168934 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 362523 Page 1 of 1
ONE CIVIC SQUARE JOHN CRAWFORD CHECK AMOUNT: $63,930.00
'e CARMEL, INDIANA 46032 41 1ST STREET SVV
CARMEL IN 46033 CHECK NUMBER: 168934
CHECK DATE: 211712009
DEPARTMENT ACCOUNT PO N INVOI NUMBER mm AMOUNT DESCRIPTION
2200 R4460500 19795 63,930.00 RIGHT OF WAY
i
CROSSROAD ENGINEERS, P.C.
3417 S. Sherman Drive
Beech Grove, IN 46107 J. ja
Phone: 317 780 -1555
Fax: 317- 780 -6525
LETTER OF TRANSMITTAL
To: Date: 2/10/2009
Ms. Katie Neville
City of Carmel Engineering Department Project: I" Ave SW
1 Civic Square
Carmel, IN 46032
WE ARE SENDING YOU
x Attached
Shop Prints Samples Specifications
Drawings
Copy of Letter Change Order
Copies: Date: Description:
l 2/10/09 Parcel 3 (Crawford) ROW Acquisition Payment Claim
THEY ARE TRANSMITTED AS CHECKED BELOW:
x For your use Approved as noted Resubmit Xerox sets w /binder
Katie,
Enclosed are the necessary documents to process payment for the acquisition of land owned by Mr. Crawford.
Please notify me or Jill Newport when the check is ready to be picked up. Thanks!
Signed
Cc: File tephanie J. y der
Prescribed-by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CARMEL, INDIANA
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
John A. Crawford Purchase Order No.
41 1 s Street SW Terms
Carmel, Indiana 46033 Date Due
Invoice Invoice Description
Date number or note attached invoices or bills Amount
PROJECT: 1 Avenue SW Streetsca e
PARCEL: 3
X 4.
ohn Al Crawford
Sift -three Thousand Nine Hundred Thirty and 00/100 Dollars $63,930.00
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
20
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
VOUCHER NO. WARRANT NO,
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION BoardlCouncil Members
FOR
COST DISTRIBUTION LEDGER CLASSIFICATION
IF CLAIM PAID MOTOR VEHICLE HIGHWAY FUND
Acct. Account Title Amount
No.
REV -29 STATEMENT OF THE BASIS FOR JUST COMPENSATION UA Coda
031W
1 This is a written statement of, and summary of the basis for, the establishment of the amount believed to be, through a valuation
process, just compensation for the purchase of this right -of -way for highway purposes. The amount set forth in Item 5 below is not less
than the approved estimate of value. In accordance with Public Law 91 -646 as amended, the "Uniform Act and as codified in Indiana
at IC 8- 23 -17 -1 through 8- 23- 17 -35, this value disregards any decrease or increase in fair market value of the property prior to the date
of valuation caused by the public improvement for which the property is acquired other than physical deterioration within reasonable
control of the owner.
2- The legal description of this acquisition is set forth in the instrument of conveyance in the following identified parcel and
interest is being this acquisition is identified in the Acquiring Agency's records as:
Des Crawford Parcel 1 Road First Ave SW City /County Hamilton
Owner (s) John A. Crawford
3 The area and type of interest being acquired: 2,476 sq ft new 0.000 sq ft existing 2,476 sq ft total
w� of Fee Simple Right off required.
The amount in Item 5 below includes payment or the purchase ot all interests in th e r e al property and no separately held
interest is being acquired separately in whole or part except as may be explained in Item 8 below.
4- This acquisition is (check one): a. F__JA total acquisition of the real property
b. ®A partial acquisition of the real property.
5- The Agency's Offer: Just compensation has been determined to be and the Acquiring Agency's offer for the purchase of
this real property is as follows:
a. Total Land, Land Improvements and Buildings 59,550.00
b. Severance Damages (i.e.: Setback, Loss in
Value to the Residues, etc.)
c. Other damages (Itemize):
Cost -to -Cure estimates
Temporary Right -of -Way
Total Damages:
Total amount believed to be Just Compensation offered for this Acquisition is: 59,550.00
6 The amount in Item 5 above may include payment for the purchase of certain buildings and improvements and their
ownership shall pass to the Acquiring Agency. These buildings and improvements are identified as follows:
None
7- The amount in Item 5 above may include payment for the purchase of certain Land Improvements, Fixtures, Equipment,
Machinery, Signs, Etc., and their ownership shall pass to the Acquiring Agency. These items are identified as follows:
Lawn, Stone Driveway /Parking, Fence Post w /Chain
8 Items owned by others (i.e lessee, tenants, etc.) included in Item 5 above are identified as follows:
None
9 Remarks:
Acquiring A c Consultant Reviewer:
Signature i Signature
Name Printed 6 �&V) e'� iA6 Name Printed
nn
Title >k &Y14 t N Title
Date 10 1eo o Date
CITY CO �`�RMEL
JAMES BRAINARD, MAYOR
ADMINISTRATIVE SETTLEMENT MEMORANDUM
To: Stephen C. Engelking
Director
Department of Administration
From: Allen D. McFearin
Associated Right of Way Services, Inc.
Re: Request for Administrative Settlement
Project: I" Avenue SW Streetscape
Parcel: 3
Owner: John A. Crawford
December 1, 2008
The City of Carmel made the Uniform Property Acquisition Offer to John A. Crawford to
acquire a portion of his property for the above project. The offer was made in person in
Carmel on October 10, 2008. The offer was for 385 square feet from along the southern
boundary of the subject property and for 0,046 acres along the western frontage of the
subject property. The value of the 385 square feet was based upon an appraisal
performed by Dennis Otto for $8,950.00 and the value of the 0.046 acres was based upon
another appraisal performed by Dennis Otto for $50,600.00. The amount of the offer was
$59,550.00. A second appraisal of the 0.046 acre portion was performed by Joseph
Traynor. In his opinion, the value of that portion of the Crawford property was
$59,360.00.
A critical part of the acquisition and the negotiations was parking for the commercial
building owned by Mr. Crawford. Loss of parking was not included in the appraisal, but
was to be addressed through the project. Through a series of meetings with the
landowner, the designer, the negotiator, and the landowner's attorney, the parties reached
an agreed upon design and amount of compensation, which was $63,930.00.
Di'.PARTMEN 1 OF ENGINEEKING
ONE CIVIC SQUARE:, CAR01I:1., IN 46032 Orrici7 317.571.2441 FAX 317571.2439
EMAIL. cngincering@ccumcl.in.gav
4
In support of the administrative settlement we list the following:
First, were the City to proceed to file the condemnation case, it is most probable that the
landowner will introduce testimony that the true land values are in excess of those
included in the appraisal. The landowner would most likely introduce evidence related to
loss of parking. The date of valuation in the condemnation case would likely be two to
three additional months later than the date of valuation of the appraisals. All of these
instances carry the possibility that the eventual award may be higher than the amount of
the administrative settlement.
Secondly, should the City proceed to file the condemnation case, at a minimum the City
will incur the costs for the court appointed appraisers and attorney fees, which costs
would exceed the amount of the administrative settlement.
Thirdly, accepting the administrative settlement would bring a present resolution to the
question of the fair market value of the property rather than having that detennination
made at a later point in the condemnation process and the City would obtain a right of
entry at this time.
Assuming all other legal review and approvals are approved, it is our recommendation
that the City of Carmel approve the terms of the above described administrative
settlement.
This recommendation is approved.
Stephen C. Engelking
Director
i"' 2�x�,,,�
EXHIBIT "A"
Project: 1 St Avenue SW Streetscape Sheet 1 of 2
Parcel: 3 Fee Simple
All that part of the grantor's land lying within the Right -of -Way lines depicted on
the attached drawing, marked Exhibit "B being a strip of ground Fifteen and
Seventy Hundredths (15.70) feet, taken by parallel lines, off the entire west side of
the following described property:
Part of the Southeast Quarter of Section 25, Township 18 North, Range 3 East, Hamilton
County, Indiana, more particularly described as follows:
Begin at the Northwest corner of Lot Seventeen (17) in the Warren and Phelps Addition
to the Town of Carmel, Indiana, run West 45.2 feet to the East line of Willow Street in
Carmel; thence South on the East line of Willow Street 132 feet; thence East 46.18 feet;
thence North 132 feet to the Place of Beginning.
ALSO: Begin at 45.2 feet West of the Northwest corner of Lot 17 in Warren and Phelps
Addition to the Town of Carmel, Indiana, run West 61.26 feet to the East edge of the
pavement of First Avenue S.W.; thence South on and along the East edge of said
pavement 132 feet; thence East parallel to the North line of this tract 59.5 feet; thence
North 132 feet to the Place of Beginning.
EXCEPT:
That part described as follows: Part of the Southeast Quarter of Section 25, Township 18
North, Range 3 East in Hamilton County, Indiana, more particularly described as follows:
Beginning 83.4 feet West of the Northwest corner of Lot 17 in Warren and Phelps
Addition to the Town of Carmel, Hamilton County, Indiana; thence West 110 feet
measured (23.6 feet Deed) to the East edge of pavement of First Avenue Southwest;
thence Southerly on and along the East edge of said pavement 132 feet; thence East
parallel with the North line of this tract 12.05 feet measured (23.85 feet Deed) to a point
which is 82.45 feet West of the Southwest corner of Lot 17 in said Warren and Phelps
Addition; thence Northerly 132 feet to the Place of Beginning.
Containing in said 15.70 foot strip 0.048 acres, more or less.
Sheet 2 of 2
This description was prepared for the City of Carmel by Trent E. Newport, Indiana
Registered Land Surveyor, License Number 29600021, on the 18` day of August, 2008.
0
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. L 00021
STATE OF
NO S�i
I PARCEL: 3 DRAWN BY KMK 9 -2 -08
s PROJECT 1st AVE. SW STREETSCAPE��� CHECKED BY RDP 9 -2 -08
COUNTY. HAMILTON SCALE 1" 30'
SECTION: 25 OWNER: CRAWFORD JOHN A.
TOWNSHIP: 18 NORTH RECORD DOCUMENT. INSTR. #2006- 42923; DATED 07/26/06
RANGE: 3 EAST HATCHED AREA IS THE
APPROXIMATE TAKING
18t Street SW
23.6' r-- 83.4'
61.26 45.2'
NW CORNER LOT 17
10'x19' TELECOMMUNICATIONS
EASEMENT .INFAVOR OF AT &T
INDIANA EXCLUSIVELY
15.70' I
pHE�pS PDp1
I W FRRp R. H,
0
C
I CV
Q I LOT 17
W
T I
I
I
I
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I
82.45'
23.85' 4618'
59.5' —J
NORTH
15' 0 15' 30'
SCALE 1 30'
PREPARED BY:
��G t ST ERFO 'A
N LS To the best of my knowledge and belief, this plat was prepared from
information obtained from the Office of the Recorder of Hamilton County,
29600021 Indiana and from plans prepared by Crossroad Engineers, for the City of
Carmel.
STATE OF
9 NDIANP l Lf f�00 ill i-
tiU v F, Trent E. Newport Date LW 1111:8*jLMa
S U R Reg. Land Surveyor No. 29600021 Transportation
State of Indiana Development Consultants
714 S 4QNN1 7C MM 7101E M 07 (NWat W
EXHIBIT C
7'S i 5TF€E i SOU THWEST
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i r isnrp K »nI M. namty, cra. ,MDre,£aric ;a-r C'g,� ;az,' -qs ft':cus:
Lc^a^sers €ac 3t s?'e nar f�s6 e rr.
rg t et. a(" of sc+en ae e W=ran =4
of [as�E,. '..ctEanc :(r t .3 aas jtrc Once Z�$ '1 "$ae lit .kec� ?er# ?a: iii ?;an a
d ana} ftra a 5 t r 0 `d -agrc 58 n'e t ratans Wen Ka =u ;:d bea
152.0C last ato.-g f
:re^tern "rie so.-- _l t s *Ue sc 5� fens ca xter rya ae�ag 't w ;tom etw c c =:c
t_._ #vax wiaC, ie a da�Et ed ira sa Fri 'c c r; a{3[ a �r cT INNIf G 1 6-
M de c _ter Trent_ e rt nu.::
ratth 0 'deg^es. Cr nirc< s i s 'can hcs a ee cicaa he 6J�l, g _mcr io a:J'b
oc a of T a f athi e �rr
-z e ..r .he' 1;87 .acre .r�_; q tand gmma ed is
indica 3e igr, G= Tfc.. s
ira E?'!rrat tad t t c vr�t' crCz9u2g ai�i 5 n sa:3 Rewarder' flit nca mar a9 argrees a:
^rmergs 1: 1' s�conu t +e,t ir_�� egr etas iris rarheon 1 Re o? sc.d Trot: 3 to .i camen tiers f:
a� 7A ;#sE ecs c- �qi-r-- a -°.cay Crc. of 1si; eve rye aau•.'h�ue� cs• d sna :an ��ry y ?aa �?ia f e ocd�c
a$ tiisfry t) hcti bet' 2(2 -LAB 61 e$ al a1 Z go'ctzt"s tb) h n 1 rl ...n: degraet 3a nirlite ,'t
ie� -tar._ s id csfv rs�ii o 1C£'}. c ne a.: he sautfi- fin< of f•-S f-cc o ,lend s r=fed
it;' Jon:t: A... e- MW:ar�. C..,rYfarc fcect (ecardcd a iasf ctr^enL No^iti r '2�CoJCy =?9 .s reaie 3er�s.'
Of ic-0, -t*enca Fort? $a 5eareas B rninu es 71., secant: _cat ;he squfher° Mle a` 7c %f
io e P5 NIT 7F BEG j Xq, sq�nre of ac.-es), mace,.cr. les^
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'moo SURD
�f {�irfre[tt }tits li tsru z`t25-°nta��
This i ^strrr-c�t ,proPcr d b
BoncEt R. lrp cr_ i m oecss:
fntd,cna r ?r;s ared Lc rd Survey .7r ^."J.
Exhibit D
Terms and Conditions
1. The City will purchase, for the amount of $63,930.00, the property interest described in
the Uniform Land Acquisition Offer made to you on October 10, 2008. See Exhibit A,
Exhibit B, and Exhibit C for the plat drawings and legal descriptions.
2. The City will construct, at its expense, on the Landowner's property, the parking as
shown on the attached Exhibit D, Ingress to the parking area will be from 1 Street SW
and egress will be to the alley south of your property. The parking area would be paved
to code, curbed, and provide ingress and egress approaches and the sign will be
relocated, if necessary. The Landowner and the Landowner's employees, clients, and
guests also will have access to the public parking spaces being constructed as part of the
project.
3. The City will update its title work on your property and obtain partial mortgage releases
for all mortgages listed in the update. We would appreciate the Landowner's assistance
in this matter. The City will pay all processing fees. The City can not agree to restrict the
percentage of the proceeds which the mortgage holder(s) may demand in return for the
required partial mortgage releases. Such a restriction is beyond its control. You are
welcome to discuss such percentages with the mortgage holders.
4. The Landowner will execute the right of entry form provided by the City, which will allow
the City to proceed with the construction of the project as if it had acquired the property
interests described in the above mentioned Uniform Land Acquisition Offer and with the
construction of the parking lot described above. The City must have in hand this right of
entry by 5:00 PM local time on November 11, 2008. The City acknowledges that this
term and condition has been fulfilled by the Landowner.
5. After the acquisition of the property interests described in the Uniform Offer, the
Landowner will be free to deal with the utility.
6. All other terms and conditions contained in the Uniform Offer remain in full force and
effect.
EXHIBIT "A"
Project: 1 St Avenue SW Streetscape Sheet 1 of 2
Parcel: 3 Fee Simple
All that part of the grantor's land lying within the Right -of -Way lines depicted on
the attached drawing, marked Exhibit "B being a strip of ground Fifteen and
Seventy Hundredths (1.70) feet, taken by parallel lines, off the entire west side of
the following described property:
Part of the Southeast Quarter of Section 25, Township 18 North, Range 3 East, Hamilton
County, Indiana, more particularly described as follows:
Begin at the Northwest corner of Lot Seventeen (17) in the Warren and Phelps Addition
to the Town of Carmel, Indiana, run West 45.2 feet to the East line of Willow Street in
Carmel; thence South on the East line of Willow Street 132 feet; thence East 46.18 feet;
thence North 132 feet to the Place of Beginning.
ALSO: Begin at 45.2 feet West of the Northwest corner of Lot 17 in Warren and Phelps
Addition to the Town of Carmel, Indiana, run West 6126 feet to the East edge of the
pavement of First Avenue S.W.; thence South on and along the East edge of said
pavement 132 feet; thence East parallel to the North line of this tract 59.5 feet; thence
North 132 feet to the Place of Beginning.
EXCEPT:
That part described as follows: Part of the Southeast Quarter of Section 25, Township 18
North, Range 3 East in Hamilton County, Indiana, more particularly described as follows:
Beginning 83.4 feet West of the Northwest corner of Lot 17 in Warren and Phelps
Addition to the Town of Carmel, Hamilton County, Indiana; thence West 110 feet
measured (23.6 feet Deed) to the East edge of pavement of First Avenue Southwest;
thence Southerly on and along the East edge of said pavement 132 feet; thence East
parallel with the North line of this tract 12.05 feet measured (23.85 feet Deed) to a point
which is 82.45 feet West of the Southwest corner of Lot 17 in said Warren and Phelps
Addition; thence Northerly 132 feet to the Place f Beginning.
Containing in said 15.70 foot strip 0.048 acres, more or Iess.
Sheet 2 of 2
This description was prepared for the City of Carmel by Trent E. Newport, Indiana
Registered Land Surveyor, License Number 29600021, on the 1.8` day of August, 2008.
0 A
TRENT E. NEWPORT
INDIANA LAND SURVEYOR
No. 29600021 NO. L 00021
STATE OF
l NDIANP
Np S,i
PROJECT 1 st AVE. SW STREETSCAPE�� CHECKED BY RDP 9 -2 -08
COUNTY: HAMILTON SCALE 1" 30'
SECTION: 25 OWNER: CRAWFORD JOHN A.
TOWNSHIP: 18 NORTH RECORD DOCUMENT. INSTR. #2006- 42923, DATED 07/26/06
RANGE: 3 EAST HATCHED AREA IS THE
APPROXIMATE TAKING
18t Street SW
23.6' 83.4'
61.26' 45.2 NW CORNER LOT 17
10'x19' TELECOMMUNICATIONS I
EASEMENT IN FAVOR OF AT &T
INDIANA EXCLUSIVELY I
15.70' I
S Aap131oN
(o I WP RRER H 2�
0 M D
C
c
I LOT 17
T I
I
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82.45'
23.85' 46:18'
59.5' J
NORTH
15' 0 15' 30'
SCALE 1 30'
PREPARED BY
R �OI STER EO 0
To the best of my knowledge and belief, this plat was prepared-from
NO. LS
information obtained from the Office of the Recorder of Hamilton County,
29 600021 Indiana and from plans prepared by Crossroad Engineers, for the City of
Carmel.
STATE OF /1 �/_7 /0
O F, Trent E. Newport Date
S U R Reg. Land Surveyor No. 2960DO21 Transportation
State of Indiana Development Consultants
sins RU" at MZH W& w W97 PM?�MS
EXHIBIT C
I'57 STF= S�UT-PWEZ—T
0 01W OF
t
z
LcE 1 7
p i Gra c.: 01•� r
fL Jcoi n k: roa;lom v'
insf. 0Ot 42?23'
rte:
Q r CNT os� 9 =sir h1�.G
�o ?sv�_�f Ca er
1 4 A e/
i E Acres
5 "atT b i f4
fd. o y I 1 r rL 'IT ALL_
si n :Cec r LL'%
v^ fns zo7.0a c 5 Lit
IN
icrft zc,
f
LA6
a7 ace S^�f �sn✓ Q�¢riQ s Sec Qn Tc crs ii> ]t Y^SfF, r a Z=e of E,e 5eoon r.= =paf _,c:cn..
Lc-a<Yen cnc .af ncr_ `asp zn'err er. t "t m e±ez _e a e 'u ju.-� tyu
rsf r -zisf, :-3_ea' i`sFC aetar geae Z3 >C '1® gce I e isecc- ier �t �=ii�tan
'rdana #kr e` ai#s Df7'�tig3� es f sec^ni3 4 ia��_..ec wee itiCi ta.� G1 ;o.er
IERI ,i CiC SG �.e- r sLi z J k£a"t�R3 9t e,. M `S Jeia ii t r :C Y. C-
t *^s -ws .ie deli= ed ua``sa pia= t� T e,: -JtK, car E� �l ft�tKG a f; dQ �r r.- Tc_nc
saLf3s '(3 deg. n& rnv u es x se^sna a a c =Ufheriv _x_= 'fl:- F,nr`
grcn y3. is [rci�-a �g� G ntc:
r ;L?r Lretar�ad Iz -m rsi, �a rr e v ^5 c4 sdfd Rader` taae� f i� {ce �r b9 dears'es s_
nerr em I n a? sc d Trae= B to n n r#'rr1_s em darn S Esrs:f.'
n �a. e e Cr c mgt r c "ay t rc. R° t sf a ❑e c h +uesf' iris an sarr�y ?y inn _tea r-e sued.
❑r' t[ skram ex tvuc -irel L3 a �a Ca ca -gq 's fir zo Is ii t' r T degrze �a rns�uta 1
secrna: =a 5:3G ee, lac s td b st rrh, a.�sf^y .r3e .e:. hs :nom IinF of 1 c o i3rc_ted
3on t. ra man G.Mxp• ?rd irec' ,ecx�a trecti du -iAer Z��v�c us is a,d Ric des:
�t;cp Bien e. S•gr h 3..Ijen ens T�3' riin�hgs. sc nr.� st, 3 Faaf o cng !he aihei�r ne 0 ;c7:d
�cr x,ar a.. cq. ^e F C? 13Eoih�ri ;;:can #c,r ng 38 squa a ,ceeti l�G�9 ac 2s rnare sr. 1
ti �tt�A 7 itt ?aa ar5..�er+-
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4 No
QUIT CIL
a r E 4a ^fl5O -aec_ T1 7 X5.,::.•¢5
T5T A 'l LIG[..� II,
This in strumen:1 prmpc �d by
R-. tin ar. sue- E II cis
!�c cnII R5 s ere d Lcrd Suire; :;r ra 96000.
1
1st AVEAU Sw
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Dorothy E &John A. Crawford
Instr. #200000046044
Ri
r
W 9 Request for Taxpayer Give forth to the
(Rev. November 2Or Identificatiar� NEir3i�er and Ceftitieation requester_ Bo not
o.p� M of aw Tr ,y send to the IRS.
Lnemnr rte..enue swim
Name (as shown ort yc corn tax ratum
D .UA
m
m
c Business name, if different from above
p
fiCl h Catparation C] Partnership Qther Exempt from backup
i Check appropriate bmc t Sole pnsprietor withrtolding
a
m Aticress (number, street, and apt, or Write no flequatefs name and a dres (optional)
Al 1 c e
1 5r
City. state, and 7JP cads
CL M E
m f List accourrt numbers) here (eptlonal)
Taxpayer Identification Number (TIN)
Enter your nN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
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 instrucdans on page 3. For other entities, it is
your employer identification number (0" If you do riot have a number, see How to get a 771V on page 3. or
Note, if the account is in more than one name, see the chart on page 4 for guidelines on whose Empicyer identification number
number to enter.
Certification
Under penalties of perjury, I certify that
1. The number shown on this form is my correct taxpayar 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 (SRS) that I am subject to backup withholding as a result of a fa una 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).
Cor"aation InstrucUons. You must cross aid item Z above it you have been notified by the IRS that you are earrentfy subject to backup
withholding because you have faded to report all interest and dividends an your tax reb m. For real estate �nsactions, 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, au are not required to sign the Certifrcabon, but you mt;st
provide your correct T1N. (See the instructions on page 4_1
Sign signal" or
Here u s person nose I q Vo s
Purpose of Form An individual who is a citizen or resident of the United
A person who is required to file an )ntcn'nation return with a States,
IRS, must obtain your cotraq tataxpayer identification number A partnership, corporation, company, or association
MN) to report, for example, income paid to you; real estate a'eated 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 Any estate (other than a fore=ign estate) or bust 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 113. person information.
(nciuding 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 gene,^aily required
1. Certify that the 7 I you are giving is correct (or you are to pay a withholding tax on any foreign partners' share of
waiting far 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 exermpticn 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, ri applicable, you are also certifying that as a United States, provide Form W -9 to the partnership to
U.S. parson, your allocabfe share of any partnership income establish your U.S. status and avoid withholding an 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
is
Note. It a requester gives a ra other than Form W purposes of establishing its U.S. status and avoiding
to Withholding on its Oocabie share of net income fran the
request your TIN, you must t use m se the requester's form i f ft is
substantially sirnilar to this Form W -9. partnership =nducting a trade or business in the United
States is in the following cases:
For federal tax purposes, you are considered a person if you
are: The U.S. owner of a disregarded entity and not the entity,
Cat No. 111 JX Forst W -9 (Rev. 11-ZOR5)
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.
Payee
John Crawford
Purchase Order No.
41 1 st Street SW
Terms
Carmel, IN 46033
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02/10/09 n/a ROW acquisition 1 st Avenue SW Streetscape $63,930.00
Parcel 3
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.
ALLOWED 20
Jahn Crawford IN SUM OF
41 1 st Street SW
Carmel, IN 46033
$63,930.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
19795 -01 n/a 2 00- R4460500 .00 materials or services itemized thereon for
which charge is made were ordered and
received except
2 aktj 20
Signature
C:�-y Erect �vto4✓
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund