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Home My WebLink About186137 06/07/2010 e CITY OF CARMEL, INDIANA VENDOR: 362948 Page 1 of 1 ONE CIVIC SQUARE JOHN MARQUE L CHECK AMOUNT: $500.00 CARMEL, INDIANA 46032 735 CANAL COURT APT K INDIANAPOLIS IN 46202 CHECK NUMBER: 186137 CHECK DATE: 6/7/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4359003 001 500.00 JAZZ ON MONON From: John Marque 735 Canal Court Apt K IN t Indianapolis, IN 46202 C 513.505.6053 INVOICE #001 DATE: MAY 1, 2010 TO: FOR: Carmel Redevelopment Commission 30 W. Main St., Suite 220 Jazz performance Carmel, In 46032 DESCRIPTION AMOUNT Jazz performance in Arts and Design District on 6/13/10 $500.00 TOTAL $500.00 Thank you for your business! f orm Request for Taxpayer Give form to the (ter. tt artier Ident[fication Number and Certifloation requester. Do not I)Ln-mawnt at ft T=Ixy send to the IRS. M04AF Ref M SIPM" Ills SIVWli toy. rutulq V 8usl.ies,-, nanh. If dllicmit from awyc Cr C rndM E] duW/ Exempt from ba-l' up, approprivic bov Soic; prep Tatar L withholdirv3 Addre" (nuffltw. sitrmt, and apl. a suite rho.) floquestar's name and Dftes My. etwa, and zip 03do CL L t Out kxounl numbartfl hart, loptional) E Taxpayer Identification Number (T11N)___ Enter your TIN in the appropriate box. The TIN provided must match M name given on Line, I to avoid Hnc al Wmift number backup Mthholdtng. For individuals, this is your social ssorurity number (SSNI). However, for a 1 ids"lls alien, sold proprietor, w disregarded entity, see the Part I instructions on page 3. Foi atfiet en, as, It your employer Iden�iicafivrr nurniae• IEIN). 11 you do riot have a number, See HE)W 10 get 4R 77N on pag e or Note. If the account Is In more Chun me namb, see the chart on page 4 for guidelines on whose 1- 1_.P]UyGf k101111133fiCTRI numbar to enter. Certification Under p"Wes of penury. f oerlilty that: I The number shown on this form is my correct taxpayer identification number for I am waiting for a number Io be Issued to me), and 2. 1 bin nut subject to backup withholding beaause: (a) I am exempt trom bar:Pjap withholding. or (b) I have not been notified by the Internal Revertuie Service (IRS) ftl I am wbjeot to bapkap wilrilholding as a roll of rA fature 1c; report all interest or dividends, or (cj the IRS has notirtea arie that i am no longer subject to berloup vAthIlding, and 3, 1 am a U.S, person fndvdiog a U.S. residen alien). Certification instructiorm- You must cross out Item 2 above if you have lwen notified by the IRS that you are currently suNect to haci;up w1ditioldirIg be-wase you Have failed w report till interest and dividends oh yout tax return. For real estate transactions, item 2 does not applV- For mortgage Interest paid, acquisition or nbandonrn9ni of secured property mncenation of debt, contributions to an Jndi%�dual retirement arrangarnent (IRAJ, and genaratly, payments other than interest and dividends, you are not reoulrW to sign The Certification, but you must provide your correct TIN, (See the Instructions an page 4.) Sign Bigrartum of Here I U.S. Parson 1 Date Purpose of Form a An individual who is a citizen of resident of the United A pemon who Is required to file an information return with Me States, IRS, must obtain your correct taxpayer identification number a A partnership, corporation, company, or association (i'IW) to report, for example, income paid to you, real estate created or organized in the. United States or under the laws lransectlorts, mortgage interest you paid, acquisition or of tine United States, or abandotinient of secured properly, cancellailon of debt, or m Any estate (other than a forelUn estate) or trust. See contributions you made to an IRA. Regulations sections 3D1.7701-6(a) and 7(a) for addiVonal U.S. person. Use Form W-9 Only If YOU are a U.S. person information. (Including a resident alien), to provide your correct 71NI to the Special rules for partnerships. Partnerships that conduct a person requesting it (tire requester) and, when applicable, to: trade or business in the United Sla.les are porterrilty required 1. Certify that the TINII you are giving is correct (or you am to pay a withholding tax on arty foreign partners' 0 of vmfting for a number to be L--sued), income from such business, Further, In certain cases vA•ere a 2. Ceriffy that you are not suNeal to bacluip withholding, or Form W-f) has not been received, a partnership is required to presume that P partner is a foreign person, and pay the 3� Claim exemption from backup withholding it you are U.S. exempt payee, withholding twl. Therefore, If you are a U.S. person that is a parlinet In a partnership conducting a trade or business In the In 3 above, if applicable, you are also certifying tlial as a United States, provide Form 1N -9 to the partnership to U.S, person, your allocable share of any partnership income estabil your U.S. status and avoid withholding on your from a U.S. trade or business is not subje�A to the share of partnership income, witlihoiding W on foreign partners' share of effectively connected income.. The person who gives Form W-9 to the partnership for Note. If a requester gives you a to" other than Form W-9 to purposes of establishing its U.S. status and avoiding partnership On its allocable share of net income front lice request your 1114, you must use the requester's form H it is partnership conducting a trade or business In the United substanflall� similar to this Fomi W-9. States is in the following cases: 1- federal tax purposes, you are considered a person if you e The U.S. Owner of a dIsregaided erifty anti not the entity, am: Gat 140, 1OZ31N Form W-9 (Ruv. 11-201151 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL r An invoice or 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 4= Purchase Order No. '7 C (m C kt A( Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) )Oa a 0h G f �+er� c rmtn C 5o Q0 Total 5_0 0, op I 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 VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF 7 Cane Court 61 k J:njjknfio ;s, jN 462 -02- J 50 Ito ON ACCOUNT OF APPROPRIATION FOR Pay from Cash 9 02 /g)59003 Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or �L 00 s�D(?3 5 1 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 20 I0 Signature Director of Redeveln mPnt Cost distribution ledger classification if Title claim paid motor vehicle highway fund