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Home My WebLink About307264 01/20/17 CITY OF CARMEL, INDIANA VENDOR: 362435 ONE CIVIC SQUARE INDIANA SECTION AWWA CHECK AMOUNT: $ f* k M r 815.00 CARMEL, INDIANA 46032 2680 EAST MAIN STREET#106 CHECK NUMBER: 307264 9PLAINFIELD IN 46168 CHECK DATE: 01/20/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 11484 315.00 OTHER EXPENSES 601 5023990 11590 500.00 OTHER EXPENSES N E N O m U- O N W U Q Q a o g *k LP o F- O N Z O 3 00 d O 4t c g uNi rn CO f+ 0< v M a ~ a U V N MZ Q o o L rnt co z y O L > k Wap z o o v W Q � W VM: LO z 1L OU z Le > V,CNI — z o v M z CO a O d U v Indiana Section,AWWA Invoice 11484 2680 East Main Street, Suite 106 Plainfield, IN 46168 US (866)213-2796 DATE PLEASE PAY DUE DATE 12/30/2016 $315-0001 f01/ 017 BILL TO City of Carmel 3450 W. 131 st St. Carmel, IN. 46074 Please detach top portion and return with your payment. .......... .......... ...... ....... ......... ...... ACTIVITY AMOUNT .........................-............ ........................ ...... ... Indiana Section,AWWA 109th Annual Conference, January 31 - February 2, 2017 in Indianapolis, IN Full Conference-Jamie Foreman 125.00 Tuesday Only-Jack Spears 100.00 Meals: TL(2);WL(1);ThB (1) 90.00 .. ............. .................... ................. TOTAL DUE $315.00 THANK YOU. Indiana Section,AWWA Invoice 11590 2680 East Main Street, Suite 106 Plainfield, IN 46168 US (866) 213-2796 DATE PLEASE PAY RUE DATE 01/09/2017 $500.00 02/01/2017 BILL TO City of Carmel 3450 W. 131 st St. Carmel, IN. 46074 Please detach top portion and return with your payment. ............ ..... ACTIVITY AMOUNT I'll.,...... ........... Indiana Section, AWWA 109th Annual Conference, January 31 February 2, 2017 in Indianapolis, IN Wednesday Only- Daniel Jenkins, Anthony Isenberger,John Mascari, Andrew Creasy 400.00 Meals: TL();WL (4);ThB 100.00 ............ TOTAL DUE $500.00 THANK YOU. 109th Annual Meeting MMA SECTION AWWA Marriott Hotel-Indianapolis,IN January 31-Februar3 2,2017 R E G I S T R AT 1 0 N F 0 R M A L L A T T E N D E E S Autility ❑ Service Provider NAME: (only one name perform) AWWA MEMBER#: Last First Initial TITLE: O P e r4 o/' ORGANIZATION: CQ(-rn ADDRESS: 3 451-0 w: 1 3/ CITY 1 STATE 1 ZIP: OFFICE TELEPHONE: ( 31 7 )_73 3 -11YFAX:(31- ) 7733— ao-52 EMAIL: REGISTRATION FEESThe DEADLINE for . registration Full conference-member* ❑ Advance:$125 ❑ On-site:$185 Jan.13,2017 Full conference-non-member* ❑ Advance:$215 ❑ On-site:$265 One day-member* k Advance:$100 ❑ On-site:$135 Day: 6 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) COWL94ENTARY REGISTRATIONS ❑ Student,full-time ❑ Retired(AWWA members only) ❑ Guest(Admittance to receptions only) Name: ❑ First time attendee 1 Haven't Attended in At Least 5 Years (UTILITY REGISTRANTS ONLY) EARLY BIRD REGISTRATION Monday,Jan.30, 3:00-7:00 p.m. MEALS-Tickets required El Tuesday,Jan.31, 12-noon:Keynote luncheon-$25 **ednesday, Feb. 1, 12-noon:Awards luncheon-$25 ❑Thursday, Feb.2,7:30 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: , Card number: Exp.date: Security Code: ONLY ONE NAME PER SPECIAL.NEEDS REFUND POLICY REnJRN COMPLETED FORM,PLEASE 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.9, j 2680 East Main Street,#106 or go to our web site Dawn Keyler at(866)213-2796 2017,to Dawn Keyler. Plainfield, IN 46168 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 109th Alnual Meeting MMA SECTION AWWA Marriott Hotel r Indianapolis,IN January 31-February 2,2017 R E G I S T R AT I O N F O R M A L L A T T E N D E E S r�utility ❑ Service Provider NAME:=SFIBE ".? AlwrNor►V (only one name perform) AWWA MEMBER#: LastFirst Initial TITLE: OPEr2ATOE ORGANIZATION: C%-N OF CACALL- ADDRESS: to 212 Bv"orluj000 0 V, CITY/STATE/ZIP: NOBLFSUILL6 114. ybo6Z OFFICE TELEPHONE: (311 ) 733 -Z 855 FAX: aY-? 7 33- ;®'s EMAIL: + i r REGISTRATION FEES The DEADLINE fo . Full conference-member* ❑ Advance:$125 ❑ On-site:$185 idn. Full conference-non-member* ❑ Advance:$215 ❑ On-site:$265 One day-member* [Avance:$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.30,3:00-7:00 p.m. MEALS—Tickets required ❑Tyesday,Jan.31, 12-noon:Keynote luncheon-$25 CgWednesday, Feb. 1, 12-noon:Awards luncheon-$25 ❑Thursday, Feb.2,7:30 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: Card number: Exp.date: Security Code: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM,PLEASE! 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.9, 11 2680 East Main Street,#106 or go to our web site Dawn Keyler at(866)213-2796 2017,to Dawn Keyler. I Plainfield, IN 46168 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 109th Annual Meeting MMA SECTION AWWA Marriott Hotel-Indianapolis,IN January 31--February 2,2017 REG ISTRATIO N F A R M A L L ATT E N D E E S "r, ❑ Service Provider _�r NAME: / ►!�5 ✓'ir ^1 Q►'1 y1 - (only one name perform) AWWA MEMBER#: _ Last first Initial � TITLE: - ORGANIZATION: L-�Gtr"e( Gri ADDRESS: C. 55_r'� 'C CITYISTATEIZIP: G�l'a�ct,40�/SS OFFICE TELEPHONE:( i`7 FAX:(,? -? EMAIL: ,j w\a 5e-c-rl.- 6 CG eV REGISTRATION FEES The DEADLINE for . . Full conference-member* ❑ Advance:$125 ❑ On-site:$185 Jan. Full conference-non-member* ❑ Advance:$215 ❑ On-site:$265 One day-member* *,Advance:$100 ❑ On-site:$135 Day: o?- 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) CONPLIlvIENTARY REGISTRATIONS ❑ Student,full-time ❑ Retired(AWWA members only) ❑ Guest(Admittance to receptions only) Name: ❑ First time attendee 1 Haven't Attended in At Least 5 Years (UTILITY REGISTRANTS ONLY) EARLY BIRD REGISTRATION Monday,Jan.30,3:00-7:00 p.m. MEALS—Tickets required ❑Tuesday,Jan.31, 12-noon:Keynote luncheon-$25 ft�Nednesday, Feb. 1, 12-noon:Awards luncheon-$25 ❑Thursday, Feb.2,7:30 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: Card number: Exp.date: Security Code: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM,PLEASE! 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.9, 2680 East Main Street,#106 or go to our website Dawn Keyler at(866)213-2796 2017,to Dawn Keyler. Plainfield, IN 46168 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 109th Annual Meeting MMA SECTION AWWA Marriott Hotel-Indianapolis,IN January 31-February 2,2017 R E G I S T R AT 1 0 N F 0 R M A L L A T T E N D E E S $6 utility ❑ Service Provider pp NAME: Ceeq" A+% (only one name perform) AWWA MEMBER#: L sf InRial TITLE: 1PIN, Q .fel. ORGANIZATION: �a✓rws Wa T♦i ADDRESS: CITY 1 STATE I ZIP: OFFICE TELEPHONE: (31-7 733 - ze SS FAX: 20 S-7-? EMAIL: 19 CalL#nal. REGISTRATION FEES The DEADLINE for ADVANCE registration Full conference-member* ❑ Advance:$125 ❑ On-site:$185 Full conference-non-member* ❑ Advance:$215 ❑ On-site:$265 One day-member* A-dvance:$100 ❑ On-site:$135 Day: One day-non-member* dvance:$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 1 Haven't Attended in At Least 5 Years (UTILITY REGISTRANTS ONLY) EARLY BIRD REGISTRATION Monday,Jan.30,3:00-7:00 p.m. MEALS—Tickets required OTuesday,Jan,31, 12-noon:Keynote luncheon-$25 '(Wednesday, Feb. 1, 12-noon:Awards luncheon-$25 ❑Thursday, Feb.2,7:30 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: Card number: Exp.date: Security Code: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURNCONIP'L.EM FORK PLEASES 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.9, j 2680 East Main Street,#106 or go to our web site Dawn Keyler at(866)213-2796 2017,to Dawn Keyler. Plainfield, IN 46168 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 109th Annual Meeting R*ML4NA ,3jzCTI0N AWWA Marriott Hotel-Indianapolis,IN January 31-February 2,2017 R E G 1 S T R A T 1 0 N F 0 R M A L L A T T E N D E E S Clutility ❑ Service Provider r NAME: (only one name perform) AWWA MEMBER#: _&U� Last 3� First Irn5a', TITLE:__t'56104w � ORGANIZATION: - - - - ADDRESS: 3q SO V✓• 13 15` St CITY/STATE/ZIP: CCL r M _l-- --- OFFICE TELEPHONE: (31_-7 3- a FAX: (317-) -] 3 3 053 EMAIL: REGISTRATION FEES The DEADLINE for ADVANCE registration Full conference-member* ❑ Advance: $125 ❑ On-site: $185 Jc1n. Full conference-non-member* ❑ Advance: $215 ❑ On-site:$265 One day-member* X 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. 30, 3:00-7:00 p.m. MEALS-Tickets required ❑Tuesday,Jan.31, 12-noon: Keynote luncheon-$25 ❑Wednesday, Feb. 1, 12-noon:Awards luncheon-$25 ❑Thursday, Feb.2, 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: Card number: Exp.date: Security Code: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM,PLEASE 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.9, 2680 East Main Street,#106 or go to our web site Dawn Keyler at(866)213-2796 2017,to Dawn Keyler. Plainfield, IN 46168 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 i