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Home My WebLink About195086 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 00350078 Page 1 of 1 ONE CIVIC SQUARE INDPLS CHAMBER OF COMMERCE FOUNM AMOUNT: $1,095.00 CARMEL, INDIANA 46032 C/O MAGIC 320 N MERIDIAN ST #200 CHECK NUMBER: 195086 INDIANAPOLIS IN 46204 CHECK DATE: 3/2/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 R4355300 28042 2011 1,095.00 MEMBERSHIP 0 0 0 1 1 I�� i c� Membershi p Application lication GREATER INDIANAPOLIS CHAMBER OF COMMERCE CAAP: Yes NO CHASE TOWER 111 MONUMENT CIRCLE, SUITE 1950 INDIANAPOLIS, IN 46204 T 317.464.2230 F 317.464.2217 www.indychamber.com CONTACT INFORMATION t I J I Company Name r m P 1 �,I W t I A rks Oonn?�cyl Local Executive l S L Title 41 r Le +r m 6t. n dt `ate/` Individual Email 11 ez S CI CaLnt e, e ho (r S Cam r ❑Mr. Ms. Salutation Direct Phone (3J7 73 •/O a U Direct Fax (3�7) SoZ 5 y Human Resource Contact Individual Email I r�SSQ J 0,1 G(rm� h1 Clay /cs CU m COMPANY INFORMATION Number of Employees CRFr 315 D ar Established Locally IM Choose One: X Headquarters ❑Branch Check Largest Market Served: [TiLocal Statewide Nationwide Worldwide Is Your Business (optional): Minority Owned Female Owned Hispanic Owned I do not want to be included on lists sold from the Chamber's database. *Please note: if you check this, you will not be able to purchase lists. MEMBER DIRECTORY LISTING Your company will be listed on our searchable, online Business Directory and in our printed Membership Directory. Please indicate how you would like your free listing to appear. Street Address 1,2 c3 rile V r V E City C a r ✓Y+ a- State Zip '7d 13 Q County Web site www CArm GIB, joar G oYrr Toll Free General Business Phone d gS- 70- General Business Fax Indicate Location: txjNorth ❑South []East ❑West ❑Downtown I do not want the above address listed on the Chamber Web Site. I do not want the above phone number listed on the Chamber Web Site. Classification (the category that your businff 55 will be listed under) A f0 list of categories can be viewed by )''ting f ndychambeccofn andclickingon "SwinezSearch' 1) Ike A7`7 L�6% rlc,-S o t c 2) GOLD LEVEL ONLY Business Profile: Please include a two or three sentence profile with description of your company's products and services. This description will be displayed with your compan informann on the Chamber web site Business Directory: (20 50 word max.) carmei C� pankt ec s rnl's sI' /5 s re OU n) s LO `2'& ✓✓fir i'1 m P�-✓�' bf h I N r u ci r�cre�r'h a �J�s errs f�'o r, �rt.l /�>��r4m -r BILLING IN (IF DIF ENT FROM ABOVE) I Name Pau i Gl Scl f .1)1 ��n e_ r Title 1 T� f L V ar K3 /C �o c! uw� Email SC 1 Em m (?eO-r 0-1 J ati AGt l- s Gaul Direct Phone S? ,3 y D a 3 Billing Addres if different from above: City r `P_ I State I Y Zip LIST ADDITIONAL EMPLOYEES TO RECEIVE CHAMBER INFORMATION BY EMAIL: J Name Mar k l,j C'S�) t� tiQ <I Pr Title Z I P C�r Email M rs/PS 1� rme r er" (e Ci411me le /u r�C Go rye Nam I Chc; Ej k1 1t% 1 v,q Title A- rfL Email S be b(' Email M G Q Q m a>" d v r Name SUSgYI CCiI/r`� I!n Title c>h Cyyn 7 J�v s ay m9h_ MEMBER -TO- MEMBER DISCOUNT Please check here if you are willing to provide a discount on products or services to members of the Greater Indianapolis Chamber of Commerce. Please enter percentage of offer. Describe offer: 6 1ndianapolis Membership Application Pg 2 GREATER INDEANAPOUS CHAMBER OF COMMERCE 2010 GOLD MEMBERSHIP BENEFITS (RECEIVE ALL STANDARD BENEFITS, PLUS): Enhanced business listing on IndyChamber.com's searchable Membership Directory. Gold members stand out from the competition in a gold background. includes free logo placement and pop -up box. (40,000 unique visits per month) Exclusive Gold Member section on Chamber web site. Additional business category listing in print and online directory. Enhanced business listing in the Chamber's printed Membership Directory. (Distribution 20,000) Link to your web site from IndyChamber.com Submit press releases for posting on IndyChambercom's homepage. Targeted introduction letters sent to as many as 10 Chamber businesses, signed by Chamber president, Roland Dorson. Connect with potential customers and prominent business leaders at monthly Chamber events. Gold member framed certificate. How did you hear about the Greater Indianapolis Chamber of Commerce? Advertisement Referral Web site Chamber Event Other Do you know of a non member company that could also benefit from being a member of the Indianapolis Chamber? If so, please let us know. Company Name Contact Phone Payment Information Standard [Gold Private 100 Commercial Club ❑Leadership Circle Main Affiliate Amount Due oU Chamber ID Membership Sponsor Rr 4 jacoh hone_- 317404-2209 Method of Payment: Check El Visa El American Express Mastercard Cash Expiration Date Card Number CVV2 Number Name on Card What is a CW2 number and where do I find it? Visa /Mastercard: last 3 digits of code on back of your card Signature American Express: 4 digits above your card number on o front of Lard Amount of Enclosed Check a �`h Check Date Date Authorized Hint Name Approval Please note: Membership dues are not refundable. Auth. Total Amount Clerk Anthem insurance use only Anthem Effective Date Anthem BC/BS Anthem Account Name Agent Name Phone Please fax this completed form to 317- 464 -2217 or mail to: Greater Indianapolis Chamber of Commerce Chase Tower, 111 Monument Circle, Ste. 1950, Indianapolis, IN 46204 Ninety-three percent (93 of your membership investment is deductible as a business expense. The Omnibus Budget Reconciliation Actof 1993 disallows as a business expense that portion of your dues, which are allocable to lobbying at the state or federal level. Dues, contributions, or gifts to the Greater Indianapolis Chamber of Commerce are not deductible as charitable contributions for income tax purposes. The Greater Indianapolis Chamber of Commerce is a tax exempt entity, but it is classified as a 501(c)6 organization by the IRS. The IRS has ruled that contributions made to 501(c)6 organizations, such as the chamber, are not eligible as charitable deductions. Further information on this law should be obtained from your tax advisor. W -9 information: Greater Indianapolis Chamber of Commerce is a corporation (IN). itsTIN1EIN is 35- 0412920. ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Greater Indianapolis Chamber of Commerce Terms Chase Tower Date Due 111 Monument Circle, Ste 1950 Indianapolis, IN 46204 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 2116111 2011 Chamber membership 28042 F 1,095.00 Total 1,095.00 1 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. Greater Indianapolis Chamber of Commerce Allowed 20 Chase Tower 111 Monument Circle, Ste 1950 Indianapolis, IN 46204 In Sum of 1,095.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. kCCT #/TITLE AMOUNT Board Members Dept 28042 F 2011 4355300 1,095.00 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 24 -Feb 2011 Signature 1,095.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund