205894 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 00351464 Page 1 of 1
ONE CIVIC SQUARE INDIANA RURAL WATER ASSOC
CHECK AMOUNT: $350.00
CARMEL, INDIANA 46032 Po sox sus
NASHVILLE IN 58559 CHECK NUMBER: 205894
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 998144 350.00 OTHER EXPENSES
Indiana Rural Water Association
Serving professionals in the n ate. industry since 1968
Alain Office
I
P. O. Box 679: Nashville, IN 47448
f, 866-895-4792-0 ce: 855 -202 -7298 Fax
U e `e uirir.indiunnriiictAratei-.or8
MEMBERSHIP INVOICE
Date: January 13, 2012 Invoice #998144
To: Jaimie Foreman Amount Due: $350
Carmel Water Dept. For Period: 2/17/2012 to 2/17/2013
760 3rd Avenue SW; Prior payment: Date: 2/3/2011
Carmel, IN 46032 Ck 194241
Amt. Paid: $350
From: Odetta Cadwell, Executive Director
Indiana Rural Water Association
Enclosed you will find information regarding membership. Please make changes as necessary to the information listed
below and return with membership dues.
i
Company Name: Carmel Water Dept. NOTE –ALL MEMBERS: If others
from your organization would
Contact: Jaimie Foreman i like to receive information on
E -Mail: jforeman @carmel.in.gov IRWA events, please indicate
Website: i names and e-mail addresses on i
Addressl: r e SW 3L4 5U (,0 S` S+q the back. i
Addressl:
i NOTE ASSOCIATE MEMBERS: i
City, St, Zip: Carmel, IN 4693-2
Please include a brief company
Office Telephone: ��3 3 7 ?3 description on the back. In
Cell: i addition to your company's web i
Office Fax: link, we will include your
I
description on IRWA's website. l
of Meters (or Population Served):
I
Thank you for your membership! You and your organization are an import Ru Water
Association and we look forward to your continued support!
ANNUAL MEMBERSHIP DUES emit to:
Water Wastewater Utilities
Number of Meters in operation Non-Community Water Systems $60 ox 679 (or approximate population served) ville, IN 474481 300 meters 60 Associate Members (vendors) $250 (approx. 3 to 750 population) 301 600 meters 90
Combined Membership $600
(approx. 751 toISOOpopulation) Paying by Credit Card
601 1000 meters 140 Corporate with Multiple Facilities
(approx. 1501 -2500 population) Call IRWA office to check applicability Visa MC Discover Amer Exp
1001- 1500 meters 200
(approx. 2501 —3750 population)
1501- 3000 meters 250
(approx. 3751 -7500 population) Exp.: Security:
3001 meters and above 350
(approx. 7501 population and above) NAME ON CARD:
SIGNATURE:
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
351464
INDIANA RURAL WATER ASSOCIATION Purchase Order No.
P.O. Box 679 Terms
Nashville, IN 47448 Due Date 1/23/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/23/2012 998144 $350.00
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
do 7 1 1
Date Officer
VOUCHER 113501 WARRANT ALLOWED
351464 IN SUM OF
INDIANA RURAL WATER ASSOCIATIO
P.O. Box 679
Nashville, IN 47448 WATM
:)PERATIONS
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
998144 01- 6040 -03 $350.00
i
i
1
Voucher Total $350.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
a