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Home My WebLink About196837 04/26/2011 CITY OF CARMEL, INDIANA VENDOR: 00351464 Page 1 of 1 ONE CIVIC SQUARE INDIANA RURAL WATER ASSOC CHECK AMOUNT: $120.00 o CARMEL, INDIANA 46032 PO 13Ox679 !tiy NASHVILLE IN 58559 CHECK NUMBER: 196837 CHECK DATE: 412612011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN D 601 5023990 997128 120.00 EMPLOYEE PEN BENEFI Friday, April 08, 2011 6:04 PM MaryJane Miller 812 988 -6961 p.01 L Indiana Rural Water Association PO Box 679 Nashville, IN 47448 ATTN: ACCOUNTS PAYABLE Invoice BILL TO DATE INVOICE NO. City of Carmel 4/8/2011 997128 345 W 131 st St. Carmel, IN 46032 Membership Renewal Date 2/17/2012 Questions? Marylane Miller, Office Manager P.O. No TERMS Telephone 812 -988 -6631 Fax 812- 988 -6961 [:Due on receipt DESCRIPTION AMOUNT IRWA Spring Conference, April 18 -20, 2011 in Columbus, IN Tuesday Only William Bell, Brian Tolan, Tim Vandergriff 120.00 4/8 Faxed 1- 317 733 -2053 Payments /Credits Credit Card payments accepted: Credit Card Visa VIC Disc Am Exp Exp: Security Name on Card: Signature: Balance Due $120.00 e v' REGISTRATION FORMA IRWA April 18 -20, 2011 Please ,print or type one form for EACH ATTENDEE! First time attendee? Attendee Information Billing Information: Name 21- s l' A. I i, I A i) Company Name:�,(�' Irn Title Ek ►CAI 'sk i)+ ]CCG Billing Contact 1 j� ��A Spouse's name if attending T C Address r� Address 2 c CU �,J. U 1 4 `l r City A ,�.1V1 r;=- k St Zip L( C 7 L/ City r'`('`c 5t Zip 1p(�� Telephone -7 51 7 7 75 Telephone, ?i 7 �3 )g l Fax j ►'7 7 3 7 Fax L r 7 C) E -mail ttc 1 c►A r- n e I. 1 1\. i o E -mail invoice Lr1• `?pv I will be submitting contact hours for Please print clea y Water I' Wastewater None Purchase Order MONDAY SESSIONS IRWA Member Non- Member Operator Certification Test Refresher (8:30a 4:00p) $25.00 $50.00 Stormwater Program Management (8:30a Noon) $25.00 $50.00 Wastewater Sessions (1:00p S:00p) $25.00 $50.00 TUESDAY WEDNESDAY SESSIONS IRWA Member Non- Member Tuesday Wednesday $50.00 $90.00 General /Technical Sessions Board /Mgmt Utility Business Forum Tuesday ONLY $40.00 $80.00 o. Mf General /Technical Sessions Board /Mgmt Utility Business Forum Z a Wednesday ONLY $25.00 $50.00 M General /Technical Sessions m r MEALS Monday Lunch Tuesday Lunch Tuesday Reception Attendee $16.00 Attendee $16.00 Attendee No Fee Spouse $16.00 Spouse $16.00 Spouse No Fee One BOARD MEMBER or MAYOR per system is NO CHARGE Please check if planning to attend! entitled to (1) COMPLIMENTARY Tuesday Lunch MARILYN GAMBOLD EDUCATION FUND DONATION (MGEF) Mon Tues /Wed .Q_ Lunch MGEF gn Q Mail IRWA Fax 812 988 -6961 PO Box 679 /Bill us Enclosed Credit Card Nashville, IN 47448 We welcome registrations on -site. Visa MC Discover Amer Exp Exp.: Please submit cancellation Security: requests in writing NAME ON CARD: No refunds after April 15, 2011. SIGNATURE Questions MaryJane Miller Email address for receipt: Telephone: 812 988 -6631 E -mail. mimmiller@att.net ll REGISTRATION FOR flA IRWA A nil 18 -20 2011 Please pant or type one form for EACH ATTENDEE! First time attendee? Attendee Information: Billing Information: Name �IM �V%I tj J e.r5f F1' Company Name: Title PJA,J 1 1' 0AEP +of Billing Contact r J1Yti1D Spouse's name if attending U� Address Address Jq o W, 1 cit r A J^ St Zip q G q City 5t Zip Telephone Telephone 17"733 ,2 t Fax 317 7 5'� u 3 Fax E -mail iya n rca P f E3 y rm E -mail invoice I will be submitting contact hours for Please print Deady Water Wastewater None Purchase Order MONDAY SESSIONS IRWA Member Non- Member Operator Certification Test Refresher (8:30a 4:00p) $25.00 $50.00 Stormwater Program Management (8:30a Noon) $25.00 $50.00 Wastewater Sessions (1:00p 5:00p) $25.00 $50.00 TUESDAY WEDNESDAY SESSIONS IRWA Member Non- Member Tuesdav Wednesday $50.00 $90.00 General/Technical Sessions Board /Mgmt Utility Business Forum m o Tuesday ONLY $40.00 $80.00 a JV General/Technical Sessions Board /Mgmt Utility Business Forum 3 Wednesday ONLY $25.00 $50.00 19 General/Technical Sessions Y s MEALS Monday Lunch Tuesday unch Y Tuesday Reception Attendee $16.00 Attendee $16.00 Attendee No Fee Spouse $16.00 Spouse $16.00 Spouse No Fee One 80ARO MEMBER or MAYOR per system is NO CHARGE Please check if planning to attend! entitled to (1) COMPLIMENTARY Tuesday Lunch MARILYN GAMBOLD EDUCATION FUND DONATION (MGEF) Mon Tues /Wed Lunch MGEF Mail IRWA Fax 812 988 6961 PO Box 679 )ffiBill us Enclosed Credit Card Nashville, IN 47448 FAME MC Discover Amer Exp Exp.: We welcome registrations on -site. Security: Please submit cancellation requests in writing CARD: No refunds after April 15, 2011. SIGNATURE Questions MaryJane Miller Email address for receipt: Telephone: 812- 988 -6639 E -mail. mjmmiller @att.net U REGISTRATION FORM IRWA April 18 -20, 2011 Please print or type one form for EACH ATTENDE First time attendee? Attendee Information: Etil,ling Information: U! Name 1 A 1`1 1 y n Company Name: Title J" I A 3 A 4,o Billing Contact Spouse's name if attending O t F i S Address Address J City A Q fV e— St l Zip City St Zip Telephone )K/ Fax 2l7• '7,?-?- )LCj Telephone i I Fax E -mail W fJt� 1 t0, cci('Yy V E -mail invoice I will be submitting contact hours for print cl earl y Water Wastewater None Purchase Order# MONDAY SESSIONS IRWA Member Non Member Operator Certification Test Refresher (8:30a 4:00p) $25.00 $50.00 Stormwater Program Management (8:30a Noon) $25.00 $50.00 Wastewater Sessions (1:00p 5:00p) $25.00 $50.00 TUESDAY WEDNESDAY SESSIONS IRWA Member Non- Member c Tuesday Wednesday $50.00 $90.00 General/Technical Sessions Board /Mgmt Utility Business Forum M Tuesday ONLY C 40 00 $80.00 CL General/Technical Sessions Board /Mgmt Utility Business Forum _0 Wednesday ONLY $25.00 $50.00 10 Genera I/Tech nica I Sessions s MEALS Monday Lunch Tuesday Lunch Tuesday Reception Attendee $16.00 Attendee $16.00 Attendee No Fee Spouse $16.00 Spouse $16.00 Spouse No Fee One BOARD MEMBER or MAYOR per system is NO CHARGE Please check if planning to attend! entitled to (1) COMPLIMENTARY Tuesday Lunch MARILYN GAMBOLD EDUCATION FUND DONATION (MGEF) Mon Tues /Wed Lunch MGEF q 0 0 0 Mai! IRWA Fax 812 988 6962 PO Box 679 'N XC13ill us Enclosed Credit Card Nashville, IN 47448 Visa_. MC_ Discover Amer Exp Exp.: We welcome registrations on site. Security: Please submit cancellation requests in writing NAME ON CARD: No refunds after April 15, 2011. SIGNATURE Questions MaryJane Miller Email for receipt: Telephone: 812 988 -6639 E -mail. mimmiller@ VOUCHER 104608 WARRANT ALLOWED 351464 IN SUM OF INDIANA RURAL WATER ASSOCIATIO P.O. Box 679 Nashville, IN 47448 WATER '��A77nwi.. Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 997128 01- 6040 -03 $120.00 Voucher Total $120.00 Cost distribution .ledger classification if claim paid under vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show, kind of service, where performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 351464 INDIANA RURAL WATER ASSOCIATION Purchase Order No. P.O. Box 679 Terms Nashville, IN 47448 Due Date 4/18/2011 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4/18/2011 997128 $120.00 .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 ff L/ I W I 1ti�� Date Officer