HomeMy WebLinkAbout252325 12/08/15 ,CAq .
*f CITY OF CARMEL, INDIANA VENDOR: 362435
i ONE CIVIC SQUARE INDIANA SECTION AWWA CHECK AMOUNT: $ ....*125.00`
?4 CARMEL, INDIANA 46032 PO BOX 534 CHECK NUMBER: 252325
•.y,,.__,:• ATTN: ALAN WISEMAN CHECK DATE: 12/08/15
,roH�°' NASHVILLE IN 47448
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 12515-2 125.00 OTHER EXPENSES
108th Annual Meeting
U14DMA SECTION AWWA
Marriott Motel-Indianapolis,IN
January 25-28,2016
E G 9 S T R A T 9 0 N F 0 R
A L L A T T E N D E E S
utility
❑ Service Provider
NAME: GooK Sieve (only one name per form) AWWA MEMBER#: �� a L4
Last First Initial
TITLE: l�r4TeJ. - T• V�q '-' ORGANIZATION: A'1 V ;C i�
1
ADDRESS:
OFFICE TEL PHON : FAX:
EMAIL: SCIs`� G�.a��•.e 7-,,z, c��/
REGISTRATION FEES The DEADLINE for ADVANCE registration is
Full conference-member* /?f-,Advance:$125 ❑ On-site:$185 '
Full conference-non-member* ❑ Advance:$215 ❑ On-site:$265 Jan.89
16
One day-member* ❑ Advance:$100 ❑ On-site: $135 Day: _
One day-non-member* ❑ Advance: $195 ❑ On-site: $230 Day:
*A$10.00 fee will be charged for all on-site name changes on pre-registration name badges.(Service Providers Only)
COMPLIMENTARY REGISTRATIONS
❑ Student,full-time ❑ Retired (AWWA members only)
❑ Guest(Admittance to receptions only) Name:
❑ First time attendee/Haven't Attended in At Least 5 Years (UTILITY REGISTRANTS ONLY)
EARLY BIRD REGISTRATION
Monday,Jan.25, 3:00-7:00 p.m.
MEALS-Tickets required
❑Tuesday,Jan.26, 12-noon:Keynote luncheon-$25
❑Wednesday,Jan.27, 12-noon:Awards luncheon-$25
❑Thursday,Jan.28,7:30 a.m.: Breakfast-$15
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I Check made payable to Indiana Section AWWA is enclosed. (Check"no.: )
❑ Please charge to my: ❑Visa ❑ MasterCard ❑American Express ❑ Discover J
Name as it appears on card:
PP Signature:
Billing address:
Card number: Exp. date: Security Code:
ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY i RETURN COMPLETED
FORM,PLEASE Every reasonable effort will be You can recover your pre-pay- j FORM TO:
Photocopy the registration made to accommodate special ment by written request, post- Indiana Section AWWA
form for use by others needs. Please contact marked no later than Jan.4, j 5265 E.82nd Street,#310
or go to our web site Dawn Keyler at(866)213-2796 2016,to Dawn Keyler. Indianapolis, IN 46250
for additional forms. or dawn.keyler@inawwa.org Request for refunds made after Office: (866)213-2796
www.inawwa.org with your request. that date cannot be honored. FAX:(866)215-5966
108th Annual Meeting
INDMA SECTION AWWA
Marriott Hotel-Indianapolis,IN
January 25-28,2016
'A
utility A L L A T T E N D E E S
❑ Service Provider
NAME:CYJ(LpGtJ VLQ- ���.�' jr (only one name per form) AWWA MEMBER
Last First 11081TITLE: ��a�. O ZSa-_ 1,ti1SD ORGANIZATION:
i r, 4_ tt
ADDRESS:. -\c4W 0,_4 S�
CITY I STATE I ZIP:C P2fl i't L_._� �C y(O-q-1 y —
---- --- --........ -------......--...................._...--.....-----... ------
OFFICE TELEPHONE:( 1-1_�-1.33- 1357 _ FAX: (31� ) 3-3_--.a?J�_3______.......---.------.._..---------
EMAIL:
REGISTRATION FEES
Full conference-member* Advance: $125 ❑ On-site: $185 , , •f I '
Full conference-non-member* ❑ Advance:$215 ❑ On-site:$265
One day-member* ❑ Advance:$100 ❑ On-site:$135 Day:
One day-non-member* ❑ Advance:$195 ❑ On-site:$230 Day:
*A$10.00 fee will be charged for all on-site name changes on pre-registration name badges.(Service Providers Only)
COMPLIMENTARY REGISTRATIONS
❑ Student,full-time ❑ Retired (AWWA members only)
❑ Guest(Admittance to receptions only) Name:
❑ First time attendee I Haven't Attended in At Least 5 Years (UTILITY REGISTRANTS ONLY)
EARLY BIRD REGISTRATION
Monday,Jan.25,3:00-7:00 p.m.
MEALS-Tickets required
❑Tuesday,Jan,26, 12-noon: Keynote luncheon-$25
❑Wednesday,Jan, 27, 12-noon;Awards luncheon-$25
❑Thursday,Jan, 28,7:30 a.m.: Breakfast-$15
Total Amount Enclosed:$ Return this completed form with payment to the address below.
❑Check made payable to Indiana Section AWWA is enclosed. (Check no.: )
❑ Please charge to my: ❑Visa ❑ MasterCard ❑American Express ❑ Discover
Name as it appears on card: Signature:
Billing address:
,a
Card number: Exp,date: Security Code:
ONLY ONE NAME PER i SPECIAL NEEDS REFUND POLICY RETURN COMPLETED
FORM,PLEASE l Every reasonable effort will be You can recover your pre-pay- FORM TO:
Photocopy the registration ! made to accommodate special ment by written request,post- Indiana Section AWWA
form for use by others needs. Please contact marked no later than Jan.4, 5265 E.82nd Street,#310
or go to our web site Dawn Keyler at(866)213-2796 ; 2016, to Dawn Keyler. ; Indianapolis, IN 46250
for additional forms. or dawn.keyler@inawwa.org Request for refunds made after j Office: (866)213-2796
www.inawwa.org with your request. that date cannot be honored. FAX: (866)215-5966
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
TAVVVVA*
INDIANA SECTION AVVWA Purchase Order No.
5265 E 82ND ST Terms
SUITE 310 Due Date 12/2/2015
INDIANAPOLIS, IN 46250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/2/2015 12516 $125.00
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
Date Officer
VOUCHER # 153727 WARRANT# ALLOWED
TAWWA* IN SUM OF $
INDIANA SECTION AWWA
5265 E 82ND ST
SUITE 310
INDIANAPOLIS, IN 46250
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
12516 01-6040-05 $125.00
Voucher Total a50-(D 00
Cost distribution ledger classification if
claim paid under vehicle highway fund