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Home My WebLink About310552 04/24/17 +ur G.Iq*f ,a; � CITY OF CARMEL, INDIANA VENDOR: 00351464 e ONE CIVIC SQUARE INDIANA RURAL WATER ASSOC CHECK AMOUNT: $"""""396.00' q CARMEL, INDIANA 46032 PO Box 242 CHECK NUMBER: 310552 •.y. ZIONSVILLE IN 46077-0242 CHECK DATE: 04/24/17 •, rTON DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 1707883 396.00 OTHER EXPENSES E E to0 U- 0 LU D IT < z Ct) ZU D 0 Z O CO 0 < CO CN .2 CN C) a. Cl) LU F- U") < M a. cl CY) < g V- U- z 0 C-4 W z w D co m > r- EL C14 -j 0 z 9 LU v z < X O co co < M z < :5 CL Z O E 0 0 0 LO o Z CL m c) N CL > Remit To: Indiana Rural Water Association PO Box 242 Zionsville, fN 46077-0242 ATTN: ACCOUNTS PAYABLE Invoice BILL TO DATE INVOICE NO. City of Carmel 3450 W 131 St. St. 4/f 0/2017 17-07883 Carmel, IN 460747 ;------------------------------------------ IRWA is proud to be funded solely by membership dues and registration fees 1 with no federal government assistance. ; '-----------------------------------------� Membership Renewal Date 2/17/2017 Questions? MaryJane Peters,Administrative Director MaryJane@indianaruralwater.org Telephone-866-895-4792 P.O. No. TERMS Fax-855-202-7298 Due on receipt DESCRIPTION AMOUNT IRWA Spring Conference, April 24-26, 2017 Monday-Well Drillers& Pump Installers-John Mascari 60.00 Tuesday Only- Daniel Jenkins, Andrew Creasy 120.00 Tuesday/Wednesday-William Bell,Jr. 100.00 Wednesday Only- Matt Bichel 40.00 Meals: ML(1)TL(3) 76.00 w Subtotal $396.00 Payments/Credits $0.00 Balance Due $396.00 SHIPPED APR 17 2017 7 0 EGISTRATION FORM - IRWA Sprint Conference -April 24-26, 2017 Please print or type one form for EACH ATTENDEE! Attends Information: Billing Information: Name 1 Company Name: Title ihi:nt At) lan Billing Contact Guest's name;if attending Address 4h 92, Address 15 !cb City CiSt�V ju zip r Telephone&?- 7/-4142.Fax,51 T,51(-q 1qo Telephone_kl-1436-,785 15 E-mail Fax 1 will be submitting contact hours for- E-mail Involce lkf o\e f t (a nti . In.ao�/ Please print dearly Water Wastewater O Well Drifters/Pump Installers Engineer PDHs O None 17 Purchase Order# MONDAY SESSIONS IRWA Member Non-Member Water Operator Certification Test Refresher-(9:00a-4:00) ❑$60.00 13$120.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) PD$60.00 11$120.00 $ , 0 ,00 Energy Audits in Water&Wastewater Systems-(1:1130p-5:00) ❑$40.00 ❑$80.00 $ Wastewater Technical Sessions-(1:00p-5:00) 13$40.00 ❑$80.00 $ TUESDAY&WEDNESDAY SESSIONSIRWA Member Non-Member „ 13 Tuesday&Wednesday — — ❑ $100.00 ❑ $200.00 $ ❑ Utility Business Forum ❑ Board Members&Managers C N ❑ Tuesday ONLY -------- ❑ $60.00 ❑ $120.00 $ 'oma ❑ Utility Business Forum ❑ Board Members&Managers m ❑ Wednesday ONLY ——————— ❑ $40.00 ❑ $80.00 $ a► —L� � Monday Lunch Tuesday Lunch Tuesday Reception $ 06 Attendee V $19.00 Attendee ❑ $19.00 Attendee ❑ $No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $No Fee NOTE:One BOARD MEMBER or MAYOR per system is entitled to 11)COMPLIMENTARY Monday or Tuesday Lurch GAMBOLD EDUCATION FUND DONATION (GEF) $ Mon $ + Tues/Wed $ + Lunch $ l�I O° + GEF$ _ $2Q.00 MAIL:fRWA E-MAIL: FAX: 855-202-7298 , Bill us PO Box 242 Marylane@lndianaruralwater.org ❑ Pay On-Site Zionsville,IN 46077-0242 REGISTER ONLINE:www.lndlanaruralwater.ora ❑ Credit Card E-mall cc receipt - We welcome registrations on-site. -- Visa_ MC_ Discover AmExp Please submit cancellation requests In writing. # Exp.: No refunds after April 21,2017. NAME ON CARD: Security: Questions- MaryJane Peters SIGNATURE Bllling Zip Code: Telephone:866.895-4792,812.340.1868 E-mail., MaryJane@jndianarurshveter.org EGISTRATION FORM - IRWA Spring Conference -April 24-26, 2017 ease print or type one form for EACH ATTENDEE! Attendee Information: Billing Information: Name Company Name: Title • - Guest's ame;if attending^ a I tmhf Billing Contact k](T) 101400 Address � Address City 1 St J&Zip 6 City a- )`h(L1' St Zip Telephone04i2LIW=Fax`3i1 140 Telephone E-mail Fax rr n I will be submitting contact hours for• E-mail invoice 'L101Q Please pn tdaedy Water Wastewater ❑ Well Drillers/Pump Installers❑ Engineer PDHs O None O Purchase Order# MONDAY SESSIONS IRWA Member Non-Member Water Operator Certification Test Refresher-(9:00a-4:00) ❑$60.00 ❑$120.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) ❑$60.00 ❑$120.00 $ Energy Audits in Water&Wastewater Systems-(1:00p-5:00) ❑$40.00 ❑$80.00 $ Wastewater Technical Sessions-(1:00p-5:00) ❑$40.00 11$80.00 $ T ESDAY&WEDNESDAY SESSIONS IRWA Non-Member Tuesday& Wednesday ———— $100.00 ❑ $200.00 $ 1 UU.1110 ❑ Utility Business Forum ❑ Board Members&Managers C o ❑ Tuesday ONLY -------- ❑ $60.00 ❑ $120.00 $ ❑ Utility Business Forum ❑ Board Members&Managers ❑ Wednesday ONLY --------- ❑ $40.00 ❑ $80.00 $ Monday Lunch Tuesday Lunch Tuesday Reception $ 00 Attendee ❑ $19.00 Attendee $19.00 Attendee ❑ $No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $No Fee NOTE:One BOARD MEMBER or MAYOR per system Is entitled to(1)COMPLIMENTARY Monday or Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(GEF) $ Mon $ + Tues/Wed $ p + Lunch $ l9.0' + GEF $ — $ )IQ.Ob i MAIL:IRWA E-MAIL: f.M: 855-202-7298 Bill us Po Box 242 MatyJane@lndlonaruralwater.org ❑ pay On-Site Zionsville,IN 46077-0242 REGISTER ONLINE:www.lndlanaruralwater.ora ❑ 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 April 21,2097. NAME ON CARD: Security: Questions- MaryJane Peters Telephone:866-895-4792,,812-340-1868 SIGNATURE Billing Zip Code: E-mail: MaryJane@lndlaneruratwaterorg REGISTRATION FORM - IRWA Spring Conference -April 24-26, 2017 Please print or type-one form for EACH ATTEND Attenda Informatlon:�� Billing Information: Name yn I d �-hL.�f-U1�5 Company Name: Ain „'.F_ Title Billing Contact Guests name;if attending Address 1 f Address -m � �, . City st Zip d City St IM zip 4r�oc�x� Telephone&7-671-447_Fax3-T-5101140 Telephone_%511-735_Z865 E-mail Fax will be submitting contact hours for- E-mail invoice !Gj(� _Q .,� Please print cleady Water Wastewater O Well DrillerslPmnp Installers D Engineer PDHs O Horne o Purchase Order# MONDAY SESSIONS IRWA Member Non-Member Water Operator Certification Test Refresher-(9:00a-4:00) 13$60.00 ❑$120.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) 11$60.00 ❑$120.00 $ Energy Audits in Water&Wastewater Systems-(1:00p-5:00) ❑$40.00 ❑$80.00 $ Wastewater Technical Sessions-(1:00p-5:00) 13$40.00 ❑$80.00 $ e TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ❑ Tuesday& Wednesday ———— ❑ $100.00 ❑ $200.00 $ ❑ Utility Business forum ❑ Board Members&Managers a. Tuesday ONLY -------- -6 $60.00 ❑ $120.00 $ (�00 ❑ Utility Business Forum ❑ Board Members&Managers m ❑ Wednesday ONLY -------- ❑ $40.00 ❑ $80.00 $ u 06 MondayLunch Tuesday Lunch Tuesday Reception $�L� Attendee ❑ $19.00 Attendee $19.00 Attendee ❑ $No Fee Guest 0 $19.00 Guest ❑ $19.00 Guest ❑ $No Fee NOTE:One BOARD MEMBER or MAYOR per system is entitled to(1)COMPLIMENTARYMondayorTuesday Lunch GAMBOLD EDUCATION FUND DONATION(GEF) $ 10 Mon $ +Tues/Wed $ b•r'o + Lunch $ 46 + GEF$ _ $ b b MAIL;IRWA E-MAIL: FAX: 855-202-7298 Bill us PO Box 242 MaryJane@lndionaruralwater.org ❑ Pay On-Site ' Zionsville,IN 46077-0242 REGISTER ONLINE:www.lndianaruralwater.org I ❑ Credit Card E-mail co receipt: We welcome registrations on-site. - Visa•—•— MC_ Discover Am Exp Please submit cancellation requests in writing. # Exp,:_._ No refunds after April 21,2017. NAME ON CARD: Security: Questions- MaryJane Peters SIGNATURE Billing Zip Code: Telephone:886.895.4792;812-340.1868 E-mail. MaryJane@indianamrshveterorg EGISTRATION FORM - IRWA Spring Conference -April 24-26, 2017 Please print or type one fonn for EACH ATTENDEE! Attonde,q Inf atlon: Billing Information: Name Company Name: Title Billing Contact Guest'sgame;if attending Address &per Address City St-I Zip 4&090 City . — St W Zip 41-0 4 TeIephone�,�/?- 57/-4 ,Fax,�l7��(��q� Telephone E-mail Fax rr will be submitting contact hours for- E-mail invoice Please pnm clsady Water Wastewater O Well DrlllerslPump Installers 0 Engineer PDHs 0 None o Purchase Order# MONDAY SESSIONS IRWA Member Non-Member Water Operator Certification Test Refresher-(9:00a-4:00) ❑$60.00 ❑$120.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) 13$60.00 ❑$120.00 $ Energy Audits in Water&Wastewater Systems-(1:00p-5:00) ❑$40.00 13$80.00 $ Wastewater Technical Sessions-(1,00p-5:00) ❑$40.00 0$80.00 $ e TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ❑ Tuesday& Wednesday ———— D $100.00 D $200.00 $ ag ❑ Utility Business Forum ❑ Board Members&Managers C a. Tuesday ONLY -------- `1" $60.00 D $120.00 $ D Utility Business Forum ❑ Board Members&Managers m D Wednesday ONLY ——————— ❑ $40.00 ❑ $80.00 $ Monday Lunch Tuesday Lunch Tuesday Reception $ Attendee ❑ $19.00 Attendee $19.00 Attendee ❑ $No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $No Fee NOTE: One BOARD MEMBER or MAYOR persystem Is entitled to(1)COMPLIM£NTARYMonday or Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(GEF) $� Mon $ +Tues/Wed $�_ + Lunch $�00 + GEF$ _ $_-,- 06 MAIL:IRWA E-MAIL: FAX: 855-202-7298 Bill us PO Box 242 Marylane(Alndlanarurolwater.org 13 Pay On-Site Zionsville,IN 46077-0242 REGISTER ONLINE:www.lndlanaruralwaier.ora ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. Visa— MC— Discover AmExp Please submit cancellation requests Iniwr tinct. # Exp.:_-_ No refunds after April 21,2017. NAME ON CARD: Security: Questions- MaryJane Peters SIGNATURE Billing Zip Code: Telephone:866.895.4792;812-340-1868 E-mail: MaryJane@fnd(anamralwaterorg 0.1 011 QGISTRATION FORM - IRWA Spring Conference -April 24-26, 2017 Please print or_lvne_one form for EACH ATTENDEE! Attendee Information: I Billing Information: Name rC�3-a � 1�toJ' Company Name: Title Billing Contact Guesfs name;if attending Address b-M Address City St A Zip Q CitybSt Ztp Telephone �/ - Z Fax l7-5"](-�1Q0 Telephone t5,_1-7436_ZB E-mail Fax will be submitting contact hours for- E-mail Invoice Please p dearly � Water Wastewater 0 Well Drlllersmump Installers D Engineer PI)Hs O None 0 Purchase Order# MONDAY SESSIONS IRWA Member Lion-Member Water Operator Certification Test Refresher-(9:00a-4:00) ❑$60.00 13$120.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) 13$60.00 ❑$120.00 $ Energy Audits in Water•&Wastewater Systems-(1:00p-5:00) ❑$40,00 ❑$80.00 $ Wastewater Technical Sessions-(1:00p-5:00) 13$40.00 ❑$80.00 $ TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ❑ Tuesday& Wednesday ———— ❑ $100.00 ❑ $200.00 $ ❑ Utility Business Forum ❑ Board Members&Managers c Q ❑ Tuesday ONLY -------- ❑ $60.00 ❑ $120.00 $ ❑ Utility Business Forum ❑ Board Members&Managers Wednesday ONLY -------- )M $40.00 ❑ $80.00 $ 60 r Monday Lunch Tuesday Lunch Tuesday Reception $ Attendee ❑ $19.00 Attendee ❑ $19.00 Attendee ❑ $No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $No Fee NOTE: One BOARD MEMBER or MAYOR per system Is entitled to(1)COMPLIMENTARYMonday or Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(GEF) $ Mon $ + Tues/Wed Vt.Do + lunch $ + GEF $ _ $�40,60 MAIL:IRWA E-MAIL: FAX: 855.202.7298 Bill us PO Box 242 Marylane@Indlanaruralwater.org ❑ Pay On-Site Zionsville,IN 46077-0242 REGISTER ONLINE.,www.tndfanaruralwater.om ❑ 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 April 21,2017. NAME ON CARD: Security: Questions- MaryJane Peters Telephone.866-896-4792,,812-340-1808 SIGNATURE selling Zip Code: E-mail. MaryJane@lndlanamralwaterorg