157536 03/19/2008 CITY OF CARMEL, INDIANA VENDOR: 164103 Page 1 of 1
ONE CIVIC SQUARE INTL MUNICIPAL LAWYERS N ECK AMOUNT: $365.00
ASSOCIATI2
4 CARMEL, INDIANA 46032 7910 WOODMONT AVE SUITE 1440
CH
BETHESDA MID 20814 CHECK NUMBER: 157536
CHECK DATE: 3/1912008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4357004 365.00 EXTERNAL INSTRUCT FEE
(MLA's Mid Year Seminar
Omni Shoreham Hotel V Washington, DC `e1; April 13 -15, 2008
Do. not use this form unless you are a speaker for the IMLA 2008 Mid Year Seminar. If you are not a speaker, please contact the
IMLA Office or visit our web site for the appropriate registration form.
SPEAKER REGISTRATION INFORMATION
Name Douglas Haney Title _Carmel, Indiana, City Attorne
Badge Name l)nngl ac Hanp31 Local Government Entity Cam, of Cnrtnpl Tndi nnn
Address One Civic Square, Department of Law
City >^armel State Indiana Zip 46032
Phone 317 -571 -2472 Fax 317 -571 =2484 E -mail dhaney@carinel.in.gov
Guest Name Guest Badge Name
(complete only if registering Guest) Badges are required for all /unctions.
Please indicate your registration type and options listed below (check all that apply)
Speaker Registrant $365 O Guest Registrant(see below) O Luncheon Ticket(s) $40.00 each, No. of ticket(s) (only guest need to purchase)
O CLE Credits, please specify state(s) Indiana Your Bar No's. 11207 -49
Registration Fees include: Admission to all sessions, all workshops, seminar materials, Sunday night reception, Monday's luncheon and all coffee
breaks (not applicable to guest). Guest Fees include: Attendance at the Sunday night reception, Monday's hospitality suite.
Cancellation Refund Policy: Cancellations must be received in writing by March 1, 2008 to qualify for a refund. All cancellations are subject to a
$50.00 administrative processing fee. After March 1, 2008 those not attending will receive the event materials in full consideration of registration fees
paid. Replacements are always welcomed. Guest cancellations are subject to a $25.00 administrative processing fee. All refunds will be remitted 90
days after the event. Send all cancellations in writing to IMLA Events Department.
NOTE NEW POLICY: Discounted Registration Fees Expire 15 Days After Rate Ends, If Payment Is Not Received, Next Rate Will
Apply.The discounted registration fees below are available for those staying in IMLA Seminar Hotel, otherwise $100 will be added to
your registration fee to help defray IMLA Seminar expenses (local attendees exempt from $100). Seminar payment must be received
within 15 days. To process credit cards payments, please provide IMLA with your card three digit security code.
NEW CD /HARD COPY POLICY* Registration fees include CD of speakers materials. These materials will also be available for
registrants from IMLA's web site one to two weeks prior to the meeting. If you require paper copies of speaker materials you must add
an additional $120 to your registration fee and check here. O
*'FOUR EASY WAYS TO REGISTERI MAIL: IMLA, 7910 Woodmont Avenue, Suite 1440, Bethesda, MD 20814 a
PHONE: 202 466 -5424 FAX: 202 785 -0152 b E -MAIL: info @imla.org
b
Super Early 6 5
Saver Rate Bird Rate
Registration Ends Ends 4egular At Door REGISTRATION 121,Lo PAYMENT INFORMATION
Type 1/07/08 2/01 /08 Rate Rate f °Q, A 17? 1
X Bill Me Q Enclosed O Visa o Master Card
First Member $488 $525 $593 $630 Make all checks payable to IMLA; U.S. currency only.
Addt'I. Member $400 $4 $530 $565 Amount
3 or More From
Same Office Name
Each person $325 00 $450 $500
AQ%. Account No.
Judicial $289 ��$289 $289 $289 Expiration Date 3 Digit Security Code
Nonmember $840 �7'r $945 $998 $1,019
Signature
Guest of Seminar GC5
Registrant $75 $100 $100 $125
For program updates visit our web site: http: /www.imla.org
0 INDIANA RETAIL TAX EXEMPT PAGE
'r CERTIFICATE NO. 003120155 002 0
C 1L l PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
�g
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPO NDENCE
PURCHASE ORDER DATE DATE REQUIREPI REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR f,r- y„ jl� /Q SHIP TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE f DESCRIPTION UNIT PRICE EXTENSION
r (AMA) `F
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Send Invoice To:
I
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS G� I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.•
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 7945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
.b 8 g CLERK TREASURER
DOCU C ONTROL NO. A.P. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
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IN THE SUM OF
l0 GC/ �,c�c %�/yo
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ON A COUNT OF APPRO IATION FOR
Board Members
PO# or INVOICE NO. ACCT #(TITLE AMOUNT
I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
S•49 0 materials or services itemized thereon for
which charge is made were ordered and
received except_
20
nature
Title
Cost distribution ledger classification if w
claim paid motor vehicle highway fund