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Home My WebLink About302392 08/25/16 CITY OF CARMEL, INDIANA VENDOR: 371035 (i� f ONE CIVIC SQUARE JIMMY JOE PHARIS CHECK AMOUNT: $***"""'160.00* CARMEL, INDIANA 46032 505 S HARBOUR DR CHECK NUMBER: 302392 MUTON�, NOBLESVILLE IN 46062 CHECK DATE: 08/25/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4341992 073016 160.00 SECURITY SERVICES Voucher No. Warrant No. Pharis, Jimmy Joe Allowed 20 505 S Harbour Dr Noblesville, IN 46062 In Sum of$ $ 160.00 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members Dept# 1091 Ck Request 4341992 $ 160.00 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 17, 2016 1P Signature $ 160.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund 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. Pharis, Jimmy Joe Terms 505 S Harbour Dr Noblesville, IN 46062 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 8/11/16 Ck Request Security Services 7/30/16 40445 $ 160.00 Total $ 160.00 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 AUG2016 Fore- W-9r Request for TaXpay Give Formto the (Eley.Dertofih Treasury Identification Number and Certification requester. Do riot Gepa•tnrrtoftne?rasiry Send t0 the IRS. Internal RevenU6 Servi,_E 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. Jimmy Joe Pharis N 2 Business name/disregarded entity name.if different from above c� C CO e- 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to C certain entities,not individuals:see w ❑✓ Individuallsole proprietor or. ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust:estate instructions on page 3): d e single-mamber LLC 4 e Exar,,pt payee code(if any) ❑Limited liability company.Enter the tax classification(C=C corporation,S=S corporation.P=pannership)a- `a 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 reposing «� the tax classVication of the single-member ovmer. code(if any) ,C C A es to acWn[3 mantanetltwlsifne U.S. p, u ❑Other(see instructions)► v 5 Address(number..street,and apt.or suite no.) Requzster's name and address(optional) 9 505 S Harbour Dr y 6 City,state,and ZIP code Noblesville,IN 46062 7 List account number(s)here(optional) JUM Taxpayer Identification Number(TIN) 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.For individuals,this is generally your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a TM 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. 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. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have riot 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 i;you have been notified by the IRS that you arc currently subject to backup withholding because you have failed to report all interest and dividends on your tax reiurn.Por real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an i idividual retirement arrangement(IRA),and generally,payments other than i erest and 'vid ou are not required to sign inc certification,but you must provide your correct TIN See the instructions on page 3. /) Sign Signature of -- -- — - — —._�.,-- ------- —------ / /� Here u.s.person► ► r Date General Instruetio •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T (tuition) Section references are to the In al Revenue Code unless otherwise noted. •Form 1099-C(canceled debt) Future developments.Informs' n 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 wwov.frs.gov/fw9. Use Form W-9 only if you are a U.S.person(including a resident alien),to Purpose of f=orm provide your correct TIN. An individual or entity(Form W-9 requester)who is required to file an information 1f you do riot return Form W-9 to the requester with a 71N,you might be subject return with the IRS must obtain your correct taxpayer identification number(TIM) 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: numuer(ITIN),adoption taxpayer identification number(ATIN),or employer 1.Certify that the TIN.you are giving is correct(oryou are waiting 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 1099-INT(interest 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 partnership 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-B(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 Whatis 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) VVV Carmel ® Clay Parks&Recreation CHECK REQUEST Date: August 11,2016 Check payable to: Name: Jimmy Joe Pharis Address: 505 S Harbour Dr City,State,Zip Noblesville, IN 46062 _XX Mail check to payee Return check to requestor Check Amount:$ 160.00 Date Required: Purpose of Check: Security Services 7/30/16 Supporting documentation or invoice(s)MUST be attached. To be paid from: PO#(if applicable) 40445 Budget account-GL# 1091-4341992 Budget Line Description Security Services Requested by(print): Paula Schlemmer Requested by(signature/date): Approved by(print): Audrey Kostrzewa Approved by(signature/date) Form recreated 3/10/15(Business Services)