HomeMy WebLinkAbout177065 09/15/2009 CITY OFCARMEL,INDIANA VENDOR: 363046 Page of
ONE CIVIC SQUARE CARL xxH|wsaJR
CA*MEL.|N�AmA 45032 ,ovux,um CHECK AMOUNT: $�o0�oo
INDIANAPOLIS /w^oom,u2 CHECK NUMBER: 177065
CHECK DATE: 9115/2009
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902 4359003 500.00 I0/04/09 JAZZ ON M000
rF6 t'RL HINES FAX N0. 3172576157 8 Sep. 03 2009 01:34PM P2
R. armel edevelapnent Comm, 09/03/2009 14,36 9793 P.002/002
from:
INVOICE
INVOta #[100]
DATE: SEPTE IDER 3, 2009
TO; FOti:
Cartu,el development Commission.
30 W, Main St, Site 220
Carmel, In 46032
asesttu ars ANDUNT
0 C. we /0--q-(7C/
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TOTAL
Make all checks payable to
Payment Is due wlthln 30 Gays.
If you have any questbns concerning this Invoice, contact [Flame, phone number, e-mail)
Thank you for your businl
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FROM CARL HINES FAX NQ. 3172576157 B .Fun. 19 2eO9 12:57P[q P2
Request forr Taxpayer (Chia fornn to the
w requester. Do not
Ow AMWY 2M Identification Number and oertifica on to the I RS.
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Enter ymw TIN In the approAriate
box. The TIN provided must mater ttw name given an U- t to avoid Sodni xr
For indivfdu t; �.is your Social SoGuz y heather (S3M- however, tor'a resident
or •,d r rtlad entity, see the Ian I tn:&ucWrra on page 3 For aMrer cut•itina, H Or
Your �ptoYw i¢mrtifir sdOn number MM U you do not have a number. aoe How to pot a TIN on page 3:
Ngtr� M the acrormt bin mare than am nerno, sae the Chad an pr3$e
et for Wldallnes on whose number a8on f
to enlist..
Carbi!'caWn
Under panakUO. of WIUTY 1 oartih' that:
1. Tyro number shown on ttro farm to my correct taxpaya' dwtircation number (or I em waiting for a number to be iwu od to me), and
2, f am not s to bada+r Wv#>tiholdkV beCB ter kV t err+ exempt from badarp w nrtraidtnp. a (b) I have not been lit d% o by the I hat
"Wonuo Service pR% diet i ern gubl a to trams wfttdipldin� as a result e1 a failura to rsport al) WOrast or dtvldends, or (G} t}1a I RS tra8
na4lilad me tires I M no kxW nubject to bnclWp kUr*. and
3. I a a U.S. pane+ (irccluding a U.S. raaidant agen). to backup
t;artifiGtrt�it uzvuctlom You must GM*O out Item it 2 a b ov e H you have been nbtlftad by the IRS that you are currently dose not aPPivo
rani ng becaim you revo fefied to. report 69 Interest. and "dands on your tag mturn. For rest estate Uumactionu, rim
nor morfpage Interest paid, acq+ or abandoamnt of secured dvk t dreC. you I required W
attars Wnatd (IFuVs7 W.Wggally, paymartfs attrer than Interest and
provide your corred TIN. (See t h ucUorra en pegs A.) r
s of
i>4era U.& I*
Purpose of Form
A persM who IS ISquirOd to file err infomratian return with the R Any estate (ether than foreign, )slate) t fo rst. Sae
IRS. must obtain your correct taxpayer tq�ictition number Regulations sections 301 .7701 t3(a) and 7 {e) for BcdHicnal
inkorrrtction.
(Tim 10 report. for ewsmpl% Income i� to you, heat If otr are a foreign person, do not use
trartsactions, mortgage Interest you paid, azqui or Foreign pea'em I Y
abandonment of eectared property, cancellation of debt, or Form W-9. Instead, use the appropriate Form W-$ (see
cons bud= you tTrmde to an IRA. publication 515, y4ftthttoiding o1 Tax on Noitrasident Atiarrs
U.S. perswu Use Form W-g only if you are a U.S. person end Foreign t:ntities)..
(Including s resident alien); td provide Your correct 1nN to the Norausident alien who becamas a mgldent alien.
peraaci requesting it (the r6gUaStOd and, when applicable, to: Generally, ony a nonresident alien Individual ratty use the
that TIN ya�r are givin9 cotre+ (or you are terms of a tax treaty to reduce or 6liMirWite US, tax art
1,
certain types of f xvne. Howovw, most tax WOOS axttain a
weiWv for a number to be provision known as a -mving OWL"-_ F=80vns spW
2. Certify etas you are not subject to backup withholding, in the saving clause may permit an exemption from tax to
continue for certain of income Bien after the Mctp rat
or continue
Cdakm exemption from backup wlthholding If you are a has othervAse b3CGIne a U.S. resident alien for fair purposes.
US. exerrIpt Payee• H you are a US. resident alien who is relying on an
Pelota.ffs req mster you a !form ottrer ftn Fora W -9 to exception cordained in the saving cause of a tax treaty to
request your 71N, you must use the regUS$b1eS form H It Is c m an exemption from US. tax on certain types of thrums,
substerwaw slydlel' to this Form W-R you must attach a statertant to Form W-0 that speCW= the
For federal tax purposes you am cortsidgred a parson If you foilowIng five Hems:
sue: 1. The treaty country. Generally, this must be the saline
a An Individual who IS a olt M or resident of the United treaty under whICh you Claimed exemption from tax as e
States,
nonresident alien.
a q p arn
ip corporudion, cpeny. or a�iatfon 2. The treaty article addressing the income.
c or oNginized In the United States or under the laws 3. The article number (or in the tare treaty that
of the United States, Or contains the saying Clause end its exceptiom
kaki, rat, 10anx Form W -9 Puy. 1-2m
Presbribetl by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form 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
C �,r1 N h� S Purchase Order No.
P. o. Boy 12 02 Terms
1_ h Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9_3_p Wpb
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 v
Clerk- Treasurer
.VOUCHER NO. WARRANT NO.
i
ALLOWED 20
IN SUM OF
Z
5UA
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
43 5 %r 5 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
Si na re
Direc�or of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund