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HomeMy WebLinkAbout257325 04/05/16 4eq CITY OF CARMEL, INDIANA VENDOR: 370379 1 ONE CIVIC SQUARE TYLER TECHNOLOGIES, INC. CHECK AMOUNT: $*****2,085.00* ,� ,�; CARMEL, INDIANA 46032 840 W.LONG LAKE ROAD CHECK NUMBER: 257325 �'��iori�°' TROY MI 48908 CHECK DATE: 04/05/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 33720 048373 2,085.00 NEW WORLD CONF REGIST 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 Date Invoice# Description Amount Dept. Fund# (or note attached invoice(s)or bill(s)) 03/03/16 048373 New World conference registration-Bricker $2,085.00 1110 210 I hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 TYLER TECHNOLOGIES, INC. 840 W. LONG LAKE ROAD IN SUM OF$ TROY, MI 48908 $2,085.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police �P0#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member: 3372- ; 048373 43-570.00 $2,085.00 I hereby certify that the attached invoice(s), or 1110 I I 210 I 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 Monday, March 14, 2016 Cost distribution ledger classification if claim paid motor vehicle highway fund Form W-9 Request for Taxpayer Give Form to the (Rev.December 2014) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue 9etvlce I Name(as shown on your Income tax return).Name is required on this line,,do not leave this fine blank. Tyler Technologies,Inc. N 2 Business name/disregarded entity name,if different from above g, New World Systems Corporation merged with and into Tyler,with Tyler being the surviving entity 11.16.15 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(oodes apply only to certain entitles,not individuals;see y ❑IndividuaUsolo proprietor or ❑✓ C Corporation ❑S Corporation ❑ Partnership ❑Trustlestate instructions on page 3): single-member LLC Exempt payee coda Qt any) E]Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)10- o Note.For a single-member LLC that Is disregarded,do not check LLC;check the appropriate box in the line above for Exemption from FATCA reporting the tax classification of the single-member owner. codef an El Other(see Instructions)Ill- f�apls ro occounfemernleN•dartsFa•R e vsd b Address(number,street,and apt.or suite no.) Requester's name and address(optional) 5101 Tennyson Parkway 6 City,state,and ZIP code Plano,Tx 75024 7 Ust account numbers)here(optional) REMITTANCE ADDRESS: Tyler Technologies,Inc. 840 W.Long Lake Rd.,Troy,MI 48098 __Taxpayer Identification Number IN Enter your TIN In the appropriate box.The TIN provided must match the name given on line 1 to avoid social security number backup withholding,s For individuals,this is generally your social security number(SSN).However,fora � —m — resident alien,solele proprietor,or disregarded entity,see the Part I Instructions on page 3.For otherFTM entities,It Is your employer identification number(EIN).If you do not have a number,see Now to get e TIN 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 identNication number guidelines on whose number to enter. 7 5 - 2 3 0 1.3 1 91 2 F • Certification Under penalties of perjury,l 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. 1 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. 1 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 a (�ment of secured property,cancellation of debt,contributions to an Individual retirement arrangement(IRA),and generally,payments other th intafest a ends,you are not required to sign the certification,but you must provide your correct TIN.See the Instructions on page 3. $Ign Signature ofL4A f r� Here U.S.person► Date► J General Instructions •Form 1098(home mortgage Interest),1098-E(student loan lnterest),1098-T (tuition) Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-0(canceled debt) Future developments.Information about developments affecting Form W-9(suoh .Form 1099-A(acquisition or abandonment of secured property) as legislation enacted atter we release it)is at wwwrrs.g4W/Av9. Use Form W-9 only If you are a U.S,person(ncludlng 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 lfyou do not return Form W-9 to the requester with a TIN,you might be subject return with the IRS must obtain your correct taxpayer Identification number(riM to backup withholdln9.Sea What is backup wlthhofding?on page 2. which may be your social security number(SSM,Individual taxpayer identification By signing the filled-out form,you: number OTIM,adoption taxpayer Identification number(ATIN) or employer 1.Certify that the TIN you are giving is correct(or you are wafting for a number Identification number(EIN),to report on an Information return the amount paid to to be issued), you,or other amount reportable on an information return.Examples of Information returns Include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or •Form 10994NT Gnterest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If •Form 1099-DN(dividends,Including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of • various t any partnership Income from a U.S.trade or business is not subject to the Form 1099 MISC { types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and •Form 1099-B(stock or mutual fund sales and certain other transactions by 4.Carlo that FATCA code(s)entered on this form(if any)Indicating that you aro brokers) exempt from the FATCA reporting,is correct.See What/s FATCA reporting?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) p© INVOICE tyler- *0 technologies 840 W.Long Lake Rd. Troy,MI 48098 Invoice Number: 048373 (248)269-1000 Invoice Date: 3/3/2016 PO Number: Terms: Net 30 ATTN:Pat Young Customer ID: HAM1237 Carmel Police Department 3 Civic Square Carmel,IN 46032 Aegis 2016 Customer Conference 2,085.00 Carmel Police Department Kristy Bricker Aegis 2016 Customer Conference Item Total: Sales Tax Total: Invoice Total: $2,085.00 08760rpt v INDIANA RETAIL TAX EXEMPT Page 1 of 1 City ®_ Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 33720. ONE CIVIC SQUARE 35r60009.72 THIS NUMBER MUST APPEAR ON INVOICES,AIP CARMEL,.INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE . FORM.APPROVED BY STATE BOARD OF RCI CITY OF CARMEL-1997 PURCHASE.ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 3111/2016 370379 TYLER TECHNOLOGIES;INC., Carmel Police VENDOR .840 W. LONG LAKE ROAD. SH/P 3 Civic Square TO Carmel,:IN 46032- TROY; MI 489087 .CONFIRMATION BLANKET' CONTRACT, PAYMENTTERMS FREIGHT ' QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION. Department: 1110 Account, 43-576-.00 Fund:2,10Contlnwng`Education,' 1 Each New World Conference registration $2085.00. Sub Total $2,085.00 Send Invoice To: Carmel Police Kristy Bricker!-New World Conference 4/24-4/26 in Phoe-nix;AZ 3 Civic Square Carmel,IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT .$2,085.00. SHIPPING INSTRUCTION 'Alf?VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O..NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THEPROPER SWORN 'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN E 'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 ORDERED BY AND ACTS AMENDATORY THEREOF.AND SUPPLEMENT THERETO. TITLE CONTROL NO. 33720 CLERK-TREASURER