219444 04/24/2013 „Mf CITY OF CARMEL, INDIANA VENDOR: 366565 Page 1 of 1
ONE CIVIC SQUARE PARS INTERNATIONAL CORP CHECK AMOUNT: $3,261.43
CARMEL, INDIANA 46032 ATTN WILDO FABELO
253 W 35TH STREET-7TH FLOOR CHECK NUMBER: 219444
NEW YORK NY 10001
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 4359300 47616 3 , 261 . 43 ECONOMIC DEVELOPMENT
:'DATE--,,',.,.. _ INVOICE,#z''
3/19/2013 47616
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a BILL T fY,,.x, `• a r. "s;SHIP-_TO;
ks i.
City of Carmel,Indiana City of Carmel,Indiana
Attn:Candy Martin Attn:Candy Martin
Office of the Mayor Office of the Mayor
1 Civic Square 1 Civic Square
Carmel,IN 46032 Carmel,IN 46032
.�r�::a—"-r". `.cam,-,t' -,a-:•�an� v�.._:ti.:,,_ _ �.a�::'.'s'= --
.;P.O.'NO. Y REP', -TERM DUE DATE` SHIP'DATE SHIP VIA':
WF Net 30 4/78/20.73 ~'r 3/19/2013 UPS Ground
ITEM „� -PRODUCT. DESCRIPTION Pgs' COLOR, „QTY AMOUNT;
MONEY Reprints August 2010"Best Places To Live-2010" 2 4C 1,000 3,219.00
Shipping UPS Ground+Handling 42.43
Please-.Note .� payments, rius'fbe made'in.U:S;:Funds Total ' $3,261'43
and drawatile'on;a'U'S`-BankinW-htti,tu'tion ,... t
yN, . Payments/Credits
$0.00
Please remit'to-addresi�b'dloW.arid-'rriakd alf-checks payable fp
r; Balance Due $3,261.43
.PARS International:'Taii'�ID#X13.3783920"-:':: � -
253 West 35th Street
7th Floor
New York, NY 10001
(212)221-9595
Give Form to.the
Form ` ..9 Request.for Taxpayer
(qev.January 2011) requester,Do not.
Oepartmerltof the Treasury Identification Number and Certification send to the IRS.
Internal Revenue Service
Name(as shown on your income tax return)
Business name/disregarded entity name,if different from above
N
c PARS International Corp.
n. Check appropriate box for federal tax
C
O classification(required): ❑ Individual/sole proprietor n C Corporation S Corporation ❑ Partnership ❑Trust/estate
N
d O rr-��
0 ❑ limited liability company.Enter the tax classification(G--C corporation,S=S corporation,P=partnership)0.- t 0,Exempt payee
C N
p`u .,_;❑ Other,(seeinstructions)►
r_ Address(number,street,and apt.of suite no.) Requester's name and address"(optional)'
U
x::253 West 35th Street,7th Floor
N City,state,and ZIP code
a�
V? :New York,NY 10001
List account numbers)here(optional)
Taxpayer-Identification,Number(TIN)
Enter-your TIN in,.the appropriate box.The TIN provided must match.the name given on the"Name"line Social secbrit number
to avoid,backitp withholding.For individuals,this is your social security number(SSN).However,for a
7M resident alien,sole proprietor,or disregarded entity,see the Part I Instructions on page 3.For other
entities,KU your employer Identification number(EIN).If you do not have a number,see How to get a t :r J.
t ^
TIN on page 3.
Note:If the.account is in more than one name,see the chart on page 4 for guidelines on whose �!?±p!oirer fdaiitattgn number
number to enter,
1� 3- 3 7 8 1 3 9 Z '6
• ,_._..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)1 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.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 iegOlPed to sign the certification,but you must provide your correct TIN.See thee_
Instructions orfpage:4.
Sign Signature of n a ^�7
Here U.S.-person►. . YA'(1( P� 2RD Date► Z1 / 3.;
General Instr Cti Note.If a requester gives you a form other than Form W-9 to request
Section references are a Internal Revenue Code unless otherwise your TIN,you must use the requester's form if it is substantially similar
to this Form W-9.
noted.
Definition,of_a U.S.person.For federal tax purposes,you are
Purpose of Form considered a U.S.person if you are:-
A person'who is required to file an,information return with the IRS must •An individual who is a U.S.citizen or U.S.resident alien,
obtain yoUrcorrect taxpayer identification number(TIN)to report,for •A partnership,corporation,company,or association created or
example,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the united States,
you paid,acquisition or abandonment of secured property,cancellation .An estate(other than a foreign estate),or
of debt,or contributions you made to an IRA.
•A domestic trust(as defined in Regulations section 301.7701-7).
Use Form W-9 only if you are a U.S.person(including a resident
alien),to provide,your correct TIN to the person requesting it(the Special rules for partnerships.Partnerships that conduct a trade or
requester)and,when applicable,to: business in the United States are generally required to pay a withholding
tax on any foreign partners'share of income from such business.
1.Certify that the TIN you are giving Is correct(or you are waiting for a Further,in certain cases where a Form W-9 has not been received,a
number to be issued), partnership is required to presume that a partner:is a foreign person,._
2:Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a
3.Claim exemption from backup withholding if you are a U.S.exempt partner In a partnership conducting a trade or business in the United
payee.If applicable;you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S.
allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership income.
is not subject to the withholding tax on foreign partners'share of
effectively connected income.
Cat.No.10231X Form'W-9.(Rev.1-2011)
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))
03/19/13 47616 $3,261.43
1 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
PARS International Corp.
IN SUM OF $
253 West 35th Street, 7th Floor
New York, NY 10001
$3,261.43
ON ACCOUNT OF APPROPRIATION FOR
Community Relations
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1203 I 47616 I 43-593.00 I $3,261.43 1 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
Friday,April 19, 2013
Director, Community Relations/Economic Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund