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Home My WebLink About160532 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00351024 Page 1 of 1 1 0� ONE CIVIC SQUARE POTAWATOMI INN CHECK AMOUNT: $270.84 s CARMEL, INDIANA 46032 6 LANE 100 LAKE JAMES ANGOLA IN 46703 CHECK NUMBER: 160532 CHECK DATE: 6/10/2008 DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOUNT DESCRIPTION 2201 4343002 270.84 EXTERNAL TRAINING TRA i c r. I li w IN Street Commissioners Assoc. Reservation Form Please Fax or Mail your Reservation No Later Than -7/26108 Mail to: Potawatomi Inn 6 Lane 100A Lake James Angola, IN 46703 Or fax to: (260) 833 -8957 Please indlcatethe appropriate Arrival and- Departure -Dates in the space provided below Arrival Date: 8/26/2008 Departure Date: 8/28/2008 Arrival Date: Departure Date: Arrival Date: Departure Date: Name A Y 1 U If you plan to share a room, please print that person's name. Address If sharewith is sharing expenses, please indicate: City zip I L N Yes O No O Phone Number adults: Number children: Fo i Please lndicMe Room Preference (Subject to Availability) Type S /NS Rate Type S /NS Rate 2 Queen $94.35 Historic Cabin $58.83 2 Double $78.81 Cabin Suite $160.95 Double $67.71 Hoosier 2 Queen $94.35 Inn Suite $127.65 (Price includes applicable Tax) An Advance Deposit in the amount of the first night's stay is required to guarantee your reservation. You may send a check or money order in the amount of the first night's stay or you may send a credit card number and expiration date. Your card will be charged at this time Credit Card Exp. Date: Name of person or company credit card is issued to: Please Note: Cancellation notice is required four days prior to arrival for full refund of deposit. Check -in is after 4:00 PM Check -out is prior to Noon Late fees will be charged after 12 noon You can also make reservations on -line, www.indianainns.com or call 877.563.4371 Reservation Number: 139700 Group Block Number: 08261N ,t IN Street Commissioners Assoc. Reservation Form N Please orMall your Reservation Later Than k w Mail to: Potawatomi Inn 6 Lane 100A Lake James Angola, IN 46703 Or fax to: (260) 833 -8957 [Arri Please indicate the approp� ate Arrival and Departure Dates n the space provided below ;,r� val rrival Date: 8/26/2008 De arture Date: 8/28/2008 Date: Departure Date: Arrival Date: Departure Date: Name VTl If you plan to share a room, please print that person's name. Address n 0) 1 3 If sharewith is sharing expenses, please indicate: City Zip Yes O No O Phone Number adults: l Number children: 4 Please Indicate Room Preference (Subiect tojAvailability) Type SINS Rate Type SINS Rate 2 Queen $94.35 Historic Cabin $58.83 2 Double $78.81 Cabin Suite $160.95 Double $67.71 Hoosier 2 Queen $94.35 n IQ fits- Inn Suite $127.65 (Price includes applicable Tax) An Advance Deposit in the amount of the first night's stay is required to guara your reservation. You may send a check or money order in the amount of the first night's stay or you may send a credit card number and expiration date. Your card will be charged at this time Credit Card M Exp. Date: Name of person or company credit card is issued to: Please Note: Cancellation notice is required four days prior to arrival for full refund of deposit. Check -in is after 4:00 PM Check -out is prior to Noon Late fees will be charged after 12 noon) You can also make reservations on -line, www.indianainns.com or call 877.563.4371 Reservation Number: 139700 Group Block Number: 08261N e io Form w_9 _9 Request for Taxpayer Give form to the (Rev. January 2003) Identification (dumber and Certification requester. Do not oepanrrmc of the Treasury send to the IRS. Intemal Revenue Service Name �y a�i �>C m C- Business name, if different from above c 0 m CL o Individtia U Exempt from backup Check appropriate box: El Sole proprietor Corporation Partnership Other withholdi o `-s Address (number, street, and apt. or suite no.) Requesters name and address (optionaq City, sta and ZIP code CL V) List account numbar(s) here (optional) M Ma d Tax payer Identification Number (TIN) Enter your TIN in the appropriate box. For individuals, this is your social security number (SSN). Social security number 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 number Employer identification number to enter. 7 iJ 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 ORS) 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 ORA), 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.) Sign Signature or c Here I U.S. person Date 10- Purpose of. Form Nonresident alien who becomes a resident alien. 1-ft Generally, only a nonresident alien individual may use the A person who is required to file an information return with terms of a tax treaty to reduce or eliminate U.S. tax on the IRS, must obtain your correct taxpayer identification certain types of income. However, most tax treaties. contain a number (TIN) to report, for example, income paid to you, real provision known as a "saving clause." Exceptions specified estate transactions, mortgage interest you paid, acquisition in the saving clause may permit an exemption from tax to or abandonment of secured property, cancellation of debt, or continue for certain types of income even after the recipient contributions you made to an IRA. has otherwise become a U.S. resident alien for tax purposes. U.S. person. Use Form W -9 only if you are a U.S. person If you are a U.S. resident alien who is relying on an ncluding a resident alien), to provide your correct TIN to the exception contained in the saving clause of a tax treaty to person requesting it (the requester) and, when applicable, to: claim an exemption from U.S. tax on certain types of income, 1. Certify that the TIN you are giving is correct (or you are you must attach a statement that specTmes the following five waiting for a number to be issued), items: 2. Certify that you are not subject to backup withholding, 1. The treaty country. Generally, this must be the same or treaty under which you claimed exemption from tax as a 3. Claim exemption from backup withholding if you are a nonresident alien. U.S. exempt payee. 2. The treaty article addressing the income. Note: If a requester gives you a form other than Form W -9 3. The article number (or location) in the tax treaty that to request your TIN, you must use the requester's form if it is contains the saving clause and its exceptions. substantially similar to this Form W -9. 4. The type and amount of income that qualifies for the Foreign person. If you are a foreign person, use the exemption from tax. appropriate Form W -8 (see Pub. 515, Withholding of Tax on 5. Sufficient facts to justify the exemption from tax under Nonresident Aliens and Foreign Entities). the terms of the treaty article. Cat. No. 10231X Farm W -9 (Rev. 1 -2003) VOUCHER NO. WARRANT NO. Potawatomi Inn ALLOWED 20 IN SUM OF 6 Lane 100 A Lake James Angola, IN 46703 $27 0. 8 4 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members 2201 43- 430.02 1 hereby certify that the attached invoice(s), or 2201 43- 430.02 $270.84— 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 Fri June 6 008 i SLf et"l 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)) 06/04/08 $270.84 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