171890 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00350077 Page 1 of 1
ONE CIVIC SQUARE INDIANA STREET COMM ASSOCIATION CHECK AMOUNT: $360.00
i4 2a CARMEL, INDIANA 46032 ATTN: LARRY LEE
1301 LAFAYETTE AVE CHECK NUMBER: 171890
LEBANON IN 46052
CHECK DATE: 4/29/2009
DEPARTME ACCOUNT PO NUMBER INV NUM AMOUNT DESCRIPTION
2201 4357004 mm 360.00 EXTERNAL INSTRUCT FEE
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2009 ANNUAL CONVENTION REGISTRATION FORM
AUGUST 18 19 20 2009
Name of Registrant 6V i a �U:; rr imcq n
Address: 3 q OO J J 11- 6t
W I Q 440
Phone: L 3 aj l oot
Spouse's Name (if attending): I
E -Mail Address: d h u J
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REGISTRATION FEE MUST BE ENCLOSED WITH FORM
Current ISCA Member $120.00 (Convention Package)
Asst. Commissioner /Foreman $120.00 (Convention Package) NAr& LOV?AII
Other Additional Registrant $120.00 (Includes Meals) j ,_Vn Iii is ✓1
Vendor Registration $300.00 (Includes Meals Vendor Cookout)
1 Table 2 Chairs (if you do not have $150.00
a hospitality room and want a booth space at the Convention)
Note(s): Vendors must purchase a registration for each additional person in their group
at a cost of $120.00
All hotel accommodations must be made with a credit card at Renaissance Indianapolis North Hotel
11925 N. Meridian Street
When making hotel reservations, let hotel know you Carmel, IN 46032
are with the Indiana Street, Commissioners Association Ph: (317) 816 -0777
(ISCA) Fax: (317) 814 -2516
*These rates will be guaranteed until July 27, 2009 (Check -in time is 4:00 p.m.)
Cancellation must be made four days prior to arrival for full refund of deposit.
*Vendors who want hospitality rooms must advise the hotel of this when making reservations.
Please complete and return ISCA form-only with check by ]uly 31, 2009
ISCA Convention Registration
Larry Lee, Secretary /Treasurer
Lebanon Street Department
1301 Lafayette Avenue
Lebanon, Indiana 46052
If you have questions, please contact Larry Lee, Secretary/Treasurer at (765) 482 -8870.
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))
04/20/09 $360.00
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
k -(4fa ft4 11A +'ST) 0"
VO a ER NO. WARRANT NO.
ALLOWED 20
ESC Convention Registration
Larry Lee, Secretary /Treasurer Lebanon St. De IN SUM OF
1301 Lafayette Avenue
Lebanon, IN 46052
$360.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept, INVOICE NO. ACCT #!TITLE AMOUNT Board Member:
2201 43- 570.04 $360.00 I 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
We nesd April 22, 2001
c'e Street Commils ner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund