Okaloosa County BOCC — March 15, 2016 — The Agency Group invoice

Cummins Station Phone: 615 564 2580 209 10th Avenue South Suite 511 The Fax: 615 564 2585 Nashville, Tennessee 37203 Booking Agent: Alec Vidmar United States Geoup Lid DEPOSIT INVOICE FOR CONTRACT # 115232 Artist: Chris Janson Promoter: Okaloosa County Show(s): Due Date Venue City May 12, 2016 Emerald Coast Convention Ft. Walton Beach, United States Center Payments: Deposits to The Agency Group Inc. by certified check or bank ACH quoting reference 115232 Due Date Comment Amount Due Mar 19, 2016 50%, 60 days prior 20,000.00 USD Total due 20,000.00 USD Payments by bank ACH to United Talent Agency, LLC quoting reference #115232 Bank: City National Bank 400 N Roxbury Dr, Beverly Hills, California 90210, United States Sort Code: Account #: 123947126 Swift: Currency: USD IBAN #: BIC #: ABA #: 122016066 Transit #: Promoter must advise their bank that funds are to be paid as per the requested currency and not converted by an intermediate or remitting bank Page 1 of 1 Company reg No: Registration No: W-9 Form (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. The Agency Group Inc. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank 2 Business name/disregarded entity name, if different from above D Individual/sole proprietor or C Corporation single-member LLC the tax classification of the single-member owner. D Other (see instructions) » Print or type 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: [:] S Corporation D Partnership D Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) » Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for 4 Exemptions (codes apply only to certain entities, not individuals: see instructions on page 3): Exempt payee code (if any) D Trust/estate Exemption from FATCA reporting code (if any) (Applies o accounts mantained cutside the U.S 5 Address (number, street, and apt. or suite no.) 209 10th Avenue South, Suite 511 Requester’'s name and address (optional) 6 City, state, and ZIP code Nashville, TN 37203 See Specific Instructions on page 2. 7 List account number(s) nere (optional) Taxpayer ldentification 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 Part | instructions on page 3. For other - - entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. [ Social security number or Employer identification number ] 114 -/ 1|18|8(6|9|5]|2 Part i Certification Under penalties of perjury, | certify that: 1. 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. am 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 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 | 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 back