The URL can be used to link to this page

Home My WebLink About181946 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 00353282 Page 1 of 1 jd ONE CIVIC SQUARE INDIANA ASSOC OF CITY ENGINEERS CHECK AMOUNT: $60.00 i CARMEL, INDIANA 46032 ATTN: CHERYL MENCSIK PO BOX 273 LAGRANGE IN 46761 CHECK NUMBER: 181946 CHECK DATE: 2/3 /2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 60.00 ORGANIZATION MEMBER I MEMBERSHIP APPLICATION AND INVOICE For calendar year 2010 INDIANA ASSOCIATION OF CITY ENGINEERS (IACE) Please type or print: Individual Name: 1:) klV\ C.O cC Last First 1 M.I. Mailing Address: C C V■C U vC eY VV8 1 �Z Number Street City or town State Zip E -Mail Address: C\C VACadl @L' cot yi4L t V, 9 0V Position or Title: QV\* tiQ V City /Town/Company /Organization: C CVa 5A Telephone: j11-• 244k Fax: 2-4? Area Code Number Area Code Number Membership Classes (Please check appropriate class and remit dues for that class): /REGULAR MEMBER Any individual serving full time as a city or to engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. Annual dues are $25.00. AFFILIATE MEMBER Employees in municipal engineering departments, Public Works Directors, Town Managers, etc. or representatives of IACT, Indiana LTAP, INDOT, FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. Annual dues are $10.00. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Annual dues are $100.00. Make checks payable to: "IACE" and mail with this form to Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. Our Federal EIN is 35- 2132826. Please reproduce form for applications for your employees, associates, etc. MEMBERSHIP APPLICATION AND INVOICE For calendar year 2010 INDIANA ASSOCIATION OF CITY ENGINEERS (IACE) Please type or print: Individual Name: C, \J J t CU Last First M.I. Mailing Address: OW.(2_, C\\i'kCG S Q yy 4(d3% Number Street V City or Town State Zip E -Mail Address: i(V\1(Vlr\o ,de p C1ai Vl,,.d r c\ov Position or Title: C■ E.nf City /Town/Company /Organization: c-_, c Coy( Telephone: 3V- 5\ 2=A 4 t Fax: '3' 1E Z 21 Area Code Number Area Code Number Membe ship Classes (Please check appropriate class and remit dues for that class): REGULAR MEMBER Any individual serving full time as a city or town engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. Annual dues are $25.00. AFFILIATE MEMBER Employees in municipal engineering departments, Public Works Directors, Town Managers, etc. or representatives of IACT, Indiana LTAP, INDOT, FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. Annual dues are $10.00. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Annual dues are $100.00. Make checks payable to: "IACE" and mail with this form to Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. Our Federal EIN is 35- 2132826. Please reproduce form for applications for your employees, associates, etc. MEMBERSHIP APPLICATION AND INVOICE For calendar year 2010 INDIANA ASSOCIATION OF CITY ENGINEERS (IACE) Please type or print: Individual Name: 2 --ek"`,( Last First M.I. Mailing Address: .11 C,\ V S Q 4 Number Street City or Town State Zip E -Mail Address: Oft cOe n C Q,vyvo Q 1'r1 9CO`! Position or Title: 1 0,\C1 \A" e we City /Town/Company /Organization: C k Telephone: 2C 51- 2'1A Fax: 39-- Si- 2475 Area Code Number Area Code Number Membership Classes (Please check appropriate class and remit dues for that class): REGULAR MEMBER Any individual serving full time as a city or town engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. Annual dues are $25.00. /AFFILIATE MEMBER Employees in municipal engineering departments, Public P g g p Works Directors, Town. Managers, etc. or representatives of IACT, Indiana LTAP, INDOT, FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. Annual dues are $10.00. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Annual dues are $100.00. Make checks payable to: "IACE" and mail with this form to Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. Our Federal EIN is 35- 2132826. Please reproduce form for applications for your employees, associates, etc. 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 rates per day, number of hours, rate per hour, number of units, price per unit, etc. c/o Cheryl Mencsik, Secretary Purchase Order No. P.O. box 2/3 Terms LaGrange, IN 46761 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1129/10 nra 2010 Membership Mike McBride "Regular Member" Status) $25.00 Nick Redder' "Affiliate Member" Status) $10.00 $60.00 Total 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. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 LACE IN SUM OF c/o Cheryl Mencsik, Exec. Secretary P.O. Box 273 LaGrange, IN 46761 $60.00 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members D PT INVOICE NO. ACCT #ITITLE AMOUNT 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the nfa EvU 43s5300 $60.00 materials or services itemized thereon for which charge is made were ordered and received except 2_(1N 0 .72742-AC 20 Signature CC n�,szA✓ Cost distribution ledger classification if Title claim paid motor vehicle highway fund