170709 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 361809 Page 1 of 1
ONE CIVIC SQUARE 3 C M A CHECK AMOUNT: $800.00
CARMEL, INDIANA 46032 PO BOX 20278
WASHINGTON DC 20041 CHECK NUMBER: 170709
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUN PO NU MBER IN VOICE NUM AMOUNT DESCRIPTION
"1160 4355300 800.00 ORGANIZATION MEMBER
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cite _county
6) (Cj'MA communications and
marketing association
Membership Application
$375 Individual CS3 $800 Associate $1100 Enhanced
Official Representative
Name: N VA 4P__C_y__ Jurisdiction: L A o Co r "'\P-.A
Title: �C�,c ,r��muhy 4 e a� Y3��ddress:
Phone: City /State /Zip: crnal .�ti L 1�C 32
Fax: How Did You Hear About 3 MA:
E -Mail: nhee l4-C -i (r .a00
Additional Member #1
Name: M'% Gh e_k I e 1'.`c m e cc Jurisdiction: �\F N �Lcm�1
Title: ri m/ ,�a I;dn <1 Sri a h4 Add ress: on G\ v i c:
Phone: 2 City /State /Zip:
Fax: 2_ g
E -Mail YY�1<rr_mQC�I @C�cm� i n .gOU C.” as n c«i
\e�s_ r�o v,r, �s+ mom �5 S K r�m-e.r y
Additional Member #2
Name: M -PAoin i e �—e y-A-z Jurisdiction:
Title: e al;ans S ma6 IkV 'A Address:
Phone: (311 S 2y 4 t j City /State /Zip: <rr��
Fax: (3
E -Mail C_a c m j, I V
Additional Member #3
Name: Jurisdiction:
Title: Address:
Phone: City /State /Zip:
Fax:
E -Mail
Additional Member #4
Name: Jurisdiction:
Title: Address:
Phone: City /State /Zip:
Fax:
E -Mail
Please fill out the form, print it and send it along with your check to:
3CMA Membership
P.O. Box 20278
Washington Dulles International Airport
Washington, DC 20041
Or fax it to: (703) 707 -0867
C4
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
3/16/09
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
3 CMA Membership Purchase Order No.
P 0. Box 20278 Terms
Washington Dulles International Airport
Date Due
Washington,
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Stmt City-County Communications Marketing Association $800.00
Dues
Total 800.00
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.
4�' /lh /09.. r
ALLOWED 20
3CMA IN SUM OF
P. 0. Box 20278
Washington— Dulles International Airp
Washington, DC 20041
SOO.00
ON ACCOUNT OF APPROPRIATION FOR
1160 Mayor 4355300
Organizational /Membership Dues
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
Stmt 4355300 $800.00 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
c 20 D 9
,'g nature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund