HomeMy WebLinkAbout177219 09/15/2009 Ir
CITY OF CARMEL, INDIANA VENDOR: 363331 Page 1 of 1
ONE CIVIC SQUARE MARCUS P GUTTRICH
CARMEL, INDIANA 46032 934 E MAIN ST CHECK AMOUNT: $13,400.00
LI.o „-Eo CARMEL IN 46033 CHECK NUMBER: 177219
CHECK DATE: 9/15/2009
DEPARTMENT ACCOUN PO NUM INVOICE NUMBE AMOUNT DESCRIPTION
920 4470502 13,400.00 131TH /KEYSTONE R -O -W
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF 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
Marcus P. Guttrich Purchase Order No.
934 E. Main Street Terms
Carmel, IN 46033 Date Due
Invoice Invoice Description
Date number or note attached invoices or bills Amount
PROJECT: 07 -08: Keystone Parkway 131 Street
PARCEL: 76
COUNTY: Hamilton
Compensation for Permanent and Temporary Right -of -Way Total: $13,400.00
I 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
2009
(Signature) Marcus P. Guttrich
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.
1 2009
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION Board /Council Members
FOR
COST DISTRIBUTION LEDGER CLASSIFICATION
IF CLAIM PAID MOTOR VEHICLE HIGHWAY FUND
Acct. Account Title Amount
No.
Form W °9 Request for Taxpayer Give form to the
(Rev. October 2007) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
Name (as shown on your income tax return)
m Marcus P. Guttrich
m Business name, if different from above
a
C
O
Q o Check appropriate box: 91 Individual /Sole proprietor Corporation El Partnership Exempt
CL Limited liability company. Enter the tax classification (D= disregarded entity, C= corporation, P= partnership) payee
o 2 Other (see instructions)
ti Address (number, street, and apt. or suite no.) Requester's name and address (optional)
cL o 934 E. Main Street
City, state, and ZIP code
to Carmel, IN 46033
aa) List account number(s) here (optional)
rn
Taxpayer Identification Number IN
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 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.
IMW 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. citizen or other U.S. person (defined below).
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 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 of
Here U.S. person Date 41h, vl 00
General Instructions Definition of a U.S. person. or f eral tax purposes, you are
considered a U.S. person if yo are:
Section references are to the Internal Revenue Code unless
otherwise noted. a An individual who is a U.S. citizen or U.S. resident alien,
e A partnership, corporation, company, or association created or
Purpose of Form organized in the United States or under the laws of the United
A person who is required to file an information return with the States,
IRS must obtain your correct taxpayer identification number (TIN) e An estate (other than a foreign estate), or
to report, for example, income paid to you, real estate e A domestic trust (as defined in Regulations section
transactions, mortgage interest you paid, acquisition or 301.7701 -7).
abandonment of secured property, cancellation of debt, or Special rules for partnerships. Partnerships that conduct a
contributions you made to an IRA. trade or business in the United States are generally required to
Use Form W -9 only if you are a U.S. person (including a pay a withholding tax on any foreign partners' share of income
resident alien), to provide your correct TIN to the person from such business. Further, in certain cases where a Form W -9
requesting it (the requester) and, when applicable, to: has not been received, a partnership is required to presume that
1. Certify that the TIN you are giving is correct (or you are a partner is a foreign person, and pay the withholding tax.
waiting for a number to be issued), Therefore, if you are a U.S. person that is a partner in a
2. Certify that you are not subject to backup withholding, or partnership conducting a trade or business in the United States,
provide Form W -9 to the partnership to establish your U.S.
3. Claim exemption from backup withholding if you are a U.S. status and avoid withholding on your share of partnership
exempt payee. If applicable, you are also certifying that as a income.
U.S. person, your allocable share of any partnership income from The person who gives Form W -9 to the partnership for
a U.S. trade or business is not subject to the withholding tax on purposes of establishing its U.S. status and avoiding withholding
foreign partners' share of effectively connected income. on its allocable share of net income from the partnership
Note. If a requester gives you a form other than Form W -9 to conducting a trade or business in the United States is in the
request your TIN, you must use the requester's form if it is following cases:
substantially similar to this Form W -9. e The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231X Form W -9 (Rev. 10 -2007)
Form W -9 (Rev. 10 -2007) Page 2
o The U.S. grantor or other owner of a grantor trust and not the 4. The IRS tells you that you are subject to backup
trust, and withholding because you did not report all your interest and
o The U.S. trust (other than a grantor trust) and not the dividends on your tax return (for reportable interest and
beneficiaries of the trust. dividends only), or
Foreign person. If you are a foreign person, do not use Form 5. You do not certify to the requester that you are not subject
W -9. Instead, use the appropriate Form W -8 (see Publication to backup withholding under 4 above (for reportable interest and
515, Withholding of Tax on Nonresident Aliens and Foreign dividend accounts opened after 1983 only).
Entities). Certain payees and payments are exempt from backup
Nonresident alien who becomes a resident alien. Generally, withholding. See the instructions below and the separate
only a nonresident alien individual may use the terms of a tax Instructions for the Requester of Form W -9.
treaty to reduce or eliminate U.S. tax on certain types of income. Also see Special rules for partnerships on page 1.
However, most tax treaties contain a provision known as a Penalties
"saving clause." Exceptions specified in the saving clause may
permit an exemption from tax to continue for certain types of Failure to furnish TIN. If you fail to furnish your correct TIN to a
income even after the payee has otherwise become a U.S. requester, you are subject to a penalty of $50 for each such
resident alien for tax purposes. failure unless your failure is due to reasonable cause and not to
If you are a U.S. resident alien who is relying on an exception willful neglect.
contained in the saving clause of a tax treaty to claim an Civil penalty for false information with respect to
exemption from U.S. tax on certain types of income, you must withholding. If you make a false statement with no reasonable
attach a statement to Form W -9 that specifies the following five basis that results in no backup withholding, you are subject to a
items: $500 penalty.
1. The treaty country. Generally, this must be the same treaty Criminal penalty for falsifying information. Willfully falsifying
under which you claimed exemption from tax as a nonresident certifications or affirmations may subject you to criminal
alien. penalties including fines and /or imprisonment.
2. The treaty article addressing the income. Misuse of TINs. If the requester discloses or uses TINS in
3. The article number (or location) in the tax treaty that violation of federal law, the requester may be subject to civil and
contains the saving clause and its exceptions. criminal penalties.
4. The type and amount of income that qualifies for the
exemption from tax. Specific Instructions
5. Sufficient facts to justify the exemption from tax under the Name
terms of the treaty article.
Example. Article 20 of the U.S. -China income tax treaty allows If you are an individual, you must generally enter the name
an exemption from tax for scholarship income received by a shown on your income tax return. However, if you have changed
Chinese student temporarily present in the United States. Under your last name, for instance, due to marriage without informing
U.S. law, this student will become a resident alien for tax the Social Security Administration of the name change, enter
purposes if his or her stay in the United States exceeds 5 your first name, the last name shown on your social security
calendar years. However, paragraph 2 of the first Protocol to the card, and your new last name.
U.S. -China treaty (dated April 30, 1984) allows the provisions of If the account is in joint names, list first, and then circle, the
Article 20 to continue to apply even after the Chinese student name of the person or entity whose number you entered in Part I
becomes a resident alien of the United States. A Chinese of the form.
student who qualifies for this exception (under paragraph 2 of Sole proprietor. Enter your individual name as shown on your
the first protocol) and is relying on this exception to claim an income tax return on the "Name" line. You may enter your
exemption from tax on his or her scholarship or fellowship business, trade, or "doing business as (DBA)" name on the
income would attach to Form W -9 a statement that includes the "Business name" line.
information described above to support that exemption.
If you are a nonresident alien or a foreign entity not subject to Limited liability company (LLC). Check the "Limited liability
withholding, company" box only and enter the appropriate code for the tax
backup g, give the requester the appropriate classification "D" for disregarded entity, "C" for corporation, "P"
completed Form W -8. for partnership) in the space provided.
What is backup withholding? Persons making certain payments For a single- member LLC (including a foreign LLC with a
to you must under certain conditions withhold and pay to the domestic owner) that is disregarded as an entity separate from
IRS 28% of such payments. This is called "backup withholding." its owner under Regulations section 301.7701 -3, enter the
Payments that may be subject to backup withholding include owner's name on the "Name" line. Enter the LLC's name on the
interest, tax exempt interest, dividends, broker and barter "Business name" line.
exchange transactions, rents, royalties, nonemployee pay, and
certain payments from fishing boat operators. Real estate For an LLC classified as a partnership or a corporation, enter
transactions are not subject to backup withholding. the LLC's name on the "Name" line and any business, trade, or
You will not be subject to backup withholding on payments DBA name on the "Business name" line.
you receive if you give the requester your correct TIN, make the Other entities. Enter your business name as shown on required
proper certifications, and report all your taxable interest and federal tax documents on the "Name" line. This name should
dividends on your tax return. match the name shown on the charter or other legal document
creating the entity. You may enter any business, trade, or DBA
Payments you receive will be subject to backup name on the "Business name" line.
withholding if: Note. You are requested to check the appropriate box for your
1. You do not furnish your TIN to the requester, status (individual /sole proprietor, corporation, etc.).
2. You do not certify your TIN when required (see the Part II Exempt Payee
instructions on page 3 for details),
3. The IRS tells the requester that you furnished an incorrect If you are exempt from backup withholding, enter your name as
TIN, described above and check the appropriate box for your status,
then check the "Exempt payee" box in the line following the
business name, sign and date the form.
Form W -9 (Rev. 10 -2007) Page 3
Generally, individuals (including sole proprietors) are not exempt part I. Taxpayer Identification
from backup withholding. Corporations are exempt from backup Number (TIN)
withholding for certain payments, such as interest and dividends.
Note. If you are exempt from backup withholding, you should Enter your TIN in the appropriate box. If you are a resident
still complete this form to avoid possible erroneous backup alien and you do not have and are not eligible to get an SSN,
withholding. your TIN is your IRS individual taxpayer identification number
The following payees are exempt from backup withholding: (ITIN). Enter it in the social security number box. If you do not
have an ITIN, see How to get a TIN below.
1. An organization exempt from tax under section 501(a), any If you are a sole proprietor and you have an EIN, you may
satisfies the requirements of section 401(f)(2),
IRA, a custodial account under section 403(b)(7) if the account enter either your SSN or EIN. However, the IRS prefers that you
use your SSN.
2. The United States or any of its agencies or If you are a single- member LLC that is disregarded as an
instrumentalities, entity separate from its owner (see Limited liability company
3. A state, the District of Columbia, a possession of the United (LLC) on page 2), enter the owner's SSN (or EIN, if the owner
States, or any of their political subdivisions or instrumentalities, has one). Do not enter the disregarded entity's EIN. If the LLC is
4. A foreign government or any of its political subdivisions, classified as a corporation or partnership, enter the entity's EIN.
agencies, or instrumentalities, or Note. See the chart on page 4 for further clarification of name
5. An international organization or any of its agencies or and TIN combinations.
instrumentalities. How to get a TIN. If you do not have a TIN, apply for one
Other payees that may be exempt from backup withholding immediately. To apply for an SSN, get Form SS -5, Application
include: for a Social Security Card, from your local Social Security
Administration office or get this form online at www.ssa.gov. You
6. A corporation, may also get this form by calling 1- 800 772 -1213. Use Form
7. A foreign central bank of issue, W -7, Application for IRS Individual Taxpayer Identification
8. A dealer in securities or commodities required to register in Number, to apply for an ITIN, or Form SS -4, Application for
the United States, the District of Columbia, or a possession of Employer Identification Number, to apply for an EIN. You can
the United States, apply for an EIN online by accessing the IRS website at
www.irs.gov /businesses and clicking on Employer Identification
9. A futures commission merchant registered with the Number (EIN) under Starting a Business. You can get Forms W -7
Commodity Futures Trading Commission, and SS -4 from the IRS by visiting www.irs.gov or by calling
10. A real estate investment trust, 1- 800 -TAX -FORM (1- 800 829 3676).
11. An entity registered at all times during the tax year under If you are asked to complete Form W -9 but do not have a TIN,
the Investment Company Act of 1940, write "Applied For" in the space for the TIN, sign and date the
A common trust fund operated by a bank under section form, and give it to the requester. For interest and dividend
12.
5812. payments, and certain payments made with respect to readily
tradable instruments, generally you will have 60 days to get a
13. A financial institution, TIN and give it to the requester before you are subject to backup
14. A middleman known in the investment community as a withholding on payments. The 60 -day rule does not apply to
nominee or custodian, or other types of payments. You will be subject to backup
withholding on all such payments until you provide your TIN to
15. A trust exempt from tax under section 664 or described in the requester.
section 4947. Note. Entering "Applied For" means that you have already
The chart below shows types of payments that may be applied for a TIN or that you intend to apply for one soon.
exempt from backup withholding. The chart applies to the Caution: A disregarded domestic entity that has a foreign owner
exempt payees listed above, 1 through 15. must use the appropriate Form W -8.
IF the payment is for THEN the payment is exempt part II. Certification
for...
To establish to the withholding agent that you are a U.S. person,
Interest and dividend payments All exempt payees except or resident alien, sign Form W -9. You may be requested to sign
for 9 by the withholding agent even if items 1, 4, and 5 below indicate
Broker transactions Exempt payees 1 through 13. otherwise.
Also, a person registered under For a joint account, only the person whose TIN is shown in
the Investment Advisers Act of Part I should sign (when required). Exempt payees, see Exempt
1940 who regularly acts as a Payee on page 2.
broker Signature requirements. Complete the certification as indicated
Barter exchange transactions Exempt payees 1 through 5 in 1 through 5 below.
and patronage dividends 1. Interest, dividend, and barter exchange accounts
Payments over $600 required Generally, exempt payees opened before 1984 and broker accounts considered active
to be reported and direct 1 through 7 during 1983. You must give your correct TIN, but you do not
sales over $5,000' have to sign the certification.
2. Interest, dividend, broker, and barter exchange
See Form 1099 -MISC, Miscellaneous Income, and its instructions. accounts opened after 1983 and broker accounts considered
2 inactive during 1983. You must sign the certification or backup
However, the following payments made o a corporation (including gross withholding will apply. If you are subject to backup withholding
proceeds paid to an attorney under section 6045(f), even if the attorney is a
corporation) and reportable on Form 1099 -MISC are not exempt from and you are merely providing your correct TIN to the requester,
backup withholding: medical and health care payments, attorneys' fees, and you must cross out item 2 in the certification before signing the
payments for services paid by a federal executive agency. form.
Form W -9 (Rev. 10 -2007) Page 4
3. Real estate transactions. You must sign the certification. Secure Your Tax Records from Identity Theft
You may cross out item 2 of the certification.
Identity theft occurs when someone uses your personal
4. Other payments. You must give your correct TIN, but you information such as your name, social security number (SSN), or
do not have to sign the certification unless you have been other identifying information, without your permission, to commit
notified that you have previously given an incorrect TIN. "Other fraud or other crimes. An identity thief may use your SSN to get
payments" include payments made in the course of the a job or may file a tax return using your SSN to receive a refund.
requester's trade or business for rents, royalties, goods (other
than bills for merchandise), medical and health care services To reduce your risk:
(including payments to corporations), payments to a Protect your SSN,
nonemployee for services, payments to certain fishing boat crew Ensure your employer is protecting your SSN, and
members and fishermen, and gross proceeds paid to attorneys 0 Be careful when choosing a tax preparer.
(including payments to corporations).
interest aid b Call the IRS at 1- 800 829 -1040 if you think your identity has
5. Mortgage
p y you, acquisition or been used inappropriately for tax purposes.
abandonment of secured property, cancellation of debt,
qualified tuition program payments (under section 529), IRA, Victims of identity theft who are experiencing economic harm
Coverdell ESA, Archer MSA or HSA contributions or or a system problem, or are seeking help in resolving tax
distributions, and pension distributions. You must give your problems that have not been resolved through normal channels,
correct TIN, but you do not have to sign the certification. may be eligible for Taxpayer Advocate Service (TAS) assistance.
You can reach TAS by calling the TAS toll -free case intake line
What Name and Number To Give the Requester at 1 -877- 777 -4778 or TTY/TDD 1- 800 -829 -4059.
Protect yourself from suspicious emails or phishing
For this type of account: Give name and SSN of: schemes. Phishing is the creation and use of email and
1. Individual The individual
websites designed to mimic legitimate business emails and
websites. The most common act is sending an email to a user
2. Two or more individuals Qoint The actual owner of the account or,
account) if combined funds, the first falsely claiming to be an established legitimate enterprise in an
individual on the account' attempt to scam the user into surrendering private information
3. Custodian account of a minor The minor' that will be used for identity theft.
(Uniform Gift to Minors Act) The IRS does not initiate contacts with taxpayers via emails.
4. a. The usual revocable savings The grantor- trustee Also, the IRS does not request personal detailed information
trust (grantor is also trustee) through email or ask taxpayers for the PIN numbers, passwords,
b. So- called trust account that is The actual owner' or similar secret access information for their credit card, bank, or
not a legal or valid trust under other financial accounts.
state law
5. Sole proprietorship or disregarded The owner' If you receive an unsolicited email claiming to be from the IRS,
entity owned by an individual forward this message to phishing@irs.gov. You may also report
For this type of account: Give name and EIN of: misuse Of the IRS name, logo, or other IRS personal property to
the Treasury Inspector General for Tax Administration at
6. Disregarded entity not owned by an The owner 1- 800 366 -4484. You can forward suspicious emails to the
individual Federal Trade Commission at: spam @uce.gov or contact them at
7. A valid trust, estate, or pension trust Legal entity www.consumer.gov /idtheft or 1- 877- IDTHEFT(438- 4338).
8. Corporate or LLC electing The corporation
corporate status on Form 8832 Visit the IRS website at www.irs.gov to learn more about
9. Association, club, religious, The organization identity theft and how to reduce your risk.
charitable, educational, or other
tax- exempt organization
10. Partnership or multi- member LLC The partnership
11. A broker or registered nominee The broker or nominee
12. Account with the Department of The public entity
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
List first and circle the name of the person whose number you fumish. If only one person
on a joint account has an SSN, that person's number must be furnished.
Circle the minor's name and furnish the minor's SSN.
J
You must show your individual name and you may also enter your business or "DBA"
name on the second name line. You may use either your SSN or EIN (if you have one),
but the IRS encourages you to use your SSN.
List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN
of the personal representative or trustee unless the legal entity itself is not designated in
the account title.) Also see Special rules for partnerships on page 1.
Note. If no name is circled when more than one name is listed,
the number will be considered to be that of the first name listed.
Privacy Act Notice
Section 6109 of the Intemal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest,
dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or
contributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return.
The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S.
possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal
nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.
You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other
payments to a payee who does not give a TIN to a payer. Certain penalties may also apply.
Page 4 PROJECT 07 -08: Keystone Parkway 131 St. PARCEL 76
If you decide to accept the offer of 13.400.00 made by the City of Carmel, sign your name
below and mail this form to the address indicated above. An additional copy of this offer has been
provided for your file.
ACCEPTANCE OF OFFER
I (We), Marcus P. Guttrich
landowner(s) of the above described property or interest in property, hereby accept the offer of
$13,400.00 made by the City of Carmel on this 0?q day of 2009.
a t ew L
(Signature)
Marcus P. Guttrich
(Printed Name)
NOTARY'S CERTIFICATE
STATE OF
SS:
COUNTY OF l-Ian*' f 'n
Subscribed and sworn to before me this day of Tidy 2009.
My Commission Expires: o11,e
My County of Residence is: 'ort
(Signature)
tom..
NANCY HER
;te•• MANN
Marion County anQl/
a,•. M y Commission E)ires
AWW4,2016 (Printed)i NOTARY PUBLIC
03/08 STATEMENT OF THE BASIS FOR JUST COMPENSATION Code #3782
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
this acquisition is identified in the Acquiring Agency's records as:
Des. Project 07 -08 Parcel 76 Road Keystone County Hamilton
Parkway, E.
131 Street
Owner(s) Marcus Guttrich
3. The area and type of interest being acquired: Fee simple take of 1,169 SF
The amount in Item 5 below includes payment for the purchase of all interests in the real 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. A 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 $6,750
b. Severance Damages (i.e.: Setback; Loss in
Value to the Residues, etc) $6,250
c. Other Damages (Itemize)
Cost- To-Cure estimates:
N/A
Temporary R/W $400
Total Damages (Rounded) $6,650
Total amount believed to be Just Compensation offered for this Acquisition is: $13,400
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:
N/A
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:
Approximately 1,100 SF of manicured lawn, three mature trees, and 128 SF of asphalt paved driveway.
8. Items owned by others (i.e.: lessee, tenants, etc.) included in Item 5 above are identified as follows: N/A
9.Remarks: N/A
City of Car el Approval: Reviewer.
Signature: Signature:
Name Printed: Cv N Name Printed:
Title: ��l Company:
Date: Z t 7 Date:
CF -3 Code #3782
APPRAISAL REPORT
Value Findings Short Form Long Form
Partial Acquisition Total Acquisition Page 1 of 39
Type of Property Residential Project 07 -08
Indicate:(Residential, Commercial, Bareland, Farm, Special, Industrial)
Location NE Keystone Parkway E. 1 Street Parcel 7
Owner Marcus Guttrich Phone (317) 844 -2689 Road E. 131 Street (Main
Street)
Address 934 E. Main Street, C Indiana County Hamilton
Tenant Contract Buyer Phone
Address
Land Areas: Before: 15,341 SF After: 14,172 SF Acquisition 1,169 SF
Temp. R/W 300 SF Perpetual R/W N/A PER N/A Access Rights N /.a
CERTIFICATION OF APPRAISER
I hereby certify:
That I have personally observed of the property herein appraised and that I have personally made a field inspection of the comparable sales relied upon in making said appraisal. The property being appraised and the
comparable sales were as represented or referenced within the appraisal.
That t o the best of my knowledge and belief the statements contained in the appraisal herein set forth are true and the Information upon which the opinions expressed herein are based Is correct; subject to the limiting
conditions set forth.
That I understand that such appraisal MAY be used in connection with the acquisition of right -of -way for a project utilizing Federal funds.
That such appraisal has been made In conformity with appropriate taws, regulations, policies and procedures applicable to the appraisal of property for such purposes; and that to the best of my knowledge no portion of
the value assigned to such property consists of such items which are noncompensable under appropriate established law.
That this appraisal assignment may have called for less than would otherwise be required by the specific guidelines of the Uniform Standards of Professional Appraisal Practices (USPAP), bulls not so limited in scope that
It may tend to mislead the users of the report, or the public.
That neither my employment nor my compensation for making this appraisal and report are in any way contingent upon the values reported herein.
That any decrease or Increase in the fair market value of real property prior to the date of valuation caused by the public Improvement for which said property is acquired, or by the likelihood that the property would be
acquired for such improvement, other than that due to physical deterioration within the reasonable control of the owner, was disregarded In determining the compensation for the property.
That the reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions and are my personal, Impartial, and unbiased professional analyses, opinions, and conclusions.
That I have no direct or Indirect present or prospective interest in the property that is the subject of this report and no personal Interest with respect to the parties Involved or in any benefit from the acquisition of such
property appraised.
That I have no bias with respect to any property that is the subject of this report or to the parties involved with this assignment.
That the owner or a designated representative was afforded the opportunity to accompany me on the property Inspection.
That I have not revealed the findings and results of such appraisal to anyone other than the proper officials of the Acquiring Agency or officials of the Federal Highway Administration and I will not do so until authorized by
said officials or until I am required to do so by due process of law, or until I am released from this obligation by having publicly testified as to such findings.
That I have not given consideration, or included in my appraisal, any allowance for relocation assistance benefits.
That no one provided significant real property appraisal assistance to the person signing this report with the exception of those signing below.
That my opinion of fair market value for the property to be acquired and residue damages, if any, as of the 8th day of May 2009, which is the effective date of this appraisal is $13,400 based upon by
Independent appraisal and the exercise of my professional judgment.
SUMMARY PRIMARY APPRAISER
BEFORE VALUE 150,000
Signature
AFTER VALUE 136,600 Named Typed Erick Landeen, M
Appraisal License CG40400483
Land Taken 5,000 Broker
Date: J 9, 2009
Land Improvements 1, 75 0
ASSISTED BY
Improvements 0
Signature
Cost -to -Cure 0 Named Typed James R. Green
Appraisal License CG40600238
Damages to Residue 6,250 Broker
Date: June 9, 2009
Temporary R/W 400
Signature
TOTAL DUE OWNER 13,400 Name Typed
Appraisal License
Broker
Form 25008 (Rev. 05) Dale:
TE"Z IXDOLOGNA INC. Real Estate Counselors and Appraisers Pagel
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
Marcus P. Guttrich Purchase Order No. NA
934 E. Main Street Terms
Carmel IN 46033 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/24/09 NA 07 08 Keystone Parkway 131 st Street
Land C ost
Parcel 76 $13,400.00
Total $13,400.00
I hereby certify that the attached invoice(s), or bills(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.
Marcus P. Guttrich ALLOWED 20
934 E. Main Street IN THE SUM OF
Carmel IN 46033
13,400.00
ON ACCOUNT OF APPROPRIATION FOR
Marcus P. Guttrich
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
DEPT.#
NA NA 4470502 $13,400.00
I hereby certify that the attched 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
September 14 20 09
$13,400.00 Signature
Cost distribution ledger classification if Cit En
claim paid motor vehicle highway fund Title