226665 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 363572 Page 1 of 1
`i. ONE CIVIC SQUARE FUN WITH FRANNIE CHECK AMOUNT: $240.00
CARMEL, INDIANA 46032 9805 LAKEWOOD DRIVE EAST
INDIANAPOLIS IN 46280 CHECK NUMBER: 226665
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 5023990 240 . 00 OTHER EXPENSES
Fun with Frannie
Family Entertainment
9805 Lakewood Drive East
Indianapolis, Indiana 46280
(317) 696-5757 funwithfrannie@yahoo.com
Invoice & Service Agreement
Date: November 18, 2013
Client: The City of Carmel
Contact: Stephanie Marshall
Phone: (317) 571-2787
Event: Holiday In The Arts District
Event Date: Saturday, December 14, 2013
Event Location: PNC Bank, 21 N. Rangeline Road, Carmel, Indiana, 46032
Service To Be Provided: Face painting from 3:00 p.m. to 6:00 p.m
Fee: $240.00 ($80.00 per hour x 3 hours x 1 artist)
Amount Due Day of Event: $240.00
Please make checks payable to: Fun with Frannie
Fun with Frannie to provide all supplies associated with face painting and Client to
provide one tent.
Form
IN-9 Request for Taxpayer Give Form to the
(Rev.August 2013) requester.Do not
Department of the Treasury Identification Number and Certification send to the IRS.
Internal Revenue Service
Name(as shown on your income tax return)
Jane E.Summitt
Business name/disregarded entity name,if different from above
N
Fun with Frannie Family Entertainment
m
° Check appropriate box for federal tax classification: Exemptions(see instructions):
Cr
° Q Individual/sole proprietor ❑ C Corporation ❑S Corporation ❑ Partnership ❑Trust/estate
m z Exempt payee code(if any)
CLs
v ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► Exemption from FATCA reporting
2 code(if any)
a ❑ Other(see instructions)►
it Address(number,street,and apt.or suite no.) Requester's name and address(optional)
°
a 9805 Lakewood Drive East
City,state,and ZIP code
cn Indianapolis,IN,46280
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 L.social security number
to avoid backup withholding.For individuals,this is your social security number However,for a _
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 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.
WMM 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)1 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),and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been noted 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 3.
Sign Signature of
Here U.S.person► NV 1 Date►
General Instruction withholding tax on foreign partners'share of effectively connected income,and
4.Certify that FATCA code(s)entered on this form(if any)indicating that you are
Section references are to the Internal Revenue Code unless otherwise noted. exempt from the FATCA reporting,is correct.
Future developments.The IRS has created a page on IRS.gov for information Note.If you are a U.S.person and a requester gives you a form other than Form
about Form W-9,at wwwJrs.gov 1w9.Information about any future developments W-9 to request your TIN,you must use the requester's form if it is substantially
affecting Form W-9(such as legislation enacted after we release it)will be posted similar to this Form W-9.
on that page. Definition of a U.S.person.For federal tax purposes,you are considered a U.S.
Purpose Of Form person if you are:
A person who is required to file an information return with the IRS must obtain your •An individual who is a U.S.citizen or U.S.resident alien,
correct taxpayer identification number(TIN)to report,for example,income paid to •A partnership,corporation,company,or association created or organized in the
you,payments made to you in settlement of payment card and third party network United States or under the laws of the United States,
transactions,real estate transactions,mortgage interest you paid,acquisition or .An estate(other than a foreign estate),or
abandonment of secured property,cancellation of debt,or contributions you made
to an IRA •A domestic trust(as defined in Regulations section 301.7701-7).
Special rules for partnerships.Partnerships that conduct a trade or business in
Use Form W-9 only if you are a U.S.person(including a resident alien),to
the United States are generally required to pay withholding tax under section
provide your correct TIN to the person requesting it(the requester)and,when 1446 on any foreign partners'share of effectively connected taxable income from
applicable,to:
such business.Further,in certain cases where a Form W-9 has not been received,
1.Certify that the TIN you are giving is correct(or you are waiting for a number the rules under section 1446 require a partnership to presume that a partner is a
to be issued), foreign person,and pay the section 1446 withholding tax.Therefore,0 you are a
2.Certify that you are not subject to backup withholding,or U.S.person that is a partner in a partnership conducting a trade or business in the
3.Claim exemption from backup withholding If you are a U.S.exempt payee.if United States,provide Form W-9 to the partnership to establish your U.S.status
applicable,you are also certifying that as a U.S.person,your allocable share of and avoid section 1446 withholding on your share of partnership income.
any partnership income from a U.S.trade or business is not subject to the -
Cat.No.10231X Form W-9(Rev.8-2013)
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fun with Frannie
IN SUM OF $
9805 Lakewood Drive East
Indianapolis, IN 46280
$240.00
ON ACCOUNT OF APPROPRIATION FOR
Community Relations Gift Fund 854
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
854 Invoice �3° $240.00
I hereby certify that the attached invoice(s), or
I 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
Monday, December 02, 2013
Director, Community Relations/Economic Development
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))
11/18/13 Invoice $240.00
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