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Home My WebLink About168125 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 358915 Page 1 of 1 ONE CIVIC SQUARE NLC MEETING SERVICES CHECK AMOUNT: $375.00 CARMEL. INDIANA 46032 11208 WAPLES MILL RD #112 FAIRFAX VA 22030 CHECK NUMBER: 168125 CHECK DATE: 1/21/2009 DEPARTMENT ACCOUNT. PO NU MBER I NVOICE N UMBER AMOUNT DESCRIPTION 1701' 4357004 375.00 EXTERNAL INSTRUCT FEE (3 ne Henry B. Gonzales Convention Center, San Antonio, Texas November 10 -14, 2009 Jo'housing or registration will be processed without accompanying payment in full. Hotel Reservations: You must be registered for the Conference to reserve a hotel room. To guarantee C 'OS CONFERENCE ID# C your room, all hotels require one night's deposit plus 16.75% tax (subject to change), 30 days prior to g Q your arrival. /This is required even if you plan to arrive before 6:00 p.m. If accommodations are not Are you a newly elected official? Size of City? J guarante 30 days in advance, the reservation will be canceled. Please make my hotel reservation as indicated below. Name CTS i r Gender _'r I do not require hotel accommodations at any of the hotels listed below. n, i_] Although I am providing information for a standard room now, please contact me regarding Title C JV 06f V- '4d p U Mc suite information. City /Organization IT�r Room Dates: Arrival Date: /LG V q Departure Date: l I Ci t y Mailing Ad ddl J $s Room Type: Ingle (1 person /l bed) �6moking rn State zi Double (2 people /l bed) Non- Smoking City r hhp V&6 Double /Double (2 people /2 beds) Phone 5- 71-,: ;it //q Fax S �6) Triple (3 people /2 beds) J s� n Quad (4 people /2 beds) Email (1 (_`c�II�C� �'�-Ll �i �Ad`r�� -t i f /'l `'IOI� Registrant's Email Room types cannot be guaranteed but Hotels will attempt to accommodate all requests. ��11 Sharing My Room With (for Hotel Rate and Check In Purposes): Spouse /Guest Name* ($60 fee) *Spouse /Guest not eligible for a separate hotel room. Fee is NONREFUNDABLE. 1) 2) _3) Special Housing Request (e.g., wheelchair accessible rooms, etc.): Child Name (14 and under, no fee) Age_ If you have special housing or transportation needs, please contact NLC Meeting Services. Youth Delegate" (15 -18, $100 fee) Age Hotc! Choices: I. ,,.ate you F; choice hotel y4th the -umber "I", Number .he cthzr ..ctc!c fro- '2"!c "Local officials are encouraged to register youth as active participants in this conference to in order of preference. Grand Hyatt San Antonio is the headquarters hotel. contribute to NLC's youth agenda. If the youth delegate requires hotel accommodations Smoking NLC Rate Breakfast separate from yours, attach ftleir registration form with your completed form. Order Hotel Property? SgllDblririp /Quad Included? Youth Chaperone Name ($100 fee) Grand Hyatt No $2241$2241$2491$249 No Marriott Rivercenter No $2241$2241$244.$264 No (Local Elected City Officials are not eligible for this rate.) Marriott Riverwalk No $219/$2191$239/$259 No Special Conference Rates Hilton Palacio del Rio No $219/$219/$239/$259 No P 0 Hyatt Regency No $221/$2211$246/$271 No Menger Hotel No $160/$160/$160/$160 No $365 At COC Member Registration Sheraton Gunter No $189/$1891$189/$189 No $475 At COC Non Member Registration The Westin Riverwalk No $237/$237/$257/$277 No To be eligible for the SPECIAL CONFERENCE RATE registration must be faxed or Holiday Inn Riverwalk Yes $184/$184/$194/$204 No postmarked by NOVEMBER 28, 2008 Hotel Deposit Information: All major credit cards with expiration date of 11109 or later are accepted SG 60 Spouse /Guest (non refundable) at the conference hotels. All checks must be submitted to the hotel after September 9 but before 7 $100 Youth Delegate October 9 and are subject to approval. Please include your 6 digit REG ID indicated on the NLC Meeting Services confirmation. 8 $100 Youth Chaperone (not applicable to elected officials) 22 $175 Student Registration Fee Payment Information Charge my REGISTRATION FEES to VISA, MasterCard or AmEx listed below Registration for Leadership Training Institute Seminars will be available in Check for REGISTRATION FEES made payable to National League of Cities June 2009. Purchase Order for REGISTRATION FEES copy must be enclosed payment must be received by October 03, 1009. Constituency Group 2010 Combined Dues and Special Event Fees Hotel Deposit Payment Information: (You must check one of the options below.] You must be registered for the conference in order to attend. Charge my HOTEL DEPOSIT to the credit card listed below elected /member city) t-1 Check for HOTEL DEPOSIT please submit to hotel address noted on confirmation after Al $75 APAMO Dues/Activities y) September 9 and before October 9 subject to hotel approval. A2 $90 APAMO Dues /Activities (elected /nonmember city) A3 $135 APAMO Dues/Activities (supporting /corporate member) G1 $45 GLBLO Dues Credit Card Authorization: NLC Registration and Housing Services is authorized to use the card below H1 $120 HELO Dues/Activities (elected /member city) to pay all applicable registration fees and guarantee my hotel reservation. I understand that one night's room charge will be forfeited if I fail to show up for my assigned housing on the confirmed arrival date H2 $130 HELO DueslAciivities (eiectedlnonmeinber city) unless I have canceled my reservation with the hotel at least 72 hours in advance. I understand that if I do H3 $145 HELO Dues /Activities (supportingloorporate member) s not show at the hotel on my confirmed arrival date, my reservation will not be reinstated for remainder of H4 $65 HELO Activity Fee (nonmember only) the stay unless I instruct the hotel to reinstate my reservation. Reinstated reservations are subject to N1 $205 NBC -LEO Dues /Activities (elected /member�itp hotel's availability. N2 $230 NBC -LEO Dues /Activities (elected /n mber city) Visa/MasterCard /AmEx Number Exp. Date_ N3 $305 NBC -LEO Dues /Activities (s r Ing member Card Holder Name N4 $80 NBC -LEO Members ip- Luncheon Even Card Holder Signature (nonmember ON Additional Credit Card Authorization: For hotel deposit only it different than the credit card number W1 $110 WIMG Dues /Lead ship A rd Lunch Fj listed above. (Expiration date must be 11109 or later, per hotel requirement.) (elected /member ci W2 $120 WIMG Dues /Leaders \P Credit Card Number Exp. Date_ p Awar Lunch Card Holder Name (elected /nonmember y) \h W3 $135 WIMG Dues /Leadership ward L nch oftihreJalb Card Holder Signature Return Conference Registration and Housing Form to: W4 $55 WIMG Leadership Award L rich (nonme only) Fax: 703 631 -6288 (Credit Card and Purchase Orders Only No Checks) W5 $45 WIMG Reception (members nd embers) NLC Registration Housing Services, c/o J. Spargo Associates, Inc. 7 j Waples Mill Road, Suite 112, Fairfax, VA 22030 TOTAL REGISTRATION FEE: Make'a copy of this form for your records MR MORE INF1507TOR Registration Cancellation Policy: e nlcregandhouslnq(d)ispargo.com All requests must be received in writing, postmarked by October 20, 2009, and are subject to a $75 cancellation fee. No partial refunds will be made if you decide not to attend particular functions. No registrations or cancellations will be Phone: 888- 319 -3864 or 703 -449 -6418 accepted by telephone. No cancellations will be accepted after October 29- .2009. Office Use Only Payment Check# Amount Htl Subbik Cate Rate Fjresc+tbe 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 4vhom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee u�! Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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 VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF 4- 10 J �AL P 1Z�g 9 6 i l j LW ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. 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 6 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund