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Home My WebLink About251008 1 1 /04/1 5 '..�,q�' CITY OF CARMEL, INDIANA VENDOR: 369981 i' ONE CIVIC SQUARE BRATEMAN'S CHECK AMOUNT: S""`""940.00' CARMEL, INDIANA 46032 5326 COLDWATER ROAD CHECK NUMBER: 251008 9.y�, �o;r FORT WAYNE IN 46825 CHECK DATE: 11/04/15 . TON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4239011 33212 M615 940.00 FUSES ROAD FLARES BMTEMAN'S INC MWQ)Rff� 5326 COLDWATER RD FORT WAYNE, IN 46825 Invoice Number: m615 Invoice Date: Oct 25, 2015 Page: 1 Voice: 260-484-8665 Fax: 260-484-8713 Bill To: Ship to: CARMEL POLICE DEPARTMENT CARMEL POLICE DEPARTMENT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46038 CARMEL, IN 46038 Customer ID Customer PO Payment Terms CARMEL POLICE DEPT Net 30 Days Sales Rep ID Shipping Method Ship Date Due Date 11/10/15 Quantity Item. Description Unit Price Amount 20.00 FLARES 47.00 940.00 Subtotal 940.00 Sales Tax Total Invoice Amount 940.00 Check/Credit Memo No: Payment/Credit Applied TOTAL 940.00 I Form WW9 Request for Taxpayev Give Form to the rfifiester. (Rev.December 2014) 6dentifteelon NuMber au id Cecaton send requio fileDo not Department of the treasury IRS. Internal Revenue Service _ -1 Name.*shown on your income tax return). arne is required an this line;do not leave this line blank. 2 Business (D co o- 3 Check appropriate box for federal tax classification;check only,9&of the following seven boxes: .71Y to r_ Check I . Exemptions d;i. d.1 see ❑Individuallsole proprietor or 0 C Corporation EOSCorporation M Partnership ❑Trustlestale, �E2tionisi.-n'!:-t Ir3 page 4) r- single-member ILC Exempt payee code(if any) 0 ❑bmitiid liability company.Enter ft tax classification(C--C corporation,S=S corporation,P=partnership)1* Note.For a singie-m6mber LLC that is disregarded,do not dw&LLC;check the appropriate box in the line ab6v6 for Exemption from FATCA reporting thitaii classification of the single-memberbwner.' code(f any) a— ❑Other(see instructions)C* it.usa S'AdOress(ELurpber, and pt;or suite no.) Requester's name and address(optional) Z W a I 6 Ci state,and ZIP code \ U) i�8 If�- Wo, -re11 1 N L+ 62-5 7 Wt account numbers)here Joptional) 11M Taxpayer Identification_umber(TIN) Enter your-nN in theappropfiAte box.,The-nN provided must match the narnegiv6n on Ii6e to avoid J I�securt�iy number backup y-vithho'l8in-4.For-individuals,.this,is generally your social security'number(SSN).However,fora resident alien,-sole proprietor,or disregarded entity;see the Fart I i iis6tions on 6aiie3.For-other _M _FJ T_ entities,it is your,employer identification number(EIN).Ifbei,jee How to get a you do not,have a nurn 77N on page 3. or Note.if the account is in more than one name,see the Instructions for line 1 and the chart on page 4,for Employer identification number guidelines on whose number to enter- A-,% A_ Cerfift-ation , Under penditi6i of penury,I certify that 1: The number shown on this forth is my correct taxpayer Identification number(or I am waiting for a number to be issued to me);and 2. 1 am not subject to backup withhoidihg because:(a)I am exempt fnom,backup withholding,or(b)I have not been notified by.th6 Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report.,all interest ordiVi I d-ends,or(c)the IRS has notified me that,I am no longer subject to backup withholding;and -3. 1 am a U.S.citizen or other U.S.person(defined below);and '4..Th-e FATCA dode(s)entered on this form(if any)indicating that I am exempt from FATCA reporting Is correct. Cdrtifi6aticin instructions.You must cross out item 2 above if you have been notified�by the IRS that you are currently.subject to backup withholding beciausb,you have failed to report 91 interest and dividdni dson you L r tax x petum.For realestate transactions,item 2 does ikapply.For mortgage interest pald',acq'Ulsition or abandonment,of secured,property,cancellation of debt contributions to d6 individual,retirerriehl:ariangement ORA);and generally,payments other than int7er?�t and dividend i,you are not reiquired to sig, b m"' W rithecertification, utyou,must provi.e your correct TIN.Sea the instructions on page 3. Sign Signature of 57' Here. I U.S.person D Date 0- ,i Form 1098(home mortgage interest),;098-E nt deloan interest),IMB-T General Instructions (tuition) Section references are to the Internal Revenue'Code unless otherwise noted. a Form 1099-C(canceled debt) Future developments,Information about developments affecting Form W-9(such -Form 1099-A(acquisition or abandonment of secured property) as legislation enacted after we release it)is at wwwJmgov/Av9. Use Form WT9 only If you are a U.S.person(including a resident alien),to Purpose of Form provide your correct TIN. An individual or entity(Form W-9 requester)who is required to file an information ffyou do not return Fbrm W-9 to the requester with a TIN,you might be subject return with the IRS must obtain your correct taxpayer identification number MN) to backup withholding See What is backup withholding?on page 2. which may be your social security number(SSN) individual taxpayer Identification By signing the filled-out form,you: ,number(ITIN),adoption taxpayer identification number(AMM,or employer 1.Certify that the TIN you are giving is correct(or you are waitirig for a number identification number(Eft to report on an information return the amount paid to to be issued), you,or other amount reportable on an information return.EJtarnples of Information Atums include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or •Form 1.099-INT Werest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If •Form 1099-DIV(dividends,including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of any partneiship income from a U.S.trade or business is not subject to the •Form 1099-MISC(various types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively'connected income,and •Form 1099-8(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this;form(if any)indicating.that you are brokers) exempt from the FATCA reporting.Is correct.See What is FATCA repording?on •Form 1099-S(proceeds from real estate transactions) page 2 for further information. •Form 1099-K(merchant card and third party network transactions) Cat No.10231X Form W-9(Rev.12-2014) City ®J� Carmel INDIANA RETAIL TAX EXEMPT PAGE 1Jlr J CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT X292 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 90 is BI elfvan'a Carmel Pollee Dop rtmon4 VENDOR SHIP 3 Citric Rqu= 6 M2 Coleser Rd TO Camol, IN 4M Ft. %Ikmo, IN 4M (31 G)671.2m CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT i QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 42-M.11 20 Each Fusees/road Dares M7.00 $040.00 Slab Total: $940.00 0 .>. I • a Send Invoice To: '^ 'VC_ Carmel Police Depaftment Attn: P@4 Young 3 Civic squm Camel, IN 4 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT ICarmel Police Dept. A, � PAYMENT %40.00 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THATATHERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. PROPRIA,I THIS APN SUFFICIENT TO P Y FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY p SHIPPING LABELS. C o1 P®llea •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE J VOUCHER NO. WARRANT NO. ALLOWED 20 _ IN THE SUM OF$ r. ON ACCOUNT OF APPROPRIATION FOR c� Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I 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 20 ------------— --- - -.._..--...----- ._...-_..................... Signature ......................................................................................... ............................................. - --....... - ..-... Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 10/25/15 m615 Fusees $940.00 1 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 i VOUCHER NO. WARRANT NO. ALLOWED 20 Brateman's IN SUM OF $ 5326 Coldwater Rd Ft. Wayne, IN 46825 $940.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 33212 ( m615 I 42-390.11 I $940.00 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 Frida , October 30, 2015 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund