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157110 03/05/2008 ai C CITY OF CARMEL, INDIANA VENDOR: 152500 Page 1 of 1 a,�� ONE CIVIC SQUARE INDIANA LEAGUE OF MUN C -T 6 o CARMEL, INDIANA 46032 C/O TOWN of MUNSTER CHECK AMOUNT: $185.00 1005 RIDGE RD CHECK NUMBER: 157110 MUNSTER IN 46321 -1649 CHECK DATE: 3/5/2008 D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4355300 185.00 ORGANIZATION MEMBER ILMCT 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. 2008 Dues for all Classes of Membership due on or before March 31, 2008 Active Members: Towns with populations under 700 $40.00 Towns or Cities with population of 701 to 5,000 $50.00 Towns or Cities with 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 J 07 Active Member Name: b ,QV, t— Or Title (Circle One): K Clerk-Treasurer Clerk Controller Certification (Circle all that apply): IAMC CIVIC MMCA MMC CMFA_ Name of Municipality: County: L k�L[ /V A Office Address: �fY✓ C l[)�� District City/Town: (b Zip: G Office Phone: 9W C I Fax: 447 7 1 a`O 6 Home Address: O J S Rte( Home Phone: City/Town: Zip: 'I� 3 Email: 6 �a Associate Members (Any former active member or staff of an active member of the League): $3 -00 each Associate Member Name: u Title: Address: 0 ru b VJ L �q k�r�, City/Town: O dFW l �K Zip: 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: 1 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! 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 ENCLOSED CHECK: �J I hereby certify that the foregoing is just and correct, that the amount claimed is legally due after allowing for just credits and that no part of the same has been paid. Indiana League of Municipal Clerks and Treasurers Town of Munster, 1005 Ridge Road, Munster, IN 46321 -1849 Date: February 19, 2008 �%lf -CC Jam/ David F. Shafer, 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 C �L r else Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) ,S bJ 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 Tf� IN SUM OF I��, L� ON ACCOUNT OF APPROPRIATION FOR Dw 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 14 0 0 e. &q�p 20 0 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund