221863 07/17/2013 a CITY OF CARMEL, INDIANA VENDOR: 367267 Page 1 of 1
ONE CIVIC SQUARE ACE VACUUMS
CARMEL, INDIANA 46032 4000 W 106TH ST,STE 135 CHECK AMOUNT: $147.80
CARMEL IN 46032 CHECK NUMBER: 221863
CHECK DATE: 7/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350000 1-9537 147 . 80 EQUIPMENT REPAIRS & M
07/02/2013 1.44:47 PM
IVice
Ace Vacuums
4000 West 106th St ste 135
Carmel, IN 46032
(317)733-8750
Email:AceVacs @gmail.com
www.ace-vacuums.com
Bill'ro: 41�ip rl o:
City Of Carmel City Of Carmel
Fire Headquarters Fire Headquarters
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
317-508-5777 11317-508-5777
Date l erns ACCOUTA —� lr�voic.e �l�.sPerson
07!02/2013 JINET 30 1-5520 F-9537
Qty Barcode #
Description
E—C
I lted»Tc�l��!
Repair Parts:
1 0 Hoover C 18 10 Serial#010300009663 $97.85 $97.85
Repair#1-2363
Repair-Labor:
1 0` Hoover C1810 Serial##010300_0_09663 $49__9__5 _ _$49.95
Repair#1-2363 ~
F-1 71 SulA01111 I $147.80
I F___-__ j Total 1 $147.80
Q 7 ur° j $147.80
Our trade-in program gives you a discount on a new vacuum
and we donate your old one to charity or recycle it!
Form W-9 Request for Taxpayer Give Form to the
(Rev.December 2011) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
Name(as shown on your income tax return)
Ace Vacuums, LLC
N Business name/disregarded entity name,if different from above
(D
rn
m
c' Check appropriate box for federal tax classification:
C
N
❑ Individual/sole proprietor F] C Corporation E] S Corporation El Partnership E] Trust/estate
0 C
r .2
3 ✓❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)Do-
❑Exempt payee
o --------------------------------
r N
a u ❑ Other(see instructions)►
r.- Address(number,street,and apt,or suite no.) Requester's name and address(optional)
a 4000 West 106th St Suite 135
N
am City,state,and ZIP code
Carmel,IN 46032
__List account.number(s)here(optional) `
9019—Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line Social security number
to avoid backup withholding.For individuals,this is your social security number pag However,for a m -�
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.
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.
4 3 -1210101813 M75
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.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.
Sign Signature of
Here I U.S.person► Date► I
General Instructions 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 a 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
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 it 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)
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ace Vacuums
IN SUM OF $
4000 West 106th Street, Ste. 135
Carmel, IN 46032
$147.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1120 I 1-9537 I 43-500.00 I $147.80 I 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
1-9537 Repair Vacuum $147.80
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