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Home My WebLink About187654 07/20/2010 i CITY OF CARMEL, INDIANA VENDOR: 364406 Page 1 of 1 ONE CIVIC SQUARE RANDY PEAK CHECK AMOUNT: $280.00 CARMEL, INDIANA 46032 8314 BRIDGETOWN ROAD CLEVES OH 45002 CHECK NUMBER: 187654 CHECK DATE: 7/20/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4359003 5 280.00 ROCK DISTRICT Prom: Randy Peak RNWOH (CE INVOICE #005 DATE: JULY 9 TO: FOR: Carmel Redevelopment Commission Entertainment Rock The District 30 W. Main St., Suite 220 Carmel, In 46032 DESCRIPTION AMOUNT Entertainment Rock The District (Renegades) 280.00 TOTAL 280.00 Make ail checks payable to Randy Peak Payment is due within 30 days. If you have any questions concerning this invoice, contact [Name, phone number, e-mail] Thank you for your business! 07/19-2010 08:53 FAX 513 542 8309 INTERSTATE TRAILER 2012 Form r 9 Request for Taxpa Give form to the Of1pA November 2005) Ident ification Number and Certification requester, Do no t of rho 7;aaaury Inwmel RBVenua sorvico send to the IRS, N Name s show vn your income tax rotum) v a, m e Business name, fl different from above 0 o ndlVldual/ Sol L] Corporation portnership other w G> ompi from backup CnOck appropllate sox: e proprietor withholding a 9 Adtlross (number, street, 2ne Eipt, or suite no.) Pequoster'ei me and adpress (optional) a a y�Wi✓ it City, state, and ZIP coda v List account numb g) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match, the name given on line f to avoid backup withholding, For Individuals, this is your social security number (55N). However, for a resident alien, solo proprietor, or disregarded entlty, 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, sea How to get a 77N on page 3. or Note. If the account is In more than one name, sot; the chart on page 4 for guldelinat on whose �i 'rpioyer identification numl;er number to enter. Certificatkin Under penaltles of perjury, l certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a numb to be issued to rine), and 2. 1 am not subject to backup withholding because: (a) t am exempt from backup withholding, or (b) I have i t been notified by the Internal Hsvanue Service (IRS) that I am subject to backup withholding ns a result of a failure to report all interest[ r dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. person (including a U.S. resident alien), Certificatlon Instructions. You must Gross out item 2'above if you have been notified by the IRS that you ar currently subject to backup Withholding because you have fallod to report all interest and dividends on your tax return. For real estate tna aet;orns, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributic to an Individual retirement arrangement (IAA), and generally, payments other than interest and dividends, you are not required to sign th pertification. but you must provide your correct TIN. (See the instructions on page 4.) $rgn Signature of Mere U.S. person Date Purpose of Form st An individual who is a citizz or resident of the United A person who is required to file an information return with the States, IRS, must obtain your correct taxpayer identification number A partnership, corporation, .:)mpany, or association (TIN) to report, for example; income paid to you, real estate created or organized in the U ,ed States or under the laws transactions, mortgage interest you paid, aoqulSitlon or of the United States, or abandonment of secured property, cancellation of debt, or r Any estate (other than a for' 3n estate) or trust. See contributions you made to an IAA. Regulations sections 301.770: 5(a) and for additional U.S. person. Use Form W -9 only if you are a U.S. person information, (including a resident alien), to provide your correct TIN to the Special rules for partnership Partnerships that conduct a person requesting it (the requester) and, when applicable, to: trade or business in the Unite States are generally required 1. Certify that the TIN you are giving is correct (or you are to pay a withholding tax on al foreign partners' share of waiting for a number to be issued), income from such business. f- 1her, in certain cases where a 2. Certify that you are not subject, to backup withholding, or Form W -9 has not been recei :d, a partnership is required to 3. Claim exemption from backup withholding if you are a presume that a partner is a fe :ign person, and pay the U.S, exempt payee. withholding tax. Therefore, if 5 .a are a U.S. person that is a In 3 above, if applicable. you are also certifying that as a partner in a partnership condt ling a trade or business in the 'arson, our allocable share of an United States, provide Form ,r 9 to the partnership to U.S. P y y partnership income establish your U.S. Status and ,void withholding on your from a U.S, trade or business is not subject to the share of partnership income. withholding tax on foreign partners' share of effectively connected Income. The person who gives Form .V -9 to the partnership for Note. If a requester gives you a form other than Form W to purposes of establishing its U status and avoiding withholding on its allocable di )e of net income from the request your TIN, you must use the requester's form If It is partnership conducting a fret �r business in the Uni substantially similar to this Form W -B. States is in the following case! For federal tax purposes, you are considered a person if you a The U.S. owner of a disregs led entity and not the entity, are: Cat. No. 10231X Form W -9 (Ftay. 11 -2005) Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev, 1995) CITY OF CARMEL 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 Rob t'. Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) l oarl corer Ad for Roek 1he PisAriol 2X0.00 Total 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. k ALLOWED 20 R i h Jy Pc d IN SUM OF 280 0� ON ACCOUNT OF APPROPRIATION FOR Pay from Cash 9OZ U59003 Board Members Po# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or q02 S 435 900 2,90- 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 7- 12- 2010 Sin t re Director o� R eg Cost distribution ledger classification if Title claim paid motor vehicle highway fund