor vehicle in interstate or foreign commerce.
This authority will be effective as long as the carrier maintains compliance with the requirements pertaining to insurance coverage for the protection of the public (49 CFR 387) and the designation of agents upon whom process may be served (49 CFR 366). The carrier shall also render reasonably continuous and adequate service to the public. Failure to maintain compliance will constitute sufficient grounds for revocation of this authority.
Jeffrey L. Secrist, Chief Information Technology Operations Division
NOTE: Willful and persistent noncompliance with applicable safety fitness regulations as evidenced by a DOT safety fitness rating of "Unsatisfactory" or by other indicators, could result in a proceeding requiring the holder of this certificate or permit to show cause why this authority should not be suspended or revoked.
CMO
W-9 Form
(Rev. October 2018) Department of the Treasury Internal Revenue Service
Request for Taxpayer Identification Number and Certification
Go t o FormW9 tor instructions and the latest inf ormation.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
Give Form to the requester. Do not send to the IRS.
2173659 Ontario Inc
2 Business name/disregarded entity name, if different from above
Forever Carrier
(') Q)
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
following seven boxes.
4 Exemptions (codes apply only to cert ain entities, not individuals; see
C
. 0"'
Q) C
......>0...0: (.)
0 :.:.:.,
Individual/sole proprietor or
0 D C Corporation
S Corporation
D Partnership
D Trust/estate
single-member LLC
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)
Note: Check the appropriate b ox in the line above for the tax classification of the single-member owner. Do not check
instructions on page 3): Exempt payee code Of any) Exemption from FATCA reporting
?'-E -C;; 0:: -;
'+=
?13
Q) 0. (/)
LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that
code (if any)
is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions)
(Appfies to accounts maintained outside tm U.S.)
5 Address (number, street, and apt. or suite no.) See instructions.
Requester's name and address (optional)
Q) Q)
32
Rutherford Road South
6 City, state, and ZIP code
Brampton, ON L6W 3J1
7 List account number(s) here (optional)
?? !!J;T.
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.
[II] -[I] -I I I I I I Social security number
I
or
[ Employer identification number
9 8 -0 677 8 5 6
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. 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 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. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form Qf 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.
Sign Here
Signature of
U.S. person
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 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 (ElN), 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)
Date
? 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 TlN.
Ifyou 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. 10231 X
Form W-9 (Rev. 10-2018)
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