HomeMy WebLinkAbout206014 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 365043 Page 1 of 1
ONE CIVIC SQUARE THE GROUNDWATER FOUNDATION
CARMEL, INDIANA 46032 PO BOX 22558
CHECK AMOUNT: $35.00
LINCOLN NE 68542
CHECK NUMBER: 206014
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 11512 35.00 EMPLOYEE PEN BENEFI
Groundwater Foundation Membership Form
Complete and return with your check or credit card information by February 15, 2012 to:
The Groundwater Foundation, P.O. Box 22558, Lincoln, NE 68542 -2558
Join online at www.groundwater.org /shop.
Name: JAMIE FOREMAN
Affiliation: CITY OF CARMEL WATER UTILITY
Mailing Address: 3450 W. 131 ST ST.
City, State, ZIP, Country: WESTFIELD, IN 46074 USA
Phone: 317- 571 -2639 Fax:
Email address: JFOREMAN @CARMEL.IN.GOV
NOTE: Please be sure to verify your information and provide your email address
in order to receive The Aquifer and Recharge Report.
Membership Levels L
A $35.00 74.00 Ripple Creator �v
O $75.00 149.00 Cool Springs Contributor
O $150.00 249.00 Big Splash Supporter
0 $250.00 499.00 Hydro Hero
0 $500.00 999.00 Groundwater Defender
O $1,000.00 2,499.00 Awesome Aquifer Advocate Membership Benefits
O $2,500.00+ Blue Planet Protector With your membership you will be
helping to protect groundwater!
Payment Options In addition, you receive The Aquifer,
the quarterly electronic journal of
O Please charge my VISA or MasterCard for the amount of The Groundwater Foundation and
the Recharge Report, a groundwater
Card number: a -zine. Membership benefits also
include reduced registration fees
Expiration date: 3 digit security code: to all Groundwater Foundation
events, and a 10% discount on all
The following information must be provided as it appears on your Groundwater Foundation
credit card statement, otherwise we may be unable to process Catalog orders.
your request.
Shop online at
Cardholder's name: www.groundwater.org.
Organization's name: All membership dues are tax
deductible. The Groundwater
Address: Foundation is a nonprofit
organization dedicated to educating
City, State, Zip: people and inspiring action to ensure
sustainable, clean groundwater for
Authorized Signature: future generations.
Enclosed, please find a check made payable to The Groundwater Federal Tax ID# 36 3413351
FoundationJor the amount of
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
365043
THE GROUNDWATER FOUNDATION Purchase Order No.
PO BOX 22558 Terms
LINCOLN, NE 68542 -2558 Due Date 1/20/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/20/2012 11512 $35.00
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
>/z -71 L C�11� /)L,-
Date Officer
VOUCHER 113491 WARRANT ALLOWED
365043 IN SUM OF
THE GROUNDWATER FOUNDATION
PO BOX 22558
LINCOLN, NE 68542 -2558 A
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
11512 01- 6040 -03 $35.00
I
Voucher Total $35.00
Cost distribution ledger classification if
claim paid under vehicle highway fund