HomeMy WebLinkAbout242311 02/17/15 oi�
CITY OF CARMEL, INDIANA VENDOR: 00350333
ONE CIVIC SQUARE INDIANA ASSOCIATION OF CITIES/TOV4WECK AMOUNT: $*****"'149.00*
CARMEL, INDIANA 46032 125 W.MARKET ST.#240 CHECK NUMBER: 242311
111 INDIANAPOLIS IN 46204 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4357004 149.00 EXTERNAL INSTRUCT FEE
2015 1ACT LEGISLATIV 0 R -
PRE-REGISTRATION DEAD MAR7
YOUR INFORMATION REGISTRATIQN- ES
-o—r5-IAC-T- egislative Day
Name 1C1 ', �` ❑$149 IACT Member/Associ-
Preferred Name for Badge1),� ate Member
City/Company ) ❑$169 IACT Member/Associ-
;e CQ f 11 ate Member(late or onsite)
Title =(/ 1rcIZ-')v cc ❑$200 Non-member
is Address �i /� l)1 L ( /� 11$220 Non-member
lJ l� (late or onsite)
> City/TowneeA—)LAq ❑$110 Spouse/Guest*
State p J Zi C�//^ 2�
❑$130 Spouse/Guest*
Phone �� ! (late or onsite)
CQ
Email (Q/CI�.i`f�L�(�i//1; !1 V Total$_W77
Name of Spouse/Guest(if attending)
*The spouse/guest registration fee
Special Needs and Dietary Restrictions is restricted to those accompany-
ing a registered attendee and who
have no professional interest in the
conference. The fee includes ad-
mission to all conference sessions
and meals.
M HOD OF PAYMENT
CANCELLATION POLICY
Check ❑MasterCard ❑Visa ❑Discover ❑American Express Only written cancellations received
13 Check Number on or before March 9 will be
refunded,minus a$40 processing
Card Number fee. Fax your cancellation to(317)
237-6206 or email to nhurt@
Expiration Date Verification Code citiesandtowns.org.
Name of Cardholder
Authorized signature HOW TO REGISTER
ONLINE:www.citiesandtowns.org
Billing Address(if different from information section) MAIL form to:
TACT,125 W.Market St.,Suite 240
Indianapolis,IN 46204
City FAX form with credit card info to:
State Zip (317)237-6206
i
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I 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.
zt�7F ALLOWED 20
IN SUM OF $
j (kj
$ q9
ON ACCOUNT OF APPROPRIATION FOR
bl�
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I 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
3 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund