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Home My WebLink AboutSILLY SAFARI SHOWS, INC.- 003327- 11/16/2012 CARMEL REDEVELOPMENT COMMISSION 003327 Silly,E;afari Shows, Inc. Check: 3327 12106 Southeastern Avenue Date: 11/16/2012 Indianapolis, In 46259 Vendor: SILLYS01 Prior Invoice P.O. Num. invoice Amt Balance Retention Discount Amt. Paid 14171 1,250.00 1,250.00 0.00 0.00 1,250.00 Reindeer Show 12/08/2012 1,250.00 1,250.00 0.00 0.00 1,250.00 • ;.}"y.'y...nTMEKEYgTO DOCUMENTLSECURIYIYMEAT ACTIVATEDjTHUMB PRINTIIAUDITIONALW6ECURITY FEATURES INCLUDED ISEE BACK FOR DETAILSVAIM /pt/y6 Dt-s . Carmel Redevelopment Commission 003327 'lt� 30 West Main Street REGIONS Suite 220 2o-1a21naD `""""` Carmel, IN 46032 3327 DATE AMOUNT 11/16/2012 *********1,250.00 PAY THE SUM OF ONE THOUSAND TWO HUNDRED FIFTY DOLLARS AND NO CENTS *********************** TO THE ORDER OF Silly Safari Shows, Inc. 12106 Southeastern Avenue Indianapolis, In 46259 � 4 i'0033 2 70 2 7n 1:0 740 14 2 1 31: 0013 7SO4 i 11u' CARMEL REDEVELOPMENT COMMISSION 003327 Silly Safari Shows, Inc. Check: 3327 12106 Southeastern Avenue Date: 11/16/2012 Indianapolis, In 46259 Vendor: SILLYS01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 14171 1,250.00 1,250.00 0.00 0.00 1,250.00 Reindeer Show 12/08/2012 1,250.00 1,250.00 0.00 0.00 1,250.00 K-11-52 COMPUTEREASE FORMS DIVISION(977)5774791 T-71771 /`I Silly Safari Shows, Inc. 1 M I/Gr -h 12106 Southeastern Avenue t, Indianapolis, IN 46259 ,aka 1 -�f 1... .„�f. p e` h 317.862:9003 FAX 862.9008 www.sillysafaris.com ? ;1n** ": CONTACT,INFORMATION. , `J <, • Carmel Redevelopment Commission I Stephanie Marshall he leader in conservation education P [.IV] ANIMAL SEIOWS 30 West Main Street Suite #220 OFFICIAL USE ONLY Carmel, IN 46032 DATE INVOICE# 10116/2012 14171 PHONE 317-571-2787 Program Confirmation Additional Comments PROGRAM DATE v TIME- ,, ; ,AUDIENCE;., : Special Repeat Visit! ° Carmel Arts District 12/8/2012 3:30 - 5:30PM Family Holiday Celebration Stephanie's cell) 496-9116 Include W-9 8 Cert of Ins REFERRED BY City of Carmel PROGRAM DESCRIPTION QTY RATE AMOUNT Reindeer Show Silly Safaris' Reindeer Reserve starring SANTA'S ELVES with TWO LIVE 1 1500.00 1,500.00 REINDEER from the North Pole! Discount We're giving you a discount! In order to qualify for discount, payment -250.00 -250.00 must be made on the day of show or before. For information on promoting the show, goto our web page and see the details on the PR Tab. NOTE FOR CANCELLATION OR WEATHER RELATED ISSUES CALL DIRECT: Coyote Chris' cell phone) 765-585.0042 Amazon John's cell phone) 317-281-6064 THANK YOU AND MERRY CHRISTMAS! DIRECTIONS TO YOU: 1) Please return this form AND include directions to your focahon above.,. - _ - 2) Silly Safaris reserves therrghf to reassign performers as necessary • ,'r� • _ • 3) Please circle your choice PAYMENT INCLUDED WILL PAY LATER • Signature Date Total: $1,250.00 Please Make Payable To SILLY SAFARIS 09 Request for Taxpayer Give Form to the :Form requester.Do not (Rev.December 2011) Identification Number and Certification requester. the IRS. S. Department of the Treasury Internal Revenue Service Name(as shown on your income tax return) ht ‘1y` SoEC-4 , 54 ,ws t Zt(G. - cd Business name/tlismgarded wilily name,II different from above 0 s :llt/ Ste- :s n Check appropriate x for federal tax classification: ic w o ❑ IndivlduaVso a proprietor ❑ C Corporation 0 S Corporation ❑ Partnership ❑Trust/estate 0. 0 B.o ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation.P=partnership)► ❑Exempt payee `o `c m _ c tl � El Other(see instructions)• Address(number,street and apt or suite no.) Requester's name and address(optional) o n° kilo (' SouKtect /'tn Ave-,--o.e_ to City,state,and ZIP code 3 t.A.R _p s oJ , tn.( Ll6z59 List account number(s) (optional) 11: 3u I. Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line i Social security number to avoid 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 77N on page 3. 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. 3 5 - 1 0 210t, 41 Part I[ Certification Under penalties of perjury.t certify that: 1. The number shown on this form is my correct taxpayer identification number for I am waiting for a number to be issued to me),and 2. I 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.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. I A / Sign Signature of Q/ �// Here u.S.person► I '` r pce-tr. Qp+..l Date► tacos 2G, 2O ( 1.. General Instructs s • 1 Note.If a requester gives you a form other than Form W-9 to request your TIN,you must use the requester's form if it is substantially similar Section references are to the Internal Revenue Code unless otherwise 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 your correct 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 Special rules for partnerships.Partnerships that conduct a trade or alien),to provide your correct TIN to the person requesting it(the 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.12-2011) Proscribed 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 5,74 /hoc - Purchase Order No. i/06 SO f��q> a"v �v->�/� Terms ) yg.,/lo/ �, /Li )425- Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) /.06/12 P-07( 5 et 5 G///I/e v„c%fiio /r2SOc Total //2 X0.00 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audite ame in accor- dance with IC 5-11-10-1.6. V 14 , 20lh er -Treasurer