HomeMy WebLinkAbout202165 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 143001 Page 1 of 1
ONE CIVIC SQUARE INDIANA ASSOC OF CITIES TOWNS CHECK AMOUNT: $15.00
CARMEL, INDIANA 46032 CONFERENCE REGISTRATION
200 S MERIDIAN ST, SUITE 340 CHECK NUMBER: 202165
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INDIANAPOLIS IN 46225
CHECK DATE: 9/27/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4239099 15.00 OTHER MISCELLANOUS
I X00
000' 000
00 C0
0 a
Indiana Association of
Cities and Towns
2011 IACI? WEDINA.R RECORDING /MA'T'ERIALS ORDER FORM
Full Name d.L C J(01- Title AAA ma
Municipality /Company 0 C .CQCCr\ A
Address C 'rVe- C y
City ca cvy State 01j Zip Code I L C)3
Phone z17'5 ZLa LS Email
I
Materials Fee
....$75.00
Method of Payment ®Check Visa MasterCard Discover
Card Number Expiration Date 3 -Digit Security Code
Billing Address
Name on Card Signature
Name or Webmar you wish to purchase:
�)CAJ-k Wr(NI m6 f-, La u
Return form to: IACT Fax: (317) 237 -62o6
Attn: Natalie Hurt Email: nhurt@citiesandtowns.org
200 S. Meridian Street
Suite 340
Indianapolis, IN 46225
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
I
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)) ^I,
,6
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
VOUC,( -I f N WARRANT NO.
V� lI b
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
i
/U OA5M--
Board Members
PC# or DEPT. INVOICE NO. ACCT #/TITLE AMOUNT 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund