213069 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 164103 Page 1 of 1
Q� ONE CIVIC SQUARE INTL MUNICIPAL LAWYERS ASSOCIATTNECK AMOUNT: $625.00
t®`. CARMEL, INDIANA 46032 7910 WOODMONT AVE SUITE 1440
BETHESDA MD 20814 CHECK NUMBER: 213069
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1180 4355300 19753550 625 . 00 ORGANIZATION & MEMBER
a
Lawyers Association
Invoice Customer ID: 000255
J
Invoice Number: 19753550
Invoice Date: 9/4/2012
Notes: Renewal invoice
Please remit payment to:
Mr. Douglas C. Haney, Esq. International Municipal Lawyers
Carmel, Indiana Association
One Civic Square 7910 Woodmont Ave
Carmel, IN 46032 Suite 1440
Bethesda, MD 20814
United States
(P) (202) 466-5424
(F) (202) 785-0152
Order Tracking #23033920 - 000255
-------------------------------------------------------------------------------------------------------------------------
Credit Card Payment Information Balance Due $625.00
Credit Card Number: Donation/Contribution $
Card Type: CVV#: Total Payment Amount $
Name On Card:
Expiration Date:
Mr. Douglas C. Haney, Esq. Customer ID: 000255
Carmel, Indiana
One Civic Square Invoice Number: 19753550
Carmel, IN 46032 Invoice Date: 9/4/2012
Notes: Renewal invoice
IMLA Membership renewal 11/01/2012 to 10/31/2013. THANK YOU FOR RENEWING IMLA MEMBERSHIP.
Payments can also be paid by credit card, online at www.imla.org, or above, by Visa or Master Card
ONLY.
If you would prefer a different membership renewal date, please list it here and the Membership
Department will contact you.
Item Misc Product Notes Unit Price Quantity Amount
Municipal Members $625.00 1 $625.00
Term: 11/1/2012 - 10/31/2013
Subtotal $625.00
Invoice Total $625.00
Balance Due $625.00
Email address for confirmation:
Please contact IMLA's Membership Department with any questions on your renewal. Phone: 202-466-5424 x7106. Fax:
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International Municipal
Lawyers Association
We want your whole office to participate in IMLA. If you have assistant/deputy attorneys who are not
involved in IMLA, please list their names and email addresses here. They are included in your cities
membership with IMLA as well. Please also feel free to update your staff list here; attorneys may have
left and new attorneys may have come on staff, and we may not have their contact information!
Please send in this form with your membership renewal or email or fax this form to Director of
Membership, bteel @imla.org or 202-785-0152.
Thank you for helping us to make YOUR association better!
City/Municipality C
Name & Position Email Address
AS�iLE V lM , a18,Qj_Cjj :T a.0/brich, f@, eartheJ in
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International Municipal Lawyers Association 7910 Woodmont Avenue, Suite 1440 Bethesda, MD 20814
(tel) 202.466.5424 (fax) 202.785.0152 (web) http://www.imla.arg (e-mail) info @imla.org
®� Carmel INDIANA RETAIL TAX EXEMPT PAGE
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PURCHASE ORDER NUMBER
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ONE CIVIC SQUARE FTHIUS NUMBER MU ST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 HER, DELIVERY MEMO, PACKING SLIPS,
ING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL—1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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PLEASE INVOICE IN DUPLICATE
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SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY _
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
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DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
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