HomeMy WebLinkAbout167981 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 362446 Page 1 of 1
ONE CIVIC SQUARE EVERYTHING DISPLAYS, INC
0 i CHECK AMOUNT: $805.98
CARMEL, INDIANA 46032 151 WEST 46TH STREET SUITE 1201
off `o NEW YORK NY 10036 CHECK NUMBER: 167981
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
853 5023990 1922 805.98 OTHER EXPENSES
Everything Displays, Inc. Invoice
151 'West 46th Street Suite 1201
New York, NY 10036 Date Invoice
4/3/2007 1922
Bill To Ship To
Caramel Clay Parks and Recreation Caramel Clay Parks and Recreation
Tom Divan Tom Divan
1235 Central Park Drive East 1235 Central Park Drive East
Caramel Indiana, 46032 Caramel Indiana 46032
P.O. Number Terms Rep Ship Via F.O.B. Project
16454/car040307 Net 30 AM 4/5/2007 UPS Ground
Quantity Item Code Description Price Each Amount
1 LEC501 Prestige Floor Lectern Podium Non Sound 632.04 632.04
lecgsn Gooseneck Assemblies for Mics 34.99 34.99
LECMH Microphone Holder 8.95 8.95
UPS Ground 130.00 130.00
Pumhose
Description —L e C r n
P.O. e
O.L it d So p- 3 9 X 10
Bud st
Une
Purchaser Date
Approval pate
f JAN 05
Please remit to above address. Total
$805.98
Payments /Credits $0.00
Balance Due $805.98
uc :iip Carmel Narks Recreatn 317 571 -2468 p
INDIANA RETAIL TAX EXEMPT PAGE
IA a-% CERTIFICATE NO. 003120155 002 0 I PURCHASE ORDER NUMBER�
s,
o f u m
FEDERAL EXCISE TAX EXEMPT c
35- 60000972 (9 J
ONE CHIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A
CARMEL. INDIANA SQUARE VOUCHER, DEUVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
ORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
1CHASE ORDER DATE DATE REQUIRED REQUISITION NQ. VENDOR NO. DESCRIPTION
W O `tl+ 1 07
=NDOR 'i' poaaws c vw• SHIP
TO
r1 N e.,� 3 F L
1 a C T_A) q4ola
flRMATWN BLANKET CONTRACT PAYMENTTERMS FREIGHT
OUANTIn UNIT OF MEASURE DESCRIPTION UNIT PRICE EXT ENSION
1 ►r L'a", 1- E E Sty 3D. by
1 3 ,y
r�
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APP 50 p SUFFICIENT T�O PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. l �j
ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. VENDOR COPY
Firm
Request for Taxpayer Give form to the
(Rev. October 20W Identification Nu mbe r and Certification requester. Do not
Nparrrnn; of the Troa,ury send to the IRS
Name (as shown on }our ln;ome tax ieium)
N Everything Displays, Inc.
Id Business name. it ditterant from above
CL
c
0
o c Check appropriate box: Individual/Sole proprietor Ccrporaiion Partnership Exempt
O U(niWO liability company. Enter the l0% GIOSSrtiLOiit7rr (13= disregarded entity. C= corporOtiori. P= parlriC�•L -h 1P 1 P Cl p
payee
o fllfier tivBe inS400lirait,j
Address fnumher, .street, anti ant. or suite no,) Requesier's name and iddress foptionall
a v 151 W. 46 St, Suite 1201
'City state, and ZIP code
New York, NY 10036
Q.1 List a=unt numbei(s) here ioptional)
W
Taxpayer Identification idumber (TIN)
Enter your TIN in the appropriate box. The TIN provided rr :ust r :iair.:h the Herne coven t}rr I „tire 1 t(r av:)id soelsl security rourntier
backup withholding. For individuals, this is your social security number (SSM. However. for a resident
alien, Sole proprietor, or disregarded entity, see the Part I inStr uc1i0AS on page 3. For airier entities, it is
your emplflyer identification number (EIN). If you do not have a number. see How to get a T1N on page 3: or
Note. If the acrotent is in more than one name, see the chart on page 4 for gi ldelines on whose Ennptoyer Identltteatlon number
number to enter, 20 1531490
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 nr)t subject to backrep witlihniding because: 4a} I ain exempt farm hwAup withholding, or (b) I have not been notified by the Inlernal
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
notifies) nip that I am no longer subiect to backup withholding, and
3. I am a U.S. citizen or other U.S_ person (defined belovi).
Certification instructions. You roust cross out ilein 2 above if you have been ncrfified by the IRS that you are Currently subject io 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 iroortgage interest paid, acquiSiiicn or abarrdownenf of Securest property, cancellation of debt, contributions to an kidividual reiirernent
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
pro-Ade your correct TIN. See the instruCliorrs txl page 4.
Sign Signaturo of 5/27/08
Here I U.S. person Date i General Instructions Definition of a U.S. person. For federal tax purposes, you are
Section references are to the Internal Revenue Code unless considered a U.S. person if you are:
otherwise Hated. An individual who is a U.S. citizen or U.S. resident alien,
A partnership, corporation, company, or association created or
Pu r po se of Form organized in the United States or under the law 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) An estate (other than a foreign estate), or
to report, for example, income paid to you, real estate o 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 Fon11 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
t. Certify that the TIN you are giving is correct for 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 The U.S. owner of a disregarded entity and not the entity,
Oai. No. iJ231X Form -9 (Rav, ip -20071
Malu Welton
To whom it concern,
This invoice is past due and this is our 4` attempt at collection. It was emailed repeatedly to the customer, Tom Divan, but no
payment has been received.
I would kindly appreciate your assistance in completing payment for this invoice.
Please contact me if you have any questions.
Take care,
Malu Welton''?_
Sales Assistant
JA N 0 5 2009.
Toll Free 800.450.4582 ext. 707
Fax 212.658.9002
Email malu @lecternsandpodiums.com
Web www.lecternsandpodiums.com
L c�c Will 1'ac�iuE�7s
S
1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice ofbill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whore, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Everything Displays, Inc. Purchase Order No.
151 West 46th Street, Ste 1201 Terms
New York, NY 10036 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s))
4/3/07 Amount
1922 Lectern
805.98
Total 805.98
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.
'Everything Displays, Inc. Allowed 20
151 West 46th Street, Ste 1201
New York, NY 10036
In Sum of
805.98
ON ACCOUNT OF APPROPRIATION FOR
853 Gift Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
853 1922 5023990 805.98 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
14 -Jan
2009
Signature
805.98 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund