HomeMy WebLinkAbout236518 08/27/14 4a L�q�f
J/ �. CITY OF CARMEL, INDIANA VENDOR: 00351333 w�*t
® ; ONE CIVIC SQUARE ERIC RUSSELL CHECK AMOUNT: $ 184.80
y: ,_�; CARMEL, INDIANA 46032 C/O STREET DEPT CHECK NUMBER: 236518
y,,TON�, C/0 STREET DEPT CHECK DATE: 08/27/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4343002 184.80 EXTERNAL TRAINING TRA
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SCIL
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2014 Annual Street Commissioners Convention
Registration Form: August 19th, 20th, 21St, 2014
www.indianastreets.org /
Name of Registrant Aav-7 00
Address: �(i�J V (.) , ' 3
Q� ►M �� z /V 116 o 7y
Phone:
Spouse's Name (if attending):
E-Mail Address: �^^ �' •-.'!
REGISTRATION FEE MUST BE ENCLOSED WITH FORM �
_�• Current ISCA Member $150.00 per person (Includes Meals)
J_ Asst. Commissioner/Foreman $150.00 per person (Include Meals)
_ Additional Registration $150.00 per person (Includes Meals)
Vendor Registration $300.00 (Includes Meals & Vendor Cookout) with NO BOOTH
Vendor Registration $500.00 (Includes Meals & Vendor Cookout) with BOOTH
Space and (1) employee
(Limited booth area — no more than 40 booth areas)
All hotel accommodations must be made with a credit card:
French Lick Resort
8670 West State Road 56
French Lick, IN 47432
(T) 812-936-9300 or 888-936-9360
(F) 812-936-5586
* When making hotel reservations, let the hotel know you are with I.S.C.A. and Group Code is
0813ISC
*The room rates are $119.00 dollars for I.S.C.A. members they will be guaranteed until July 18"
After July 19th rooms will be released to the public. Cancellation must be made four days prior to
arrival for full refund of deposit. Check-in time is at 4:00 p.m. Check-out is at 11:00 a.m.
* Vendors who want (hospitality rooms) must contact: Brandie Petry at 812-936-9300 or E-mail:
bpetry@french lick.com
* Please complete and return registration form with payment by July 181h 2014:
MAIL: CONVENTION REGISTRATION WITH PAYMENT TO
LARRY LEE SECRETARY/TREASURER
LEBANON STREET DEPARTMENT
1301 LAFAYETTE AVE
LEBANON, INDIANA 46052
PresrnLed by State Board of Accounts
General Form No.101(1955)
MILEAGE CLAIM TO
DR.
(GovernmentaTURITt
(Office.Board,Depattment or Insbtubon On Account of Appropriation No. for
DATE FROM TO ODOMETER READING* NATURE OF BUSINESS AUTO MILES MILEAGE @. �
20 Point Point Start Finish TRAVELED PER MILE
.0 X70 W.5,61e /er'1. MOS. �cldl330 `d
Auto License No. S TOTALS J y0
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155,Acts 1953,1 hereby certify that the foregoing account is just and correct,that the amount claimed is legally due,after
allowing all just credits,and that no part of the same has been paid.
Date /2A
2oJ y �Jti
VOUCHER NO. WARRANT NO.
Eric Russell ALLOWED 20
C/O Street Department
IN SUM OF$
3400 W. 131 st Street
Carmel, IN 46074
$184.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#IrITLE I AMOUNT Board Members
2201 I I 43-430.021 $184.80 1 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
.411 I/daywqg&014
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))
08/21/14 $184.80
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