166723 12/10/2008 e. VENDOR: 152500
CITY OF CARMEL, INDIANA Page 1 of 1
ONE CIVIC SQUARE INDIANA LEAGUE OF MUN C -T
CHECK AMOUNT: $185.00
CARMEL, INDIANA 46032 GO TOWN OF REMINGTON
PO Box 70 CHECK NUMBER: 166723
REMINGTON IN 47977
CHECK DATE: 12!1012008
6EPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4355300 185.00 ORGANIZATION MEMBER
ILMVICT ANNUAL DUES NOTICE
Claim and Invoice
This invoice and claim for payment is made upon the Clerk or Clerk- Treasurer of the City or Town for payment
of membership dues for the Indiana League of Municipal Clerks and Treasurers. You may pay from this
invoice any class of membership. Please check the appropriate box to indicate the actual class of membership
and dues schedule that applies.
2009 Dues for all Classes of Membership due on or before March 30, 2009
Active Members:
Towns with populations under 700 $40.00
Towns or Cities with population of 701 to 5,000 $50.00
Towns or vlticS Wit population of 5,001 to 20,000 $75.00
Towns or Cities with population of 20,001 to 35,000 $100.00
Towns or Cities with population over 35,000 $150.00
Please indicate your municipality's population 0
Active Member Name:
Title (Circle One): Clerk- Treasurer Clerk Controller
Certification (Circle all that apply): AMC CIVIC MMC CPFA
Name of Municipality: /yzf County:
Office Address: &!U G 0 At District
City/Town: M`7 Zip:
Office Phone: �°''�I Fax: �iT 1 L
l oorne Address: f!{,b ce3 Horrre- Fhon -e
City/Town: Zip: Email: r �fi
Associate Members (Any former active member or staff of of an active member of the League): $35.00 each
Associate Member Name: C A Q �h f, Title: le"
Address: a L 4 Zip: 4
Associate Member Name: Title:
Address: City/Town: Zip:
(Please copy form for any additional associate members.
Associate Business Member: $150.00
(Such membership is entitled to four (4) membership cards, a membership roster, a Quest subscription and notifications of
meetings)
Associate Business Name: Phone:
Address: City: State: Zip:
Primary Contact Name: Email:
Address (if different than above): City: ST Zip:
(2) Card Bearer Name: Email:
Address (if different than above): City: ST Zip:
(3) Card Bearer Name: Email:
Address (if different than above): City: ST Zip:
(4) Card Bearer Name: Email:
Address (if different than above): City: ST Zip:
ILMCT Membership benefits include:
A handsome membership card denoting your affiliation!
Notice of League events (includes training and professional development opportunities)
A subscription to the Quest, our official newsletter!
•3 In some cases, discounts for League sponsored events!
Access to League website www.ILMCT.org
TOTAL ACTIVE MEMBER:
TOTAL ASSOCIATE MEMBER:
TOTAL ASSOCIATE BUSINESS''.MEMBER
TOTAL_ ENCL OSELI_- CHECK:
I hereby certify4hat the foregoing, is just and correct, rthat the amount claimed is legally due after
allowing for just credits and that no part of the same hasbeen paid.
Indiana League of Municipal Clerks and Treasurers
Town of Remington, PO Box 70, Remington, IN 47977
r
Date: December 1, 2008,
Kay Brown, ILMCT Treasurer
PLEASE RETURN COPY WITH REMITTANCE!
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
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 A f
dAA,r)a Ua0j.� U,
rV Lw 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
U A� IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
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
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund