260092 06/28/16 y u'J4�`'' CITY OF CARMEL, INDIANA VENDOR: 00353283
j; ® a ONE CIVIC SQUARE AMERICAN WATERWORKS ASSOCIATI�CK AMOUNT: $********90.00*
r. ?� CARMEL, INDIANA 46032 PO BOX 972997 CHECK NUMBER: 260092
9�,_._..:' DALLAS TX 75397-2997 CHECK DATE: 06/28/16
4 i�bN�.
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 7001209548 . 90.00 OTHER EXPENSES
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
155109
AVMA* Purchase Order No.
Dept 0064 Terms
Denver, CO 80256 Due Date 6/20/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/20/2016 7001209548 $90.00
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
Den West Quincy 035- 098 IT'S TIME TO RENEW!
,\\® Denver,CO 80235-3098
Phone:800.926.7337
American Water Works Outside U5:303.794.7711
Association Fax:303.347.0804 Your membership helps AWWA carry out its mission
Dedicated to the world's Most imponnntResource'" Email:service@awwa.org successfully.Thank you for your continued support.
Dedicated to the world's most important resource,
"�II�I'I�„1'I����III111�1'�II��1'llllll�l�l�lllll�l��lllllll�" AWWA champions water knowledge,treatment,and
#BWNCWZH 15 15 informed regulation. Providing solutions to improve
#00923650 6# public health,protect the environment,sustain the
Jaimie L Foreman economy,and enhance quality of life,AWWA sets
City of Carmel Water the standard for water throughout the world.
4915 E 106th St
Indianapolis, IN 46280-1532
FIRST MEMBERSHIP RENEWAL NOTICE
Thank you for renewing your membership.A complete breakdown of your membership renewal is attached. Please complete the entire form and
return all pages with your payment.Your membership renewal will be activated and your membership card mailed once payment is received.
MEMBERSHIP DUES 09/01/2016—08/31/2017
DATE: ORDER CUSTOMER PO DATE DUE: TOTAL DUE:
NUMBER: NUMBER: NUMBER:
05/28/2016 7001209548 00923650 08/11/2016 $90.00
rn
FOUR EASY WAYS TO RENEW
Be sure to mail or fax all pages of this form along with your payment.
• Mail:American Water Works Association
PO Box 972997,.Dallas,TX 75397-2997
• Online:www.awwa.org/renew :.
• Fax: 303.347.0804 O -
• Phone: 800.926.7337or3O3.794.7711
CIN-Seck(U.S.Funds only)
❑ VISA ❑ MasterCard ❑American Express ❑ DiscoverCard �� is
� p
Card No:. 4 ':
�a
Expiration Date: Signature:
Aunnerican Water Works Association 7 01209548
00923650
ANNUAL UPDATE REQUIRED Please update this information.AWWA is audited each year to confirm its membership composition.
Please make any corrections to your information below.
2.What one business activity best describes your company?
Mrs.Jaimie L Foreman (Please select only one)
Title: A Public Water Supply Utility-Municipally Owned
City of Carmel Water B Public Water Supply Utility-Investor Owned
114915E 106th St C Government-Federal,State,Local
❑ D Consulting Firm
Indianapolis,IN 46280-1532 ❑ E Contractor
United States ❑ F Private Industrial System or Water Wholesaler
Home Phone: ❑ G Manufacturer of Equipment&Supplies(including representatives)
Business Phone: ❑ H Distributor of Equipment&Supplies(including representatives)
❑ 1 Educational Institutions(faculty and students),Libraries and other related organizations
Fax: ❑ J Fully Retired
Email: ❑ K Research Lab
❑ L Other allied to the field(please specify)
3.What one category best describes your Job title?
(Please select only one)
❑ A Executive(General Manager,Commissioner,Board Member,
City Manager,Municipal Supt,Mayor,President,Vice President,
Owner,Partner,Director,etc.)
.10 B Management/Non-Engineering(Division Head,Section Head,
Manager,Dept.Head,Comptroller,etc.)
❑ C Design and Engineering/Both Managerial and Non-managerial
(Chief Engineer,Civil Engineer,Mechanical Engineer,Elect Engineer,
Environmental Engineer,Planning Manager,Feld Engineer,System
Designer,etc.)
❑ D Scientific/Non-managerial(Chemist,Biologist,Biophysicist,
1.What areas of the water and wastewater industry are of current Researcher,Analyst,etc.)
Interest to you? ❑ E Purchasing(Purchasing Agent,Procurement Specialist,Buyer,etc.)
(Please select all that apply) ❑ F Operations(Foreman,Operator,Maintenance Crewman,Service
❑ Asset Management ❑ Public Info./Communications Representative,etc.)
❑ Backflow/Cross Connection - egulatory Issues ❑ G Marketing&Sales/Non-managerial(Market Analyst,Marketing
-- - ❑ Climate-Change --- - — Reuse - —Representative,Salesperson,Sales Representative,etc..)
Conservation/Efficiency ❑ Small Systems ❑ 1 Professorial(Educator,Teacher,etc.)
Customer Service ❑ Stonnwater ❑ Z Other(please specify)
❑ Desalination ❑ Training/Career Development
❑ Design/Construction ❑ Utility Management
1t5 Distribution/Plant Ops. ❑ Wastewater 4.What one category best describes your field served/principal activity.)
Drought I Water Loss (Please select only one)
Emer.Preparedness/Security Water Quality/Treatment ❑ 9 Both Water Supply&Wastewater
Groundwater Water Research 5 Water Supply Only
Laboratory -0 Water Resources/Planning 7 Wastewater Only
❑ Membrane Treatment ❑ Workforce Strategies ❑ 3
Public Health ❑ Young Professionals - � `
Signa reP�j � ! RjAiate_au!I V
MEMBERSHIP RENEWAL PAYMENT BREAKDOWN
ITEM DESCRIPTION AMOUNT
DUES-06 AWWA-Operations/Administrative 01-Sep-2016 to 31-Aug-2017 $75.00
IND—SECTION AWWA-Indiana Section 01-Sep-2016 to 31-Aug-2017 $15.00
TOTAL $90.00
Dues are not deductible as charitable contributions for income tax purposes.Dues maybe considered ordinaryand necessary business deductions.The following is for USPS Periodical mailing requirements only.In some AWWA
sections,a portion of the section allotment equal to 50%or more of the domestic subscription rate charged for the section periodical will be allocated toward a subscdption to that periodical.Allocation for each publication recipient
authorized—Joumal AWWA-$50;Opflow-$16. NOTE Member's phone numbers,fax numbers and email addresses are protected underAWWA's Privacy Policy and are not shared with outside parties.
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