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HomeMy WebLinkAboutPOLKABOY, INC.- 003222- 10/17/2012 I 003222 CARMEL REDEVELOPMENT COMMISSION Polkaboy, Inc. Check: 3222 377 Patricia Court Date: 10/17/2012 12012 Car me l, IN 46033 ena : POLKABO Prior Amt. Paid P.O. Num. Invoice Amt Balance Reten i n Discoo nt 6,500.00 9281 a 6,500.00 6,500.00 0.00 92812 Entertainment for Oktoberfest =_-_— 0.00 6,500.00 6,500.00 • 6,500.00 0.00 EAT A-TIVATEDITHOMB PRIN_T�'AAOD1TIONAL SECURITYFEATU-RES INCLUDED',SEE BACK FOR DETAILS�' .p( :;:p: :THE KEVyTO,pOCOMEtJTiSECURIT�Y�H_ j - -- 003222 REGIONS I A•DE., Carmel Redevelopment Commission 2D.,<2L9.D 4 tP c- 30 West Main Street I 'a Suite 220 c/s E` Carmel, IN 46032 3222 O'Sn" DATE AMOUNT 10/17/2012 6,500.00 II THE SUM OF SIX THOUSAND FIVE HUNDRED DOLLARS AND NO CENTS PAY TO THE ORDER OF Polkaboy, Inc. 377 Patricia Court Carmel, IN 46033 ;q .„M� - i 003222 u r ______ --__.--_-.---__- . u • 0740142L31: 0087504 >, 5 >, ' 003222 CARMEL REDEVELOPMENT COMMISSION Check: 3222 Polkaboy, Inc. Check: 3222 Carmel,el,Patricia 033 Vendor: POLKABO Carmel, IN 46033 Prior Amt. Paic P.O. Num. Invoice Amt Balance Retention Disco nt 6,5. Pak Invoice 6,500.00 6,500.00 0.00 92812 Entertainment for Oktoberfest __ 6,500.01 6,500.00 6,500.00 100 0.00 • I HI 52 COMPUTEREASE FORMS DIVISION(ST7)577 5791 T-71771 Page 2 of? a t. .'1J .1 g• • Fans W-9 Request for Taxpayer Give Form to the lecember gp,'pa, the, Identification ication Number and Certification I IRS.not . kernel Resew&nee • Name PPaaen an yore%COI*tax ashen) Polkaboy.Inc re tipp Kern nmrmbbrgadW any en.a derma from ebony Check appocSte bee for forma tax cbanmtion. ❑maaldavhda POarMer ❑C Caporal), 0 S Corporation ❑ Praaaip ❑Try verans D Exempt ones i D theme teary caraay Fiaa he tar dSfcoien IC•C oorooration.36 corpoabn,Patneteye --.b a ❑ Other pminWeatiamie Arians)(ranter.street me eat.Or an W..) fltgeel✓e mere end edbma IapaviW 377 Patricia Court • CW,stow and LP man y r3 Cannel,IN 45033 tit—it metope lee laaaerae Lang Taxpayer Identification Number(TIN) Enter your TIN In the appropriate box.The TIN provided nest match the name given on the Name'lie I sera[sea✓ay ranter • to mold backup watoldng•For fn4Mduate.this is year oacta security number(SSN).However,for a I - I resident alien,rob t proprietor.or disregarded entity.see the Pan I Instructions on page 3.For other - y °reties,it e yak employer Identticoibn windy(BYO.it you do not have a number.see How to got a TIN on Doge 3. Nate.ll the account is in nee tan are name.see the chant an page 4 tot guidelines on whose Employer OpN lranlpn neuter ' number to enter. ) • 6 - 4 a 6 0 j 4 3 1 2 1� Certitieatlon 111 111 Unger pastes of popsy,I certify that 1. The rxrrlber shown on this form is my oonpar tagmyar bentembon "ter(er I em waiting fa a number to be eared to me),and 2. I am not subject to backup oriole ing because((a)I am exempt from backup withholding.or Th)I have not been notified by the Internal Revenue Service(IRS)that I an subject to backup w thho erg as a restart of a failure to report all kdamt or dividends,or(c)the IRS has notified me that 1 am no longer subject to backup withholding.and 3. I am a U.S.demo or other U.S.person(oefkW blow). Certification Instructions You must awe out[ten 2 above if you have been notified by the IRS that you am currently subject to backup withholding because you have toped to report all interest and dMdands on your tax return.For red estate transacteoru.tan 2 does not interest pact cogdsitbn or abandonment of sewed property,cancellation of debt,contributions to an individual retirement arrangement end 9enae2y.payments other then interest and dividends,you are not required to sign the certification.but you must provide your correct TIN.See Mo bstcaona on page 4. Sign t1/4041ie r \ /i iHer o U.8. preen Dwe General Instructions Note.t a requests ghee you a torn other than Fare W-9 to request Section ref'fences are to to frtonuol Revenue Code odes otherwise your 11N,you mat use the requester's ben if R Is substantially Pete not W, to tnb Fpm W-9. Purpose of Form Definition of a U.S.person.For federal tax purposes.you eve considered a US.person If you tie: A parson wn Is required to Rio an blarn Lion return with to IRS mast •An Individual who Is a US.date,or U.S.resident ahem. �n y Jr taxpayer ldanta(aton nut(TIN)to report.far •A parNSshA coporatdrt coned exo Plid,Income acquisition abandonment pons.mo,gageppuai ardzed b the(toted States or�to laws Oi�te Caned United des, of debt,a tmblputon, •you made to on IRA •An testa(eta than a resign estate),Or shah. Form provide�t you we a U.S.pawn(Inducting a rcbem •A domestic bus(as defined in Regulations Section 301.7701.7). you coned TIN to the person requesting it(the Special rules for partteraktps. requester)are,wan appacable.to business In the United Stales are generally that to pay y a wade or 1.Catty to the TM you air eking a correct(a you we till an a Y faegn Partners.Shared khan such bit a tMh°Ianp number to be Issued), waling for Further.M certain cases stem Fpm W-9 tan not been received,a 2.Certify that you Pro red wgtcrt to backup dieted" Perenerelip a required to presume gust a Parka Is al 3.aim ing,or end Pay the witeadirp au.Thaobre,II you air a U.S.Wake person,l:a page,.t epW you me certifying ua imp t you N a U.S.tun, Partner k e pmutaSdp conducti g a bade a lushness M Mr United ePa W-0 10 irk partnership aatebhn your US.aaoebb Son of any sermon income from US t busi s CAWS and ewoN whiloldg an our aua d 1 pamb,erSiP kcrs.subjct to the holds g lox on foreign partners'Sae d Isnot connected income.i Is not Cat No.10231% Farm W 9(Rw.17.2Q7I) 9/24/20)2 r.,,.,. I f ,I, • Page I of Lee, Mike E From: Lentz, Melanie J Sent: Wednesday, September 26, 2012 12:46 PM To: Lee, Mike E Cc: McVicker, Megan; Heck, Nancy S; 'Vanessa Stiles' Subject: FW: Invoice- Carmel City Center Oktoberfest Mike, After taking it over with Nancy and Megan we have agreed to pay Polkabov the $7000 total. Therefore, CRC will pay the $6,500 (as originally planned) and the city will pay the remaining $500. Below is the invoice. Please let me know if you have any other questions. Thanks! Melanie Lentz Community Relations Specialist City of Carmel One Civic Square Carmel, IN 46032 (317) 571-2474 Phone (317) 571-2278 Fax Nj Please consider the environment before priming this e-mail From: Frank Dibortolo [mailto:fdibortolo©indy.rr.com] Sent: Monday, September 24, 2012 11:53 AM To: Lentz, Melanie J Subject: Invoice - Carmel City Center Oktoberfest Your reply will serve as confirmation of the following: POLKA BOY, INC 377 Patricia Court Carmel, IN 46033 317-571-9857 9/26/2012 Page 2 of 2 INVOICE Fee for performance of Polka Boy at Cannel City Center Oktoberfest S7,000.00 Performance and other contract details -Polkaboy will perform at the Carmel City Center Oktoherfest Friday October 26th 2012. -Performance time is 6 to 9 PM -In the event that the show is cancelled, Polkaboy shall be paid $3,500 or a re-schedule date agreeable to both parties. Weather related cancellation must occur prior to the setting up of any equipment. If equipment is set up, Polkaboy shall be compensated in full. -Compensation is $7,000 (to be paid at show's conclusion.) -Check to be made out to Polkaboy Inc. Thank You, Frank Di Bortolo 9/26/2012 Prescripsi by 5t We 9oaT alACCnunts Fa�,ACCOUNTS PAYABLE VOUCHER O Na.201/Rev. 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 f elkgho-j, Purchase Order No. 377 Ice ■re",/ Cod Terms 0911/7,p , /XI zlla o 3 3 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9-2Y—/2 92'x/2 O 74:01 i/ 4q ,',a eq/ ,572,.CV Total ETSCY.dD I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. 1b—n , 2072_ "'h Treasurer