HomeMy WebLinkAbout253359 01/15/16 4+u�C�q�f
CITY OF CARMEL, INDIANA VENDOR: 359065
�;/ '3. CHECK AMOUNT: $*******213.41*
ONE CIVIC SQUARE BOB HIGGINS
s. ?� CARMEL, INDIANA 46032 1895 WEST 211TH CHECK NUMBER: 253359
9M,i�oN_�` SHERIDAN IN 46069 CHECK DATE: 01/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4343004 38.41 TRAVEL PER DIEMS
1207 4343002 TRAINING 175.00 EXTERNAL TRAINING TRA
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Claim No. Warrant No, I have examined the within claim and
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IN FAVOR OF I
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INDIANA C&EN EXPO
6533 MARGARET COURT
INDTANAPOi.IS IN 96237
31'f 889 2382
Merchant. ID: 172507709
Terni ID: 2288
Sale
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Entry Method. Swiped
bpr4 Online Batchh: 000001
01iO��16 08:21:O7
Inv#, 00000025 Appr Code; 801464
Total: $ 175.00
Custon,e, Cc,w
Indiana 1 1 Attendee
PLEASE PRINT NEATLY. Membership(circle) MRTF INLA NONE
Company
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City t Cr-rte n State { Zip Code 4 6c 3
Phone J 1 — - Fax
E-mail: C f i Co. r4,-, i XPi. a.AV
First Name Middle Initial Last Name
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Cost Amount
,;-Member—-Nonmember- Dtlk- --
Tradeshow Only Badges $25 ea $25 ea
Registration:Education&Tradeshow yn 8&,2) $135 ea $175 ea 1 cr-
Ea.additional member:Ed.&Tradeshow $65 ea $175 ea
One Day,Only(Education&Tradeshow) $100 ea $125 ea
Tradeshow Lunch(Thursday only) $15 ea $15 ea
MRTF Membership see application
INLA Membership see application
Total Amount Due -
Make all checks payable to Indiana Green Expo or charge
Circle:Visa Mastercard Discover AmEx
Signature
Print Signature Above: _
Office Use:
Date Amt. Check#
Card Number.
Expiration Date
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