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Home My WebLink About177822 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 363216 Page 1 of 1 ONE CIVIC SQUARE HEATHER RAMSEY CHECK AMOUNT: $500.00 CARMEL, INDIANA 46032 8977 RIVERBEND COURT y 4.... ono INDIANAPOLIS IN 46250 CHECK NUMBER: 177822 CHECK DATE: 9/29/2009 DEPARTMENT ACCOUNT PO NUMBE INVO NUM AMOU DESCRIPTION 902 4359003 102 500.00 FESTIVAL /COMMUNITY EVTm Blair E Clark NNYORCE 836 E Auman Dr Carmel In 46032 Phone 317- 2018640 INVOICE #101L DATE: SEPTEMBER 3,2009 TO: FOR: Michael Lee Jazz on the Monon Intern 8/26/089 Carmel Arts and Design District Carmel In Email: mlee@carmel.in.gov Phone: (317) 571 -2796 Fax: (317) 571 -2789 Make all checks payable to feather Ramsey 1� Payment is due within 30 days. If you have any questions concerning this invoice, contact Blair Clark 317 2018640 DESCRIPTION AMOUNT Band performance for jazz on the Monon $500.00 Artist: heather Ramsey and Band members Performance Date 10/4/09 TOTAL $500.00 For, 9 r equest for Taxpayer Give form to the (Rev. October 2007) identification N and Certification requester. Do not Qepartment of the Treasury send to the IRS. Internal Revenue Service Nam (as shown on your income tax retur}� l�Gi�t'+ti�i2.. l `r`lhi i R Business name, if different from above C1 o Al At its o Check appropriate box: '0 Individual/Sole proprietor Corporation Partnership Exempt Limited liability company. Enter the tax classification (D= disregarded entity, C= corporation, P =partnership) payee q 2 other (see instructions) P Address (number, street, and apt. or suite no.) Requester's name and address (optional) a o�I QIViAZ1br1tq1� C1. City, state, and ZIP code rn d List account number(s) here (optional) to 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 c backup withholding. For individuals, this is your social security number (SSN). However, for a resident 3 I p 8a W 35 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. 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 ail 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 7 1 1 7 Al Here 1 U.S. parson oats General Instructions Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: Section references are to the Internal Revenue Code unless a An individual who is a U.S. citizen or U.S. resident alien, otherwise Hated. 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) An estate (other than a foreign estate), or to report, for example, income paid to you, real estate s 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. s The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W -9 (Rev. 10-2007) 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: hind 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 H eNh Purchase Order No. R I 7 R9VQhbp,11d C1. Terms J.. h J t b, I f II L it Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) t z t h %h 10A r0 Total S 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.= 4 r 2 0 Clerk- Treasurer VQUCHER NO. WARRANT NO. 1 ALLOWED 20 IN SUM OF 8 977 RiV�r�na �t N (250 ON ACCOUNT OF APPROPRIATION FOR 2 143591�0� Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 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 2� 20 0 W W LA, rlltv� Directo Wf erations Cost distribution ledger classification if Title claim paid motor vehicle highway fund