242235 02/17/15 CITY OF CARMEL, INDIANA VENDOR: 368009
ONE CIVIC SQUARE CITY OF LEWISVILLE CHECK AMOUNT: $"'*"*"280.00*
s r° CARMEL, INDIANA 46032 KTA SYMPOSIUM CHECK NUMBER: 242235
PO BOX 299002 CHECK DATE: 02/17/15
LEWISVILLE TX 75029-3704
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357004 280.00 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.
2015 ITA Symposoum RegoBtraflon
The 2015 Registration fee for KTA 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 Thomas Payne
Department Name Carmel Fire Department
Department City City of Carmel
Department State Indiana
Cell Phone 317 407-6550
Email Address t a ne44 comcast.net
Please Circle the appropriate response:
What are you signing up for (Please Only Choose One)
Honor Guard
Honor Guard Commander Team Member
Pipes
Beginner Intermediate Advanced
Drums
Snare Tenor Bass
Beginner Intermediate Advanced
Will you require transportation from the airport Yes No
We are happy to provide transportation to and from DFW or Dallas Love Field. We will
require your complete itinerary for arrival and departure flights. We also need a cell
phone number that you will have with you while traveling to coordinate your transportation.
_ Flight Information
Arrival
Airline
Flight Number
Arrival Date and Time
I
DepartdW
Airline
Flight Number \��p
Departure Date and Time
v
(wail completed registration and payment to:
Lewisville Fire Department
Attn: KTA Symposium
PO Box 299002
Lewisville, TX 75029-3704
Office 972-219-3590 Fax 972-219-3704
Email Address: tmcgrath@cityoflewisville.com
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.
20` 15 KTA S'__""'ymposoum Rl%eg �strafion
The 20.15 Registration fee for KTA is$70 ver 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 G S C—
Department Name C LL ie L �—< �G�IL 11 L I fv\-C-Lit
Department City j ku b v
Department StateA
Cell Phone 9T-675
Email Address Y \\1 OS kv 0 0'r-me \'J
Please circle the appropriate response:
What are you signing up for (Please Only Choose One)
Honor Guard ,__�
Honor Guard Commander ---Team Member
Pipes
Beginner Intermediate Advanced
Drums
Snare Tenor Bass
Beginner Intermediate Advanced
Will you require transportation from the airport 0YesNo
We are happy to provide transportation to and from DFW or Dallas Love Field. We will
require your complete itinerary for arrival and departure flights. We also need a cell
phone number that you will have with you while traveling to coordinate your transportation.
Flight Information
Arrival
Airline Flight Number
Arrival Date and Time
Departur
Airline \\a�
Flight Number
Departure Date and Time
Mail completed registration and payment to:
Lewisville Fire Department
Attn: KTA Symposium
PO Box 299002
Lewisville, TX 75029-3704
Office 972-219-3590 Fax 972-219-3704
Email Address: tmcgrath@cityoflewisville.com
I
i
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.
20"' 15 KTA Sc--"ymposaum R%eg 'Btratbn
The 2015 Registration fee for KTA 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
Department Name �.` �V;z- �Q
Department City
Department State
Cell Phone
Email Address
Please circle the appropriate response:
What are you signing up for (Please Only Choose One)
Honor Guard
Honor Guard Commander Team Member
Pipes
Beginner Intermediate Advanced
Drums
Snare Tenor
Beginner nermed' Advanced
Will you require transportation from the airport Yes No
We are happy to provide transportation to and from DFW or Dallas Love Field. We will
require your complete itinerary for arrival and departure flights. We also need a cell
phone number that you will have with you while traveling to coordinate your transportation.
Flight Information
j Arrival
Airline
Flight Number
Arrival Date and Time
j /Departure
Airline
Flight Number
Departure Date and T e
Mail completed registration and payment to:
Lewisville Fire Department
Attn: KTA Symposium
PO Box 299002
Lewisville, TX 75029-3704
Office 972-219-3590 Fax 972-219-3704
Email Address: tmcgrath@cityoflewisville.com
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 [STA Symposium rrlZeostration
The 2015 Registration fee for KTA is.$70 ver 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
Department Name "Z—
Department City
Department State
Cell Phone -X\�
Email Address
1211
Please circle the appropriate response:
What are you signing up for (Please Only Choose One)
Honor Guard
Honor Guard Commander Team Member
Pipes
Beginner Intermediate Advanced
Drums
Snare Tenor Bass
Beginner Interme iate Advanced
Will you require transportation from the airport Yes No
We are happy to provide transportation to and from DFW or Dallas Love Field. We will
require your complete itinerary for arrival and departure flights. We also need a cell
phone number that you will have with you while traveling to coordinate your transportation.
Flight Information
Arrival
Airline /
Flight Number /
` Arrival Date and Time /
I Departufe
Airline /
i
Flight Number
Departure Date and Time /
Mail completed registration and payment to:
Lewisville Fire Department
Attn: KTA Symposium
PO Box 299002
Lewisville, TX 75029-3704
Office 972-219-3590 Fax 972-219-3704
Email Address: tmcgrath@cityoflewisville.com
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))
$280.00
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
-fie I e
KTA Symposium gyp" � i3 u`.j�c� IN SUM OF $
PO Box 299002
Lewisville, TX 75029-3704
$280.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 43-570.04 $280.00 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
FEB 1 6 ZU15
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund