247324 07/1 5/1 5 j
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CITY OF CARMEL, INDIANA VENDOR: 143001
® ONE CIVIC SQUARE INDIANA ASSOC OF CITIES &TOWNS CHECK AMOUNT: $"I *****650.00*
CARMEL, INDIANA 46032 CONFERENCE REGISTRATION CHECK NUMBER: 247324
9M _ 200 S MERIDIAN ST,SUITE 340 CHECK DATE: 07/15/15
roe o°' INDIANAPOLIS IN 46225 j
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4357004 325.00 CORDRAY j
1701 43,57004 325.00 SHEEKS
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20151WCT ANNUAL, CONFERENCE & EXHIBITION REGISTRATION FORM
Pre-Registration Deadline: September 15
Full Name , Phone ��lZLIJ
Preferred Name for Badge /l Email /t ettr'cLrl�-. t_v r Idoov
Title �.{ � �� Spousell/.•Guest Name
II �
Municipality/CompanyI O Special Needs and Dietary Restrictions
(/
Council President's Name C
Address V
City/State/Zip 4&0
o3Z
, v
REGISTRATION FEES METHOD OF PAYMENT
fy i�r� Hkt° ❑ Check ❑Visa ❑ MasterCard ❑Discover ❑American Express
IACT Member—Municipal Official $325 $375nCheck#(Payable to TACT)
�
(Pop.greater than or equal to 1,000) /
Cardholder Name
IACT Member—Municipal Official $190 $240
(Pop.less than 1,000) Credit Card Number
IACT Associate Member j $325 $375 Expiration Date
(Non-Exhibitor)
IACT Associate Member(Exhibitor) $250 $300
3-digit Verification Cade
Billing Address j
Non-Member(Non-Exhibitor) $475 $525
i
Non-Member(Exhibitor) $250 $300 City/State/Zip
Spouse/Guest $190 $240 Signature of Cardholder
' Wednesday Only $250 $300
Total Amount: $ �• '
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please check the conference Events You Plan -to Aftend (For planning purposes only)
'❑TUESDAY ❑TUESDAY ❑TUESDAY 04ESDAY EDNESDAY U4EDNESDAY VxdDNESDAY UZ11URSDAY
Opening Business Workshop#1 Workshop#2 Welcome Continental Annual Awards Presidents' Continental
Session Active Living Employee Manuals Reception In Breakfast in Luncheon Reception Breakfast
Promotion Exhibit Hall ExhlbltHail
URSDAY
Closing Lunch&
Business Session
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Cancellation Policy Special Needs and Dietary Restrictions Questions?
Only written cancellations will be accepted.Please mail If you require special arrangements or a special diet,please Contact Natalie Hurt at(317)237-6200 ext.233 or
your written cancellation to 125,W.Market St.,Suite 240, notify IACT on your registration form. nhurt@citiesandtowns.org
Indianapolis,IN 46204;fax to(317)237-6206 or send to
tbaldwin@citiesandtowns.org.Written cancellations received Affiliate Group Events E-Verify Compliance
on or before September 15,will be refunded less a$40 IACT affiliate groups may hold individual meetings and IACT is an enrolled employer in the E-Verify Program verify-
processing fee.IACT is not responsible for hotel reservations events at the conference.Attendees must be registered Ing the work eligibility status of its new employees and will
or cancellations, for the conference in order to attend affiliate events. remain so until that program no longer exists.
Additional information for affiliate group members may be
mailed out separately.
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2015 IACT ANNUAL CONFERENCE & EXHIBITION REGISTRATION FORM
I
Pre-Registration Deadline: September 15
Full Name Phone
Preferred Name for Badge Email L
� s
Title Spouse/Guest Name
Municipality/company p Special Needs and Dietary Restrictions
(/
Council President's Name
Address /
ZI At v
City/State/Zip 10 4&0M,REGISTRATION FEES V t METHOD OF PAYMENT
❑ Check ❑Visa ❑MasterCard ❑ Discover ❑American Express
IACT Member—Municipal Official $325 $375 Check#(Payable to IACD
(Pop.greater than or equal to 1,000)
Cardholder Name
IACT Member—Municipal Official $190 $240
(Pop.less than 1,000) Credit Card Number
IACT Associate Member,, $325 $375 Expiration Date
(Non-Exhibitor)
IACT Associate Member(Exhibitor) $250 $300 3-digit Verification Code
i
Non-Member(Non-Exhibitor) $475 $525 Billing Address
Non-Member(Exhibitor) $250 $300 City/State/Zip
Signature of Cardholder
Spouse/Guest $190 $240
Wednesday Only $250 $300
Total Amount: $ 2-
Please Check the conference I-vents You Pian to Attend (For planning purposes only)
'❑TUESDAY ❑TUESDAY ❑TUESDAY UESDAY ` EDNESDAY EDNESDAY DNESDAY Q�RSDAY
Opening Business Workshop#1 Workshop#2 Welcome Continental Annual Awards Presidents' Continental
Session Active Living Employee Manuals Reception in Breakfast In Luncheon Reception Breakfast
Promotion Exhibit Hall Exhibit Hall
HURSDAY
Closing Lunch&
Business Session
Cancellation Policy Special Needs and Dietary Restrictions Questions?
Only written cancellations willibe accepted. Please mail If you require special arrangements or a special diet,please Contact Natalie Hurt at(317)237-6200 ext.233 or
your written cancellation to 125 W.Market St.,Suite 240, notify TACT on your registration form. nhurt®citiesandtowns.org
Indianapolis,IN 46204;fax to(317)237-6206 or send to
tbaldwin®citiesandtowns.org!Written cancellations received Affiliate Group Events E-Verify Compliance
on or before September 15,will be refunded less a$40 IACT affiliate groups may hold individual meetings and IACT is an enrolled employer in the E-Verify Program verify-
processing fee.IACT is not responsible for hotel reservations events at the conference.Attendees must be registered ing the work eligibility status of its new employees and will
or cancellations. for the conference in order to attend affiliate events, remain so until that program no longer exists.
Additional information for affiliate group members may be
mailed out separately.
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Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or.note attached invoice(s) or bill(s))
Total
hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
20
Clerk-Treasurer
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VOUCHER NO. WARRANT NO.
ALLOWED 20
�H�7 6"u, On ° " l
2� IN SUM OF$
- I
$
ON ACCOUNT OF APPROPRIATION FOR
-7quIrL 19 .
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
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund