HomeMy WebLinkAbout201258 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 365666 Page 1 of 1
ONE CIVIC SQUARE IN EMERGENCY MEDICAL SERVICES Ag
CARMEL, INDIANA 46032 407 MELROSE AVENUE
CFIECK AMOUNT: $250.00
GREENCASTLE IN 46135 CHECK NUMBER: 201258
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357004 250.00 EXTERNAL INSTRUCT FEE
IEMSA Conference Registration Form
Please print clearly
Fill out one per attendee
$125 per person (includes lunch)
$100 per person IEMSA Members (includes lunch)
Name of Attendee: Ile, e- rr
Name as it is to appear on badge: M I' 1'� C
Department Name: C 11 1Y level:
Street Address: 2 di City: ('M e, State: Zip: IoO33
Telephone: 3 1 l 5 I I' 2_ P 1 Email address: �'1 rl1'L° a n 0V
//11 Payment Information
Total Amount Due: V0
Please send payment (check, money order or cash only —no credit cards please):
IEMSA, 407 Melrose Ave., Greencastle, IN 46135.
Telephone: 765- 653 -1351 Email: mbward1222nyahoo.com
For those who would like to stay overnight there are numerous hotels located nearby.
Below is a list of hotels and the Priceline cost for each:
Homewood Suites ($116) Hampton Inn ($99) Value Place ($60)
2264 East Perry Road 2244 E. Perry Rd, 6295 Gateway Blvd.,
Plainfield IN Plainfield, IN Plainfield, IN
(317) 839 -1900 (317) 839 -9993 hamptoninnl.hilton.com (3 17) 837 -2950
Wingate by Wyndham ($94) Baymont Inn Suites ($60) Best Western ($90)
6300 Gateway Dr. 6010 Gateway Dr. 61009 Cambridge Way
Plainfield, IN Plainfield, IN Plainfield, IN
(317) 279 -2500 (317) 837 -9000 (317) 837 -7500
Cbmf6rt Imn ($85)' Holiday Inn Express ($104)
6107 Cambridge Way 6296 Cambridge Way
Plainfield, IN Plainfield, IN
(317) 839 -9600 comfortinn.com (317) 839 -9000 hiexpress.com
Staybridge Suites Plainfield ($109)
6295 Cambridge Way, Plainfield, IN
(3 17) 839 -2700 staybridge.com
ri
IEMSA Conference Registration Form
Please print clearly
Fill out one per attendee
$125 per person (includes lunch)
$100 per person IEMSA Members (includes lunch)
Name of Attendee: •',tS 2C)(U
Name as it is to appear on badge: P,C'�LC/ �GZ/� r7Q/ti
Department Name: ��zr�nel �`���ev� Title /Certification level: L',aC 4, nGA
V
Street Address: Z City: 0G�me 1 State: _J?V Zip: q603
Telephone: L3 7� S7 Z 0 5 Email address: h 0-0 n a.:, 0 C2a/ In.
Payment Information
Total Amount Due: Z S. U D
Please send payment (check, money order or cash only —no credit cards please):
IEMSA, 407 Melrose Ave., Greencastle, IN 46135.
Telephone: 765- 653 -1351 Email: mbward1222(a,yahoo.com
For those who would like to stay overnight there are numerous hotels located nearby.
Below is a list of hotels and the Priceline cost for each:
Homewood Suites ($116) Hampton Inn ($99) Value Place ($60)
2264 East Perry Road 2244 E. Perry Rd, 6295 Gateway Blvd.,
Plainfield IN Plainfield, IN Plainfield, IN
(311) 839 190 (317) 839 -9993 hampton inn l.hilton.com (317) 837 -2950
Wingate by Wyndham ($94) Baymont Inn Suites ($60) Best Western ($90)
6300 Gateway Dr. 6010 Gateway Dr. 61009 Cambridge Way
Plainfield, IN Plainfield, IN Plainfield, IN
(3 17) 279 -2500 (317) 837 -9000 (3 17) 837 -7500
Comfort Inn ($85) Holiday Inn Express ($104)
6107 Cambridge Way 6296 Cambridge Way
Plainfield, IN Plainfield, IN
(317) 839 -9600 comfortinn.com (317) 839 -9000 hiexpress.com
Staybridge Suites Plainfield ($109)
6295 Cambridge Way, Plainfield, IN
(317) 839 -2700 staybridge.com
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$250.00
1 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
IEMSA
IN SUM OF
407 Melrose Avenue
Greencastle, IN 46135
$250.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 I I 43- 570.04 I $250.00 1 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
SEP 12 2019
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund