HomeMy WebLinkAbout169947 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 143250 Page 1 of 1
ONE CIVIC SQUARE INAFSM
0 CHECK AMOUNT: $35.00
i•, CARMEL, INDIANA 46032 115 W WASHINGTON ST, SUITE 1368 S
•y C/O CHRISTOPHER BURKE CHECK NUMBER: 169947
INDIANAPOLIS IN 46204
CHECK DATE: 3/18/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4355300 19806 35.00 REGISTRATION FEE
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i
2009 INDIANA MS4 ANNUAL (MEETING
REGISTRATION FORM
Thursday, April 23, 2009
7:30 A.M. 4:30 p.m.
Hamilton County 4-H Fairgrounds
2003 Pleasant Street
Noblesville, Indiana 46060
Send your registration to: BY MAIL:
1NAFSM -MS4 Meeting
115 W. Washington Street, #1368 South Tower
Indianapolis, IN 46204
Attention: Unique Dahl
BY FAX: Attention: Unique 317 -632 -3306
MAKE CHECKS PAYABLE TO: INAFSM MS4 Annual Meeting
Unique Dahl: 317 =536 -6721 OR executivesec@inafsm.net
Registration Fees
Received By A dI 1, 2009 $35.00
Received After April 1, 2009 $45.00
Total Amount Due
Note; Refunds only if called for Active Military Duty --No exceptions
Deadline for Purchase Orders April 1, 2009 Deadline for Early. Registration April 1, 2009
Late Registration is April 2 -15, 2009 No Registrations the day of the event
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NAME
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ADDRESS
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PHONE EMAIL
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
INAFSM
Purchase Order No.
115 W. Washington Street, Suite 1368 South
Terms
,Indianapolis, IN 46204
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
n/a 19806 INAFSM Annual Meeting 2009 Indiana $35.00
Registration: Storm Water Adminstrator
Total $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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
INAFSM
ALLOWED 20
11 -1 Was t street, Sui+ 8 Sol IN SUM OF
Indianapolis, IN 46204
$35.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
19806 n/a 2200 4355300 $35.00 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
r'
Alka 20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund