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242304 02/17/15
CITY OF CARMEL, INDIANA VENDOR: 143001 ONE CIVIC SQUARE IACT CHECK AMOUNT: $*******700.00* CARMEL, INDIANA 46032 ATTN:ICOM - CHECK NUMBER: 242304 125 W MARKET ST,STE 240 CHECK DATE: 02/17/15 INDIANAPOLIS IN 46204 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1160 4355300 19979 700.00 ORGANIZATION & MEMBER .ai ®lam Indiana Conference of Mayors 125 W Market Street, Suite 240 Indianapolis, IN 46204 Phone: 317.237.6200 Fax: 317.237.62o6 www.citiesandtowns.org To: James Brainard _ One Civic Square Invoice: 19979 Carmel,IN 46032 January 30, 2015 2015 Indiana Conference of Mayors Dues: $700.00 ** Please return a copy of invoice with your dues by March 31, 2015 to Indiana Association of Cities & Towns Attn: ICOM 125 W Market Street, Suite 240 Indianapolis, IN 46204 Paying by ICOM accepts the following credit cards (please complete the following) © Check (make payable ❑ Visa ❑ Master Card ❑ Discover to TACT): # Card No.: 3-Digit Verification: ❑ Credit Card Card Exp.Date: Name of Card Holder: Billing Address: Signature: I 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)) 01/30/15 19979 $700.00 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 ICOM q ,/� /I Nom,, / ) IN SUM OF $ 125 W. Market Street' bS'ulite 24'(/0V Indianapolis, IN 46204 $700.00 ON ACCOUNT OF APPROPRIATION FOR Mayor's Office PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1160 19979 43-553.00 $700.00 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 Monday, February 16, 2015 Mayor Title Cost distribution ledger classification if claim paid motor vehicle highway fund