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185499 05/18/2010 CITY OF CARMEL, INDIANA VENDOR: 360690 Page 1 of 1 ONE CIVIC SQUARE JOHN THOMAS CHECK AMOUNT: $600.90 0 )a CARMEL, INDIANA 46032 11576 CREEKSIDE LANE CARMEL IN 46033 CHECK NUMBER: 185499 CHECK DATE: 5/18/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 206 4462838 30.90 STORM WATER PHASE II 2200 4355300 120.00 ORGANIZATION MEMBER 2200 4357004 450.00 EXTERNAL INSTRUCT FEE �ptan and Srvr�h. �0 4� 3 11 AFSM Indiana Association for Floodplain and Stormwater Management, Inc. 115 West Washington Street, Suite 1368 South 2010 Indianapolis, Indiana 46204 Tel: (317) 536 -6721 Fax: (317) 632 -3306 Annual Membership Application /Renewal Email: info(d7inafsm.net Valid through 12/31/10 Web: www.INAFSM.net Name: DaC Oyes' L�� Title: �,('�Y14,11%u�C�11C3V� ��(10 C�tic Credentials: (i.e. PE, CFM, etc.) Organization: C� C_oy" Address: L)ll�i) ��y;C� u ClY2 City: State: Zip Code: 4(a'`S2_ Phone No.: Fax: 2 E-mail: CD.� '�V o�! NOTE: Your a -mail address is cri 'cal! INAFSM's primary ode of correspondence is via e-mail. Affiliation check one Local Government State Government Federal Government Consultant Academia Student Private individual Manufacturing /Supplier Other 1 am interested in joining: Stormwater Management Committee Stormwater Quality Subcommittee Floodplain Management Committee Legislative Committee Outreach/Newsletter Committee Awards Committee Annual Conference Committee Other (please specify) Please make $40 Annual Membership fee payable to INAFSM. Donations will also be accepted and greatly appreciated. Questions may be directed to Unique Dahl, (317) 536 -6721 or info a,inat'sm.net o�F plain and 1 4 4 A Indiana Association for Floodplain and Stormwater Management, Inc. 115 West Washington Street, Suite 1368 South 2 ®1® Indianapolis, Indiana 46204 Tel: (317) 536 -6721 Fax: (317) 632 -3306 Annual Membership Application /renewal Email: infocDinafsm.net Valid through 92 139110 Web: www.INAFSM.net Name: __1a\n y', l h O�lY�C1� Title: M U20k PXA :ftI V) i��Y� Credentials: (i.e. PE, CFM, etc.) C ,121 Q_ Organization: C'4' Oc ynk-Q X- _3 Address: C G C City: 0 0, State Zip Code: 1St03Z Phone No.: SCI, ?4N Fax: S\ 1, 'ak 2 E -mail: NOTE: Yo u e mail address is critical! INAFSM's primary mode of correspondence is via e-mail. Affiliation check one): Local Government State Government Federal Government Consultant Academia Student Private individual Manufacturing /Supplier Other 1 am interested in joining: Stomiwater Management Committee Storrrtwater Quality Subcommittee Floodplain Management Committee Legislative Committee Outreach/Newsletter Committee Awards Committee Annual Conference Committee Other (please specify) Please make $40 Annual Membership fee payable to I_NAFSM. Donations will also be accepted and greatly appreciated. Questions may be directed to Unique Dahl, (317) 536 -6721 or info�r),inaism. net oc in and sto.'.0. CU m C m` 1 NABS M Indiana Association for Floodplain and Stormwater Management, Inc. 115 West Washington Street, Suite 1368 South 2010 Indianapolis, Indiana 46204 Tel: (317) 536 -6721 Fax: (317) 632 -3306 Annual Membership Application /Renewal Email: info(cDinafsm.net Valid through 12/31/10 Web: www.INAFSM.net Natne: GOV) Title: cPte �o►� Credentials: (i.e. PE, CFM, etc.) Organization: 0 1 C7p co'�rOnk Address: City: cy,( L State: Zip Code: O`�Z Phone No.: Fax: E-mail: �A- NOTE: Your e -m it address is critical! INAFSM's pri ary mode of correspondence is via e-mail. Affiliation check one Local Government V State Government Federal Government Consultant Academia Student Private individual Manufacturing /Supplier Other I am interested in joining: Stonrwater Management Committee Stormwater Quality Subcommittee Floodplain Management Committee Legislative Committee Outreach/Newsletter Committee Awards Committee Annual Conference Committee Other (please specify) Please make $40 Annual Membership fee payable to INAFSM. Donations will also be accepted and greatly appreciated. Questions may be directed to Unique Dahl, (3'17) 536 -6721 or inra tu,inafsm.net _i: COURSE INSTRUCTORS: E NVIROCERT International, Inc. LORI GATES CPESC CPSWQ, CMS4S I NTERNATIONAL, I NC. EnviroCert International, Inc. is recognized As a Senior Resource Planner with Christopher B. PRESENTS: internationally as a certification body for Burke Engineering, Ltd. Lori's responsibilities professionals in the erosion and sediment include ensuring that all municipal, construction, control and stormwater quality industries. With and industrial stormwater quality projects and over 25 years of certification experience, permits are in compliance with the NPDES REVIEW COURSES AND EXAMS FOR: EnviroCert International, Inc. takes pride in Stormwater Permit program. Lori also currently CPESCO- CERTIFIED offering these programs, serves as the Stormwater Chair of the Indiana PROFESSIONAL IN EROSION Association of Floodplain and Stormwater AND SEDIMENT CONTROL This will be the first offering of the CMS4ST'" Managers (INAFSM), the Administrative Vice Certified MS4 Specialist certification. Chair of EnviroCert International, Inc. and the EnviroCert International Inc. is excited to offer this new certification to the many individuals Chair of the CMS4S, Inc. Council. CPSWQ CERTIFIED who work in an MS4 program throughout JENNIFER HILDEBRAND, CPESC, CPSWQ, n PROFESSIONAL IN STORM WATER QUALITY Indiana and the United States. CESSWI, CISEC;,, �A As the National Storm Water Manager for Weis V/ n More about the new CMS4S certification Builders, Inc. Jennifer's specialties include ,r! -Z) y� CESSWI� CERTIFIED The program is available to all qualified compliance issues, inspection programs, progra 1 j' EROSION, SEDIMENT AND MS4 program staff, operators, coordinators, design, and site plan reviews. Her involvement CJ with the construction industry has p rovided her STORM WATER INSPECTOR w and others who wish to demonstrate their y p proficiencies. with experience in a wide variety of erosion and sediment control products and services. Jennifer CMS4STm CERTIFIED MS4 Candidates must have at least 5 years of is the previous Administrative Vice Chair for SPECIALIST directly related experience and possess a CPESC, Inc. and is currently the Executive I High School diploma (or equivalent) along Director for the Vegetation Management with work references. Association of Minnesota. The mission of the CMS4S program is to serve the public trust through the H o s T E D BY: certification of individuals who are I ND'I ANA' `D E'P A R T N T O.F technically and ethically qualified to manage E N v I.R o N'M to L M •A'N A'G; T or coordinate national consistent EPA A'N D I N;D I A N A A•-S:S O C i T 1 O.N FOR' BA NNING E NGINEERING FACILITY NPDES MS4 programs which are in F L O'O`D'P L A V-W AN D S T Q Rl:MW A T E0 853 COLUMBIA ROAD compliance with applicable (local, state and MA NAGEMENT PLAINFIELD IN 46 168 federal) laws and regulations. ID Registrants must understand the minimum. requirements for the US EPA NPDES Stormwater permit requirements, as it related to overall coordination and x� j�) Envir ceirt International, Inc. implementation of the MS4 program. PA REGISTRATION INFORMATION REGISTRATION INFORMATION Please INAFSM Non Dates: sign me Date Member Member The Review Courses are open to up for: Price Price everyone and represents good stand May 10 CMS4S Review Course Review Course: Please circle your selection alone educational opportunities. May 11 CPESC Review Course CMS4S May 10 $150 $250 May 12 CESSWI Review Course The registration fee(s) for the exam review course is separate from the May 13 CPSWQ Review Course CPESC May 11 $150 $250 application fee(s). For more information, May 14 Exams (all certifications) CESSWI May 12 $150 $250 see www.envirocertintl.org. May 15 Exams (all certifications) CPSWQ May 13 $150 $250 The exam review course manual is You may choose the date of your exam. All Exam: Please indicate which exam and date included in the registration cost. exams will be offered on both dates. The application process must be Payments will be accepted in check form $30 $80 completed to be eligible to take the exam. Exam: Please indicate which exam and date p g only. Make checks payable to INAFSM. Attendees must present their letter of $30 $80 eligibility to take the exam. subtotal All review courses and exams will begin A registration confirmation will be emailed promptly at 8:30 am. Please plan to arrive not Advance shipment of manual $10 to each participant. later than 8:15 am for the review course or Total Visit www.enviracertintl.org for more exam. information on the application process. Please keep in mind that it may take up Review courses are expected to be completed Mail registration form and check made payable to 30 days for the applications to be by 5:00 pm. Exam length will vary by to: reviewed and accepted. It is strongly certification. INAFSM encouraged that anyone seeking to sit for the actual exam begin the application We will break for lunch during the review Unique Dahl process ASAP. course and local info restaurant information will National City Center, Suite 1386 South For information on the requirements for be available for those not familiar with the area 115 W Washington Street applicants to sit for each exam, please (lunch is on your own). We will not break during Indianapolis, IN 46204 visit www.envirocertintl.org the exam period. Exam is to be taken within 1 ear of Name: Y Discounted hotel accommodations are receipt of the eligibility letter. available. Please see www.inafsm.net for more information. Company: Seating is limited, please register early. Discounts are provided for INAFSM Address: members. If you would like to become a member, please visit www.inafsm.net. City: A special THANK YOU to Banning 0 For further information on registration, please Engineering for providing the location. contact Unique Dahl at admin(c7inafsm.net or State: Zip: 317- 536 -6721. Phone: For further information on the review course content, please contact Lori Gates at Email: sw @inafsm.net. REGISTRATION INFORMATION REGISTRATION INFORMATION Please INAFSM Non Dates: sign me Date Member Member The Review Courses are open to up for: Price Price everyone and represents good stand May 10 CMS4S Review Course Review Course: Please circle your selection alone educational opportunities. May 11 CPESC Review Course May 12 CESSWI Review Course CMS4S May 10 $150 $250 The registration fee(s) for the exam review course is separate from the May 13 CPSWQ Review Course CPESC May 11 $150 $250 application fee(s). For more information, May 14 Exams (all certifications) CESSwI May 12 150 $250 see www.envirocertinti.org. May 15 Exams (all certifications) CPSwa May 13 $150 $250 The exam review course manual is You may choose the date of your exam. All Exam: Please indicate which exam and date included in the registration cost. exams will be offered on both dates. The application process must be $30 $80 pp p Payments will be accepted in check form completed to be eligible to take the exam. only. Make checks payable to INAFSM. Exam: Please indicate which exam and date Attendees must present their letter of $30 $80 eligibility to take the exam. Subtotal S p o a All review courses and exams will begin A registration confirmation will be emailed promptly at 8:30 am. Please plan to arrive not Advance shipment of manual $10 to each participant. later than 8:15 am for the review course or Total 0 O Visit www.envirocertinti.org for more exam. information on the application process. Please keep in mind that it may take up Review courses are expected to be completed Mail registration form and check made payable to 30 days for the applications to be by 5:00 pm. Exam length will vary by to: reviewed and accepted. It is strongly certification. INAFSM encouraged that anyone seeking to sit for the actual exam begin the application 0 We will break for lunch during the review Unique Dahl process ASAP_ course and local info restaurant information will National City Center, Suite 1386 South For information on the requirements for be available for those not familiar with the area 115 W Washington Street applicants to sit for each exam, please (lunch is on your own). We will not break during Indianapolis, IN 46204 visit www.envirocertinti.org the exam period. Exam is to be taken within 1 ear of Name: 90\0 Y Discounted hotel accommodations are receipt of the eligibility letter. available. Please see www.inafsm.net for more {n� information. Company C ��v L Seating is limited, please register early. Discounts are provided for INAFSM Address: members. If you would like to become a member, please visit www.inafsm.net. City: C45- y A special THANK YOU to Banning For further information on registration _please Engineering for providing the location. contact Unique Dahl at admin(@inafsm.net or State: Zip: 317 -536 -6721. Phone: For further information on the review course content, please contact Lori Gates at Email: `t)( Vs kg_ sw @inafsm.net. p \_f REGISTRATION INFORMATION REGISTRATION INFORMATION Please INAFSM Non Dates: sign me Date Member Member The Review Courses are open to up for: Price Price May 10 CMS4S Review Course everyone and represents good stand Review Course: Please circle your selection alone educational opportunities. May 11 CPESC Review Course CMS4S May 10 $150 $250 May 12 CESSWI Review Course The registration fee(s) for the exam review course is separate from the May 13 CPSWQ Review Course CPESC May 11 $150 $250 application fee(s). For more information, May 14 Exams (all certifications) CESSWI May 12 $150 $250 see www.envirocertintl.org. May 15 Exams (all certifications) CPSWQ May 13 $150 $250 The exam review course manual is You may choose the date of your exam. All Exam: Please indicate which exam and date included in the registration cost. exams will be offered on both dates. The a process must be $30 $80 pp p Payments will be accepted in check form completed to be elig to take the exam. Exam Please indicate which exam and date p g only. Make checks payable to INAFSM. Attendees must present their letter of $30 $80 eligibility to take the exam. Subtotal lS0 n� All review courses and exams will begin A registration confirmation will be emaiied promptly at 8:30 am. Please plan to arrive not Advance shipment of manual $10 to each participant. later than 8:15 am for the review course or Total e Visit www.envirocertinti.org for more exam. information on the application process. Review co Please keep in mind that it may take up courses are expected to be completed Mail registration form and check made payable to 30 days for the applications to be by 5:00 pm. Exam length will vary by to: reviewed and accepted. It is strongly certification. INAFSM encouraged that anyone seeking to sit for the actual exam begin the application We will break for lunch during the review Unique Dahl process ASAP. course and local info restaurant information will National City Center, Suite 1386 South For information on the requirements for be available for those not familiar with the area 115 W Washington Street applicants to sit for each exam, please (lunch is on your own). We will not break during Indianapolis, IN 46204 visit www.envirocertintl.org the exam period. Exam is to be taken within 1 year of Discounted hotel accommodations are Name: receipt of the eligibility letter. available. Please see www.inafsm.net for more r Company: information. C l�l C�� Seating is limited, please register early. Discounts are provided for INAFSM Address: y�c members. If you would like to become a member, please visit www.inafsm.net. City: CQ( A special THANK YOU to Banning For further information on registration, please Engineering for providing the location. contact Unique Dahl at admin(cbinafsm.net or State: Zip: !k�,00 317 -536 -6721. Phone: For further information on the review course r� content, please contact Lori Gates at Email: P� ri. e, �al sw@inafsm.net. REGISTRATION INFORMATION REGISTRATION INFORMATION Please INAFSM Non- Dates: sign me Date Member Member The Review Courses are open to up for: Price Price everyone and represents good stand May 10 CMS4S Review Course Review Course: Please circle your selection alone educational opportunities. May 11 CPESC Review Course CMS4S May 10 $150 $250 May 12 CESSWI Review Course The registration fee(s) for the exam review course is separate from the May 13 CPSWQ Review Course CPESC May 11 $150 $250 application fee(s). For more information, May 14 Exams (all certifications) CESSwI May 12 $150 $250 see www.envirocertintf.org. May 15 Exams (ail certifications) CPSWQ May 13 150 $250 The exam review course manual is You may choose the date of your exam. All Exam: Please indicate which exam and date included in the registration cost. exams will be offered on both dates. The application process must be 0 Payments will be accepted in check form $30 $80 completed to be eligible to take the exam. only. Make checks payable to INAFSM. Exam: Please indicate which exam and date Attendees must present their letter of $30 $80 eligibility to take the exam. Subtotal ESQ o c, All review courses and exams will begin A registration confirmation will be emailed promptly at 8:30 am. Please plan to arrive not Advance shipment of manual $10 to each participant. later than 8:15 am for the review course or total o C Visit www.envirocertintf.org for more exam. information on the application process. Please keep in mind that it may take up Review courses are expected to be completed Mail registration form and check made payable to 30 days for the applications to be by 5:00 pm. Exam length will vary by to: reviewed and accepted. It is strongly certification. INAFSM encouraged that anyone seeking to sit for the actual exam begin the application We will break for lunch during the review Unique Dahl process ASAP. course and local info restaurant information will National City Center, Suite 1386 South For information on the requirements for be available for those not familiar with the area 115 W Washington Street applicants to sit for each exam, please (lunch is on your own). We will not break during Indianapolis, IN 46204 visit www.envirocertintl.org the exam period. Exam is to be taken within 1 year of Discounted hotel accommodations are Name: V VA �pYV»S receipt of the eligibility letter. available. Please see www.inafsm.net for more Company: cay O information. Seating is limited, please register early. Discounts are provided for INAFSM Address: CU'i (2- tlLa�' members. If you woulikl e to become n member, please visit w.inafsm.net p City: t «V 0"4 P 9 o furt X� A special THANK YOU to Bannin For f rth ifo rmatio r n t i r ti n lease sao, Engineering for providing the location. contact Unique Dahl at admin(a)inafsm.net or State: Zip: 317- 536 6721. Phone: S� Z�1 For further information on the review course content, please contact Lori Gates at Email: &�0CV\q Cay .o sw @inafsm.net. tiY1 uCTV JOHPd GHARR:IYY THOMAS ,11 w 740 40 5 4 3 JESSICA KENDALL'THOMAS 7azs71osa 11576 'CREEK SIDE LANE l CARMEL,: IN 46033 DATE R THE O ORDER OF ✓/L EtJg. l DOLWS u w and i,71+�✓ MEMO mP , &S4 3 I INVOICE NUMBER 6728021 DATE: 05/12/2010 Page: 1 Be Right'" TOTAL: $30.90 Hach Company 2207 Collections Center Drive Chicago, IL 60693 Have you ordered online Phone: (800) 227 -4224 Order at WWW.HACH.COM 67280214 400397337 00000003090 051210 DETACH HERE_. _Original_. INVOICE NO 6728021 DATE: 05/127 S l�L�l�ll„ IL����Il���l�ll���l�l�l��ll�rl�l��ll������lll���lf PURCHASE S McMu 05122010062543 ORDER 0 CARMEL ENGINEERING DEPT NUMBER D 1 Civic Sq Paid by Visa Carmel, IN 46032 -7569 TERMS T United States 0 FREIGHT Prepay And Bill Customer S Sort Seg: 576 Tray: 3 CARRIER RPS- RPS *FedEx Ground H CARMEL ENGINEERING DEPT ACCOUNT i 40039733 I 1 CIVIC SO I R EF. NO. 1309161643 -1 Remit to: P CARMEL, IN 46032 -7569 Hach Company T United States 2207 Collections Center Dr O Chicago, IL 60693 Phone: (800,1 227 -4224 These commodities are sold, packaged, marked, and labeled for destinations in the United States. Exportation of these commodities may require special licensing, packaging, marking or labeling. LN# PRODUCT DESCRIPTION ITEM NO. QUANTITY UNIT PRIC EXT. PRICE 1 KTO: PH BUFFER SOLUTION KIT 500mL 2947600 1 20.95 20.95 ORDER CONTACT: SUBTOTAL 20.95 SARA MCMULLEN FREIGHT CHARGES 9.95 317- 571 -2314 TAX 0.00 Notes: INVOICE TOTAL 30.90 Invoice has been paid. Copy for your records. hn, 1,617 !g 7.,9 �0� Py� P MA ��1 lE: of, 6l� For order discrepancies or product exchanges please call 800- 227 -4224 or 970 669 -3050 to obtain Return Authorization. FEDERAL TAX ID 42- 0704420 ff 'p s Hach.,Hydrornet T Hach Flow- Services Environmental Tes #eSystems (ETS} Qther Bach B''rantls 80Q 949,3766` 8Q0 368 2723' 8 ©0 548 4381 T 0,4 54 0263' 4 k fax 970 461 J921 Fax =301 874, 8459 Fax 574 `264 4533 g A Fax 970 461 3919 M '4��aa m Fkescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1985) 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 John Thomas Purchase Order No. Engineering Department Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 05111/10 nla INAFSM memberships; Bob, Dan, John $120.00 05111/10 INAFSM stormwater training $450.00 2 Stormwater testing supplies $30.90`' Total 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 I VOUCHER NO. WARRANT NO. ALLOWED 20 John Thomas IN SUM OF Engin eering Dep $600.90 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or na 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 claim paid motor vehicle highway fund