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Home My WebLink About195138 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 358862 Page 1 of 1 ONE CIVIC SQUARE NATIONAL AFTERSCHOOL ASSOC CO YRECK AMOUNT: $3,690.00 CARMEL, INDIANA 46032 C/O MMc 8400 WESTPARK DR SECOND FLOOR CHECK NUMBER: 195138 MCCLEAN VA 22102 CHECK DATE: 3/2/2011 DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIPTION 1081 4357004 2011 CONFRN 3,690.00 EXTERNAL INSTRUCT FEE O C 1 A i O sgx a 'q,.. �g r �,��p�, ,..'r, rr:4 i ¢ii L •�1 °r 1 �ryq 4 r WT t 7GaylOrd3Palrrt RQSbt CpnVBn"ti6h Center �v x4:.: au2• ��,.uva�f��+s�.�s+:�� a.!s� ..5... £�4ii*s..p c� ,aa e �..,.p. Your confirmation will be sent via e rnaii. Be sure to include an e -mail address. Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG Name S e t q JggtjSoti Badge Name Organization CAM tiL. Program /Agency (if applicable) Address 1q11 E 11 VW S City (or Military Base) GRRMEL State (or County of Province) Zip y�0o3 Email 6jWiSOn (Armtid AmIT&IKS Phone 1 594 0 Fax 3 73 LI/ Registration Cate gories Step 3 Advanced 1 On -Site Tell LIS MOYC tl+ Earl Reg Reg i Sept 'l— Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31 2010 Mar 20, 2011 2010 31,2011 Member Rate )(Afterschool Program $335 $385 $410 Full Convention�� Administrator /Director /Coordinator E Trainer /Consultant/Curriculum Specialist =�a° College Instructor /Professor /Researcher Member Rate a Sat/Sun $290 $340 $365 g 2 Days I 4 Sun /Mon I J Public School Administrator /Principal /School Board Join Now or Renew $395 $445 $470 j Government Employee Your Membership Join Full Convention Renew For AfterSchool Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days Sat/Sun t Youth Serving Organization Sun /Mon U Teacher /Frontline Staff Non Member '___T_$4""5_5'_ $505 $530 Full convention J Director /CEO g J Supporter /Researcher Nornmember Sat/Sun 1 :,2 _$4i 5 $465 $490 x Parks and Recreation 2 Days I i Sun /Mon I i Private, for profit J Private, not for profit J Public School A Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. Payment Information J C Car (Visa, MC, AM Discover) Check to NAA istration TOTAL Re 368o (jA-gE x #ylo Qa.. Make Checks Payable to: 9 National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 nd Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 Fax: 703 610 -0203 registration @naaconvention.org Billing address p ac i n§ t I 4 A x a':n �vrW A. Ile Y Aprl! 16 18,_2011 s Geytord Palms Resort 8 ,Convention Center you C" i:.n I iinlat$4: n vvi i h7'' "E,IiE uiE E3 .€E B0 1� to tnc'1:! de' ;non• {ad Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG Name JENti1 ZOPim Badge Name JFNa1iFE2 Organization CAMEL WAZVO Program /Agency (if applicable) Address ��0 Sir City (or Military Base) CAM State (or County of Province) Zip Email 140WO &_CA(4 C1 UT&[kT.CoM Phone 111- M-Sabo Fax 3s?- 571 P iStraation Categorie Step 3 Advanced On -Site Tee US r°s� ora Eariy.Reg Reg Reg Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 Member Rate _t $335 $385 $410 Afterschool Program Full Convention Administrator /Director /Coordinator J Trainer /Consultant/Curriculum Specialist Sun /Mon $3�5 2 Days College Instructor /Professor /Researcher Member Rate Sat/Sun a $2 $340 a public School Administrator /Principal /School I Su Board Join Now or Renew $395 $445 $470 Government Employee Your Membership Join Full Convention Renew I _...._,____y_._ For Afterschool Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days Sat/Sun Youth Serving Organization Sun /Mon 455 Teacher /Frontline Staff $505 Non Member $530 F It Convention Director /CEO $415_ _$465_ �aso Parks Supporter/Researcher Non member Sa f I and Recreation 2 Days Sun /Mon I I J Private, for profit Private, not for profit 1L,' Public School Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. I'aymenf inform tion 1 -.t Credit Card (Visa, MC, AMEX, Discover) Y Check to NAA Q ql o Make Checks Payable to: TOTAL Registration 3�qo (i eri tmr National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 nd Floor McLean, VA 22102 Card Name (printed) Phone: 703 -610 -0257 Fax: 703- 610 -0203 Billing address registration @naaconvention.org e f ,S t;�tlA li O'ik AE y f Ga iorcf Palms,ftesort &,Convention.Cen ter Your confirinat� €fir, i,,Ii bva '-vi vi'e t. ifIr7"; F,e sure to L:ki Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG 1 Name V El t PER— t 1 4d4 M'0' J S Badge Name �JENN 1, Organi zation CAMEL Ct.A`l Program /Agency (if applicable) Address 1q 11 E. 116 City (or Military Base) GRMEL State (or County of Province) zip Email ihjt Md OAG 0,CArt4gc(AtltALfI'LE.CoM Phone W-S??'5'a40 Fax 3 !ref istrntior tCf t it~5 Ste .3 Advanced On -Site 4 1 Ll Early Reg Reg Reg Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 Member Rate Afterschool Program $335 $385 i $410 Administrator /Director /Coordinator Full Convention J Trainer /Consultant/Curriculum Specialist College Instructor /Professor /Researcher Member Rate SaUSun $290 $340 $365 g 2 Days _i Sun /Mon I I ?Public School Administrator /Principal /School Board Join Now or Renew $395 $445 $470 Government Employee Your Membership J Join Full Convention Renew For Afterschool Program Staff, please indicate Join Now or Renew ,loin J $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days Sat /Sun a ::,5 Youth Serving Organization t Sun /Mon _._...m_.� Teacher /Frontline Staff Non•Member $455 $505 $530 Full Convention Director /CEO 3 Supporter /Researcher Non member U Saysun f $415 f $465 $490 Parks and Recreation 2 Days I Sun /Mon I I; Private, for profit Private, not for profit J Public School Wa Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. Pay,rnent lnfocMition J Credit Card (Visa, MC, AMEX, Discover) Check to NAA r p Q TOTAL Registration 3640 1f x qlo Make Checks Payable to; National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 Floor McLean, VA 22102 Card Name (printed) Phone: 703- 610 -0257 l=ax: 703 610 -0203 registration @naaconvention.org Billing address '�Nw[i`onwt. 5 G 3ylord Palms Resort �4 Convention Center y ti E9CdN t; f €I`STiia tliZii fed i bc'- s t.r v n1a0. C Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMC t^r n,. l Name 11M 1 Ivcpt-J&H4m Badge Name f y Organization L d` �0 Program /Agency (if applicable) Address M11 E. 11V City (or Military Base) C AME L State (or Countll Zip �Email Q•\ i CA117149JA'T WkT CoM Phone Ill 5l3- Saito Fax Registration Cate °icy Step 3 Advanced On -Site EarlyReg Reg Reg Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar E 20, 2011 2010 31, 2011 Member Rate AfterschoolProgram $335 $3s5 $410 Full Convention Administrator /Director /Coordinator 6 4 Trainer /Consultant/Curriculum Specialist 1. _M_ e_r Rate Sat/Sun $34 4 0 $365 g Colle e Instructor /Professor /Researcher Member $290 2 Days I Sun /Mon f Public School Administrator /Principal /School Board Join Now or Renew $395 $445 $470 Government Employee Your Membership Join Full Convention Renew For Afterschool Program Staff, please indicate Join Now or Renew F Joan $360 $435 the type of program from the list below. Your Membership Renew 2 Days Sat /Sun Youth Serving Organization Sun/Mon J Teacher /Frontline Staff Non- Member $455 $505 $530 Full Convention Director /CEO Supporter /Researcher Non member saysun f $415 $465 $490 Parks and Recreation 2 Days i Sun /Mon I Private, for profit FI Private, not for profit i Public School ,.i Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. Payment Infor nation j Credit Card (Visa, MC, AMEX, Discover) Check to NAA 77�� pp Q Make Checks Payable to: TOTAL Registration �IOlO x qjopa National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 Floor McLean, VA 22102 Card Name (printed) Phone: 703 -610 -0257 Fax: 703 -610 -0203 Billing address registration @naaconvention.org s h Gaylord halms Resort d Conve t(oi 1 5 0U r,;onfWmaU0n 111 bf ;.yen vi iTka0:2 f',;? sur"� ='3'St..�t3aiF?.:,,.i Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchooi Association, c/o MMG Name N I Badge Name CyAlb Organization CAXWL d' WWTO Program /Agency (it applicable) Address 1q II E. 116-m City (or Military Base) GRfU ELr State(orCounty zip Email CCQu1m CA`0 54 C(AgTW k -T. CoM Phone 1 M Fax 3 -:M R;4e,istrntion Categories Step 3 Advanced i On -Site P us t e... Early Reg Reg Reg 'Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 11 It Member Rate y Atterschool Program $335 $385 $410 Full Convention Administrator /Director /Coordinator Trainer /Consultant/Curriculum Specialist Member Rate Sat/Sun $340 $365 College Instructor /Professor/Researcher 2 Days Sun /Mon I Public School Administrator /Principal /School __..,.W Board Join Now or Renew $395 $445 470 ,,,.4 Government Employee Your Membership Join Full Convention Renew For Afterschool Program Staff, please indicate Join Now or Renew i Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days Sat/Sun �=1 Youth Serving Organization Sun /Mon Teacher /Frontline Staff Non Member W 'o I 'l l Full Convention Director /CEO J Supporter /Researcher Non member i satisun $415 $465 $490 Parks and Recreation 2 Days 1 Sun /Mon Private, for profit I_f Private, not for profit .J Public School :j Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. f:layment lnfos miation ..i Credit Card (Visa, MC, AMEX, Discover) Check to NAA r p Q ,A�r Make Checks Payable to: TOTAL Registration Qo� 1��.G 1 X National Afterschool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 Fax: 703- 610 -0203 Billing address registration @naaconvention.org �k�, t rt'. t' r 3 .r i a"V ii 7 1 ft: d •s,4:^ 4 f S U C 1 A Cl W Aprt! TC 18, 2x11 yam.' o Gaylord palms Resort B:Conveiition Center our confli F?1d.t':f611 Ai c i .ai; ":k- sure tC Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG Name A M Y U LDA UP Badge Name AMY Organization CAMSL CLM Tol 4 Program /Agency (if applicable) Address MI E. 116 S 1 City (or Military Base) CAME State (or County of Province) zip 4t0o3 Email 0Lbf AA0+ i? C 009 CI "[J LT GM Phone �0� Sa�14 Fax 3 Registration CatE gori0S Step 3' Advanced On -Site i,€ LiS, f 0t Early: Reg Reg Reg Sept t Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 Member Rate' )(Afterschool Program Full Convention $335 $385 $41 o Administrator /Director /Coordinator Trainer /Consultant/Curriculum Specialist Membe Day s 65 College Instr $3 uctor /Professor /Researcher r Rate t satlSun ,a $290 $340 y I S u n/Mon J Public School Administrator /Principal /School �W_ r.._ ..r 45 Board Join Now or Renew $395 $4 $470 {government Employee Your Membership Join Full Convention Renew For Afterschool Program Staff, please indicate Join Now or Renew -Join $360. $435 the type of program from the list below. Your Membership Renew 2 Days sausun Youth Serving Organization Sun /Mon Teacher /Frontline Staff Non Member $455 $505 $530 Full Convention €k Director /CEO Supporter /Researcher Non- member sausun I $415 $465 $a90 Parks and Recreation 2 Days Su /M on T Private, for profit Private, not for profit Public School Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. p Itiiol`ITisitiGii j Credit Card (Visa, MC, AMEX, Discover) Y Check to NAA r p (iA -rri jw f Make Checks Payable to: TOTAL Registration Vo x #qto pa) National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 nd Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 Fax: 703- 610 -0203 Billing address registration @naaconvention.org r tC�'�� b'�d GT r "2"'S"�� ''xwr., o•x .,tr q, �t s J t ►k%' 7 April16 18, 201x1 .,,v�, cfi Gaylord PaUrn Re5ort ,8 Co.nve tit ion Center S yot°t` confirmaiioni i 11 .:}e w<: pi=t Et ;lre !o Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG Name 6Eow40 EA Badge Name &E00 L.,� Organization CAXMSL CL -iflags a gggonotJ Program /Agency (if applicable) Address Iq II E. 116 -m City (or Military Base) CAME State (or County of Province) zip �1(003 Email �P,OIWACk t?CA(4C(A%IT&EIi Phone IeI 5;Lqa Fax 3i1-573-!L� R eciistratiorf Cat eg ie Step.3 Advanced On -Site EPHY Reg Reg Reg fit Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 Member Rate r $335 $385 $410 Afterschool Program Full Convention Administrator/Director/Coordinator i Trainer /Consultant/Curriculum Specialist College Instructor /Professor /Researcher ��nnemee� Rate sausun $290 $340365 2 Days Bun /Mon Public School Administrator/Principal/School Board in Now or Renew $395 $445 $470 f Government Employee Your Membership Join Full Convention Renew For AfterSchool Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days Sat /Sun SunlMon __f Youth Serving Organization Teacher /Frontline Staff Non Member f y $455 $505 $530 Director/CEO Full Convention Non member SatlSun $ai 5 $ass $4e0 Parks aT SupporterlResearcher and Recreation 2 Days _..i Sun /Mon `a Private, for profit _......._W Private, not for profit J Public School i Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. l merit Information Credit Card (Visa, MC, AMEX, Discover) Check to NAA P p Q q 1 0 TOTAL Registration I Make Checks Payable to: National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 Fax: 703 610 -0203 Billing address registration @naaconvention.org Aprt1 16 18` 2011 o `Gaylnrd Pallms Resort '.Convention Center Your iif' :3a pit "i, F. i:.:` w;3 k�lS<�w L'a ..51 t_9 'a�} °r �a Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG Name uOAw Love Badge Name /VA -ALIT Organi zation C A E L C LA AMS M 0 Program /Agency (if applicable) Address IqII 1E6 S� City (or Military Base) CAMEL State (or County of Province) Zip Email V\ 10 \J e- C_CA(15 4C6 1D UI&T.CoM Phone 311- 5 Fax 3111-571 W Registrntion €latc'gorit: Step Advanced On -Site Early. Reg Reg Reg Sept 1 Dec 18 Apr 17- Your position (select one of the following): Step 1 Ste{] 2 Dec 31, 2010 Mar 20, 2011 .2010 31, 2011 '(Afterschool Program Member Rate' $335 $385 $410 Full Convention Administrator /Director /Coordinator J. Trainer /Consultant/Curriculum Specialist J College Instructor /Professor/Researcher �Membe� RaFe saysun J $290 �$340 $365 f Public School Administrator/Princ ailSchool Board 2 Days Sun /Mon I p Join Now or Renew $395 $445 $470 Government Employee Your Membership Join Full Convention Renew For Afterschool Program Staff, please indicate �oT� Now or Renee Joifl� x$360 $410 1 $435 the type of program from the list below. Your Membership Renew 2 Days seusun Youth Serving Organization Sun/Mon $530 Teacher /Frontline Staff Non Member, $455 $505 Full Convention Director /CEO J Supporter /Researcher Non- member saysun $415 I $465 $490 Parks and Recreation 2 Days I Sun /Mon I J J Private, for profit —i Private, not for profit Public School Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. Payment fnfonrin lon- Credit Card (Visa, MC, AMEX, Discover) Check to NAA o N A rromf ,r �r1 ice- Make Checks Payable to: TOTAL Registration 3bgo x fto National AfterSchool Association c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 nd Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 Fax: 703 -610 -0203 Billing address registration@naaconvention.org E ei 2 q'� A'pr11 1 -B 182011 C�ylord l?airns,Resort Convention Center y 0 U r on f ir m3 i ion 'v t be ;11 1 '"n Wf41- ;:0 .'t11 1;9 °i...1 E ,k 6 Register Today! Complete requested information and mail /email /fax registration with payment to: National AfterSchool Association, c/o MMG Name AAW G (KEA- Badge Name Organization EC. 4- Program /Agency (if applicable) c� Address 1q11 E. 116,W S I City (or Military Base) CRMEL State (or County of Province) Zip y(oo3a- Email A Ca(M C(Atl11 k T C0M Phone 111-M- Salvo Fax 311'573 iGt3 atE to C ateF o ies Step 3 Advanced On -Site w i z Early Reg Reg Reg Sept 1 Dec 18 Apr 17 Your position (select one of the following): Step 1 Step 2 Dec 31, 2010 Mar 20, 2011 2010 31, 2011 s Member Rate $335 Program $335 $385 $410 Full Convention Administrator /Director /Coordinator e5 Trainer /Consultant/Curriculum Specialist Me Rat Sat/Sun $290 $3 0 $365 College Instructor /Professor /Researcher 2 Days SunfMon I i Ll Public School Administrator /Principal /School Board Join Now or Renew $395 $445 '.$470 Government Employee Your Membership Join Full Convention Renew For AfterSchool Program Staff, please indicate Join Now or Renew Join $360 $410 $435 the type of program from the list below. Your Membership Renew 2 Days sausun m Youth Serving Organization s i Teacher /Frontline Staff m Non Member $455 $505 $530 Full Convention Director /CEO Supporter /Researcher Non- member sausun $415 $465 $490 Parks and Recreation 2 Days Sun /Mon f Private, for profit Private, not for profit J Public School ;a Please do not send me convention related materials from NAA authorized exhibitors. Cancellations must be made in writing by March 26, 2011 and are subject to a $50 administrative fee. Refunds will not be processed after March 26, 2011. Substitutions are welcome in lieu of cancellation anytime. Payment! nronriat ion i Credit Card (Visa, MC, AMEX, Discover) X- Check to NAA Q p,�r q lo p Make Checks Payable to: TOTAL Registration 6 o J l A +G l x ru�-� National AfterSchool Association If c/o Meetings Management Group Card Number Exp. 8400 Westpark Dr., 2 nd Floor McLean, VA 22102 Card Name (printed) Phone: 703 610 -0257 Fax: 703 610 -0203 Billing address registration @naaconvention.org 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. 358862 Nat'l AfterSchool Assoc Convention Terms ATTN: Registrar 8400 Westpark Dr, Suite 200 McClean, VA 22102 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 2116111 2011 NAA Convention registration 3,690.00 9 x 410.00 Meagan Decker Natalie Love Georgianna Edwards Amy Baldauf Cyndi Canada Tiffany Buckingham Jennifer Hammons Jennifer Brown Ben Johnson Total 3,690.00 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. 358862 Nat'l AfterSchool Assoc Convention Allowed 20 ATTN: Registrar 8400 Westpark Dr, Suite 200 McClean, VA 22102 In Sum of 3,690.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1081 -99 2011 4357004 3,690.00 1 hereby certify that the attached invoice(s), or bi11(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 3,690.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund