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HomeMy WebLinkAbout200703 08/17/2011 CITY OF CARMEL, INDIANA VENDOR: 143001 Page 1 of 1 ONE CIVIC SQUARE INDIANA ASSOC OF CITIES TOWNS (i CHECK AMOUNT: $275.00 CARMEL, INDIANA 46032 CONFERENCE REGISTRATION 200 S MERIDIAN ST, SUITE 340 CHECK NUMBER: 200703 INDIANAPOLIS IN 46225 CHECK DATE: 8/17/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4357004 275.00 EXTERNAL INSTRUCT FEE 2011 ANNUAL CONFERENCE REGISTRATION FORM 1. Registrati Deadline: September 22 r Full Name �l� r City orTown /State /Zip Preferred Name for Badge Phone C I �+�(L Title v� V r� Email i First Time Attendee? Yes ;A0 Spouse /Guest Name i i Municipality /Company colt n Special Needs and Dietary Restrictions Council President's Name 1 vx d', i i Address Registration Fee M thod of Payment On /Before After EnterAmount i 9/22 9/22 1 4heck Visa MasterCard Discover i Member Municipal Official (Population $275 $325 11 Check (Payable to TACT) i greater than or equal to 1,000) f Member Municipal Official (Population S175 $225 Cardholder Name less than 1,000) Credit Card Number i Associate Member $275 $325 Expiration Date Spouse /Guest• $175 $225 i 3 -digit Verification Code Non Member $425 $475 i Billing Address Municipal Day (Monday Only) $225 $275 City orTown /State /Zip i Total Amount Due: Signature of Cardholder *The spouse /guest registration fee is restricted to those who are not municipal officials and who have no professional interest at the conference. The fee includes admission to all conference events, the exhibit hall, meals and participation in the spouse /guest program. i PI ase Check the Conference Events You Pan to A 'end Sunday, Opening Sunday, Early Sunday, Early Sunday, Wel- Monday, Conti- i *Monday, onday, Presl- Tuesday, Closing Business Session Bird Workshop #1: Bird Workshop come Reception nental Breakfast Annual Awards dents' Reception runch Business Understanding #2: Managing Luncheon Session your Municipal Change in a Code Enforce- Changing World ment Tool Box i i i i *This year's IACT Annual Awards Luncheon will have assigned seating. Only registrants who check the Annual Awards luncheon above will be assigned a seat. We will do our best to accommodate seating requests. Requests are not guaranteed. i i Seating Requests; i i i Cancellation Policy Only written cancellations will be accepted. Please mail your written cancellation to 200 South Meridian Street, Suite 340, Indianapolis, IN 46225; fax to (317) 237 -6206 or send to nhurt @citiesandtowns.org. Written cancellations received on or before September 29, will be refunded less a $40 processing fee. IACT is not responsible for hotel reservations or cancellations. Special Needs and Dietary Restrictions IACT will make the conference accessible to you. If you require special arrangements or a special diet, please notify IACT on your registration form. We may not be able to accommodate such requests made the day of the event. Meeting room temperatures may vary beyond our control; please wear layers of clothing for your comfort. I Affiliate Group Events IACT affiliate groups may hold individual meetings and events at the conference. Attendees must be registered for the conference in order to attend affili- ate events. Additional meeting and event information for affiliate group members may be mailed out separately. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or 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. P pee )q�5 S y Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 7 Total 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. 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. yu W d 7 ALLOWED 20 /'11W- IN SUM OF 34 ja S W6 A- c �7�7 ON ACCOUNT OF APPROPRIATION FOR r7 -4`7 Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I 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 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund