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HomeMy WebLinkAbout194625 02/16/2011 CITY OF CARMEL, INDIANA VENDOR: 00350029 Page 1 of 1 ONE CIVIC SQUARE ILMCT CARMEL, INDIANA 46032 C/O TERESA GLEN CHECK AMOUNT: $185.00 PO BOX 607 CHECK NUMBER: 194625 GREENCASTLEIN 46135 CHECK DATE: 2/16/2011 DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4355300 185.00 ORGANIZATION MEMBER ILMCT ANNUAL DUES NOTICE Claim and Invoice This invoice and claim for payment is made upon the Clerk, Controller or Clerk- Treasurer of the City or Town, for payment of membership dues for the Indiana League of Municipal Clerks and Treasurers. You may pay from this invoice for any classes of membership. Please check the appropriate box to indicate the actual class of membership and dues schedule which applies. 2011 Dues for all Classes of Membership due on or before March 1, 2011! Active Members: Towns with population under 700 40.00 Towns or Cities with population of 701 to 5,000 50.00 Towns or Cities with population of 5,001 to 20,000 75.00 Towns or Cities with population over 20,001 to 35,000 $100.00 Towns or Cities with population over 35,000 $150.00 Please indicate your municipality population Active Member Name: Title: Ierk- Treasurer Clerk Controller Certification (Check all that apply): IA CMC MMCA MMC CMFA Name of Municipality: l.f�'fl �f County Office Address: City/Town /Zip: Y60 Office Phone: ((C Zifro� Fax: 7 Office e -mail: Ot Co rJ r Home Address: City/Town /Zip: Home Phone: ILMCT Membership Benefits Include: A membership card denoting your affiliation Notice of League events (includes training and professional development opportunities) A subscription to the QUEST, the ILMCT official newsletter In some cases, discounts for League sponsored events Access to League website www.ILMCT.org Associate Members: $35.00 (Any former active member or staff of an active member of the league): Associate Member Name: [Yid Title. u G Address: City /Town /Zip: �Y Associate Member Name: Title: Address: City /Town /Zip: (Please copy form for additional Associate Members) Affiliate Members: (Any person who is elected or an appointed officer in municipal government who is not already qualified for another membership class may ;njoyall p�g�s, except the right to vote and hold office.) Affiliate Member Name: Title: UK Address: City/Town /Zip: Affiliate Member Name: Title: Address: City /Town /Zip: (Please copy form for additional Affiliate Members) Associate Business Member: $150.00 (Entitled to four (4) membership cards, a membership roster, a Quest subscription and meeting notices) Associate Business Name: Phone: Address: City /State /Zip: 1. Primary Contact Name: e -mail: Address (if different from above) 2. Card Bearer Name: e-mail: Address (if different from above) 3. Card Bearer Name: e-mail: Address (if different from above) 4. Card Bearer Name: e-mail: Address (if different from above) TOTAL ACTIVE MEMBER: Checks to be made payable to the TOTAL ASSOCIATE MEMBER Indiana League of Municipal Clerks TOTAL AFFLIATE MEMBER Treas s and mailed to: TOTAL ASSOCIATE BUSINESS MEMBER ILMCT c/o Teresa Glenn l P.O. Box 607 TOTAL AMOUNT ENCLOSED Greencastle, IN 46135 I hereby certify that the foregoing is just and correct, that the amount claimed ally due after allowi just credits and that no part of the same has been paid. .J7e&,eja J C&i, Treasurer PLEASE RETURN A COPY OF THIS INVOICEICLAIM WITH YOUR REMITTANCE Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 Rev. 1995) 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 Purchase Order No. 0 1 Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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. C� J ALLOWED 20 V J IN SUM OF M Liz ON ACCOUNT OF APPROPRIATION FOR Board Members Po# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I 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 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund