HomeMy WebLinkAbout174352 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 363046 Page 1 of 1
ONE CIVIC SQUARE CARL W HINES JR CHECK AMOUNT: $450.00
CARMEL, INDIANA 46032 PO BOX 1202
•y- roN ,_o, INDIANAPOLIS IN 46206 -1202 CHECK NUMBER: 174352
CHECK DATE: 7/8/2009
DE ACCOUNT PO NUMBER INVOIC NUMB AMO DESCRIP
902 7 4359003 450.00 FESTIVAL /COMMUNITY EV
FRiJM CARL HINES FAX N0. 3172576157 8 Jun. 22 2009 01:17PM P1
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c. (50 PERFORMANCE CONTRACT
This is a contract for musical services to be provided on the occasion and according to the
terms listed below:
Date: S Yt c1 cz C/ *7 40
Time: rte- Until
Location:
Function _74Z2z 4 4-fa.e kYco L'Z c' v7 7'Q
Band: (Z7 v l�r r/t e a d
Fee: S e7v
Terms: G A -ec.(< a.. h f 4
Additional terms, concerns or requests may be listed below:
Signature, Client: Signature, Band Representative:
Signature
Name Carl Hines
P. O. Box 1202
Address Jndianapolis rN 46206 -1202
317 257 6157 or cell:317 -440 -6074
CHines13090aol.com
Phone: Date
E -mail:
Fax:
Date:
Contract is deemed valid by both parties upon acceptance of contract
I
FROM CARL HINES FAX NO. 317257E157 8 Jun. 19 2009 12:57P11 P2
Request for Taxpayer Give form to tm
I IdentHication Dumber and Certification Do not
send to the IRS.
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Individuals, UAS
bcm The TIN provided must mg" the name given on une 1 to avoid
b a cja your ON h the number (SSN)- However, tot a resident
batirsV wtdnttotdinp. For W iai ity 3. For.4ttter etttitfee. it is
Bien, Sole prrvirkor. or daregarded WWW, SW the ftn 1 Irmdruedor18 w page or
your employer kWA f>�ion numtw MR, If you do tat have a numb see Haw to $et a 'nN on page 3.
riots. pf tape eCWLW Is in more than are name, we the dram en page dS e 4 for quit on whose numer' b
to enter.
t�r@rtilr
UrKW Penalties of Pte, f cesdy that:
1. The num� shown on this farm W my cortact taxpayer idendficatiart numt)er (a t am wraitlrt8 few a ntxnbar to be issued to me), and
2. 1 am ot n nubjed to backup W&MWq bem se: W I am exempt front badW wftjwidina. or (b) I have rtat been notified by the Irrierrted
pevmrtue awyloe (I" that i ern to bacla wtthhoi I4V as result of a Nikxe to mport ai intansat or dtvl<WA, or (cl tote IRS has
nofiRed my that I am no longer subject to badwi) wldttrolding, and
3. I am a U.S. person (including a U.S. reafdent aW)•
Wn i Wrtg. You must cross out room 2 strove H y«, have been notified by m. or that you are aactior h am t to backup
wifhho1*4 bwAu$ a you have tidied to report a ll mere and dnidends W Your tax rattrrr. For real tpsteta hertsa an a item 2 d oes net s ppdy.
For mor�egs interest paid, kk n or abando dy nt of secured p roRixty, cancebtion of debt. cor�ttibu ors tten, but you mush
srrar*wnw4 paA), and gwwraly, POWW" other than rttwebt WW ditrklanda. You ere not required to von
provide your oWNd TIN. (see the hshWt)orm on case 4
sign
r i w an o I ux w",«r d
Purpose of Form
7
A person who I$ required 14 file an hnforrnatian retum with q1e a Any trstete as tar than a icre gn estate) or fo trust. Sae
IRS, must obtain you correct taxpayer ►derttificat�ri number lReguiatiDris sections 301 .7701 fr(a) and 7(s) fo a3ccitional
MM to report for w arnpte, inoome paid to you, reed 89t0te Intornation.
transaotions, mortgage Irderest you paid, acquisttiOn or Foreign per4Qm if you are a foreign person, do not use
abandonment of secured property, cancellation of debt, or Form W-9. Instead. US$ the WWOpriate Farm W 8 (Bee
Ogntributiorls y ou pads to an IRA. Publication 515, Withhoiding of Tax On Nonresident Aliens
U$ pM'sw%. Use Form W 9 tXify if you are a U.S. PBraon and Foreign Entities).
{including a "Clent alien), to provide your correct'nN to the Non�dent alien who Becomes a resident alien..
person requelating it (the requester) and, when applicable, to: Generally, only a nonresident alien Individual may use the
Certify that the T)N you are giving is correct (or You are kerrns of a tax treaty to reduce or elin1 t to U.S tax art
1.
vreitlrtg for a numtser to Be issued), taut tYP� of irtcone. I�to►veNer, mast tax trestles cofttain a
Certify that you are not eutxect 1D backuP WitftttoldkV- In the on krtovvq as a "satring tfause.' Exceptions sp kX to
2. Ce
in the savit>g clatase May permit arc exemptiOrt born tax tD
or continue for certain types Of hrcxy W even after the recipient
3. Claim exemption from backup withholding H you are a hay otherwise t19COrrte a U.S. resident alien for tax purposes
U.. exempt payee. If you era a U.S. resident alien who is retyhtp on an
Note. K a mqmww gtm you a form oMar Own Form W tO exception contained In the saving clause of a tax treaty to
,request yore 17N. gnu Mt4w r•sa the requsstaes form if It Ls cWm an exemption firm U.S. tax on oartain types of income,
pl skrdlar to this Fmm W -9. you nwst attadh a all temwd to Form W-9 that spectlims the
For federal tax purposes you ere considered a person If you following five Items:
are: 1. The treaty country. Generally, this mast tae the sarne
An individual who is a cltumn or mident of tie United treaty under which you clahned exemptlan from tax a$ a
Stews, nonresident alien.
w A partnership, corporation, comPanY. or &530 iautxn 2. The treaty article addressing the income.
Cr aWd or oi;;WOrW In the United States or under the laws 3. The atiale number (or location) in the tax treaty that
of ttte United Stales. ar contains the saving clause 8rtd Its exceptions-
cte. No. 10=X Farm W-9 (Aev- 1,20D5)
Prescribed�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, C� i hY'- Purchase Order No.
104 eQX Terms
/'t /2!:::; a Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
G'011/ /7h �s IN SUM OF
O 0 2
12a
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�a2 62809 V5 o,00 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
7 20 O�
Signature
Cost distribution ledger classification if T itle
claim paid motor vehicle highway fund