HomeMy WebLinkAbout165496 10/29/2008 «4 CITY OF CARMEL, INDIANA VENDOR: 3621 D6 Page 1 of 1
t' ONE CIVIC SQUARE IRRIGATION ASSOCIATION
CARMEL, INDIANA 46032 6540 ARLINGTON awe CHECK AMOUNT: $100.00
FALLS CHURCH VA 22042 -6638 CHECK NUMBER: 165496
CHECK DATE: 1012912008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
4.
601 5023990 102708 100.00 MISC EXP -ADMTN GENE
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IA Membership Application A S SOCI A IO N
Membership Categories (Applicant must select primary business, see category descriptions on reverse page)
Annual Investment
Company Membership (In cludes current, full -time employees) Member Bro nze Silver Gold
Manufacturer $1,500 $3,000 $6,000 $12,000
Specialty Product Manufacturer $800 $1,600 $3,200 $6,400
Distributor $750 $1,500 11$3,000 $6,000
Dealer $750 $1,500 11$3,000 $6,000
Manufacturers' Representative $500 $1,000 $2,000 $4,000
Contractor $300 $600 $1,200 $2,400
Consultant $300 $600 11$1,200 $2,400
Affiliate Organization $300 n/a n/a n/a
Affiliate Organization Contractor* $150 n/a n/a n/a
'Must provide documentation showing current membership in IAaffiliate organization
Associate Membership Includes cu rr e nt, full -time e mployees)
Industry Supplier $800 13$1,600 $3,200 $6,400
,Water Energy Agency ,500 $1,000 $2,000 $4,000
Grower /Producer $300 $600 $1,200 $2,400
Commercial End User $300 $600 $1,200 $2,400
University/Government $300 n/a n/a n/a
Individual Membership
Technical* $100 Technical Lifetime $500 Retired $60 Retired Lifetime $300 Student* $30
*UniversitylGo 'Must include proof of enrollment
Member Infor atio Number of Employees
Name
Trtle [)'C C e C(�I- ir�Y1� Utz Annual Irrigation Related Sales
Company Name f I 1 e Primary Focus (Check only one)
It�'i� El Agriculture �furflLandscape ❑Golf
Mailing Address r
City Yhe, Type of Organization (C heck only one)
C1 Manufacturer El Golf Course
State _l-t ZiplPostal Code V� Manufacturers' Rep Grower /Farmer
Country us t, J r C3 Distributor [3 Government City/County
Phone 3 DI _C�` 6 Fax -5 7( a LT Dealer Govemment: State /Federal
Contractor University
E -mail r El 11 o C d r l nI v V Consultant �ater /Energy Agency /Utility
Website 1� f VV'* f P;� `1 I `�1V t/ Commercial End User Industry Supplier (non irrigation)
Landscape Architect Other
Dues are non refundable. IA dues are not deductible as charitable Contributions for income
lax purposes. However, they are deductible under other provisions of the Internal Revenue Code. Primary .Job Responsibility (Check only one)
Check enclosed J n6 uS C3 Owner /Partner C3 Administration
l" V
Ell Executive Management ❑Customer Service
(remit in US drawn on a US bank, payable to the Irrigation Association) Sales Instructor /ProfessorlExt Agent
Charge VISA MasterCard American Express �arketing1PR/Advertising ❑Technician (install, maintain)
Card Number Engineering Golf Course Superintendent
Research /Development Irrigation Manager
Expiration (month /year) Design Cl Turf Manager
Name on Card Purchasing Water Conservation
Warehouse /Logistics Other
Signature Branch Manager
Irrigation Association`' 6540 Arlington Boulevard Falls Church, VA 22042 -6638 www.irrigation.org
TeL 703.536.7080 Fax: 703.536.7019 E -mail: membership @irrigation.org 8.20.2008
Fax or mail today fax this form with credit card information or mail this form with payment
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T1002
1
IRRIGATION ASSOCIATION Purchase Order No.
6540 Arlington Blvd Terms
Falls Church, VA 22042 -6638 Due Date 10/22/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/22/20M 102708 $100.00
r
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 083501 WARRANT ALLOWED
T'i002 IN SUM OF
IRRIGATION ASSOCIATION
6540 Arlington Blvd
Falls Church, VA 22042 -6638
Carmel Water Utility
r.
:,ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
!o 7 5'.C>
102708 01- 6940 -08 $100.00
Voucher Total $100.00
Cost distribution ledger classification if
claim paid under vehicle highway fund