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HomeMy WebLinkAbout308874 03/07/17 `� °y� CITY OF CARMEL, INDIANA VENDOR: 371546 g t ONE CIVIC SQUARE TERRI NIX CHECK AMOUNT: $*******130.00* s =a; CARMEL, INDIANA 46032 1024 3RD AVE NW CHECK NUMBER: 308874 �MiroN..� CARMEL IN 46032 CHECK DATE: 03/07/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4340800 17001 130.00 ADULT CONTRACTORS 0 0 00 § $ m2 0 / © R 2 © > 0 k 2 2 0 0 2 3A < 0 3M CD CD 3 C)m �_ k \ # 0 o k > � < 0 CD \ T / � / : E o _ m w E 00g 0 P 2 [ Z59 CD m : \ 40 40 \ P Z � 2 � 2 coa o \ 0 � o q ] L / 5 D o w � R e f c $ Eg M z ] A ? 0) 0 Q >ƒ f $ 3 0 ® o k @ 7/ \ k 2 / ƒk t § k @ CD R m c o o & -= CDCL w \ƒ I f t 0 k» ` CD o q a 0 A o (D 'T, § | 0 o , 4 For►n W-9 Request for Taxpayer cm r-01101 lbse (Rev.January 2011) Don It � T, ,y Identification Number and Cent n __ tntemai Re+rereue sere ' ;;sadtd�a fine . Name(as shown on your 1—1- "T . ) N O V 17 2016 #, ej BinmeAmmosaftongatidW soft mairre>;,ittd Biwaimtttan above Y: i aL 6 Ikaplproporerlbacfarfadw 'In C: 0 �t O dWdW&d1MpeeeWM8ftr ® ceauepasar- ®ss imm ❑ ❑T 21 IS ❑ tirited fanny cwn arV.Enter ttetmc Banca m(r=C cwparation,S.S oorporatiore P=Patrwahip)► wee ----------------------- c • ML o ❑ offer(see irafrudio rs)► Ad*ess tiurnber,-I e IaN, or suke noReque Ws name and address(opbo naq i ( tAJ .stale.and zJP coda List acca rd mm mss)hdre(optional) Taxpayer Identification Number(TIM Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line180chda—ftombiar to avoid backup withholding.For individuals,this is your social security number(SSM.However,for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other ( -® - errdfitiit W.it is your eamplove r" 91 1 io n rmr aim W ff you duo rine laws a n wribe,vee F/•a 1s¢ta Tiftf an palge& MAP-Bthhe account is in rnoteiltorn one name,see tine than an patge 41 arr 9dddff%es an whose a� n eerrnler anrmihartb errdar- M TTI CAM diatn Under penalties of perry,I cartiiythratt 1. The number shown on tlis tams my correct taxpayer identification number(or 1 am waisting for a number to be issued tome),and 2- 1 am not subject to backup withh(hdrrg beCauli e:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service P74 that I am suuNect to backup withholding as a result of a faihYe W report all interest or dividends,or(c)the IRS has notified me that 1 am no longer sutipul to backup wi hhcildiM and 3. 1 an a U.S. -, or other U.S.person(defined belawj. 01 tiffir-11ion hasinwdons.You must crass out i l ern 2 above if you have been notTied by the IRS that you are currently suf*ct do bacla wthholdrg because you have failed to report all interest and dividends on you-tax return.For reel estate transactors,Awn 2 does not ap*For mor19 ge interest patio,acquisition cr abandonment of seared property,cancellation of debt,conlydi itions to an indvidual retirement arraogusnm(9W and generally.paynwrts other than interest and dividends,you are riot required to sign the certification.bunt you must provide your conrerd Tirl.see" i>sbuctfions on page 4. Stunft-ft aa` Herts ui.&perecri tate► General Dons Nome.If a requester gives you a Ionrru cos. lhraar ROM W-8QID"Mmoesit Section references are to the Internet Revenue Code unless otherwise t your TIN,you must use the regetese�taaaum inti is cul si)y 9iimliar to this Form W-9. rnateci Purpose of Fortin aU.S person 9you�IttaK ,1�� A person who is required to foe an information return with the IRS must 'An individual who is a U.S.citizen ver W1SL a aidisi t atiitaq, obtain your correct taxpayer identification martini(TIN)to report,for •A Partnership.corporation,eompm W®ro m¢iadom anawlYed!carr example,;income paid to you,real estate tratsactons,mortgage interest organized in the United States or undlar*w bw%asf*ee UiRMd you paid,acquisition or abandomrent of secured property,canceiatibn .An estate(other than a foreign estat*err of debt,or contrrbutons you made to an IRA- •A domestic bust(as defined in Reguita6ans se F N"r 3M-7M-7)- Ube Form W-9 only if you area US.person(nakrdng a rasiden alive*to provide your correct TIN to the person requesting it(the Specidindesforlon ' P We-Partnerstrpps that nornd uct a trade or requester)and,when applicable,to: business in the United States are generally req eked to piny a wdddhlirg tax on ary foreign parbneW share of income tom such bursnoess_ 1-Certify that the TIN you are giving is correct(or you are waiting for a Further.in certain cases Wwre a Form W-9 has not teem reeeiverq,a nurrtxs to be issued), partnership is required to presume that a paartmrer its a faaegm pesaa 11 2.Certify that you are not subject to backup withholding,or and pay the wiWeolding tac Thereftm,iifyww are a WtSi., ttheEJt iir'ail 3.Claim exemption from backup wdhholding t you are a UB_exempt partnin a partnership conducting attuanilewrbuaiinc iiisine Whtii nd payee.If applirte,you are also arMyirg that as a US.person,yotr Stater,provide Form W-9 to the padres hijp lb iiiln gmwr us. allocable share of any partnership income from a U.S.trade or business stats and avoid withholds g on yoursi'm 's not subject to the will tx*fNg tax on foreign partners'share of effectively eornacted income. mac.ratm.lt®rox Form W-S(Rev.1-2011) Wellness FEB 2 1 1011 t BY: Monon Community Center Invoice# 017001 Mary Evans Invoice Date 01/31IM7 1235 Central Park Drive East Carmel IN 46032 Amount Due $130A0 United States Own Desctipwmn Unit Cost Quantity Line l obf Wellness Class Get Older Later on 1/11/17 80.00 1 80'00 Lunch and Learn The WOW of Wellness 1117/17 50.00 1 50.00 0.00 0 0.00 Subtotal 13 0# Total ;130.00 Ten's Terri Nuc 1024 3rd Ave_NW Purchase Carmel,IN 46032 Description P.O.# t — P"C% G.L.# IcAb'L'1..�340 _ _ Budget Line Descr Purchaser Date Approval !�E�� Date L� 11 Page 1/1 This invoice was sent using Involoebeny oom