192512 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 219460 Page 1 of 1
ONE CIVIC SQUARE NATIONAL LAWYERS ASSOCIATION
j CARMEL, INDIANA 46032 44 COOK STREET SUITE 100 CHECK AMOUNT: $200.00
DENVER CO 60206
CHECK NUMBER: 192512
CHECK DATE: 1217/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4355300 200.00 ORGANIZATION MEMBER
NATIONAL LAWYERS ASSOCIATION
44 Cook Street, Suite 100 Denver, Colorado 80206
(303) 398 -7030 (800) 471 -2994 Fax (303) 398 -7001
http: /wvfw.nla.org/
201.1 NLA MEMBERSHIP DUES
Name: Q a S C• 146 A El
Member (/1 ao
Address: C nI E CuU 1 C'_ &Q U A A L
."141 LZ MV 3�3;
Phone 3I'? 5 'T/ c;W7cZ.
Fax 31 7 5 '7I
Email Address: 1 Q t2 e- y 0 12 m e i n 0 Q V
Law Student /1st year Lawyer/Retired /Part Time Practice Member $25.00
D( Regular Membership $200.00
Board Member $250.00
Patron Membership $250.00 (all Regular benefits plus a 25% discount off registration fees for the NLA
Educational Conference or midyear meeting, excluding receptions /dinners)
Benefactor Member $500.00 (all Regular benefits plus 50% discount off registration fees for the NLA
Educational Conference or midyear meeting, excluding receptions /dinners)
Lifetime Member $5,000.00 (all Regular Benefits plus 100% discount off registration fees for the NLA
Educational Conference or midyear meeting, excluding receptions /dinners)
Make check payable to: National Lawyers Association
or
Pay online at www.nta.org
or
Please Bill My: Visa MasterCard
Card Expiration Date
Amount: Signature:
Ci of C armel CE INDIANA RETAIL TAX RTIF CATE NO. 003 20155 0 2 0 PAGE EEMPT PURCHASE ORDER NUMBER
t y
J )'.*t) FEDERAL EXCISE TAX EXEMPT A 1,
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP
CARMEL INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SNIPPING LABELS AND ANY CORRESPONDENCE.
3 URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR ��1'e�° Lp..f',�^)?� TOIP
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UMT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT 0, 10 6-06
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PAHT OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER-
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE 1 J A7 7,,g g
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. a
CLERK TREASURER
DOCUMENT CONTROL NO. 2 715 2 A.P.V. COPY SIGN AND RETURN TO CLERK OFF
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
00_x..... -C
I Igo
ON ACCOUNT OF APPR60R IATi FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
1 hereby certify that the attached invoice(s), or
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
:nature
Title
Cost distribution ledger Classification if
claim paid motor vehicle highway fund