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Home My WebLink About223441 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 366729 Page 1 of 1 ONE CIVIC SQUARE COVERT TRACK GROUP INC CARMEL, INDIANA 46032 8361 E GELDING DR CHECK AMOUNT: $1,200.00 SCOTTSDALEAZ 85260 CHECK NUMBER: 223441 CHECK DATE: 8/27/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4358200 4440 1, 200 . 00 SPECIAL INVESTIGATION Ship Via Sales Rep PO# Email Alicja/Greg Annual Renewal Activity Quantity Rate Amount •Renewal of unlimited 5 second updates& mapping service for 1 600.00 600.00 09/14/2013-09/14/2014: 867844000273196 • Renewal of unlimited 5 second updates& mapping service for 1 600.00 600.00 10/19/2013-10/19/2014: 867844000276496 THANK YOU for your business! Total $1.200.00 ***PLEASE FORWARD TO YOUR ACCOUNTS PAYABLE DEPT*** i Ferro W-9 Request for Taxpayer Give Form to the (Rev.January 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) CovenTrack Group Inc. C\ Business name/dlsregarded entity name,If different from above m m m Q Check appropriate box for federal tax C O classification(required): ❑ Individuallsole proprietor ❑ C Corporation ❑S Corporation ❑ Partnership ❑Trust/estate m � 0 •- El Exempt payee Z'i Q Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,Partnership)► C c 2 - - - c� a ❑Fr,ee instructions)► w ber,street,and apt.or suite no.) Requester's name and address(optional`� Gelding Dr. nd ZIP code ale,AZ 85260-3623 numbers)here(optional) Taxpayer Identification Number TIN Fitter 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 However,for a -m - resident alien,sole proprietor,or disregarded entity,see the Part I Instructions on n page 3.For other entities,it is your employer identification number(EIN).If you do not have a number,see Now 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] 6 - 0 1 5 1 3 1 3 1 3 9 1 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)l 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.cifizen 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 A p Here U.S.person 10, �= C /v Date► // Z13 General Instru ons 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 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 pald to you,real estate transactions,mortgage Interest organized in the United States brrund'er 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 pncluding a resident alien),to provide your correct TIN to the person requesting it(the Special rules for partnerships. generally re that conduct a trade l 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�has not been received,a number to be issued), partnership is required to presume that a artner Is a foreign person, 2.Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefo�e,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)) 08/15/13 4440 mapping service $1,200.00 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 VOUCHER NO. WARRANT NO. ALLOWED 20 CovertTrack Group, Inc. IN SUM OF $ 9393 N. 90th Street, Suite 108B Scottsdale, AZ 85258 $1,200.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 4440 43-582.00 $1,200.00 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 Thursday, August 22, 2013 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund