Loading...
HomeMy WebLinkAbout307850 02/06/17 CITY OF CARMEL, INDIANA VENDOR: 353831 CHECK AMOUNT: $*""""*"240.00" CARMEL SWIM CLUB i ONE CIVIC SQUARE 300 E MAIN ST,SUITE E CHECK NUMBER: 307850 CARMEL, INDIANA 46032 CARMEL IN 46032 CHECK DATE: 02/06117 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCROTHER FEES IP&IOLICENSES 1096 4358300 323 240.00 « (D 20 / / © 0 CD � Z 0 0 40 mak \ # \ K) 0 to k / 7 2 E / � q . a K \ { § o k ƒk i � 0p. / / CD / E n o \ / :3 -0 / ƒ a / J / C) -4 � / CD gR 2 z ( m 40 � m g E 2 2 ° k $ \ 0 o � Cl o 3E — D n � ; = _ CD i £ � ) ƒ $ mn i 0 E CL MUT a) n # Q a \ > q — 0 \ 2 , k u E 9 / k » ) In k ± CD - k 2 § & m o & \ & S C 2 g 7 g E ® kQ_0 ) \ f R S m - �\ $ a ° C | 2 CD Q 0 ; T ( - - i DEC 3 0 2016 �. Ive Folin to the Form 9 Request for TaxpayerBy, (Rev.December 2014) _ 1`and to thr.e Do not oeparrmentmttneTreasury Identification Number and Ce��diT===�=_`-. aendtotheIRS. Interttal Revenue Sorvice 1 Name(as shown on your income tax return).Name is required on this line:do not leave this line blank. Carmel Swim Club N 2 Business namefdtsregarded entity name,if different from above CL 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes appy only to e certain entities,not individuals;see C ❑Individuallsole proprietor or ❑✓ C Corporation ❑S Corporation ❑ Partnership ❑Trust estate instructions on page 3).- single-member ):single-member LLC Exempt payee code(d any) ❑Limited liability company.Enter the tax classification(C=C corporation,S-S corporation,P=pannership)► u Exemption from FATCA reporting p 2 Note.For a single-member LLC that is ds►egarded,do not check LLC:check the appropriate box in the line above for « the tax classification of the single-member owner. lode(t any) d ❑Other(see WwWc lons)► 1(Apra•w w—=n,•.A—d aerie•rn•US.� 5 Address(number,street,and apt.or suite no.) Requesters name and address(optionaQ a 300 E.Main Street Suite E 0 6 City.state,and 21P code th Carmel,IN 46032 7 List account number(s)here(optionall Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must thatch the name given on line 1 to avoid Social seuaity an.bar backup withholding.ole For individuals,this is generally your social security number(page However,for a -m - 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 How to get a 7T] 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 Idendficatkm number guidelines on whose number to enter. M35 - 1 4 6 8 6 1 0 Certification Under penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identification number(or 1 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 forth(d any)indicating that I am exempt from FATCA reporting is cored. Certification instructions.You must cross out Hem 2 above H 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 abimdonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other thaA interest and an s,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 3. Sign Signature Here U.S.person► Date► General Instructions •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T (tuition) Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-C(canceled debt) Future developmo ter.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 wwwJr3.gov/hv9. Use form W-9 only H you are a U.S.person(including a resident ellen),to Purpose of Form provide your correct TIN. An individual or entity(Form W-9 requester)who is required to file an information If you do not return Form W-8 to ft requester with a TIN,you might be subject return with the IRS must obtain your cared taxpayer identification number(TIN) to bac kW 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(ATIN),or employer 1.Certify that the TIN you are giving is correct(or you are waiting for a number Identification number(£IM 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 2 Certify that you are not sub to backup writhhokfi or returns include.but are not limited to,One following: N Y lett P ng. •Form 1099-INT(interest earned or paid) 3.Claim exemption from backup withholding H you are a U.S.exempt payee.It •Form 1098-DIV(dividends,including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of n9 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 1099-8(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this forth Of any)indicating that you are brokers) exempt from the FATCA reporting,is cored.see What is 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-g(Rev.12-2014) Carmel Swim Club, Inc. Invoice 300 E.Main Street, Suite E Date Invoice# Carmel, IN 46032 1/16/2017 323 Bill To Carmel Clay Parks&Recreation R IF„r�'s,T Monon Community Center Attn:Leah Weprich JAN 2 4 2017 1235 Central Park Drive East Carmel,IN 46032 BY:.............................. P.O. No. Terms Project Net-15 Quantity Description Rate Amount 4 Pool Rental;deep water 60.00 240.00 Total $240.00