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Home My WebLink About155767 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00353282 Page 1 of 1 ONE CIVIC SQUARE INDIANA ASSOC OF CITY ENGINEERS CARMEL, INDIANA 46032 ATTN: CHERYL MENCSIK CHECK AMOUNT: $70.00 PO BOX 273 CHECK NUMBER: 155767 LAGRANGE IN 46761 CHECK DATE: 1/23/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 70.00 ORGANIZATION MEMBER I e Indiana Association of City Engine MEMBERSHIP APPLICATION AND INVOICE For calendar year 2008 INDIANA ASSOCIATION OF CITY ENGINEERS (IACE) Please type or print: Individual Name: 41 �/ip� �f j c 7 Gs Last First M.I. nlailing,ddress: L--" �i e 6 nC ;'yir' ��1�h, 3 umber reet City or Town State 0 Zip E -Mail Address: /Y) h►G�%'iCl��Y /4�� Position or Title: City /Town/Company /Organization: Telephone: 5 Zt/cj Fax: 3/ 7 ��7/ 9 Area Code Number Area Code Number Membership Classes (Please check appropriate class and remit dues for that class): REGULAR MEMBER Any individual serving full time as a city or town engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. Annual dues are $25.00. AFFILIATE MEMBER Employees in municipal engineering departments, Public Works Directors Town Managers, etc. or representatives of TACT, Indiana. LTAP, INDOT. FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. Annual dues are $10.00. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Annual dues are $100.00. Make checks payable to: "IACE" and mail with this form to Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. Our Federal EIN is 35- 2132826. Please reproduce form for applications for your employees, associates, etc. P.O. Box 273 LaGrange, 1N 46761 phone /fax (260) 463 -3045 cheryl*ityengineer.org www. cityengineer.org Indiana Association of City Engineers s e MEMBERSHIP APPLICATION AND INVOICE For calendar year 2008 INDIANA ASSOCIA'T'ION OF CITY ENGINEERS (IACE) Please type or print: Individual Name: Last First M.I. Mailing Address: ,&,,0 �2 f ru,,r�c��,• -ai. ,,•,.c�,. (,Z y� a�Z umber Street L5r City or Town t to Zip E -Mail Address: ��1/. i' q o Position or Title: 009ss1- a/-Y/ City /Town/Company /Organization: Telephone: 5 Fax: 39 Area Code Number Area Code Number Membership Classes (Please check appropriate class and remit dues for that class): REGULAR MEMBER Any individual serving full time as a city or town engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. Annual dues are $25.00. AFFILIATE MEMBER Employees in municipal engineering departments, Public Works Directors,. Town Managers, etc. or representatives of IACT, Indiana LTAP, INDOT, FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. Annual dues are $10.00. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Annual dues are $100.00. Make checks payable to: "IACE" and mail with this form to Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. Our Federal EIN is 35- 2132826. Please reproduce form for applications for your employees, associates, etc. P.O. Box 273 LaGrange, IN 46761 phone /fax (260) 463 -3045 cheryl*ityengineer.org www. cityengineer.org Indiana Association of City Engineers MEMBERSHIP APPLICATION AND INVOICE For calendar year 2008 INDIANA ASSOCIATION OF CITY ENGINEERS (IACE) Please type or print: Individual Name: �4 /114 -AIA Last First M.I. Mailing Address: y L a�.��. p y 1V lli &zw tiz(, '64 .,i.�C z" v 2 7 N�bei& Stree City or Town State Zip E -Mail Address: Cdly i h RQ V/ Position or Title: S Tooe li &//4- 7�S ,e_ /LPiit i/ 4— City /Town /Company /Organization: 0 Telephone: 3l Z 5- 71 Fax: _3/ ,f71 Area Code Number Area Code Number Membership Classes (Please check appropriate class and remit dues for that class): REGULAR MEMBER Any individual serving full time as a city or town engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. Annual dues are $25.00. —1 AFFILIATE MEMBER Employees in municipal engineering departments, Public Works Directors, Town Managers, etc. or representatives of IACT, Indiana LTAP, INDOT, FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. Annual dues are $10.00. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Annual dues are $100.00. Make checks payable to: "IACE" and mail with this form to Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. Our Federal EIN is 35- 2132826. Please reproduce form for applications for your employees, associates, etc. P.O. Box 273 LaGrange, IN 46761 phone /fax (260) 463 -3045 cheryl@cityengineer.org www.cityengineer.org Indiana Association of City Engineer MEMBERSHIP APPLICATION AND INVOICE For calendar year 2008 INDIANA ASSOCIA'T'ION OF CITY ENGINEERS (IACE) Please type or print: Individual Name: 1C q-0 Z_ P Last First M.I. Mailing Address: umber Stre City or Srtate Zip E -Mail Address: �7 d�2Cl pia ems✓ nw_1 IA o Position or Title: /�h z V, eW o a P a r City /Town/Company /Organization: Telephone: 3� 7 f 7 1 Z (e fed Fax: 3/ J 7 Area Code Number Area Code Number Membership Classes (Please check appropriate class and remit dues for that class): REGULAR MEMBER Any individual serving full time as a city or town engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. Annual dues are $25.00. AFFILIATE MEMBER Employees in municipal engineering departments, Public Works Directors, Town Managers, etc. or representatives of IACT, Indiana LTAP, INDOT, FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. Annual dues are $10.00. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Annual dues are $100.00. Make checks payable to: "IACE" and mail with this form to Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. Our Federal EIN is 35- 2132826. Please reproduce form for applications for your employees, associates, etc. P.O. Box 273 LaGrange, IN 46761 phone /fax (260) 463 -3045 cheryl*ityengineer.org www. cityengineer.org Indiana Association of City Engine INDIANA ASSOCIATION OF CITY ENGINEERS (IACE) The Indiana Association of City Engineers is dedicated to facilitating communication and cooperation not only between the many city and town engineers in Indiana, but also the numerous local, state and federal agencies with whom those engineers must deal. Regular meetings will be held at both Road School and the IACT Annual Conference each year. We invite you to join us. There are several classes of membership available. They are: 1. REGULAR MEMBER Any individual serving full time as a city or town engineer, or serving as supervisor or director of a municipal engineering department. Regular members may vote, serve on committees and hold office. 2. AFFILIATE MEMBER Employees in municipal engineering departments, Public Works Directors, Town Managers, etc. or representatives of IACT, Indiana LTAP, INDOT, FHWA, etc., with an unbiased and sincere interest in the Association. Note that the dues may be waived for qualifying affiliate members with approval of the Executive Board. Affiliate members may serve on committees but may not vote or hold office. 3. ASSOCIATE MEMBER Vendors, consultants or other "friends" of the Association. Associate members may participate in meetings but may not vote, serve on committees or hold office. Note that Associate Memberships are limited to one member from each vendor or consulting firm. A membership application and invoice is attached. If you have questions concerning membership or dues please contact Cheryl Mencsik, Executive Secretary, IACE, P.O. Box 273, LaGrange, IN 46761. You may also call 260 499 -1218 for more inforination. Please copy this form and pass it along to other individuals who may be interested. P.O. Box 273 LaGrange, IN 46761 phone /fax (260) 463 -3045 cheryl@cityengineer.org www.cityengineer.org Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Farm 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 W i rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee c/o Cheryl Mencsik, Exec. Secretary Purchase Order No. OX Terms LaGrange, IN 46761 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Na ern ers ip inean Arnanda Foley r $70 00 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 VQUCHER NO. WARRANT NO. SSD� ALLOWED 20 F 5 IN SUM OF c/o Cheryl Mencsik, Exec. Secretary P.O. Box 273 LaGrange, IN 46761 $70.00 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering 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 n/a n/a E G 4355300 0.00 materials or services itemized thereon for which charge is made were ordered and received except 20 of Sig ure Title Cost distribution ledger classification if claim paid motor vehicle highway fund