175773 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 363212 Page 1 of 1
ONE CIVIC SQUARE LARRY MECHEM MUSIC CHECK AMOUNT: $750.00
210 CARRIGAN PT. CARMEL, INDIANA 46032
NOBLESVILLE IN 46062 CHECK NUMBER: 175773
CHECK DATE: 816/2009
DEPARTMENT ACCOUNT PO NUM BER INVOICE NUMBER AMOUNT DESCRIPTION
902 i 4359003 100 750.00 FESTIVAL /COMMUNITY EV
l.!
F rom: L.ARR 61E4
Too, L1604 z
INVOICE #[100]
DATE: JULY 31, 2009
TO: FOR: I
Carmel Redevelopment Commission �Uc� j 6>,v
30 W. Main St., Suite 220 F
Carmel, In 46032
DESCRIPTION AMOUNT
PC, T f3A� D 09
TOTAL a erl
Make all checks payable to LA R �j r m
Payment is due within 30 days.
If you have any questions concerning this invoice, contact [Name, phone number, e-mail]
Thank you for your business!
Form -9 Request for Taxpayer Give form to the
(Rev. November 2005) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue service
ni Name (as shown on your income tax return)
r
ro
a Business name, ifferent from above
Ll��R l�C HCM UIC'
N N
a o Individual/ Exempt from backup
o Check appropriate box: Sole proprietor El Corporation El Partnership ether withholding
a
r y Address (number, street, and apt. or suite no.) Requester's name and address (optional)
o a
City, state, and ZIP code
CL
No 9Les vi 11E �6z-
m List account number(s) here (optionalf
a�
m
Taxpayer Identification Number (TIN)
E=nter 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
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. 6 161
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 general l ayments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. (See fanstructions on page 4.)
Sign Signature of
Here I U.S. person 2 Date
Purpose of Form e An individual who is a citizen or resident of the United
A person who is required to file an information return with the States,
IRS, must obtain your correct taxpayer identification number o A partnership, corporation, company, or association
(TIN) to report, for example, income paid to you, real estate created or organized in the United States or under the laws
transactions, mortgage interest you paid, acquisition or of the United States, or
abandonment of secured property, cancellation of debt, or e Any estate (other than a foreign estate) or trust. See
contributions you made to an IRA. Regulations sections 301.7701 -6(a) and 7(a) for additional
U.S. person. Use Form W -9 only if you are a U.S. person information.
(including a resident alien), to provide your correct TIN to the Special rules for partnerships. Partnerships that conduct a
person requesting it (the requester) and, when applicable, to: trade or business in the United States are generally required
1. Certify that the TIN you are giving is correct (or you are to pay a withholding tax on any foreign partners' share of
waiting for a number to be issued), income from such business. Further, in certain cases where a
2. Certify that you are not subject to backup withholding, or Form W -9 has not been received, a partnership is required to
3 presume that a partner is a foreign person, and pay the
Claim exemption from backup withholding if you area
U.S. exempt payee. withholding tax. Therefore, if you are a U.S. person that is a
partner in a partnership conducting a trade or business in the
In 3 above, if applicable, you are also certifying that as a United.States, provide Form W -9 to the partnership to
U.S. person, your allocable share of any income establish your U.S. status and avoid withholding on your
from a U.S. trade or business is not subject to the share of partnership income.
withholding tax on foreign partners' share of effectively
connected income. The person who gives Form W -9 to the partnership for
purposes of establishing its U.S. status and avoiding
Note. If a requester gives you a form other than Form W -9 to withholding on its allocable share of net income from the
request your TIN, you must use the requester's form if it is partnership conducting a trade or business in the United
substantially similar to this Form W -9. States is in the following cases:
For federal tax purposes, you are considered a person if you o The U.S. owner of a disregarded entity and not the entity,
are:
Cat. No. 10231X Form W-9 (Rev. 11 -2005)
PERFORMANCE AGREEMENT
This Performance Agreement (the "Agreement is executed as of Di
2009 (the "Effective Date by and between The City of Carmel Redevelopment Commissi "CRC"),
and LA mL°G E"/yy (the "Performer").
1. Performance. Performer shall perform live musical entertainment (the "Performance on
of 20r� (the "Performance Date from 6 A4sr /P.M to A-M./P.M., and
shall be held at SA M AW (the "Venue Performer shall provide all equipment necessary
or desirable for the Performance, except for standard audio equipment, lights, and staging, all of which
shall be provided by CRC. Performer shall comply with: (a) all rules and regulations of the Venue
applicable to all performers; and (b) all reasonable directives of CRC with respect to the Performance.
r7 W
2. Payment. On the Performance Date, CRC shall pay to Performer �Q (the "Payment
3. Non Performance. If the Performance is rendered impossible or infeasible by: (a) any cause
within CRC's control, then CRC shall pay to Performer the full amount of the Payment; (b) any cause
within Performer's control, then Performer shall pay to CRC the amount of $250.00 as liquidated
damages; or (c) any cause beyond the control of CRC or Performer, which shall include, without
limitation, Performer's illness, then neither party shall pay any amount to the other on account of the
impossibility or infeasibility of the Performance, with exception "(d) (d) in the event of inclement
weather, the performer is not required to perform, but must be present to be paid in full.
4. Sales. CRC shall not sell tickets or charge admission to the Performance. On the Performance
Date, Performer may sell Performer's merchandise at the Venue, and Performer shall retain all proceeds
therefrom without contribution to CRC.
5. Relationship. Performer is not (and shall not be considered for any purpose to be) the employee
of CRC or the City of Carmel, Indiana (the "City"). Performer shall indemnify and hold harmless CRC
from and against all claims, suits, judgments, liabilities, losses, costs, and expenses (including, without
limitation, reasonable attorneys' fees and court costs) that result from any claim for wages, benefits, or
otherwise by any agent, employee, or contractor of Performer.
6. Indemnity. Performer shall indemnify and hold harmless CRC from and against all claims, suits,
judgments, liabilities, losses, costs, and expenses (including, without limitation, reasonable attorneys'
fees and court costs) that result from the Performance or the breach of this Agreement by Performer.
7. Assignment. Performer shall not assign this Agreement or any of its obligations hereunder.
8. Miscellaneous. The indemnities set forth herein shall survive the termination of this Agreement.
This Agreement shall be governed by, and construed in accordance with, the laws of the State of Indiana.
The invalidity or unenforceability of any term or condition of this Agreement shall not affect the other
terms and conditions, and this Agreement shall be construed in all respects as if such invalid or
unenforceable term or condition had not been contained herein.
IN WITNESS WHEREOF, CRC and Performer have executed this Agreement as of the
Effective Date.
THE CITY OF CARMEL REDEVELOPMENT PERFO ER:
COMMISSSO
By: By:
Printed: Printed: 4
Title: Title: N
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, raW"er hour, number of units, price per unit, etc.
Payee
L.yrGy ����UJ Purchase Order No.
216 Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 73�o.G�j
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
VQUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
2�� �Gyri /7
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
GZ /OlJ 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
L ig 20 09
Signatur
Director of O perations
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund