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168378 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 362516 Page 1 of 1 1J ONE CIVIC SQUARE BRAD WIESLEY ASSOCIATES CHECK AMOUNT: $2,385.36 s CARMEL, INDIANA 46032 PO BOX 3583 BOULDER CO 80307 -3583 CHECK NUMBER: 168378 CHECK DATE: 2/4/2009 DEPARTMENT ACCOUNT PO N INVOICE N UMBER AMOUNT DESCRIPTION :1110 4357004 1268 795.12 EXTERNAL INSTRUCT FEE 1115 4357004 1268 795.12 EXTERNAL INSTRUCT FEE 1120 4357004 1268 795.12 EXTERNAL INSTRUCT FEE I Brad Wiesley Associates PO Box 3583 Date: 1/15/2009 Invoice Number: 1268 Boulder CO 80307 -3583 PO Number: Phone: (303) 884 -2200 Fax: (303) 673 -0751 Due Date: 2/14/2009 Email: brad(@wiesleyassoc.com Shipping Method: Billing Address Shipping Address Fishers Fire Department Fishers Fire Department Fishers IN Travel Time Travel"to Site 2009 -01 -11 1 500 500.00 Crystal Reports Training Day 2009 -01 -12 through 2009 -01 -14 3 950 2,850.00 Travel Time Travel Home 2009 -01 -15 1 500 500.00 Travel Expenses Estimated Travel 1 1,715.9 1 Customer Note: SubTotal; 5,565.90 Attn: Jim Alderman Tax: 0.00 Total: 5,565.90 The total cost for the Crystal Reports class is $5565.90 There were 14 students in the class. The cost per student is $397.56. The following agencies /personnel attended the class... Fishers Fire Department ($1192.68) Jim Alderman Jerry Nulliner Ann Cichocky Hamilton County Sheriff s Office ($1590.24) Kim Jowitt Jim Mann Brian Reily Graham Packham Carmel Communication ($795.12) Dennis Stilts Janet Arnone Carmel Fire Department ($795.12) Becky Pace Becky Lannan Cicero Fire Department ($397.56) Lance Overholser Carmel Police Department ($795.12) Laura Mulligan Linda Ross Please submit your portion of the invoice for payment. If you have any questions let me know. Thanks! Jim Alderman Division Chief Fishers Fire Department Form WN9 Request for Taxpayer Give form to the (Rev. January 2005) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service �i Name (as shown on your income tax return) Brad Wiesley m Business name, if different from above o Brad Wiesley Associates 4) y CL o Individual{ Exempt from backup Check appropriate box: Sole proprietor Corporation Partnership Other ❑withholding o t Address (number, street, and apt. or suite no.) Requester's name and address (optional) PO Box 3583 E City, state, and ZIP code U CL Boulder, CO 80307 -3583 N m List account number(s) here (optional) m rn ORM Taxpayer Identification Number (TIN) 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 1 5 1 21 1+716+01714 6 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. 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. 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 (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 U /2U�2005 Here U.S. person 11 Date 01 Purpose of Form A person who is required to file an information return with the Any estate (other than a foreign estate) or trust. See IRS, must obtain your correct taxpayer identification number Regulations sections 301.7701 -6(a) and 7(a) for additional (TIN) to report, for example, income paid to you, real estate information. transactions, mortgage interest you paid, acquisition or f=oreign person. If you are a foreign person, do not use abandonment of secured property, cancellation of debt, or Form W -9. Instead, use the appropriate Form W -8 (see contributions you made to an IRA. Publication 515, Withholding of Tax on Nonresident Aliens U.S. person. Use Form W -9 only if you are a U.S. person and Foreign Entities). (including a resident alien), to provide your correct TIN to the Nonresident alien who becomes a resident alien. person requesting it (the requester) and, when applicable, to: Generally, only a nonresident alien individual may use the 1. Certify that the TIN you are giving is correct (or you are terms of a tax treaty to reduce or eliminate U.S. tax on waiting for a number to be issued), certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified 2. Certify that you are not subject to backup withholding, in the saving clause may permit an exemption from tax to or continue for certain types of income even after the recipient 3. Claim exemption from backup withholding if you area U.S. exempt payee. has otherwise become a U.S. resident alien for tax purposes. Note. If a requester gives you a form other than Form W -9 to If you are a U.S. resident alien who is relying on an request your TIN, you must use the requester's form if it is exception contained in the saving clause of a tax treaty to substantially similar to this Form W -9. claim an exemption from U.S. tax on certain types of income, For federal tax purposes you are considered a person if you fol owing fi ea temsaatement to Form W -9 that specifies the are: 1. The treaty country. Generally, this must be the same An individual who is a citizen or resident of the United treaty under which you claimed exemption from tax as a States, nonresident alien. A partnership, corporation, company, or association 2. The treaty article addressing the income. created or organized in the United States or under the laws 3. The article number (or location) in the tax treaty that of the United States, or contains the saving clause and its exceptions. Cat. No. 10231X Form w-9 (Rev. 1 -2005) 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)) 01/15/09 I 1268 I $795.12 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 Brad W iesley Associates IN SUM OF P.O. Box 3583 Boulder, CO 80307 $795.12 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# I Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members 1115 1268 43- 570.04 $795.12 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 Tuesday, January 27, 2009 Dir Title Cost distribution ledger classification if claim paid motor vehicle highway fund The total cost for the Crystal Reports class is $5565.90 There were 14 students in the class. The cost per student is $397.56. The following agencies /personnel attended the class... Fishers Fire Department ($1192.68) Jim Alderman Jerry Nulliner Ann Cichocky Hamilton County Sheriff's Office ($1590.24) Kim Jowitt Jim Mann Brian Reily Graham Packham Carmel Communication ($795,12) Dennis Stilts Janet Arnone Carmel Fire Department ($795.12) Becky Pace Becky Lannan Cicero Fire Department ($397.56) Lance Overholser Carmel Police Department ($795.12) Laura Mulligan Linda. Ross Please submit your portion of the invoice for payment. If you have any questions let me know. Thanks! Jim Alderman Division Chief Fishers Fire Department Brad Wiesley Associates PO Box 3583 Date: 1/15/2009 Invoice Number: 1268 Boulder CO 80307 -3583 PO Number: Phone: (303) 884 -2200 Fax: (303) 673 -0751 Due Date: 2/1412009 Email: brad Cabwiesleyassoc.com Shipping Method: Billing Address Shipping Address Fishers Fire Department Fishers Fire Department Fishers IN item Travel Time Travel to Site 2009 -01 -11 1 500 500.00 z� TM"Fle t 4�.a CReports T,rainmg Day y .2009 O1 12 through 2009 01 14 3 950A ti 2,850' 00,,. IJr...... Travel Time Travel Home 2009 -01 -15 1 500 500.00 �K "_T"[c"' "T" F•'r "fi.'T"TP� '7T*4tN� r4'.' s"'— mr..^r..- ..•.1""'T"°+"� Travel Expenses 4rR,� ;fwk E stimated Traver 5r' r 1 rG ��1,715 9* 1,715:90"x x n �T a y k i� I a.n...�.S..aa�w I t 'Gv .S f �Ys:+" L .La..- .a- .._..•.e.. L�.j.. .4.1..�u .aJ.+_.+w�.... s...A..�.,...�_.u.a... _...�a.� Y.....��Lt— u...... e.. r ..�.r`L.J'�+`'�.�,'i.::i. -_.r .3' Customer Note: SubTotal: 5,565.90 Attn: Jim Alderman Tax: 0.00 Tota 1: 5,565.90 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)) 1268 CFD Portion Crystal Reporting Class $795.12 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, WA RRANT NO. ALLOWED 20 .Brad Wiesley Associates IN SUM OF P.O. Box 3583 Boulder, CO 80307 $795.12 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# I Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 1268 43- 570.04 $795.92 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 FEB 2 2009 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Brad iesley Associates PO Box 3583 Date: 1/15/2009 Invoice Number: 1268 Boulder CO 80307 -3583 PO Number: Phone: (303) 884 -2200 Fax: (303) 673 -0751 Due Date: 2/14/2009 Email: brad(&wiesleyassoc.com Shipping Method: Billing Address Shipping Address Fishers Fire Department Fishers Fire Department Fishers IN Travel Tme Travel to Site 2009 -01 -11 1 500 500.00 Crystal ReportsTraming Day 2009 01 1Zuthrough 2009,061 14 3 3a 3 950 2 850 00 4 L� P E .i,��01 5 s W ,N �.J t...�, ,r„ 4#' '.r„ p w r a "::a ;d "4 ;m a� r iy, a6 iii `g a':" .E 0 r, Travel Time Travel Home 2009 -01 -15 1 500 500.00 Travel Expenses1 Est mated Travel 1v` "E_� 1 715 9 1 715 90 y Tsai, ✓"r.a ..-e r k .nM& �3 &i"r'i 3 3 u^ Ttt a�sPb�f .w w W &.tEs.. z B V Customer Note SubTotal: 5,565.90 Attn: Jim Alderman Tax: 0.00 Total: 5,565.90 The total cost for the Crystal Reports class is $5565.90 There were 14 students in the class. The cost per student is $397.56. The following agencies /personnel attended the class... Fishers Fire Department ($1192.68) Jim Alderman Jerry Nulliner Ann Ciehocky Hamilton County Sheriff's Office ($1590.24) .Kim Jowitt Jim Mann )3rian Reily Graham Packham Carmel Communication ($795.12) Dennis Stilts Janet Arnone Carmel Fire Department ($795.12) Becky Pace Becky Lannan Cicero Fire Department ($397.56) Lance Overholser C tment $795.i2 Laura Mulligan Linda Ross Please submit your portion of the invoice for payment. If you have any questions let me know. Thanks! Jim Alderman Division Chief Fishers Fire Department 1 Form w_9 Request for Taxpayer Give form to the (Rev. January 2005) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue service c i Name (as shown on your income tax return) m Brad Wiesley CU Business name, if different from above Z Brad Wiesley Associates a3 0 a Individual/ Exempt from backup Check appropriate box: Sole proprietor Corporation Partnership Other withholding o m Address (number, street, and apt. or suite no.) Requester's name and address (optional) c PO Box 3583 CL U City, state, and ZIP code U CL Boulder, CO 80307 -3583 (n a) List account number(s) here (optional) v Taxpayer Identification Number (TIN) 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 5 2 t 7 6 0 7 4 6 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. 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. 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 (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 1 0120/2005 Here U.S. person III 11 1 Purpose of Form A person who is required to file an information return with the e Any estate (other than a foreign estate) or trust. See IRS, must obtain your correct taxpayer identification number Regulations sections 301.7701 -6(a) and 7(a) for additional (TIN) to report, for example, income paid to you, real estate information. transactions, mortgage interest you paid, acquisition or Foreign person. If you are a foreign person, do not use abandonment of secured property, cancellation of debt, or Form W -9. Instead, use the appropriate Form W -8 (see contributions you made to an IRA. Publication 515, Withholding of Tax on Nonresident Aliens U.S. person. Use Form W -9 only if you are a U.S. person and Foreign Entities). (including a resident alien), to provide your correct TIN to the Nonresident alien who becomes a resident alien. person requesting it (the requester) and, when applicable, to: Generally, only a nonresident alien individual may use the 1. Certify that the TIN you are giving is correct (or you are terms of a tax treaty to reduce or eliminate U.S. tax on waiting for a number to be issued), certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified 2. Certify that you are not subject to backup withholding, in the saving clause may permit an exemption from tax to or continue for certain types of income even after the recipient 3. Claim exemption from backup withholding if you area U.S. exempt payee. has otherwise become a U.S. resident alien for tax purposes. Note. If a requester gives you a form other than Form W -9 to If you are a U.S. resident alien who is relying on an request your TIN, you must use the requester's form if it is exception contained in the saving clause of a tax treaty to substantially similar to this Form W -9. claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W -9 that specifies the For federal tax purposes you are considered a person if you following five items: are: 1. The treaty country. Generally, this must be the same o An individual who is a citizen or resident of the United treaty under which you claimed exemption from tax as a States, nonresident alien. o A partnership, corporation, company, or association 2. The treaty article addressing the income. created or organized in the United States or under the laws 3. The article number or location In the tax treat that of the United States, or contains the saving clause and its exceptions. y Cat, No. 10231X Form W -9 (Rev. 1 -2005) 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 Brad Wiesley Associates Purchase Order No. P.O. Box 3583 Terms Boulder, CO 80307 -3583 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1/15/09 1268 paymen6t for Crystal Reports training for Laura Mulligai 795.12 and Linda Ross on January 12 14, 2009 in Fishers, IN 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 Brad Wiesley Associates IN SUM OF P. 0 Box 3583 Boulder, CO 80307 -3583 795.12 ON ACCOUNT OF APPROPRIATION FOR police general fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 7i I hereby certify that the attached invoice(s), or 1110 1268 570 -04 795.12 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 January 30 20 09 7 AdZdidd J) aed Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund