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Home My WebLink About160406 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00350333 Page 1 of 1 y. ONE CIVIC SQUARE INDIANA ASSOCIATION OF CITIES/TOW AMOUNT: $165.00 CARMEL, INDIANA 46032 200 S MERIDIAN ST SUITE 340 INDIANAPOLIS IN 46225 CHECK NUMBER: 160406 CHECK DATE: 6/10/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4355300 70.00 ORGANIZATION MEMBER 1701 4357004 95.00 EXTERNAL INSTRUCT FEE i 1 i i i 2008 IACT LEADERSHIP CONFERENCE REGISTRATION FEES (Please Check All that Appl Sponsored by the City of Rising Sun X $95.00 IACT Municipal Official or Associate Member July 14 -16 120.00 IACT Municipal Official or Associate Member (after July 2) Grand Victoria Casino Resort $85.00 Spouse /Guest $110.00 Spouse/ Guest (after July 2) REGISTRATION FORM $90.00 Golf Total q P Full Name: 1-1 C r� Preferred Name for Badge: Municipality /Company: 6—j( Title: Address: Cvv (!x vu UGC -rp- City /Town: State: Zip: V" 3a Phone: `t Fax: —St S 71-'azlm E -mail: �FQv PAYMENT INFORMATION Method of Payment (Circle One): Check MasterCard Visa Discover Check Number: Car umb r: Expiration Date: T hree -digit Security Code: Name Cardholder: Authorized Si ature: B Zina A d ess if different from above): Ci Town: State: Zip: 1ACT LEADERSHIP CONFERENCE GOLF OUTING 1.) The Golf Outing is Wednesday, July 16 beginning at 11:00 a.m. 2.) Please list your foursome: 3.) 4.) *Fax completed form to (317) 237 -6206 or Mail to IA CT, 200 South Meridian Street, Suite 340, Indianapolis, IN 46225* 2008 TACT LEADERSHIP CONFERENCE Sponsored by the City of Rising Sun July 14 -16 Grand Victoria Casino Resort Registration Form PRE REGISTRATION SPOUSE /GUEST REGISTRATION The deadline for pre- registration is July 2. Registrations may be faxed or The spouse /guest registration fee is restricted to those who are not mailed. Your registration is considered your commitment to attend. Unless municipal officials and who have no professional interest at the attendees follow the cancellation policy, no -shows will be billed. conference. The fee includes admission to all conference sessions and meals. Golf Outing is not included. REGISTRATION PROCEDURE CANCELLATION POLICY How to register: Refunds will be made only if IACT is notified of cancellation in Mail registration form to IACT, 200 South Meridian Street, Suite 340, writing on or before July 9 by fax, mail or email to Indianapolis, IN 46225 lheinzman@citiesandtowns.org Fax form to IACT at (317) 237 -6206 If paying with a check, please make payable to Indiana Asso ciation of Cities DIRECTIONS and Towns, Attn: Leadership Conference and include the name of the Directions to the IACT Leadership Conference are available on the attendee on tEe cffec k. Grand Victoria website at wvvw.grandvictoria.com and the IACT website at www.citiesandtowns.org HOTEL RESERVATIONS IACT has blocked rooms at the Grand Victoria Casino Resort for $79 per DISABILITIES AND SPECIAL NEEDS night (plus tax). Please contact the hotel directly to make your reservation at IACT will make all programs accessible to you. If you require (800) 472 -6311 and request the special "IACT" rate. A limited number of special arrangements, or a special diet, please notify IACT rooms are available, and your reservations must be made by July 2 to on your registration form. We may not be able to accommodate receive the special IACT rate. Only registered participants may occupy a room such requests on the day of the program. within the room block. IACT is not responsible for hotel reservations or cancellations. LATE FEE The pre registration deadline is July 2. Any registration received GOLF OUTING after July 2 will be treated as an on -site registration with an This year's golf outing is scheduled for Wednesday, July 16, beginning additional charge of $25. at 11:00 a.m. Grand Victoria features a Tim Liddy designed 18 -hole Scottish -style links course. Please complete the golf portion of the MORE INFORMATION registration form to participate. Please contact Lindsay Heinzman at (317) 237 -6200 x229 or theinzmangcitiesandtowns.org (Please turn over, registration form on back side) PACT Indiana Municipal Personnel Administrators for Cities and Towns IMPACT formed in 1997 as an affiliate group of the Indiana Association of Cities Towns (IACT) to provide a network for municipal human resource professionals. All appointed and elected municipal officials who deal with personnel policies, records, compensation, administration and benefits programs will benefit from membership in IMPACT. 2008 IMPACT Annual Membership Dues 6 $50.00 Primary Member (first person from a municipality) $20.00 Secondary Member (each additional person from municipality) Cl $100.00 Associate Membership TOTAL Please provide the following information. l Name: c" a-- Title: Municipality: Address: C Y J L C q G Phone No.: 3 L 01`-11 1 Fax No.: E -mail Address: l G L- V n Make checks payable to: Indiana Association of Cities and Towns Mail completed form with payment to: IMPACT, 200 S. Meridian St., Suite 340, Indianapolis, IN 46225 1 understand that as a member of IMPACT, I agree to: (1) maintain the confidentiality of shared information when warranted; (2) share information with other members of the group; (3) abstain from using my official membership position to secure special privilege, gain or personal benefit; (4) contribute relevant materials to the personnel information resource library; and (5) actively participate in training sessions and group meetings. Signature Date 3 Ci� IMPACT Indiana Municipal Personnel Administrators for Cities and Towns IMPACT formed in 1997 as an affiliate group of the Indiana Association of Cities Towns (IACT) to provide a network for municipal human resource professionals. All appointed and elected municipal officials who deal with personnel policies, records, compensation, administration and benefits programs will benefit from membership in IMPACT. 2008 IMPACT Annual Membership Dues $50.00 Primary Member (first person from a municipality) i 0 $20.00 Secondary Member (each additional person from municipality) $100.00 Associate Membership TOTAL CD Q Please provide the following information. Name: Tit1e: �S�Y711(1� Municipality: Address: Phone No.: 3a-5 5 Fax No.: 3 E -mail Address: M 4 1' 41 cc�01r� CQ emt? b t f1. QO1/ Make checks payable to: Indiana Association of Cities and Towns Mail completed form with payment to: IMPACT, 200 S. Meridian St., Suite 340, Indianapolis, IN 46225 I understand that as a member of IMPACT, I agree to: (1) maintain the confidentiality of shared information when warranted; (2) share information with other members of the group; (3) abstain from using my official membership position to secure special privilege, gain or personal benefit; (4) contribute relevant materials to the personnel information resource library; and (5) actively participate in training sessions and group meetings. Signature Date 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. Payee Indiana Association of Cities and Towns Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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. 06/09/08 ALLOWED 20 Indiana Association of Cities and To wns IN SUM OF 2 -00 S. Meridian Street, Suite 340 Indianapolis, IN 46225 $70.00 ON ACCOUNT OF APPROPRIATION FOR GENERAL FUND 1205 Administration Board Members PO# or DEPT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 0 (naterials or services itemized thereon for which charge is made were ordered and received except 20 Signatur Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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. Payee V c l E7 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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. ALLOWED 20 IN SUM OF Jo pznll a�v� �3 Ins Aa 5 C, b ON ACCOUNT OF APPROPRIATION FOR TiZt,�.n FO 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 �P 20 6 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund