181324 01/13/2010 y CITY OF CARMEL, INDIANA VENDOR: 358915 Page 1 of 1
o. e ONE CIVIC SQUARE NLC MEETING SERVICES
s 24= CARMEL, INDIANA 46032 11208 WAPLES MILL RD #112 CHECK AMOUNT: $445.00
1 °'s FAIRFAX VA 22030
CHECK NUMBER: 181324
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 R4357004 21161 445.00 CONF REGISTRATION
No housing or registration will be processed without accompanying payment in full. Registration Cancellation Policy: 4,
All cancellation requests must be received in writing, postmarked by February 15, 2010, and are subjec
Are you elected official? 'I, Size of City 1 cancellation fee. No partial refunds will be made it you not to attend particular functions. No registrations
p y� y :r rte. or cancellations will be accepted by telephone. No cancellations will be accepted alter February 15, 2010.
Name I I z1 Spouse Guest fees are non refundable.
Title 2I"(n f� /��J �c. L r 0 rc( Gender Return Conference Forms to: Fax: (703) 631 -6288
City /Organization c2_ i e� Mail: NLC Meeting Services, C/0 J. Spargo and Associates 11208 Waples Mill Rd, Ste 112, Fairfax VA
Mailing Address O e-f Jt,c_ i-e QUESTIONS ABOUT REGISTRATION ,HOUSING, INVOICES?
r E- Mail: nlcregandhousinx@isoargo.com Phone: 888 -319 -3864 or 703- 449 -6418
City l' "`�-f State k) Zip (0(} 3�
Fhone Fax
Email Hotel Reservations: You must be registered for the Conference to reserve a hotel room. To guarantee
d C r d rC 6 earm e.. 14, U 1 1 your room, all hotels require one night's deposit plus 14.5% tax (subject to change.) 30 days prior to your
L 6 arrival. This is required even if you plan to arrive before 6:OOPM. It accommodations are not guaranteed
Registrant's Email 30 days in advanced the reservation will be cancelled.
PI 'case select one of the following:
Spouse /Guest Name' ($50 fee)
Youth Delegate” (15 -18, $100 fee) Age hid P lease make my hotel reservations as indicated below
**Local officials are encouraged to register youth as active participants in this conference to contribute to I do not require hotel accommodations at any of the hotels listed below
NLC's youth agenda. If the youth delegate requires hotel accommodations separate from yours, attach their Although I am providing information for a standard room now, please contact me
registration form with your completed form. regarding suite information.
Youth Chaperone Name ($100 fee) ilk Departure: 3 `6
(Local Elected City Officials are not eligible for this rate.) Room Dates: Arrival:, e Ito
Room Type: 77777������
2010 Registration Rates
g Single, 1 person /1 bed r Double, 2 people /1 bed
Please select only one Registration Type (except Spouse Guest) Forms received after the listed deadlines will Double /Double 2 people /2 beds LI Triple 3 people /2 beds
automatically be corrected to corresponding fee schedule.
Quad 4 people /2 beds
Congressional Cities On Site 2009
Conference Advanced '10 Regular '10 On -Site '10 Congress of Cities J Smoking lid Non Smoking
Conference Room types cannot be guaranteed but hotels will try to accommodate requests.
Registration Type Valid Valid Valid Valid Sharing my Room With (For Hotel Rate and Check in Purposes): ,j/
(FULL) 11/28- 2/15/10 2/16/- 3/11/10 3/13 -17/10 11/13 27/2009 1 2 3
Member $445 $540 $595 $380 Special Housing Request e.
g q g., wheelchair accessible rooms, etc.):
Associate Member $445 $540 $595 $380 It you have special housing or transportation needs, please contact NLC Meeting Services
SML Member $565 $625 $670 $505 Hotel Choice: Indicate your first choice hotel with the number "1." Number the other hotels from "2" to "3" in order of
Non Member $670 $715 $765 $620 preference. The Marriott Wardman Park Hotel is the headquarters hotel.
First Time Member $375 $375 $375 $375 Smoking
Student $175 $175 $175 $175 Order Hotel Property SGL DBL TRIP QUAD
l
Youth $100 $100 $100 $100 Marriott Wardman Park No $235 $255 $275 $295
Chaperone $100 $100 $100 $100
Spouse Guest $50 $50 $50 $50 Omni Shoreham Yes $229 $229 $229 $229
Days Inn No $139
Constituency Group Special Event Fees $139 $149 $159
Hotel Deposit Information: All Major credit cards with expiration of 3/10 or later are accepted at the conference
C Group Selection Activity Fee hotels. All checks must be submitted to the hotels after January 20, 2010 but before February 19, 2010 and are
subj t to approval. Please include your 6 digit REG ID indicated on the NLC Meeting services confirmation.
APAMO $40
R gistration Fee Payment Information
GLBLO $40 I Charge my REGISTRATION FEES to the VISA, MasterCard, or AMEX listed below
J Check for REGISTRATION FEES made payable to National League of Cities is enclosed
HELD $45 03 i P P urchase Order for REGISTRATION FEES -Copy must be enclosed and payment must be received by March 1 2010
NBC -LEO $95 Hgytel Deposit Information
!:Charge my HOTEL DEPOSIT to the credit card listed below
J Check for HOTEL DEPOSIT Please submit to hotel address noted on confirmation after January 20, 2010 but
WIMG $45' before February 19, 2010.
Celebrate Diversity Awards Breakfast $35 Credit Card Authorization: NLC Registration and Housing Services is authorized to use the card below to pay all applicable
1 registration fees and guarantee my hotel reservation. I understand that one night's room charge will be forfeited if Hail to show up for
r WIMG cost is for WIMG Luncheon my assigned housing on the confirmed arrival date unless I have canceled my reservation with the hotel at least 72 hours in advance.
I understand that if I do not show at the hotel on my confirmed arrival date, my reservation will not be reinstated for the remainder of
Leadership Training Institute Seminars the stay unless I instruct the hotel to reinstate my reservation. Reinstated reservations are subject to the hotel's availability. Further, I
When registering for LTI's please provide the event code listed on the web -site in the space provided below. You may not agree to the stated Registration Cancellation policy and I understand that upon cancelling my registration I will accrue a 75.00 non-
select a Full Day LTI and a Half -Day session occurring on the same day. refundable processing fee. Additionally I understand that no portion of the spouse -guest registr lion fee is refundable. crci
Date Price Event Code
Visa /Masters. ri /AMEX ►umber 374=2S
7 ��j j� Y E xxp L� L`�
Full Day, Day 1 $180 U. e
Card Holder Name
Morning Day 1 $120 411111//
Card Holder Signature._- a��_J.
Afternoon Day 1 $120 Additional Credit Card Authorization: For Hotel Deposit Only. Use it different from credit card listed above:
Full Day, Day 2 $180 Visa /Mastercard /AMEX Number Exp
Morning Day 2 $120 Card Holder Name
Afternoon Day 2 $120 Card Holder Signature
For Office Use Only: HTL SUBBLK CATE RATE
Total Your Registration Fees Here
airrtm
.._..u, .v.._..,
National League of Cities
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
M Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
MWareeS
Total
VOUCHER NO. WARRANT NO.
�\J /L ALLOWED 20_
v IN SUM OF
fib
Kd au m a
tQS I mo-
aAA,6
VA:
1 44
ON ACCOUNT OF APPROPRIATION FOR
""p)
Board Meml
PO# or INVOICE NO. ACCT #/TITLE AMOUNT hereby certify invoice( s)
DEPT. I hereb certi that the attached invoice s
J J'kle\ bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund