241946 02/10/15 CITY OF CARMEL, INDIANA VENDOR: 368009
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•�• ONE CIVIC SQUARE CITY OF LEWISVILLE CHECK AMOUNT: $***"***140.00*
CARMEL, INDIANA 46032 KT aox POST CHECK NUMBER: 241946
LEWISVILLE TX 75029-3704 CHECK DATE: 02/10/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357004 140.00 EXTERNAL INSTRUCT FEE
Print and Mail Completed Form To Address Below. You can fill this out scan and email it to
me if you wish to pay via credit card. I will call you to complete the registration.
201 - KTARegistration
The 20Z5 Reese istration Fee for)MA is$70 per attendee. Checks can be made payable
to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish
to use a credit card please include a daytime phone number and I will contact you to get the
necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR
PAYMENT! Each participant MUST complete the form. Please choose between Pipes and
Drums or Honor Guard, but not both.
Name A&Ye
Department Name r'yi/f r VQ .YI
Department City Lot f m
Department State
Cell Phone 31-7) 6,YS7 3q3
Email Address �-
Please circle the appropriate response:
What are you signing up for (Please Only Choose One)
Honor Guard
Honor Guard Commander Team Member
_Ppes-
Beginner Intermediate Advanced
Drums
Snare Tenor Bass
Beginner Intermediate Advanced
Will you require transportation from the airport Yes No
Print and Mail Completed Form To Address Below. You can fill this out scan and email it to
me if you wish to pay via credit card. I will call you to complete the registration.
2015 K"TA Symposium Registration
The 2016Re4istrativn fee for &$70 per attendee. Checks can be made payable
to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish
to use a credit card please include a daytime phone number and I will contact you to get the
necessary information. YOU WILL NOT SE REGISTERED UNTIL WE RECEIVE YOUR
PAYMENT! Each participant MUST complete the form. Please choose between Pipes and
Drums or Honor Guard, but not both.
Name e cf
Department Name &rV'k .' ce, 'DR 'C&
Department City CA
Department State CL
Cell Phone 31 9<66:5-
Email
<665Email Address ice c� C&rw•et. d1 • ' �
Please circle the appropriate response:
What are you signing up for (Please Only Choose One)
Honor Guard
Honor Guard Commander Team Member
II '
Pipes
Beginner Intermediate Advanced
Drums
Snare < Teno Bass
Beginner Intermediate nvanced
Will you require transportation from the airport es No
VOUCHER NO. WARRANT NO.
ALLOWED 20
KTA Symposium IN SUM OF$
PO Box 299002
Lewisville, TX 75029-3704
$140.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 43-570.04 $70.00 I hereby certify that the attached invoice(s), or
1120 43-570.04 $70.00 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
FEB - 9 2015
�IA
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
rescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
n invoice or bill to be properly itemized must show: kind of service,where performed,dates service rendered, by
hom, 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))
Reppert $70.00
Reeves $70.00
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