The URL can be used to link to this page

Home My WebLink About222548 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 367292 Page 1 of 1 ONE CIVIC SQUARE PROFESSIONAL CONSULTING ASSOCIATES CARMEL, INDIANA 46032 PO Box 09626 CHECK AMOUNT: $3,634.00 COLUMBUS OH 43209 CHECK NUMBER: 222548 CHECK DATE: 7/30/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4357002 25374 1974 3 , 634 . 00 STAFF TRAINING Professional Consulting Associates, LLC Invoice P.O. Box 09626 Date Invoice# Columbus, OH 43209 7/24/2013 1974 Bill To Carmel P.D. Teresa Anderson 3 Civic Square Carmel, Indiana 46032 P.O. No. Terms Project Quantity Description Rate Amount Material Preparation&Session Layout 0.00 Develop Focus Group Format/Questions-Survey Memo 0.00 Preliminary Interviews 3,634.00 3,634.00 Total $3;634.00 Form ®9 Request for Taxpayer Give Form to the (Rev.December 26eas 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) Business name/disregarded entity name,if different from above N m Professional Consulting Associates,LLC a Check appropriate box for federal tax classification: c O ❑Individual/sole proprietor ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate N no v I ✓❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation.P- arinershi P)I- ❑Exempt payee ``o C ut C d � ❑ Other(see instructions)► Address(number,street,and apt.or suite no.) Requester's name and address(optional) U a P.O.Box 09626 VI City.state,and ZIP code (Columbus,OH 43209 List account number(s)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 security number re avoid backup withholding.For individuals,this is your social security number n page However,fora ��j -m resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other ( II I I I� entities,it is your employer identification number(EIN).It you do not have a number,see How to get a �L�J TIN on page 3. Note.Il the account is in more than one name.see the chart on page 4 for guidelines on whose Employer identification number number to enter. M31 - 1 6 1 9 2 1 9 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 � 13 Here U.S.person► � ,!, `' j - . Date General Instructions Note.If a requester gives you a form er than Form 1N-9 to request Section references are to the 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 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 Stales 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.12-2011) CiINDIANA RETAIL TAX EXEMPT PAGE ty , o : C°,�rme l CERTIFICATE NO.003120155 002 0 JL ��//C�.� �+► PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35-60000972 2M74 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 7123,293 Profoosional Consulting Asweiates, LLC Camel Polio@ Department VENDOR SHIP 3 Civic Square TO P.O. Box OM Carmel, IN 46032 Columbus, OH 4 (397)571-2m CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 00.670.00 9 Each Staff&Supervisory`d'raining $3,634.00 $3,634.00 Stab Total: $3,634.00 •. st, . m . r �x • Send Invoice To: Camel Police Oepartmont Attn: Teresa Anderson 3 Civic Square Camel, IN QW2. PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. PAYMENT $3,64.10 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFVHAT IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. ` •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY �11 �'°�' �✓w •PURCHASE ORDER NUMBER MUST APPEAR ON ALL AChle�f SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE P�II�I AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. �5 37 4 CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF$ n ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# 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 - - - -- - - ---- - -- -.. - -- - . 20 ............................................................... .............-_.....-..............._..-............_-.......__...-_.......---....------.....----.....----.......... Signature ....................................--....-..........._......................................-......................-......._..... Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. Professional Consulting Associates, LLC ALLOWED 20 IN SUM OF $ P.O. Box 09626 Columbus, OH 43209 $3,634.00 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25374 1974 -570.00 $3,634.00 I hereby certify that the attached invoice(s), or I I _ 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 Wednesday July 24, 2013 , Chief of Police 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)) 07/24/13 1974 staff&supervisory training $3,634.00 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