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HomeMy WebLinkAbout168537 02/04/2009 f CITY OF CARMEL, INDIANA VENDOR: 00350077 Page 1 of 1 ONE CIVIC SQUARE INDIANA STREET COMMISSIONERS AS p O HCK AMOUNT: $35.00 .o CARMEL, INDIANA 46032 CIO JOHN SCHNADENBERG 609 GRANT AVE CHECK NUMBER: 168537 CHESTERTONIN 46304 CHECK DATE: 2/4/2009 DEPARTMENT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION 2201 4355300 35.00 ORGANIZATION MEMBER Gt f' INVOICE INDJANA STREET COMMISSIONER'S ASSOC4TION 2009 I. S. CA MEMBERSHIPS ARE NOW DT rE SEND DUES (935.00) TO: John SchnadenbM Membership Director -609 Grant Avenue Chesterton, IN 46304 219 926.2222 2009 ISCA DUES $35.00 Only one $,35. fee required for memhership per community Tf'your assistant or foreman needs a membership card, please note on your application fnrm. APPLICATION FOR MEMBER.S14IP CITY/TOWN: NAME: E -MAIL h��� AUI7RESS: 1 a n BUSINESS ADDRESS: 3 o tA4 N BUSI PHONE: (3 6 3 X00 f FAX L311 6 3 �-o 0 5 DtJES ENCLOSED: -4 3 0 W CLAIM .FORM: RENEWAL: NEW MENDER: Catl or send with this registration y our Suggestions for topics at this year's convention. f Form -9 Request for Taxpayer Give form to the (Rev. January 2003) Identification Number' and Certification requester. o no Deparvnent of me Treasury send to the IRS. fternai PxA=A service Name C" cc rs Business name, If dffereM from above o Individual/ Exempt from backup Check appropriate box: El Sole proprietor Corporation Partnership other withholding o Address (number, and apt or suite no.) Requesters name and address (optional) CL 3© 7 r= City sta .and LP rvda C m List account numbers) here (optional) CD N Taxpayer Identification Number IN Enter your TIN in the appropriate box For Individuals, this Is your social security number (SSN). social sammih mmiber 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: Y the account d in more than one name, see cite chart on page 4 for guidelines on whose number �PIOY� identification raarnber alter. e 7 a RE Certification Under penalties of perjury, I certify that I. 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 Sigrmtura ot► Datn 6 Pu rpose of. Form Nonresident alien who becomes a "resident alien. 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 (including 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 specifies 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: It requester gives you a form other than Form W -9 3. The article number (or location) in the tax treaty that to request your 77N, you must use the requester's form if it is contains the saving clause and its exceptions. substantialty 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 Form W -9 (Rev. 1 -2003) 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)) 01/27/09 $35.00 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. WARRAN NO. I.S.C.A. Membership ALLOWED 20 IN SUM OF 609 Grant Avenue 1 Chesterton, IN 46304 $35.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Member' 2201 43- 553.00 $35.00 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 Thursda Ja y 29, 200, Street Commission Street C:Titlelssionet- Cost distribution ledger classification if claim paid motor vehicle highway fund