159002 04/30/2008 �,gtif CITY OF CARMEL, INDIANA VENDOR: 00350617 Page 1 of 1
ONE CIVIC SQUARE NATIONAL BUSINESS INSTITUTE CHECK AMOUNT: $239.00
`4 CARMEL, INDIANA 46032 PO BOX 3067
EAU CLAIRE WI 54702 CHECK NUMBER: 159002
CHECK DATE: 4/30/2008
DEPARTMENT ACCOUNT PO N INVOICE NUMBER AMOUNT DESCRIPTION
1180 4357004 239.00 EXTERNAL INSTRUCT FEE
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REGISTRATION FORM
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Does this confirm a phone or fax registration. Yes No
RO B�L
SOLINGFOR
ATTENDEE INFORMATION
Please photocopy this form for multiple registrants.
PAR= ALEGALSu
Carla NPw�
NAME ome r
TITLE Paralegal
May 22 E- MAILADDRESS rnaWr6mPrfd( 1 in goy
Indianapolis, IN NAME
Seminar Number: 43790 TITLE
E -MAIL ADDRESS
SEIIAINART_UITION>`
i COMPANY NAME City of .Carmel Department --of L aw
$289 first registrant
$279 each adt'I registrant CO. SIZE
ADDRESS _One. Civic Square
=`UNABLE TO ATTEND
;Purchase- fheau8o-reco'�d'ing CITY Carmel
and manual of thistsemmar
Ifyou would like to order, please STATE Indiana Zip 46032
select the box below.
Please provide street address and PHONE (17) 571 -2472
allow 2 weeks following seminar
date for delivery.
PAYMENT INFORMATION
$289 $7.95 shipping Check enclosed payable to NATIONAL BUSINESS INSTITUTE
($14 to AK, HI or PR) MasterCard VISA American Express Discover
Shipments to CA, MN, NV, RI, SD and Card No.
WI must also include sales tax. Exp. Date.
Signature G
®Copyright 2007 Please bill me. (If your organization requires a purchase order, please provide it.)
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C't INDIANA RETAIL TAX EXEMPT PAGE
p' --of C armel CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
.r• Mci FEDERAL EXCISE TAX EXEMPT 0 0
1 35- 60000972 j
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VEND ®R�� t�L'�'� SHIP
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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6 {y y p ty y Q 1 j "C�t t�
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Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
31 7 M 7L'� PAYMENT
{�fy >t '��dd•' ``^i•..5'�.'/ i A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART 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. T HIS AP-P-ROPRIATIO�CIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. fV/
CLERK TREASURER
DOCUMENT CONTROL NO. A. COPY SIGN AND RETURN TO CLERK'S OFFICE
'VOUCHER NO. WARRANT NO.,...___..:_.....__
ALLOWED 20
IN THE SUM OF
L) W7 /_W
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
I hereby certify that the attached invoice(s), or
1
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 D F
S" ature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund