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HomeMy WebLinkAbout193540 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: 00351669 Page 1 of 1 s ONE CIVIC SQUARE UMBAUGH ASSOCIATES CARMEL, INDIANA 46032 PO BOX 40458 CHECK AMOUNT: $1,800.00 INDIANAPOLIS IN 46240 -0458 �o CHECK NUMBER: 193540 CHECK DATE: 1/5/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 R4340300 21718 123741 1,800.00 CAFR WORK H. J. Umhaugh Associates Certified Public Accountants, LLP 8365 Keystone Crossing, Suite 300 P.O. Box 40458 Indianapolis, IN 46240 -0458 (317) 465 -9500 Ms. Diana Cordray, Clerk- Treasurer City of Carmel One Civic Square Carmel, IN 46032 Re: Arbitrage Rebate Calculation for City of Carmel, Indiana Redevelopment Authority County Option Income Tax Lease Rental Revenue Bonds, Series 2006 Invoice No. 123741 Date 1212112010 Client No. C00600 For preparation of an Arbitrage Rebate and Yield Reduction payment calculation on the above -named Bonds. (Interim computation period August 29, 2006 through October 19, 2010.) Current Amount Due 1.800.00 Pursuant to the provisions and penalties of Chapter 155, Acts of 1953, 1 hereby certify that the following is just and correct, that the amount claimed is legally due after allowing all just credit, and that no part of the same has been paid. Partner David C. Frederick, CPA Form w ©9 a Request for Taxpayer (Rev. October 2007) p Give form to the Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. tntemal Revenue Service Name (as shown on your income tax return) c' H. J. Umbaugh 8r Associates, Certified Public Accountants, LLP Q Business name, it different from above o Umbaugh Q. o Check appropriate box? 1:1 IndividuaVSole proprietor Corporation Partnership 2 V Limited liability company. Enter the tax classification (D =disregarded entity, C= corporation, P= partnership) b� _El F11 Exempt o Other (see instructions) S* payee Address (number, street, and apt. or suite no.) Requester's name and address (optionaq w 8365 Keystone Crossing, Suite 300 to City, state, and ZIP code y Indianapolis IN 46240 List account number(s) here (optional) Tax a er Identification Number IN Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number backup withholding. For individuals, this is your social security number (SSN). However, for a 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 Now to get a TIN an page 3. or Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number number to enter. 35 1309391 Certification Under penalties of perjury, I 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. t am not subject to backup withholding because: (a) I 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). 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 TfN. See the instructions on page 4. Sign Signature of Here U.S. person Date 0, f ps/xl General Instructions Definition of a U.S. person. For federal tax purposes, you are Section references are to the Internal Revenue Code unless considered a U.S. person if you are: otherwise noted. o An individual who is a U.S. citizen or U.S. resident alien, e A partnership, corporation, company, or association created or Purpose of Form organized in the United States or under the laws of the United A person who is required to file an information return with the States, IRS must obtain your correct taxpayer identification number (TIN) An estate (other than a foreign estate), or to report, for example, income paid to you, real estate e A domestic trust (as defined in Regulations section transactions, mortgage interest you paid, acquisition or 301.7701 -7). abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Special rules for partnerships. Partnershipy that conduct a Use Form W -9 only if you are a U.S. person (including a trade or business in the United States are generally required to resident alien), to provide your correct TIN to the person pay a withholding tax on any foreign partners' share of income requesting it (the requester) and, when applicable, person from such business. Further, in certain case$ where a Form W -9 has not been received, a partnership is required to presume that 1. Certify that the TIN you are giving is correct (or you are a partner is a foreign person, and pay the withholding tax. waiting for a number to be issued), Therefore, if you are a U.S. person that is a partner in a 2. Certify that you are not subject to backup withholding, or partnership conducting a trade or business in the United States, provide Form W -9 to the partnership to establish your U.S. 3. Claim exemption from backup withholding if you are a U.S. status and avoid withholding on your share of partnership exempt payee. If applicable, you are also certifying that as a income. U.S. person, your allocable share of any partnership income from The person who gives Form W -9 to the partnership for a U.S. trade or business is not subject to the withholding tax on purposes of establishing its U.S, status and avoidin withholds foreign partners' share of effectively connected income. 9 g on its allocable share of net income from the partnership Note. If a requester gives you a form other than Form W -9 to conducting a trade or business in the United States is in the request your TIN, you must use the requester's form if it is following cases: substantially similar to this Form W -9. s The U.S. owner of a disregarded entity and not the entity, Cat, No. 10231X Form W -9 (Rev. t0 2007) Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Farm 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. Payeee l Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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. n ALLOWED 20 d IN SUM OF 1 ON ACCOUNT OF APPROPRIATION FOR Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1V141 &bb 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 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund