227004 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 154002 Page 1 of 1
ONE CIVIC SQUARE INDIANA MUNICIPAL LAWYERS ASSOC CHECK AMOUNT: $175.00
CARMEL, INDIANA 46032 200 S MERIDIAN ST SUITE 340
L;oN.LO INDIANAPOLIS IN 46225 CHECK NUMBER: 227004
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4355300 9072 100 . 00 ORGANIZATION & MEMBER
1180 4355300 9179 75 . 00 ORGANIZATION & MEMBER
Miana MunWpa� Lawyers Asso ation
200 S. Meridian St., Suite 340, Indianapolis, IN 46225 Invoice Nr: 9072
Phone: 317-237-6200 Fax: 317-237-6206
jwoods @citiesandtowns.org
invoice for 2014 Membership
Membership is open to any Indiana attorney with an interest in local governmental law.
Membership Type Contact Information
$100: Individual Membership Douglas Haney
$100: First "participating attorney" City Attorney
of a government entity Carmel
❑ One Civic Square$75:Second "participating attorney" Third Floor
El $50:Additional "participating attorney(s)" Carmel, IN 46032
Phone: 317571-2472
Fax:
Email: dhaney @carmel.in.gov
Attorney Nr: 11207-49
Member Dues For 2014: $100.00
Positions
Many attorneys hold Client Title
positions with more
than one entity. Please Carmel City Attorney
add additional client
and job titles here if
needed:
AREAS OF PRACTICE -check all that apply
❑ Cities ❑ Council ❑ Counties ❑ Schools ❑ Sewer ❑ Solid Waste Districts
❑Towns ❑Townships ❑ Utilities ❑Zoning
I hereby certify that the foregoing is just and correct, that the amount claimed is legally due
after allowing all just credits, and that no part of the same has been paid.
JoAngela Woods
IM LA Secretary-Treasurer
TACT General Council
Ondiana Munidpap Lawyers Assodation
200 S. Meridian St., Suite 340, Indianapolis, IN 46225 Invoice Nr: 9179
Phone: 317-237-6200 Fax: 317-237-6206
jwoods @citiesandtowns.org
Invoice for 2014 Membership
Membership is open to any Indiana attorney with an interest in local governmental law.
Membership Type Contact Information
❑ $100: Individual Membership Ashley Ulbricht
❑ $100: First "participating attorney" Carmel
of a government entity One Civic Square
-
0$75:Second "participating attorney" Carmel, IN 46032
❑ $50:Additional "participating attorney(s)"
Phone: 317-571-2472
Fax: 317-571-2484
Email: aulbricht @carmel.in.gov
Attorney Nr: 26930-20
Member Dues For 2014: $75.00
Positions
Many attorneys hold Client Title
positions with more
than one entity. Please Carmel City Attorney
add additional client
and job titles here if
needed:
AREAS OF PRACTICE -check all that apply
❑ Cities ❑ Council ❑ Counties ❑ Schools ❑ Sewer ❑ Solid Waste Districts
❑Towns ❑Townships ❑ Utilities ❑Zoning
I hereby certify that the foregoing is just and correct, that the amount claimed is legally due
after allowing all just credits, and that no part of the same has been paid.
JoAngela Woods
IMLA Secretary-Treasurer
IACT General Council
Alk
Indiana
Municipal
Lawyers
Association
November 21, 2013
Dear 2013 IMLA Member:
Thank you for your 2013 membership in IMLA. Enclosed you will find an invoice for your 2014 dues
payment and a W-9 form for the dues payor. The invoice design is produced by the IACT database so
please make changes if anything is wrong or fill in any blanks! All of the information on the invoice helps
us to update our database,provide you with information and to report CLE credits.
IMLA is always planning municipally related CLE opportunities. Each year the annual Municipal Law
Seminar,which is specifically designed for those with a local government law practice,seems to improve
and it always provides an opportunity for networking with other local government colleagues.-I'he
annual Municipal Law Seminar is tentatively set for Thursday-Friday June 19 - 20, 2014 at
an Indianapolis location to be determined. It includes the popular Municipal Law Updates. Plans
are to allow for at least six(6) CLE credits on the first day and three(3) credits on the next day including
ethics. Your membership in IMLA will entitle you to a reduced registration fee for the Municipal Law
Seminar and to special electronic and"snail mail" mailings about other CLE workshop programs that
might affect your city,town or county.
IMLA has a services agreement with the Indiana Association of Cities and Towns(IACT). As part of this
relationship some of the workshops that are a part of IACT's local official education program will be CLE
qualified and available to IMLA members. However, not every workshop and all webinars are not CLE
eligible so please call us to see which ones are CLE. Most CLE eligible workshops will have attorney
speakers and are posted on the IACT website at www.citiesandtowns.org. The IACT Annual
Conference will be in Ft.Wayne, September 9-11, 2014. It provides an opportunity for CLE
credits at an extremely reasonable rate too. In the past you could attend the entire event or attend only
on"Municipal Day". This past year the TACT Annual Conference offered 6.8 hours of CLE credit. IMLA
members may also benefit from the relationship with IACT by signing up to receive IACT's electronic
Legislative Summary(the weekly report on legislative matters during the legislative session),the Final
Statehouse Report, the biweekly Municipal Dispatch(IACT's electronic newsletter) and the annual
Budget Bulletin. IACT's membership in the national municipal lawyers association(International
Municipal Lawyers Association) also benefits IMLA members.
Again,please make sure your information is correct on your renewal form. Also note that as of
December 6, 2013, IACT and thus IMLA will be relocating its offices to 125 West Market
Street, Suite 240, Indianapolis, IN 46204. Phone numbers do not change.
Once again, thank you for your past support. I look forward to assisting you in your municipal law
practice. Please do not hesitate to call me.
Ve truly yours,
ltl,010
�/odie Woods
IACT General Counsel
IMLA Administrative Director
200 S.Meridian St., Suite 340, Indianapolis IN 46225 ■ Phone: 317.237.6200 Fax: 317.237.6206
www.citiesandtowns.org
Form N W 9 Request for Taxpayer Give Form to the
(Rev.August 2013) Identification Number and Certification requester.Do not
Department of the Treasury
Internal Revenue Service send to the IRS.
Name(as shown on your income tax return)
Indiana Municipal Lawyers Association, Inc.
N Business name/disregarded entity name,If different from above
m
rn
CO
Check appropriate box for federal tax classification: Exemptions(see instructions):
0 ❑Individual/sole proprietor ✓ C Corporation p p ❑ p ❑ S Corporation ❑ Partnership ❑Trust/estate
c o Exempt payee code(if any)
2 [] ners 10,Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=parthip)
0 Exemption from FATCA reporting
code(if any)
IL — -❑ Other(see instructions)b-
ra- Address(number,street,and apt.or suite no.) Requester's name and address(optional)
Station Place,200 S.Meridian St., Ste.340
City,state,and ZIP code
d
Indianapolis, IN 46225
List account number(s)here(optional) -
EMIM 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
avoid backup withholding.For individuals,this is your social security number However,for a
re -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 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.
3 1 - 1 0 9 3 4 4 4
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),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 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 3.
Sign Signature of ,_ G,�
Here U.S.person► "°`��ac / iY+Q�G y i i Date► `•/ Z/�o�d�`
General Instructions withholding tax on foreign partners'share of effectively connected income,and
Section references are to the Internal Revenue Code unless otherwise noted. 4.Certify that FATCA code(s)entered on this form(f any)indicating that you are
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 www.irs.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).
Use Form W-9 only if you are a U.S.person(including a resident alien),to Special rules for partnerships.Partnerships that conduct a trade or business in
provide your correct TIN to the person requesting it(the requester)and,when the United States are generally required to pay a withholding tax under section
applicable,to: 1446 on any foreign partners'share of effectively connected taxable income from
1.Certify that the TIN you are giving is correct(or you are waiting for a number such business.Further,in certain cases where a Form W-9 has not been received,
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,if 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)
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth No.201(Rev.1995)
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
Indiana Municipal Lawyers Association
Purchase Order No.
125 West Market Street, Suite 240
Terms
Indianapolis, Indiana 46204
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/4/13 4355300 2014 Membership Dues per attached (Haney) $100.00
4355300 2014 Membership Dues per attached (Ulbricht) $75.00
Total
$175.00
1 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.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
1 IN SUM OF $
125 West Market Street, Suite 240
Indianapolis, IN 46204
$ $175.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Law
4355300 - Organization & Member Dues
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
1180 907 Gj�r $100.00 or bill(s) is (are) true and correct and that
1180 917 75.00 the materials or services itemized thereon
for which charge is made were ordered and
received except
2013
et v
gnature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund