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Home My WebLink About237905 10/08/14 (9, CITY OF CARMEL, INDIANA VENDOR: 367628 ONE CIVIC SQUARE MAGNA PLUMBING INC CHECKAMOUNT: $'•"'2,265.90'CARMEL, INDIANA 46032 4922 ROCKNE CIRCLE CHECK NUMBER: 237905 CARMEL IN 46033 CHECK DATE: 10/08/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4350100 2,265.90 BUILDING REPAIRS & MA Magna Plumbing Inc. 4922 Rockne Circle Carmel, IN 46032 info@magnaplumbing.net (317)575-4399 September 30,2014 Customer Name: Carmel Fire Department Contact: J. Moriarty Address: Station 41 Headquarters Attn: Denise Snyder 2 Civic Square Carmel,IN 46032 Invoice Work completed; • remove two old water fountain • install two new water fountain Elkay EHFSA8 SS $732.95 each (before tax) Labor for fountain install $400.00 each Total Due: Labor and Materials $2,265.90 Form W-9 Request for Taxpayer Give form to the (Rev.January 2003) Identification Number and Certification requester. Do not Depar mere of the Treasury send to the IRS. Internal Revenue Service N Name CL Business na e,if d'Ifferent from above c 0 rn IndividuaV Exem t from backup ` Check appropriate box: El Sole proprietor Corporation ❑ Partnership ❑ Other► __________________ ❑ withholding t.5 Address( surae.and apt. no.) Requester's name and address(optional) a`� u City,s d ZIP code CL yList account number(s)here(op oval) CD to Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.For individuals,this Is your social security number(SSN). Social security number However,for a resident alien,sole proprietor,or disregarded entity,see the Part 1 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. or Note:If the account is in more than one name,see the chart on page 4 for guidelines on whose number to identification num r to enter. IMM 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 1 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.person(including a U.S.resident alien). 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 you tax return.For real estate transactions,item 2 does not apply. For mortgage Interest paid,acquisit or abandonment of secured property, ncellation of debt,contributions to an individual retirement arrangement(IRA),and generally, y ents other than interest atV dividend , ou are not required to sign the Certification,but you must provide your correct TIN.(See the Insnpctions on page Sign Signature of qHere D.S.person ►/ Date I J V Purpose of Form Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the A person who is required to file an information return with terms of a tax treaty to reduce or eliminate U.S.tax on the IRS, must obtain your correct taxpayer identification certain types of income. However, most tax treaties contain a number frIN)to report, for example, income paid to you,real provision known as a "saving clause."Exceptions specked estate transactions, mortgage interest you paid, acquisition in the saving clause may permit an exemption from tax to or abandonment of secured property,cancellation of debt, or continue for certain types of income even after the recipient contributions you made to an IRA. has otherwise become a U.S.resident alien for tax purposes. U.S.person.Use Form W-9 only if you are a U.S.person If you are a U.S.resident alien who is relying on an (including a resident alien),to provide your correct TIN to the exception contained in the saving clause of a tax treaty to person requesting it(the requester)and,when applicable,to: claim an exemption from U.S.tax on certain types of income, 1. Certify that the TIN you are giving is correct(or you are you must attach a statement that specifies the following five waiting for a number to be issued), items: 2.Certify that you are not subject to backup withholding, 1. The treaty country. Generally,this must be the same or treaty under which you claimed exemption from tax as a 3. Claim exemption from backup withholding if you are a nonresident alien. U.S.exempt payee. 2. The treaty article addressing the income. Note: If a requester gives you a form other than Form W-9 3. The article number(or location) in the tax treaty that to request your TIN,you should use the requester's form. contains the saving clause and its exceptions. However, this form must meet the acceptable specifications 4.The type and amount of income that qualifies for the described in Pub. 1167,General Rules and Specifications for exemption from tax. Substitute Tax Forms and Schedules. 5. Sufficient facts to justify the exemption from tax under Foreign person.If you are a foreign person,use the the terms of the treaty article. appropriate Form W-8(see Pub. 515,Withholding of Tax on Nonresident Aliens and Foreign Entities). Cat.No.10231X Form W-9 (Rev.1-2003) VOUCHER NO. WARRANT NO. ALLOWED 20 Magna Plumbing IN SUM OF$ i 4922 Rockne Circle Carmel, IN 46033 $2,265.90 1 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-501.00 $2,265.90 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except OCT - 6 2014 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund i j i Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) $2,265.90 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer