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Home My WebLink About313711 7/18/2017 ,r°`AMM ,;; '? CITY OF CARMEL, INDIANA VENDOR: 371804 ONE CIVIC SQUARE ORANGE LEAF CHECK AMOUNT: S"""""""174.50" ,'' CARMEL, INDIANA 46032 2499 PERRY CROSSING WAY CHECK NUMBER: 313711 PLAINFIELD IN 46168 CHECK DATE: 07/18/17 ��roH c� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4343007 8/4/17 174.50 FIELD TRIPS AV- 0 CD o � 0 N ID * OfD Cn o Z -S D Z o 0 0 .. � 3 u°,, z n to a < O > °° o0 CD o p ;CD .0 -* CA) ? d w ac v ' of (nr ;u « z . <_ O OL Z Oc Oz 0 0 3 L7 D o is m c o < s mc CY CL 0 d yr .< o. X O N m M D A N m .�, 49 (D fA 0 fl N 2 0 C- 3 m S c N N N �► fn N N O_ N t0 N n p�j W 3 O N m G1 N N m d O N O O a - s Q co m =ra a n CD m a O C' CD s � ON 0 O > > 0 Q O _a o_ Oo - N fD CD I 2 IT, O O 1 1 i i Fon„ W-9 Request for Taxpayer Give Form to the (Rev.December2014) Identification Number and Certification requester.Do not pepetbrnerrc of ti>a Treawry send to the IRS. Idemat Revenue ST1 i 1 Nemo*shown on your income tax return).Hama is required on this line;do not laevo this line Werk. �f Eli Y sinew nam disregarded entity name,ff differ from above 3 Check appropriate box for federal tax classification:check only one of the following seven boxes: 4 Fxamptions(mss apply only to ,,r-� certain entities,not individuals;see c ❑krdtvidualtsole proprietor or ❑ C Corporation 9S Corporation ❑ Partnership ❑T-Westste instructions on page 3): c single-member LLC Exempt payee code(if any) e ❑blmited liability company.Enter the tax dassification(C corporation,S=S corporation,P=paMersNp)10, p Note.for a single-member LLC that is disregarded,do not check LLC;check the appropriate box In the Erre above foreiron FATCA reporting w the tax classification of the single-member owner. code(If any) ❑ Other(see Instructions)0- rtppr•em,eea psm.huYud«roin•n•usj 6 Address�(nu r.street,and apt or softs no.} Requester's name and address(optional) e CA �y(e,and ZIP' xrJ � 7 List account number(s)here(optional) Taxpayer Identification Number(TIN) Faster your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social seaulty r amber backup withholding.For Individuals,this Is generally your socia)security number(SSN).However,for a FTI -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 71N 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 EmPlWw ideneficatlen 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 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 Intemal Revenue Service ORS)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 belowf and 4.The FATCA oode(s)entered on this form Of any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out Rem 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,Rem 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 Date► 7:-U--f,7 Here U.S.persat► ^,i;a(,iyr►yf •Form 109a(home mortgage Interest),1OWE(student loan interest),1098-T General Instructions (tuitlon) Section references are to the Internal Revenue Code unless otherwise noted. -Form 1098-C(canceled debt) Fubure drwlopmerf.Information about developments affecting Form W-9(such -Form 1099-A(acquisition or abandonment of seared property) as legislation enacted after we release it)is at www.ksgov/iw9. Use Foran W-9 only if you are a U.S.person Csnckuding a resident titian),to Purpose of Form provide your correct TIN. M individual or entity(Form W-9 requester)who re required to file an Information if you do not return Form W-9 to the requester with a 71N,you might be subject to backup witluhoiding.See What is backup wdthholdingl on page 2. return with the IRS must obtain your correct taxpayer Identification number(TIN) which may be your social aeertty number(SSM,individual taxpayer identification By suing the fillod-out form,you: number(mM,adoption taxpayer Identification master(ATIM,or employer 1.Certify that the TIN you we giving is correct(or you are waiting for a number Identification number(EIM,to report on an Information ratum the amount paid to to be Issued), you,or other amount reportable on an information return.Examples of Information 2 That you are not subject to backup withholding,or returns Include,but are rut limited to,the following: •Form 10994NT(Interest owned kr paid) 3.Claim exemption from backup withholding If you are a U.S.exempt payee.if •form 1099 DN dividends,Ind those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of ( ung any partnership income from a U.S.trade or busirim is not subject to the •Form 1099-MISC(vadous types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and •Foran 1099-8(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA codes)entered on this form Of arm Indicating that you are brokw* exempt from the FATCA reporting,is correct.See What is FATCA reporting?on •Form 1099-5(proceeds from real estate transecUons) page 2 for further information. •Form 1099-K(merchant card and third party network transactions) Cat.'No.10231X Form W-9(Rev.12-20141 2499 Perry Crossing Way Suite 114 Plainfield, IN 46168 + a k a 317-742-5310 2 201 7 Field trip- August 4, 2017 10:00am `` Carmel Clay Parks 43 children 7 adults 50 beginner's cups @ $3.49 without tax: $174.50 50 beginner's cups @$3.79 with tax: $189.50 I wasn't sure if you are tax exempt. Carmel • Clay Parks&Recreation CHECK REQUEST Date: z 17 JUL 1 2 2017 Check payable to: Name: Q raw Lca Address: City,State,Zip �� I [N U I Mail check to payee Return check to requestor Check Amount:$ L4, 5o Date Required: !3 117 Purpose of Check: P ld 1 r i P at r Ow Supporting documentation or invoice(s)MUST be attached. To be paid from: PO#(if applicable) \ ' � Budget account-GL# Budget Line Description \��c G� Requested by(print): l 11 r t U c�CLC Requested by(signature/date): C � Z 7 Approved by(print): Approved by(signature/ Z Form recreated 3/10/15(Business Services)