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250724 10/21/15 Q CITY OF CARMEL, INDIANA VENDOR: 00351464 CHECK AMOUNT: $ 237.00' ONE CIVIC SQUARE INDIANA RURAL WATER ASSOC ��;t'�CARMEL, INDIANA 46032 PO BOX 679 CHECK NUMBER: 250724 NASHVILLE IN 47448 CHECK DATE: 10/21/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 15-05138 237.00 OTHER EXPENSES Remit To: Indiana Rural Water Association PO Box 242 L Zionsville, IN 46077-0242 ATTN: ACCOUNTS PAYABLE Invoice BILL TO City of Carmel DATE INVOICE NO. 3450 W 131st. St. 10/13/2015 15-05138 Carmel, IN 460747 ------------------------------------------ IRWA is proud to be funded solely by membership dues and registration fees I with no federal government assistance. ; Membership Renewal Date 2/17/2016 Questions? MaryJane Peters,Administrative Director MaryJane@indiananiralwater.org Telephone-866-895-4792 P.O. No. TERMS Fax-855-202-7298 KL Due on receipt DESCRIPTION AMOUNT IRWA 2015 Water Institute, December 7-9, 2015 in Columbus, IN Monday: Well Driller/Pump Installer- Brett Ransford 60.00 Tuesday Only: Brett Ransford, Donald Simpson 120.00 Meals: ML (2); TL (1) 57.00 Subtotal $237.00 Payments/Credits $0.00 Balance Due $237.00 REGISTRi4TION,FORM, IRWA-rWAter:lnstitute.- December 7- 9,:2015, Please print or type one form for EACH ATTENDEE! Attendee Information: /7 Billing Information: / Name o/LT "�'/ ef _r �-Gf Company Name: / v 1f7/Xv Title �L s c9p�7tj f- Billing Contact a- ),aall Guest's name; if attending _ Address 3��56 (1) J?� ��- ST- Address .35y67� fir) /,r/ �S Cit �Q r (^n,�� City, l St rt zip_`� 13 M city (�'�.��/ Str•4-,zip Telephone -6(7- 3-z-,- Telephone-4/7-7M ax 3/7-733 Zc5- Fax_ ^]--7-S--5 E-mail A# 96 6iY.✓.LS��-��LTJ-�.ra'�i�� 1 �, . I will;be�submitting�contact hours for- E-mail,invoice lG��ri _11A m G Iv1_Qn,/ Please print clearly Water 1V Wastewater*O WelVDrillers/PumpinstallersK �/ � Eng ineer�PDHs°0 None 0 Purchase Order# !� T MONDAY SESSIONS : IRWA Member Non-Member Well Drillers & Pump Installers- Part 1& 2 (9:00a-4:00) X$60.00 ❑ $120.00 $ Board Members/Managers/Superintendents-(9:00a-4:00) ❑ $60.00 ❑ $120.00 $ NetDMR Workshop-(9:00a- Noon) 11 $30.00 ❑ $60.00 $ Revised Total Coliform Rule& Other IDEM Info(1:00a-5:00) ❑ $40.00 ❑ $80.00 $ c Wastewater Technical Sessions-(1:00p- 5:00) ❑ $40.00 11 $80.00 $ d TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ° Tuesday& Wednesday ❑ $100.00 ❑ $200.00 $ C ❑ Technical/General Sessions ❑ Utility Business Forum CL Tuesday ONLY ❑ $60.00 ❑ $120.00 $ la Technical/General Sessions ❑ Utility Business Forum ® Wednesday ONLY ❑ $40.00 ❑ $80.00 $ s ❑ Technical/General Sessions MEALS $ Monday Lunch Tuesday Lunch Tuesday Reception Attendee $19.00 Attendee' $19.00 Attendee ❑ $No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is - One BOARD MEMBER-or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch I entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(GEF) $ Mon $ LO + Tues/Wed $ &C + Lunch $ 3 — + GEF $ _ $ /S'p-- MAIL:IRWA E-MAIL:. Bill us PO Box 242 MaryJane@indionaruralwater.org Zionsville,IN 46077-0242 FAX: 855-202-7298 ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. Visa_ MC Discover AmExp Please,submit�cancellation requests in writing. # Exp.: No refunds.after December 4,2015. NAME ON CARD: Security: Questions- MaryJane;Peters Telephone:866:895=4792 SIGNATURE Billing Zip Code: E-mail: MaryJane@indianaruralwater.org- REGISTRAT- 10N FORM - IRWA Water Institute - December 7- 9 2015 Please print or type one form for EACH ATTENDEE Attendee Information: Billing Information: Name JQOA eA, J ht/J 5 0 viCompany Name: (-1 vim,o L( Title 'c jr 4 "7-.1ova Ins&ecTe Billing Contact ,�_r��` � t I Guest's name; if attending Address Address JY, X40. l3/� City st TO >zs-i ��— � city 6'a,WY/ St _11A zip y 0 7 Telephone �,�-?3� ^a $�Z_>f_:) Telephonel7-7/6 2FK5- Fax - E-mail c.'in 44.,0^ 0 C Fax I will be submitting contact hours for- E-mail invoice I11Q\).e(_1& �. _ � Please print clearly Water V Wastewater ❑ Well Drillers/Pump Installers E3 fynif t/1 Engineer PDHs ❑ None ❑ Purchase Order# K` MONDAY SESSIONS IRWA Member Non-Member Well Drillers& Pump Installers- Part 1 & 2 (9:00a-4:00) ❑ $60.00 11 $120.00 $ Board Members/Managers/Superintendents - (9:00a-4:00) ❑$60.00 ❑ $120.00 $ NetDMR Workshop-(9:00a -Noon) ❑ $30.00 ❑ $60.00 $ Revised Total Coliform Rule& Other IDEM Info (1:00a - 5:00) 13 $40.00 ❑ $80.00 $ -6 Wastewater Technical Sessions-(1:00p-5:00) 13 $40.00 ❑ $80.00 $ W r TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member °� Tuesday& Wednesday ❑ $- $100.00 ❑ $200.00 M ❑ Technical/General Sessions ❑ Utility Business Forum a --►Tuesday ONLY ❑ ° $60.00 ❑ $120.00 $ �U, — m Gd Technical/General Sessions ❑ Utility Business Forum ® Wednesday ONLY ❑ $40.00 O $80.00 $ u r ❑ Technical/General Sessions � MEALS $ Monday Lunch Tuesday Lunch Tuesday Reception Attendee El $19.00 Attendee M11"$19,00 Attendee ❑ $ No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is One BOARD MEMBER or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION (GEF) $ Mon $ + Tues/Wed $ t� + Lunch $-I.—q-OU+ GEF $ MAIL:IRWA E-MAIL: Bill us PO Box 242 MaryJane@indionarura/water.org Zionsville,IN 46077-0242 FAX: 855-202-7298 ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. Visa_ MC_ Discover AmExp ?- Please submit cancellation requests in writing. # Ex No refunds after December 4,2015. Questions- NAME ON CARD: Security: MaryJane Peters SIGNATURE Billing Zip Code: Telephone:866-895-4792 K E-mail: MaryJane@indianaruralwater.org p s., 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 351464 INDIANA RURAL WATER ASSOCIATION Purchase Order No. PO BOX 242 Terms ZIONSVILLE, IN 46077-0242 Due Date 10/13/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/13/201,1 15-05138 $237.00 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 /J//1,ke Date Officer VOUCHER # 153285 WARRANT # ALLOWED 351464 IN SUM OF $ INDIANA RURAL WATER ASSOCIATIO PO BOX 242 ZIONSVILLE, IN 46077-0242 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 15-05138 01-6040-05 $237.00 Voucher Total $237.00 Cost distribution ledger classification if claim paid under vehicle highway fund