The URL can be used to link to this page

Home My WebLink About301834 08/11/16 CITY OF CARMEL, INDIANA VENDOR: 370986 ONE CIVIC SQUARE PAT CARROLL CHECK AMOUNT: $`****1,040.00* CARMEL, INDIANA 46032 624 VIA SANTA PAULO CHECK NUMBER: 301834 VISTA CA 92081 CHECK DATE: 08/11/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4239039 070516 1,040.00 GENERAL PROGRAM SUPPL Voucher No. Warrant No. Carroll, Pat Allowed 20 624 Via Santa Paulo Vista, CA 92081 In Sum of$ $ 1,040.00 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1096-40 7/5/16 4239039 $ 1,040.00 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 August 8, 2016 Signature $ 1,040.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Carroll, Pat Terms 624 Via Santa Paulo Vista, CA 92081 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 7/5/16 7/5/16 Picklosophy Workshops 6/822, 6/23/16 40274 $ 1,040.00 Total $ 1,040.00 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 CE �3 Fe><mm W`9 Re41.10,st for Taxpaye AN 14'2016 1 live Form to the (Rev.August2in3) identification dumber and Ce ification eq°este:'Do not Ntrtmegc„nt�S� rt' Ir and to the IRS. Name(as shown on your income tax retum) —-- —-- Pa t3 Business rtameldisregarded entity name,if different from above i p I n c Check appropr)ete box for federal tax classification: ' Exemptions(see instructions): ° ❑lndividual/so(e proprietor ❑ C Corporation ❑S Corporation [ Partnership ❑Trusilestate, CL a Exempt payee code Of any) cU ❑ United tiabilily compaly.Enter the tax classification(C=C corLEtion,S=S corporation.P=partnership)t Exemption!roar FATCA reporting code(ii any) CL u ❑ other(see iristrvcflws)f ;b Address(number,sueft,and apt.or su:e no.) r Requester's name and address{optional) u � HiQ �?n :� • City,state,and ZIP code List account numbers)Kere(optional) Taxpayer identification Number(TIN) Enter your TIN In the appropriate box.The TIN provided must math the name given on the"Name"line socfai security number to avoid backup withholdinO.For individuals,this is your social se,urity number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Part I finsituctions on page 3.For other (� 7 4 —W — Z L y entitles,It is your employer identification number(EIM.If you do not have a number,see Flow to get a TIN on page 3. Note.If the!account is In more than one name,see the chart on page 4 for guidelines on whose Emptoyeridentitieztion numher number to enter. --1 I I iTni I M Certification Uader penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identiflrtion number(or I am wailing 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 wrrhhoiding as a result of z 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 foFm(if any)indicating that I am exempt from FATCA reporting is correct- Certification instructions.You must cross out item 2 above ii 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 secure6property,caheeilation 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 on page 3. Sign signature of iiP�e U.S. person P, Date► General instructions 4 withholding tax an foreign pann 'share eHeceivelyconnected income,and 1 4.Cerny that FATCA codes)ordered on this Corm Qf any)indicating that you are Section referenges are to the Internal Revenue Code unless otherwise Hated. exempt from the FATCA reporting,is correct Future developments.The IRS has crealed a pane on IRS.gov for lnformstion Note.if you are a U.S.parson and a requester gives you a form other than Form about Form W-9,at i vs3:ieri,povlx9.information about any future develop rds affecting Form W-9(such is legislation enacted after we release a)will be 4osted si i to requestorm W-N,you must use the raauester's form H it's substantially a sirtu'iev to this Farm W-9. on ttml page. Definition of a U.S.person.For federal tax purposes,you are considered E U.S. Purpose of Form ( person H you an: A person who is required to rite an information return with the IRS must ob sin your -An individual who is a U.S.citizen or U.S,resident alien, correct taxpayer ldentlficgion number(TIM to report,for example,income paid to •A partnershlp,corporation,company,or association created or organized in the you,payments made 10 you in settlement of payment card and third part'w1work United States or under the laws of the United States, transactions,real estate transactions,mortgage Interest you paid,acquis n or •An estate(other than a foreign estate),or abandonment of secured property,cancellation of debt,or contributions y)u made ,A domeslietrust(as defined in Regulations section 301.7701-7). to an iRtt. Use Form W-9 only if you are a U.S.person Qncludatg a resident alien), o Special rules for partnerships.Parineuahipz that conduct a trade or business in provide your correct-11N to the person requesting it(the requester)end,w I an the United States are generally required to pay a withholding tax under section applicable,to: 1440 on any foreign pariners'share at effectively connected tax-able income from such business.Further,in certain cases where a Form W-9 has not been received. 1.Certify that the TIN you are giving is corned(or yqu are waiting for a,r1rmber the rules under section 7446 require a parhserahip to presume that a partne r is a to be issued), foreign person,and pay the section 1446 withholding tax.Therefore.H you are a Z.Certify that you are not subjed to backup xdlhholdirrg,or ! U.S.person that is a partner in a partnership conducting a trade or business in the United States,arovide Form W-9 to the partnership to establish your Us.status 3.Claim exemption from backup withholding i1 you are a U.S.exempt payee.If and avoid section 1446 vftholding on your share of partnership Income. appli,,abie,you one Pisa certifying that as a U.S.person,your enoceble ehl(re at any partnership income from a U.S.trade or business is not subject to the cal.Wo.10231X Form w-9(Rev,9.2e13) i f= _.J 11 AUGog I INVOICE �D- ate• 07/0i5/7 6 r:w` `:``- / NAME: rPat,Carrol'I',: ADDRESS: 624 Via S'antaiParulo ~� CITY/STATE/ZIP: Vista., CA:r9208] :w.t_f .�1 PHONE: (760)310-6847 Date Program Rate Total Amount 6/22/16 Pat's Picklosophy Workshop $40.00 $560.00 9:00-11:00am 14 participants 6/23/16 Pat's Picklosophy Workshop $40.00 $480.00 5:00-7:00pm 12 participants T(OTAI_.k. CX-2040:0-0- CHECK PAYABLE TO: Pat Carroll ADDRESS: 624 Via Santa Paulo CITY/STATE/ZIP: Vista, CA 92081