216681 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 366915 Page 1 of 1
ONE CIVIC SQUARE ED PENMAN PAINTING
CARMEL, INDIANA 46032 5103 ST CHARLES PLACE CHECK AMOUNT: $1,260.00
.';• ''r°. CARMEL IN 46033
CHECK NUMBER: 216681
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1208 4350900 11313 630 . 00 OTHER CONT SERVICES
1208 4350900 1613 630 . 00 OTHER CONT SERVICES
Ed Penman Painting H Lill'
5103 St Charles Place DATE: 1.6.13
Carmel, IN 46033 INVOICE# 1613
Phone 317-370-2091 FOR: 12.31.12-1.6.13
Bill To:
The Center for the Performing Arts
355 City Center Drive
Carmel, IN 46032
s
-DESCRIPTION G
,.r . b AMOUNT,
Completed work as directed by Dir. of Building Operations and Asst. Facilities Manager
Misc. Painting
Drywall Repairs
Misc Repairs
Misc Tasks
�J
D
Qo
JAN 282013
Lj
By
30 hours x$21 per hour
TOTAL $ 6130.00
THANK YOU FOR YOUR BUSINESS!
Ed Penman Painting H H1.1- W(0) H C I E
5103 St Charles Place DATE: 1.13.13
Carmel, IN 46033 INVOICE# 11313
Phone 317-370-2091 FOR: 1.7-1.13.13
Bill To:
The Center for the Performing Arts
355 City Center Drive
Carmel, IN 46032
DE
-'-,AM 6U NT,",
SCRIRTTION,
Completed work as directed by Dir. of Building Operations and Asst. Facilities Manager
Misc. Painting
Drywall Repairs
Misc Repairs
Misc Tasks
z
JAN 2 8 2013 1
By
30 hours x$21 per hour
TOTAL '$
THANK YOU FOR YOUR BUSINESS!
Form m9 Request for Taxpayer Give form to the
(Rev.November Treasury Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
N Name(as shown on your incorpe tax recur )
m G_�1�_�U f
ro /�/
Business name,if different from above
c
0
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o ndividual/
Z,; Check appropriate box: Sole proprietor ❑ Corporation ❑ Partnership ❑ Other ► ❑ withholding backup
c y Address(number,stree,and apt. swte no//) i/ Requester's name and address(optional)
a S 5(63 S` �L�s°y L.�C1
�= City, tate,and ZIP co P 15 U
CO
List account number(s)here(optional)
a�
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 31/ 7 V Z 3 Z 1
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.
EM 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 pro erty, cancellation of debt, contributions to an individual retirement
arrangement(IRA), and generally, payments other than interest and d vi ends,you are not required to sign the Certification, but you must
provide your correct TIN. (See the instructions on page 4.)
Sign Signature of —
Here U.S.person ► G Date ► —1
Purpose of Form • 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 • 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 • 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. Claim exemption from backup withholding if you are a presume that a partner is a foreign person, and pay the
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 partnership 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
o5m otYier than Form W-9 to purposes of establishing its U.S. status and avoiding
Note. If a requester gives you a f
request your TIN, you must use the requester's form if it is withholding on its allocable share of net income from the
substantially similar to this Form W-9. partnership conducting a trade or business in the United
States is in the following cases:
For f2defal%,kW's mes,yoll are ConSldered a person if you • The U.S. owner of a disregarded entity and not the entity,
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))
01/06/13 1613 Palladium $630.00
01/13/13 11313 Palladium $630.00
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
Ed Penman Painting
IN SUM OF $
5103 St Charles Place
Carmel, IN 46033
$1,260.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
-
1613 $630.00
1 hereby certify that the attached invoice(s), or
11313 '5011'5011 $630.00
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
Mond y, January 28, 2013
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund