195171 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 365122 Page 1 of 1
ONE CIVIC SQUARE PPE CARE AND REPAIR
i, CARMEL, INDIANA 46032 601 NORTH BEND ROAD CHECK AMOUNT: $200.00
BEECH GROVE IN 46107
CHECK NUMBER: 195171
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE N AMOUNT DESCRIPTION
1120 4350900 1302 200.00 PASSPORT TAG HOLDER
YOUR SOURCE FOR COMPLETE TURNOUT GEAR REPAIR SERVICE
C,NRE ALL WORK ME1;7'SOR EXCEEDSNPFA 1851.2008
601 NORTH BEND RD. BEECH GROVE, IN 461.07 -2520 31.7- 847 -8538
p L sean @ppecareandrepair.com www.ppecareandrepair.com
C
�EPAI�
INVOICE
FIREFIGHTER OWNED OPERATED
DATE: 2/18/20 L I
CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE INVOICE 1302
CARMEL, IN 46032
(317) 508.5777
PAYMENT TERMS DUE DATE
NET 30 3/20/2011
GARMENT'IYPE SERIAL NUMBER CONTROL NUMBER
CUSTOM ITEM
REPAIR ITEM DkSCRIPT1oN OI' RrPAIRS QTY. UNIT PRICE LINE TOTAL
PASSPORT ACCOUNTABILITY CUSTOM MADE CLEAR PASSPOR i ACCOUN'1'ARIi-n TAG HOLDER FOR
HOLDER APPARATI.IS 00 ?oo 00
TOTAL: $200.00
THANK YOU FOR YOUR BUSINESS!
PLEASE MAKE ALI. CHECKS PAYABLE TO: PPE CARE REPAIR LLC
Form Request for Taxpayer Give form to the
(Rev. November 2005) Identification Number and Certification requester. Do not
Department of the Treasury Send to the IRS.
internal Revenue service
c� Name (as shown on your income tax return)
o, Sean E. Wood
ro
Business name, if different from above
o PPE Care Repair LLC
CL o Individual/ Partnership LLC Exempt from backup
Check appropriate box: Sole proprietor Corporation p Q Other I- withholding
N Address (number, street, and apt. or suite no.) Requester's name and address (optional)
a 601 North Bend Rd.
t City, state, and ZIP code
V
n Beech Grove, Indiana 46107 -2520
List account number(s) here (optional)
at
Taxpayer Identification Number (TIN)
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 on 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. 2 16 0 15 1 3 18 14 16 4
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. 1 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. person (including a U.S. resident alien).
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 int st and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. (SK the i tructions on page
Sign Signature of
Here U.S. person 0 Dater Z
Purpose of Form s An individual who is a citizen 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, company, or association
(TIN) to report, for example, income paid to you, real estate created or organized in the United States or under the laws
transactions, mortgage interest you paid, acquisition or of the United States, or
abandonment of secured property, cancellation of debt, or s Any estate (other than a foreign estate) or trust. See
contributions you made to an IRA. Regulations sections 301.7701 -6(a) and 7(a) 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 partnerships. Partnerships that conduct a
person requesting it (the requester) and, when applicable, to: trade or business in the United States are generally required
1. Certify that the TIN you are giving is correct (or you are to pay a withholding tax on any foreign partners' share of
waiting for a number to be issued), income from such business. Further, in certain cases where a
2. Certify that you are not subject to backup withholding, or Form W -9 has not been received, a partnership is required to
3 presume that a partner is a foreign person, and pay the
Claim exemption from backup withholding if you area
withholding tax. Therefore, if you are a U.S. person that is a
U.S. exempt payee. partner in a partnership conducting a trade or business in the
In 3 above, if applicable, you are also certifying that as a United States, provide Form W -9 to the partnership to
U.S. person, your allocable share of any partnership income establish your U.S. status and avoid 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 W -9 to the partnership for
purposes of establishing its U.S. status and avoiding
Note. If a requester gives you a form other than Form W -9 to
withholding on its allocable share of net income from the
request your TIN, you must use the requester's form if it is
substantially similar to this Form W -9. partnership conducting a trade or business in the United
States is in the following cases:
For federal tax purposes, you are considered a person if you a The U.S. owner of a disregarded entity and not the entity,
are:
Cat, No. 10231X Form 111f -9 (Rev-11-2005)
VOUCHER NO. WARRANT NO.
ALLOWED 20
PPE Care and Repair LLC
IN SUM OF
601 North Bend Road
Beech Grove, IN 46107
$200.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT /TITLE I AMOUNT Board Members
1120 I 1302 I 43- 509.00 I $200.00 1 hereby certify that the attached invoice(s), or
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
FEB 2 8 2011
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
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
Purchase Order No,
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1302 $200.00
1 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
2a
Clerk- Treasurer