212258 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 155570 Page 1 of 1
s 0 ONE CIVIC SQUARE INDIANA PROF LAWN&LANDSCAPE A WCK AMOUNT: $335.00
�i CARMEL, INDIANA 46032 PO BOX 481
CARMEL IN 46032 CHECK NUMBER: 212258
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4355300 150 . 00 ORGANIZATION & MEMBER
2201 4357004 185 . 00 EXTERNAL INSTRUCT FEE
THE
26TH L� o
ANNUAL FIELD DAY Hendricks County Conference Center & Fairgrounds
Join the WLLA for $150.00 per Year and Attend All Events at Member Rates!
We encourage you to visit our website. You can join at www.iplla.com.
Click on the MEMBERSHIP tab and then "Join IPLLA Now."We accept Visa, MC and Discover. �VISA axz�Rl
e e P;P
/1 {
First Name: `
Cu. Last Name:
Job Title: Q I9 Y.( n h cm 5 7)l "ll�;}CSI �t� Company Name:
Address: •A00 �0 ,
City: 0,Ll) n`C L \ !� State: N Zip: �1
Telephone w/Area Code: 3 I"I ) I 10 C �
Primary Email Address(please print clearly): h -1 �`7-(" In C GJ 01� u. 1(l, T_� �O Emergency Contact Name: t � ��� Iti 1 r l t Telephone: 3 1 ?)J 1
Which best describes your company?(check all thatappty) Join online, or make your $150.00 Annual Dues Check Payable to IPLLA
❑Aquatic Weed Control ❑Chemical Lawn Care ❑College or University ❑Industry Supplier ❑Institutional Grounds
❑Irrigation Contractor ❑Landscape Contractor ❑Local or State Government ❑Mowing/Maintenance ❑Parks Department
❑Pest Control ,Right-of-way Control ❑School District ❑Sports Field Management ❑Tree&Shrub Contractor
U Other
Mail Completed Applications and Payment to:IPLLA P.O.Box 481,Carmel,Indiana 46082.Or,log onto www.iplla and pay with Visa,MC or Discover
REGISTER. •
To ensure timely and proper registration,we encourage you to register online at our website.You can register at www.iplla.com.Click on the EVENTS tab
and then"2012 Summer Field Day Registration."We accept Visa,MC and Discover. Register online to be eligible for a drawing where one
person will be chosen to receive free attendance to all events in 2013.
I�
First Name: A-rK 2012 Field Day Registration Fees
Last Name: I _fz r
IPLLA Member — 1 st Person.......................................... ....�........$65.00 each
Job Title: L10 Gi'(l"rl U,15 111(�t 1�1 �4 1� Firm M — 2nd through 5th Person................. $60.00 each
9 n — Groups of 6 or more: Call IPLLA for special rates
Company Name: G l �'1"rt 1t.�
Non-Member — 1st Person............................................................$95.00 each
:i
Address: a� L (.0 �r• Firm — Each Additional Person.:....................::...........$90.00 each
����Il'l �� 1 l� Luncheon is included in price
City: State: Zip: r Please make checks payable to:
Telephone w/Area Code: 3 n > 0o IPLLA • P.O.Box 481 Carmel,Indiana`46082 • (317)575-9010
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Primary Email Address(please print clearly): 1� ► Z-t .QJ �_(�� AA i'L, I (l. .'G V
In which pesticide categories is your company licensed?
What is your home county? 'N f-A iy\I I iur.)
PLEASE LIST ALL ATTENDING(please print clearly)Mail Completed Reservation and Payments to:WILLLA P.O.Box 481,Carmel,Indiana 46082
First Name: r0\c�- rtO 7•IN Last Name: 1 0 I t1
First Name: — 11 (I�u i�- Last Name:
First Name: 1�'��Y�� S Last Name:
VOUCHER NO. WARRANT NO.
ALLOWED 20
IPLLA j �,� `,
IN SUM OF $
P. O. Box 481
Carmel, IN 46082
$335.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 43-553.00 $150.00 1 hereby certify that the attached invoice(s), or
26293 43-570.04 $185.00 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
Thur d y, st 23, 2012
Uao,d/
Street Commissiq
JLI et
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund _ ._
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))
08/20/12 $150.00
08/20/12 $185.00
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