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Home My WebLink About157114 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 353810 Page 1 of 1 0 ONE CIVIC SQUARE INDIANA PARK RECREATION CARMEL, INDIANA 46032 269 WEST JACKSON STREET CHECK AMOUNT: $685.00 PO BOX 888 CHECK NUMBER: 157114 CICERO IN 46034 CHECK DATE: 3/5/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 R4355300 17937 006 -2008 685.00 IPRA MEMBERSHIP i `1 BY:, °Q Indiana Park and Recreation Association 269 W. Jackson, P.O. Box 888 INVOICE NO. 006 -2008 A Cicero, IN 46034 IPI�A INVOICE Customer Misc Name Carmel -Clay Parks and Recreation Department Date 5- Oct -07 Address 760 Third Avenue SW, Ste. 100 P.O. No. City Carmel, State IN Zip 46032 Telephone 317 -848 -7275 DUE DATE: 30- Nov -07 DESCRIPTION AMOUNT IPRA Annual Membership Dues Agency December 1, 2007 November 30, 2008 300.00 Additional Agency Board Membership at $35.00 7 Additional Agency Professional Member at 55.00 385.00 TOTAL 685.00 Method of payment: Lr Check enclosed PO# Bill me Phone: Fax: Visa /MC Exp. Date E -Mail: 3 -Digit Security Code from back of card Total amt. to be charged There is a 3% processing fee addedlwhen using a charge card Signature MAKE CHECKS PAYABLE TO IPRA Date: Please return copy of invoice with payment and note any changes or corrections on the back. Thank you. THANK YOU OR YOUR CONTINUED SUPPORT lot r 7A Please verify all information, make corrections for each member and return to 1PRA along with one con o)� "s invoice, eck One Name Address Phone E -Mail Addre Board Staff Mark Westermei 032 317 848 -7275 v x -7eptTd 5!u. 4603 317 571 -4138 x Sue Dillon 317- 848 -72 skdillon ind rr.com Jim En ledow 1 31 iimenaIedow(o)enqIedoI x Lindsay Hola'ter 1411 E. 116th St, Carme Z"032 317- 573 -4020 Iholaiter(c)carmel eu g x Ben Johnson e. arm 3,D17-848-7275 biohnson(a e, i x Michael Klitzing 7 571 -4140 X Audrey Kostrzewa 1411 E. 116th St, Car IN 46032 317 -571- akostrzewaecarme C .Cat X X Kate Schneider 1235 C ral Park Dr., E, Carmel, IN 46032 317 573 -5238 ksc der carmelcla arks.com X Todd Snyder E. 116th St, Carmel, IN 46032 317 848 -7275 msn der c Ctg A-LId X Tim Tolson 317 848 -7275 brenda the travels -6-r-, x Te.rry I'll C'arm N 5/Go 3 ,31 e Canine/ m X Put line through anv that need to be removed above and add any new ones below. i l 1. DEC 1 0 2007 F orth -9 Request for Taxpayer Give form to the (Rev. November 2005) requester.. Identification Number and 'Certification Department or the T reasury i send tO IRS'. Internal Revenue Service N Name (as'shown on your Income tax return)_ a r Indiana Park and Recreation Association: Phone:(317) 984 4500: t a Business name, if different from above a O Individual/ Stem from backu Corporation Partnership Other 11- 501 �C� P< P Check appropriate box Sole proprietor withholding W Address (number. street, and apt or suite no.) Requester's name and address (optional) CL 5 PO Box 888, 269 West Jackson Street S City, state, and ZIP code Cicero, Indiana 46034 rn Ust account number(s) here (optional) to Taxpayer Identification Number (TIN),= 71 Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid socfai 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 How 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. 213 7 4 1 9 5 4 6 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) 1 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, t 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 �etum. For real estate trarisactions, 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 TIN. (See the instructions on page 4.) t Sign signature of V e �ai o� Here U.S. person It o Purpose of Form a An individual who is a citizen or. resident of the United A person who is required to file an information re um 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 o 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 US. 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. Claim exemption from backup withholding if you are a presume that a partner is a foreign. person, and pay the U.S. exempt payee. withholding tax. Therefore, if you are a U.S. person that is a 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 -Wto the,partnership to U.S. person, your allocable share of any partnership income establish your,U.S,. status avoid with on your from a U.S. trade: or business is not subjectto the share of partnership income. withholding tax on foreign partners' share of effectively: connected income. The person who gives Form W-9 the partnership for Note. If a requester gives you a form other than Form W -9 to Purposes of establishing its. U..Er status and avoiding request your TIN, you must use the requester's .form if it is: withholding on itsallocable. share' of net income from the 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 W -9 (Rev. 11 -2005) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Indiana Park Recreation Assoc. Terms PO Box 888 Cicero, IN 46034 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/5/07 006 -2008 IPRA annual dues 740.00 Total 740.00 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 20_ Clerk- Treasurer a. -t Voucher No. Warrant No. Indiana Park Recreation Assoc. Allowed 20 PO Box 888 Cicero, IN 46034 In Sum of 740.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept ept 17937F 006 -2008 4355300 740.00 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 3 -Mar 2008 Signature 740.00 �srsistant Director Cost distribution ledger classification if Title claim paid motor vehicle highway fund