HomeMy WebLinkAbout180129 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 358550 Page 1 of 1
ONE CIVIC SQUARE INDIANA COALITION AGAINST SEXUAL AMOUNT: $100.00
CARMEL, INDIANA 46032 55 MONUMENT CIRCLE SUITE 1224
INDIANAPOLIS IN 46204 CHECK NUMBER: 180129
CHECK DATE: 12/8/2009
DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DES CRIPTION
1110 4355300 100.00 ORGANIZATION MEMBER
N4 INCASA
INDIANA COALITION AGAINST
SEXUAL ASSAULT
2010 MEMBERSHIP PACKAGE
Join the Fight to End Sexual Violence
You owe it to yourself, your community, your business to:
Be aware and know the FACTS
Access current information and education
Be a voice through effective prevention and intervention efforts
Network with other organizations involved in the anti- sexual violence
movement
Business Name fY.'1'� /`�lyeli �f %�A
Contact Person �51' ile
Address G'r r/ <C' f�?A��t 7,
City
Phone 7/ .5OD Fax S 73
E mail address ��r/o� c Website G �r�.►�1.
E' address or addresses 'foi'hst serve
E mail address for correspondence (if different)
Student Supporting Membership $35.00
Individual Membership $50.00
Organizational Membership $100.00
Bronze Membership $200.00
Silver Membership $500.00
Gold Membership $800.00
Merbership Level in 2009:
Current Information is Correct please invoice to renew at current membership level
Renewal at Different Level
Current Information has been changed please invoice to renew at current membership level
New INCASA Member please invoice at level
Please fak this or se'an/em-aihback to Janet Brown at 317- 423 -0237 orjbrown@incasa.org
INCASA 2010
55 Monument Circle, Ste. 1224 o Indianapolis, IN 46204 e Phone: (317) 423 -0233 9 Fax: (317) 423 -0237 o www.incasa.org
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
J
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
YNCASA Purchase Order No.
55 Monument Circle, Suite 1224 Terms
Indianapolis, IN 46204 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/3/09 payment for membership renewal
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
y
VOUCHER NO. WARRANT NO. 'T
ALLOWED 20
I NCASA
IN SUM OF
55 Monument Circle, Suite 1224
Indianapolis, IN 46204
100.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT ere certify that the attached invoice
DEPT. I her Y Y s or
1110 553 100.00 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
December 3 20 09
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund