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Home My WebLink About309965 04/10/17 CITY OF CARMEL, INDIANA VENDOR: 049300 ONE CIVIC SQUARE CARMEL TROPHIES PLUS LLC CHECK AMOUNT: $ ...93.00* CARMEL, INDIANA 46032 303 WCARMEL DRIVE CHECK NUMBER: 309965 SUITE B CARMEL IN 46032 CHECK DATE: 04/10/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4350900 59983 69.00 OTHER CONT SERVICES 1120 4230200 70125 24.00 OFFICE SUPPLIES C� a O y o Z m O w O 0 0 Q rn Z o G w m N cn p 0 � O N GL N o w s w n 4S ° n o a a• m N N. pj N C S. N N W N O ro 3 01 4 y p N D w o � m m �• m �• m m < O o @ 20 � N 6 m O a 3. cs G 0 CSD m .� N 6 O 0 z. G sD 0 d mN 3 f C mCD c ` a --1 .Y TO-) N n o o p N O D > n � UN cT N N ro 4g p 4S ,(�D 4 A yy O O C. m N � a L CO Carmel Trophies Plus, LLC Invoice 303 W. Carmel Drive A'ua'Vs & Offs Suite B Date Invoice# Carmel, IN 46032 3/21/2017 70125 Bill To +I Carmel Fire Department 2 Civic Square AW Carmel,IN 46032 P.O. No. Terms Project Lara Mulpagano Due Upon Receipt Description Qty Rate Amount Name Plate 2 12.00 24.00 PUBLIC EDUCATION SUPPORT SERVICES Subtotal $24.00 Sales Tax (7.0%) $0.00 Phone# E-mail (317) 844-3770 cameltrophies@aol.com Total $24.00 Payments/Credits $0.00 Web Site www.carmelawards.com Balance Due $24.00 rVCarmel Trophies Plus, LLC Invoice 303 W. Carmel Drive Auards& IJP Suite B Date Invoice# Carmel, IN 46032 3/20/2017 59983 Bill To it Carmel Fire Department 2 Civic Square AW Carmel,IN 46032 f_:; P.O. No. Terms Project Bruce Knott Due Upon Receipt Description Qty Rate Amount Engraving Coins 12 5.75 69.00 Subtotal $69.00 Sales Tax (7.0%) $0.00 Phone# E-mail (317) 844-3770 carmeltrophies@aol.ram Total $69.00 Payments/Credits $0.00 Web Site www.carmelawards.com Balance Due $69.00 Form W'9 ,; Request for Taxpayer Give Fonn to the (Rev.December 2014) Identrfi6tion Number and Certification requester.Do not Department of the Treasury ;,i send to the IRS. Internal Revenue Services 1 Name(as shown on your income tax return).Name is1equired on this line;do not leave this line blank. Charles E Cave 11 2 Business name/disregarded entity name,if different from above N o, Cannel Trophies Plus,LLC 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 a Q El proprietor or ❑ C Corporation ❑S Corporation Partnership ❑Trust/estate instructions on page 3): C single-member LLC Exempt payee code(if any) 4,� ❑Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)Do- 0 `p 2 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 «c *9 the tax classification of the single-member owner. code(if any) .0 ❑Other(see instructions)► ftp4s baooardsm WN*d wiside Ow us./ !F 6 Address(number,street,and apt.or suite no.) Requester's name and address(optional) 0 411 S RANGELINE RD 6 City,state,and ZIP code CARMEL,IN 46032 7 List account number(s)here(optionaD • Taxpayer Identification Number(nN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Societ security number backup withholding.For individuals,this is generally your social security number(SSN).However,fora FM -m - resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other FFM entities,it is your employer identification member(EIN).If you do not have a number,see How to get a 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 I Employer ddsritifica ion number guidelines on whose number to enter. 2 7 - 3 -s161 6 1 3 7 0 • Certification Under penalties of perjury,1 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)1 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 abandonment of secured property,cancellation 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 f Here U.S.person► _ Date so. 3 [ General Instructions •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T (tuition) Section references are to the Internal Revenue Code unlew otherwise noted. .Form 1099-C(canceled debt) Future developments.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 www.as.gov/1w9. Use Form W-9 only if you are a U.S.person(including 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 Nyou 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(FIN) to backup withholcling.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(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) any 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(mf any)indicating that you are brokers) exempt from the FATCA reporting,is correct.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-9(Rev.12-2014)