HomeMy WebLinkAbout200467 08/17/2011 CITY OF CARMEL, INDIANA VENDOR: 362203 Page 1 of 1
ONE CIVIC SQUARE HILTON CHICAGO TOWERS CHECK AMOUNT: $964.76
CARMEL, INDIANA 46032 720 S MICHIGAN AVE
CHICAGO IL 60605 CHECK NUMBER: 200467
CHECK DATE: 8/17/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4343002 964.76 EXTERNAL TRAINING TRA
Milton Chicago Towers
720 S. Michigan Ave
Chicago, IL 60605
Preliminary Invoice of Charges
Name: Blanchard, James
Mast, Darren
Room Room Total Total for Deposit Total After
Name Arrival Departure Nights Rate Tax Rm Tax Stay Due Deposit
Blanchard, James -11 1�S�p -11 2 $209.00 $32.19 $241.19 $482,38 $0.00 $482.35
Mast, Darren Se 11 18- ,Np -11, 2 $209.00 $32.19 $241.19 $482.38 $0.00 $482.38
TOTAL FOR STAY $964.76
ADVANCE DEPOSIT PAID $0
Grand Total Due for Entire Stay:- $964.76
—This is a total excluding any incidental charges or changes to the reservation effecting room rate or length of stay
Please Make Checks Payable To: Chicago Hilton and Towers
Attn: Jennifer Hughes, Finance
720 S. Michigan Avenue
Chicago, IL 60605
Bass, Elaine A
From: Bass, Elaine A
Sent: Monday, August 01, 2011 5:03 PM
To: Hollibaugh, Mike P
Cc: Haney, Douglas C; Blanchard, Jim E
Subject: FW: Purchase Confirmation No. 18135060 (Jim Blanchard)
FYI
From: Trina Shropshire Paschal fmailto:Trina@imla.org]
Sent: Monday, August 01, 20114:34 PM
To: Bass, Elaine A
Subject: FW: Purchase Confirmation No. 18135060 (Jim Blanchard)
Your Copy. Trina
Trina Shropshire Paschal I Associate Director for Events
International Municipal Lawyers Association
7910 Woodmont Avenue, Suite 1440 1 Bethesda, Maryland 20814
T 202.466.5424 x 7102 1 F 202.785.0152
Future Events
2011 Annual Conference I Chicago, IL I Sept. 11 -14
Teleconferences J visit www.imla.or for listing
A Sr
From: trinaC@imla.org [mailto:trina@imla.org]
Sent: Monday, August 01, 20114:25 PM
To: ilanchard@carmel.in.gov
Cc: Trina Shropshire Paschal
Subject: Purchase Confirmation No. 18135060 (Jim Blanchard)
Dear Jim Blanchard,
THANK YOU. This is your confirmation/invoice and receipt for your purchase. For your records, here is a
summary of your purchase from The International Municipal Lawyers Association (Federal ID# 53 -0214 -280).
Please contact Trina or Brandi directly if you have a question regarding membership or events. TRINA
SHROPSHIRE PASCHAL: EVENTS trina �imla.org and BRANDI TEEL: MEMBERSHIP bteel@imia.org.
Forward Check Payments to: International Municipal Lawyers Association, 7910 Woodmont Avenue, Suite
1440, Bethesda, Maryland 20814
Date /Time: 8/1/2011 4:24 PM
Purchased By:
.Tim Blanchard
Customer ID: 11558700
(Organization: Carmel, Indiana)
(317) 571 -2472
j bl anchard(� carme 1. in. go v
Your confirmation number is: 18135060 Please keep this number for any references.
Shopping Cart Items Amount Quantity Total
Code Enforcement 2011
Main Registration Badge Name: Jim $300.00 1 $300.00
Event
Subtotal $300.00
Taxes $0.00
Shipping $0.00
Invoice Total $300.00
Grand Total $300.00
Payment $0.00
Order Balance $300`00
Shipping Billing Information
Billing Address:
Jim Blanchard
One Civic, Square
Carmel -IN 46032
United- States
(317) 571 -2472
jblanchardc�,carmel.in.gov
Payment Information
Payment Amount: 50.00
Payment= Method: Bill Me
2
CODE ENFORCEMENT CONFERENCE 2011
Program subject to change
Saturday, September 10
8:00 a.m. Registration
8:30 a.m. Service of Process and Notice
Peter Letzmann, Attorney, Mediator and Consultant [MLA Michigan State Chair, MAMA
Professionalism and Education Committee, Chair GVSU
10:00 a.m. New Section Business Meeting: Adoption of Bylaws and Election of Officers
10:15 a.m. Break
10:45 a.m. Searching for Problems: Administrative Warrants and Code Enforcement (Fourth Amendment issues)
Thomas Carpenter, Little Rock, AR
11:45 a.m. Look Before You Lead How Code Officials and City Attorneys Can Effectively Plan Enforcement
Nicholas Spiropoulos, Borough Attorney, Matanuska- Susitna Borough, AK
12:45 p.m. Lunch (on your own)
2:00 p.m. Tales from the Last Frontier: "GOV -zilla Meets the Parking Fairies" "When Towing Becomes
Predatory
Julia Tucker, Assembly Counsel, Anchorage, AK,
3:00 p.m. Junkyard "Dog" Cases: Enforcement of Codes and Remedies
Daniel Crean, Crean Law Office, Peynbroke, NH
The ABCs of Green Junkyards
James Watson, ABC Auto Parts
Sunday, September 11
8:30 a.m. As the Rooster Crows: Chickens and Other Exotic Pets
Marianne Landers Banks, Assistant City Attorney, City of Springfield, N40 Law Department
9:15 a.m. Signs, Signs Everywhere a (Digital' Sign: Issues in Code Enforcement
David Ives, Assistant City Attorney, Murfreesboro, TN
10:20 a.m. Break
10:30 a.m. Effective Witness Preparation for Trial
Ginger Wald, Assistant City Attorney, Ft. Lauderdale, FL
a IM LA
Trial Techniques Best Practices y h t
GoP,vP,vu!
Patti Gregory Chang, Senior Counsel, City of Chicago, 1L
Hon. Andy Wright, City Judge, City of Mt. Juliet, TN
and City Attorney, City of Lebanon, TN
f GIGAGD.—
-P
Noon Lunch (on your own) S Y I 201 �t
£t
t X 3
1:00 P.M. Walking Land Use Tour (free, but sign a x,
6:00 p.m. IMLA Welcome Reception
IM 76" Avwwal.
For program updates to register online
visit our web site: http:l /www.imla.org —CYlICAQ70
Se�i�.ivrl,I�er Y —14, 20Y 1
IMLA's 76 Annual Conference
Chicago Hilton Hotel
REGISTRATION INFORMATION
Name Title
Badge Name Local Government Entity
Address
City State Zip
Phone Fax E -mail
Guest Name Guest Badge Name
(Complete only if registering Guest) Badges are required for all functions.
Please indicate your registration type and options listed below (check all that apply)
Guest Registrant lsee below) Luncheon Ticket(s) $75.00 each, No. of ticket(s) (only guest need to purchase)
CLE Credits, please specify state(s) Your Bar No's.
INSTITUTE: FOR LOCAL GOVERNMENT LAWYERS (ILGL) $100 to register. For more information visit www,imla.org
Registration Fees include: Admission to all sessions, conference materials, IMLA social functions, Monday and Tuesday
luncheons and all coffee breaks (not applicable to guest). Guest Fees include: Attendance at the social events.
Cancellation Refund Policy: Cancellations must be received in writing by August 1, 2011 to qualify for a refund. All cancellations
are subject to a $50.00 administrative processing fee. After August 1, 2011 those not attending will receive the event materials in full
consideration of registration fees paid. Replacements are always welcomed. Guest Cancellations are subject to a $25.00
administrative processing fee. All refunds will be remitted 90 days after the event. Send all cancellations in writing to the IMLA
Events Department.
Discounted Registration Fees Expire 15 Days After Rate Ends, If Payment Is Not Received, Next Rate Will
Apply. The discounted registration fees below are available for those staying in IMLA Conference Hotel, otherwise
$100 will be added to your registration fee to help defray IMLA Conference expenses (local attendees exempt from
$100). Conference payment must be received within 15 days.
HARD GOPY POLICY: Registration fees include USB of speaker's materials. These materials will also be available
for registrants from (MLA's web site one to two weeks prior to the meeting. If you require paper copies of speaker
materials you must add an additional $120 to your registration fee and check here.
FOUR EASY WAYS TO REGISTER! MAIL: IMLA, 7910 Woodmont Avenue Suite 1440 Bethesda, MD 20814
PHONE: 202 466 -5424 FAX: 202- 785 -0152 E -MAIL: info @imla.org
Super Early REGISTRATION PAYMENT INFORMATION
Saver Rate Bird Rate Regular Rate
Registration Ends Ends Rate Ends After Bill Me Check Enclosed Visa MasterCard
Type 5/31/11 8/16/11 9/01/11 9/01/11 Make all checks payable to IMLA; U.S. currency only
First Member $650 $700 $775 $875
Addt'l. Member $625 $675 $700 $825 Amount
3 or More From Name
Same Office
Each person $350 $400 $475 $500
Card No.
Judicial $355 $355 $355 $355
Nonmember $1,322 $1374 $1,500 $1,600 Exp.Date
Guest of
Seminar Signature
Registrant $125 $125 $150 5200
INDIANA RETAIL TAX EXEMPT PAGE r
ty C armel CERTIFICATE NO. 0031 201 55 002 0 PURCHASE ORDER NUMBER
Dt s I f FEDERAL EXCISE TAX EXEMPT
/7j� 35- 60000972 I j t(✓
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SUPS,
FARM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
DURCHAS DATE DATE REQUIRED REQUISITION NO. VENDOR NO. D ESCRIPTION
p4
Ii b—
SHIP
VENDOR 4 TO
rf
�.�'�l.C,��� -°lam f
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
I e
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aY
C:
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Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPAR ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
�aw /f 0 /,34 L PAYMENT g
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NU
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.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.Q.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO,
CLERK TREASURER
DOCUMENT CONTROL No-27861 A.P.V. COPY SIGN AND RETURN TO CLERK OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
O ACCOUNT OF APPP I TiON FOR
Board Members
POD or INVOICE NO. ACCT #(TITLE AMOUNT
I hereby certify that the attached invoice(s), or
�►�yQ bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made Were ordered and
received except
20 1)
ature
Titi
Cost distribution ledger classification if J
claim paid motor vehicle highway fund
Hilt
Hilton Chicago Towers
720 S. Michigan Ave
Chicago, IL 60605
Preliminary Invoice of Charges
Name: Blanchard, James
Mast, Darren
Room Room Total Total for Deposit Total After
Name Arrival Departure,, Nights Rate Tax Rm Tax. Stay Due Deposit
Blanchard, James 6'e 1 1q-Sep 11 2 $209.00 $32.19 $241.19 $482.38 $0.00 $482.38
Mast, Darren 1 -11 18- 11 2 $209.00 $32.19 $241.19 $482.38 $0.00 $482.38
.Srf 11
TOTAL FOR STAY $964.76
ADVANCE DEPOSIT PAID $0.00
G ran d T otal Due for Entire Stay:
—'This is a total excluding any incidental charges or changes to the reservation effecting room rate or length of stay
Please Make Checks Payable To: Chicago Hilton and Towers
Attn: Jennifer Hughes, Finance
720 S. Michigan Avenue
Chicago, IL 60605
Stewart, Lisa M
From: Hilton Hotels Resorts Confirmed [hiltonhotels &resorts @res.hilton.com]
Sent: Friday, August 12, 2011 12:04 PM
To: Stewart, Lisa M
Subject: Hilton Hotels Resorts Confirmation #3438659898
i, Hilton.Ch1cago
720 South Michigan Avenue
a Chicago, IL
m l'rt p�
United States, 60605
Tel: 1 312- 922 -4400
Fax: 1 312- 922 -5240
Confirmation Number: 3438659898
Click here to view or edit your reservation.
l aH1LT�
Ise sA°`
Name: Darren Mast
Arrival Date: 09 Sep 2011
x
EARN INIG iPDI NT5
Departure Date: 11 Sep 2011
Tl315 8C3DKJMG Fold
a Check -in Time: 3:00 PM
"FREE STA'�� r4 Check -out Time: 12:00 AM
fhT
10 1 1N x
Rate Information:
Rate per night: 209.00 USD
Total for Stay per Room:
Rate 418 -00 USD
Taxes 64.37 USD
Total 482.37 USD
Total for Stay: 482.37 USD
r" r Includes estimated taxes and service charges. (Gratuities not
included.)
Hilton Requests Tax: 0
Upon ArrivalT"' There is a 15.40% Per Room Per Night tax.
Arrange for.amenities Additional Charges:
in your room prior to Valet parking: 55.00 /night Self parking: 43.00 /night
your arrival. Pre
order snacks, extra Rate Rules and Cancellation Policy:
towels and more Your reservation is guaranteed for late arrival.
Please contact us should you need to cancel your reservation.
Cancellations are required by 11:59 PM on 08 Sep 2011 local
hotel time.
Earn up to 30,000 Cancellation penalties may apply.
HHonors points
with the no- annual
fee Hilton HHonors Room Information:
Card from American Rooms: 1
Express Earn Clients: 1 Adult
20,000 HHonors Room Type: 1 DOUBLE BED
bonus points after
1
your first purchase on To Help You Along on Your Journey...
the card! Click here
to learn more and Our Hotel:
apply. Tour the Hotel
Accommodations
Hotel Factsheet
HILTON Services and Amenities:
HHQNORS Energize with Hilton Fitness by Precor
Hotel Services and Amenities
Dining Options:
Our Restaurants
Visit Hilton,com for great specials, packages and products.
Sign up to receive weekly email offers and click here to shop for
your favorite Hilton products.
Service of alcoholic beverages is subject to state and local laws. Must be of legal drinking age. Hilton Requests Upon
Arrival` items are subject to availability.
Hilton Worldwide will not contact you by telephone, text message or e-mail to ask for your confidential personal information,
credit card details or HHonors account login information related to upcoming stays or your account. Anyone who receives
this type of request should not respond to it. We also ask that you please notify us at fraud alertng hilton.corn should you
receive such a communication.
If you need to MODIFY or CANCEL your reservation, click here
Any change to the arrival date, departure date or room type of this reservation is subject to the hotel's availability at the time
the change is requested and may result in a possibie rate change or an additional fee. For example, shortening or
lengthening your reservation is subject to availability and may not be possible at a later date. For more information, please
click here to see all the rules and restrictions applicable to this reservation.
If you have questions regarding your reservation, please contact Hilton Reservations and Customer Care at 1- 800 HILTONS
(445 -8667) click here or email us at hiltonhelp @hiltonres.com.
Hilton HHonors membership, earning of Points Miles and redemption of points are subject to HHonors Terms and
Conditions
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@2011 Hilton Worldwide
Hilton Reservations and Customer Care 12050 Chennault Drive I Carrollton, Texas 75006, USA
2
CODE ENFORCEMENT CONFERENCE 2011
Program subject to change
Saturday, September 10
8:00 a.m. Registration
8:30 a.m. Service of Process and Notice
Peter Letzmann, Attorney, Mediator and Consultant INILA Michigan State Clair 'si.: lA
Professionalzsrt and Education Committee, Chair GVSU
10:00 a.m. New Section. Business Meeting: Adoption of Bylaws and Election of Officers
10:15 a.m. Break
10:45 a.m. Searching for Problems: Administrative Warrants and Code Enforcement (Fourth Amendment issues)
Thomas Carpenter, Little Rock, AR
11:45 a.m. Look Before You Leap: How Code Officials and City Attorneys Can Effectively Plan Enforcement
Nicholas Spiropoulos, Borough Attorney, Matanuska- Susitna Boron lt, R
12:45 p.m. Lunch (on your own)
2:00 p.m. Tales from the Last Frontier: "GOV -zilla Meets the Parking Fairies" "When Towing Becomes
Predatory
Julia Tucker, Assembly Counsel, Anchorage, AK,
3:00 p.m. Junkyard "Dog" Cases: Enforcement of Codes and Remedies
Daniel Crean, Crean Law Office, Pembroke, NH
The ABCs of Green Junkyards
James Watson, ABC Auto Parts
Sunday, September 11
8:30 a.m. As the Rooster Crows: Chickens and Other Exotic Pets
Marianne Landers Banks, Assistant City Attorney, City c Springfield, N10 Laiv f)0r�art��3ertt
9:15 a.m. Signs, S igns, Everywhere a (Digital) Sign: Issues in Code Enforcement
David Ives, Assistant City Attorney, Murfreesboro, TN
10:20 a.m. Break
10:30 a.m. Effective Witness Preparation for Trial
Ginger Wald, Assistant Cite Attornev,.Ft. Lauderdale, FL
IMLA 76"' AvwuAcEi,
Trial Techniques Best Practices
Patti Gregory Chang, Senior Counsel, City of Chicago, IL C��'�� }C
Hon. Andy Wright, City Judge, City of Mt. Juliet, TN
and Cite Attorney, City of Lebanon, TN CHIGA(44—
S teml� 1 Y 14, 2Q. 1
Noon Lunch (on your own)
1:00 P.M. Walking, Land Use Tour (Free, but sign u�?)
6:00 p.m. IMLA Welcome Reception
IMLA 76 "Annual
C&n fexe ncee! L
For program updates to register online��
visit our web site: http: /www.imla.org --CxGO
th S� 11 --14, 2011.
IMLA 's 76 Annual Conference
Chicago Hilton Hotel
REGISTRATION INFORMATION
Name Title
Badge Name Local Government Entity
Address
City State Zip
Phone Fax E -mail
Guest Name Guest Badge Name
(Complete only if registering Guest) Badges are required for all functions.
Please indicate your registration type and options listed below (check all that apply)
El Guest Registrant (see eeiow) Luncheon Ticket(s) $75.00 each, No. of ticket(s) (only guest need to purchase)
CLE Credits, please specify state(s) Your Bar No's.
INSTITUTE FOR LOCAL GOVERNMENT LAWYERS (ILGL) $100 to register. For more information visit www.imla.org
Registration Fees include: Admission to all sessions, conference materials, IMLA social functions, Monday and Tuesday
luncheons and all coffee breaks (not applicable to guest). Guest Fees include: Attendance at the social events.
Cancellation f Refund Policy: Cancellations must be received in writing by August 1, 2011 to qualify for a refund. All cancellations
are subject to a $50.00 administrative processing fee. After August 1, 2011 those not attending will receive the event materials in full
consideration of registration fees paid. Replacements are always welcomed. Guest Cancellations are subject to a $25.00
administrative processing fee. All refunds will be remitted 90 days after the event. Send all cancellations in writing to the IMLA
Events Department.
Discounted Registration Fees Expire 15 Days After Rate Ends, If Payment Is Not Received, Next Rate Will
Apply. The discounted registration fees below are available for those staying in IMLA Conference Hotel, otherwise
$100 will be added to your registration fee to help defray IMLA Conference expenses (local attendees exempt from
$100). Conference payment must be received within 15 days.
HARD COPY POLICY: Registration fees include USB of speaker's materials. These materials will also be available
for registrants from IMLA's web site one to two weeks prior to the meeting if you require paper copies of speaker
materials you must add an additional $120 to your registration fee and check here.
FOUR EASY WAYS TO REGISTER! MAIL: IMLA, 7910 Woodmont Avenue Suite 1440 Bethesda, MD 20614
PHONE: 202 -466 -5424 FAX: 202 785 -0152 E -MAIL: info @imla.org
Super Early
REGISTRATION PAYMENT INFORMATION
Saver Rate Bird Rate Regular Rate
Registration Ends Ends Rate Ends After F Bill Me [I Check Enclosed El Visa El Master Card
Type 5/31/11 8/16/11 9/01/11 9/01/11 Make all checks payable to IMLA; U.S. currency only
First Member $650 $700 $775 $875
Addt'l. Member $625 $675 $700 $825 Amount
3 or More From Name
Same Office
Each person $350 $400 $475 $500
Card No.
Judicial $355 $355 $355 $355
Nonmember $1,322 $1374 $1,500 $1,600 Exp.Date
Guest of
Seminar Signature
Registrant $125 $125 $150 $200
Bass, Elaine A
From: Bass, Elaine .A
Sent: Monday, August 01, 2011 5:03 PM
To: Hollibaugh, Mike P
Cc: Haney, Douglas C; Mast, Darren
Subject: FW: Purchase Confirmation No. 18135070 (Darren Mast)
FYI
From: Trina Shropshire Paschal fmailto:Trinaaimla.org]
Sent: Monday, August 01, 20114:33 PM
To: Bass, Elaine A
Subject: FW: Purchase Confirmation No. 18135070 (Darren Mast)
Your copy. Trina
Trina Shropshire Paschal I Associate Director for Events
International Municipal Lawyers Association
7910 Woodmont Avenue, Suite 1440 J Bethesda, Maryland 20814.
T 202.466.5424 x 7102 1 F 202.785.0152
Future Events
2011 Annual Conference I Chicago, IL I Sept- 11 -14
Teleconferences I visit www.imla.ore for listing
PAP-
P
,f.
From: trina @imla.org [mailto:trina @imla.orgj
Sent: Monday, August 01, 2011 4:32 PM
To: dmast @carmel.in.gov
Cc: Trina Shropshire- Paschal
Subject: Purchase Confirmation No. 18135070 (Darren Mast)
Dear Darren Mast,
THANK YOU. This is your confirmation/invoice and receipt for your purchase. For your records, here is a
summary of your purchase from The International Municipal Lawyers Association (Federal TD# 53- 0214 -280).
Please contact Trina or Brandi directly if you have a question regarding membership or events. TRINA
SHROPSHIRE- PASCHAL: EVENTS trinagimla.or and BRANDI TEEL: MEMBERSHIP bteelgimla.org
Forward Check Payments to: International Municipal Lawyers Association, 7910 Woodmont Avenue, Suite
1440, Bethesda, Maryland 20814
Date /Time: 8/1/2011 4:31 PM
Purchased By:
Darren Mast
Customer ID: 11558950
i
(Organization: Carmel, Indiana)
(317) 571-2450
dmast@cannel.in.go
Your confirmation number is: 18135070 Please keep this number for any references.
Shopping Cart Items Amount Quantity Total
Code Enforcement 2011
Main Registration Badge Name: Darren $300,00 1 $300.00
Event
Subtotal $300.00
Taxes $0.00
Shipping $0.00
Invoice Total $300.00
Grand Total $300.00
Payment $0.00
Order Balance $300.00
Shipping Billing Information
Billing Address:
Darren Mast
One Civic Square
Carmel W 46032
United States.
(317) 571-2450
dmastgcarmel.in.go
Payment Information
Payment Amount: $0.00
.Payment Method: Bill Ale
2
C it y o J �Jl�" /f Ili/ armel INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
f f d /j FEDERAL EXCISE TAX EXEMPT (77 2
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED 8Y STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR (�l SHIP TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1
x j 1
rt
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
1130 X/900,'2-1 PAYMENT �Y° ��o� 3 K
St y-Ji�z 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.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE A80VE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE 1 G t Fl 3f
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. r
CLERK TREASURER
DOCUMENT CONTROL NO. 2 7 8 6 2 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
P
IN THE SUM OF
0A ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO, ACCT #fnTLE AMOUNT
I hereby certify that the attached invoice(s), or
g 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
Title
-Cost distribution ledger classification it
claim paid motor vehicle highway fund