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Home My WebLink About212552 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 065950 Page 1 of 1 0 ONE CIVIC SQUARE DIANA CORDRAY CARMEL, INDIANA 46032 11843 STONEY BAY CIRCLE CHECK AMOUNT: $95.00 ?� CARMEL IN 46033-9501 CHECK NUMBER: 212552 CHECK DATE: 9/12/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1701 4357004 95 . 00 EXTERNAL INSTRUCT FEE 39211e360000990001 xoo ..".."�/"."""=""".".="". ~ How Tv Reach us 1-866517-7795 Account wmnop, Member Since aonz DIANA LcoRoRAY Customer Service 1,ccount Activity PO BOX 6500 I 24-Aug 23,2012 SIOUX FALLS,SD 57117-6500 Account Number 31ance: Summary of Account Activity 5.00 Previous Balance $240.27 - od have earne .19D Hilton HHonors Bonus-P`61 n-:ts'flil's- bill-ing-cyde.-To review Payments your total pqintsearnecl,ia comPl6te list 6i e_��16slve Hilton HHon6rs rewards,.or to redeem Purchases customer-service center at 1(800)548-8690. Payments,Cr dits and Adjustments -lalty�o`uRrof 29.92a%- ike—rest Charged Sale Post Description 4ces.call 1-877-337-13187. New Balance $9900 -24D.27 Past Due Amount $0.00 Amt.Over Rev.Cr. Lt. $0.00 Standard Purchases —- Sale' Post Description Amount, j--/ 08/03 ASSN CITIES&TOWNS INDIANAPOLIS IN Avail. Revolving,Credi $7,405 Limit $7.4D5 ees atement Closing Date 08 23 2012 Sale Post Days in Billing Cyc TOTAL FEES FOR THIS PERIOD 0.00 Interest Charged Post Description Amount 0 TOTAL INTEREST FOR THIS PERIOD Fk x� 2012 Totals Year-to-Date tions: if you suspect identity theft,Citi is there to Total Fees charged In 2012 $0.00 :?ntity and reestablish your credit-even if it's not your ected. Total Interest charged In 2012 $0.00 iorized Charges: With Citi's$0 liability policy, iauthorized charges on your account. ato IC!ti neversleeps are registered service marks of Citigroup Inc. 1GEN020611 2012 1ACT Leadership Conference Registration Form PRE-REGISTRATION DEADLINE IS WEDNESDAY, AUGUST 1 . Your Information/ Method of Payment Name r �,. (r ; C (Circle One) Check MasterCard isa Discover Preferred Name for Badge q // Check Number City/Company C� f1�N 1 Card Number Title y 1 �// /lama Expiration Date /3 AddressG� /J�IJIL rti(� Three-digit Security Code o J City/Town �j; �. Name of Cardholder, State Authorized Signatur Zip /„03 Billing Address(if different from above) Phone Il�� Email City Name of Spouse/Guest(if attending) :y State Special Needs and Dietary Restrictions Zip Hotel Information French Lick Resort 8670 West State Road 56 French Lick, Indiana 47432 Re 1(tratlon Fees (Please check all that apply) (888)936-9360 95.00-IACTMember Hotel Cutoff Date: Friday,July 20 ❑$120.00-IACT Member(Late-After August 1) ❑$s5.00-Spouse/Guest Please contact the hotel directly to make your reservation and use group code 08121AC. Reservations must be made by July 20 to C1$0 Sponsor-Spouse/Guest(Late.-After August l) receive the special IACT rate of$129.00 per night. Only registered participants may occupy a room with the IACT block. IACT is not 95, responsible for hotel reservations or cancellations. Hotel check-in is Total$! 4:00 p.m. and check-out is 11:00 a.m. Two Easy Ways to Register Mail registration form with payment to IACT at 200 S. Meridian St., Ste.340,Indianapolis, IN 46225 Fax registration form with payment to 17 237 6206 Late & Onsite Registration The pre-registration deadline is August 1. Registrations received after August 1 will be treated as onsite registrations and require and ad- ditional charge of$25. Spouse/Guest Registration The spouse/guest registration fee is restricted to those who are not municipal officials and who have no professional interest at the confer- ence. The fee includes all conference meals. Cancellation Policy Your registration is considered your commitment to attend. Unless attendees follow the cancellation policy, no-shows will be billed. Refunds will be made only if IACT is notified of cancellation in writing on or before August 1 by fax, mail or email to kstorms @citiesandtowns.org. Special Needs TACT will make all programs accessible to you. If you require special arrangements, or a special diet, please notify IACT on your registration form. We may not be able to accommodate such requests made on the day of the program. 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. 7�am� Payee 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 $ ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#!TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or 3--70 D 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 20 d Signat Title Cost distribution ledger classification if claim paid motor vehicle highway fund