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Home My WebLink About217204 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 362435 Page 1 of 1 0 ONE CIVIC SQUARE INDIANA SECTION AWWA CARMEL, INDIANA 46032 Po Box 534 CHECK AMOUNT: $775.00 ATTN: ALAN WISEMAN CHECK NUMBER: 217204 ON`O NASHVILLE IN 47448 CHECK DATE: 2/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 6397 775 . 00 OTHER EXPENSES Invoice Indiana Section, AWWA Date Invoice PO Box 534 # Nashville, IN 47448 2/1/2013 6397 TELEPHONE: 866-213-2796 Terms FAX: 866-215-59661 Due on receipt Bill To City of Carmel 3450 W. 131 st St. Carmel, 1N. 46074 P.O. No. Description Amount Indiana Section AWWA 105th Annual Conference, February 12-14, 2013 in Indianapolis, IN Utility/Operator/Government - Jaimie Foreman 125.00 Utility/Operator/Government - Tuesday Only- William Bell, Jerry Cloud, 500.00 Daniel Jenkins, Kenneth Rhodes, Jack Spears Utility,/Operator/Government- Wednesday Only- Greg Hollander 100.00 TL Q; WL (2); ThB Q 50.00 2/1/2013 E-mail to Kerri CREDIT CARD: Visa MC Discover American ENPress # I-xp.: NAME ON CARD: Security: SIGNA'T'URE Billing Zip Code: Total $775.00 105th Annual Meetin6 MMA SECTION AWWA Marriott Hotel-Indianapolis,IN �pp Febru 2ar,�1 14,2015 m E 0 S T R Q T O N F 0 R M U T I L I T Y / 0 P E R A T O R / G O V E R N M E N T (only one name per form) AWWA MEMBER#: Last First Initial TITLE: !V ORGANIZATION: (1wI�TII� ADDRESS: ��"". CITY/STATE I ZIP:`��—`-�1Q�1� OFFICE TELEPHONE: ('a��,) �� SS FAX: (�11 ) �'JJ EMAIL: r � ,(/Yy` REGISTRATION FEES Employees of Companies holding a Service Provider membership qualify for the Member rates. The DEADLINE for Full conference-member Advance: $125 ❑ On-site:$185 Feb. / Full conference-non-member ❑ Advance: $175 ❑ On-site:$185 One day-member ❑ Advance:$100 ❑ On-site:$135 Day: One day-non-member ❑ Advance: $125 ❑ On-site:$135 Day: COMPUM NI'ARY REGISTRATIONS ❑ Student,full-time ❑ Retired (AWWA members only) ❑ Guest(Admittance to receptions only) Name: EARLY BIRD REGISTRATION Monday, Feb. 11,3:00-8:00 p.m. MEAL S-Tickets required ❑Tuesday,Feb. 12, 12-noon:Keynote luncheon with Howard Kellman-$25 Wednesday, Feb. 13, 12-noon:Awards luncheon-$25 ❑Thursday, Feb. 14,7:30 a.m.:Breakfast-$15 �---------------------------------------------------22-t�- ------------------------------------------------ ToW Amonnt-&el �c$ 100 I�Wv V Return this completed form with payment to the address below. ❑ Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) ❑ Please charge to my: ❑Visa ❑ MasterCard ❑American Express ❑ Discover Name as it appears on card: Billing address: Card number: Exp. date: Signature: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORD PLEASE Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration made to accommodate special ment by written request, post- Indiana Section AWWA form for use by others needs.Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite 300 Indianapolis, IN 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office: (866)213-2796 www.inawwa.org with your request. that date cannot be honored. FAX:(866)215-5966 \\ Indiana Section AWWA PRSRT. FIRST CLASS US POSTAGE ® 8365 Keystone Crossing P A I D INDIANA Suite 300 Indianapolis, IN SECTION Permit No. 5677 -, Y Indianapolis, IN 46240 l'tl trt!<<!tl 4t"„ ll l�tt„tt:,t,Ittutttttttlt::Ittltltl„!,t *:****AUTO**3-DIi=IT 460***3***8***1004 )aimle Foreman City of Carmel Water 3450 W 131st St Carmel, IN 46074-8267 105th Annual Meeting MLANA SECTION AWWA Marriott Hotel-Indianapolis,IN INDIANA February 12-14,2013 SECT-ION with special guest Howard Kellman key note speaker AAL 105th Ailiival Meetin8 MLANA SECTION AWWA Marriott Hotel-Indianapolis,IN February 12-14,2015 w� % + U T I L I T Y 1 0 P E R A T 0 R I G 0 V E R N M E N T NAME:_I\_�_I'�L S +\��"� ' y\ O' (only one name per form) AWWA MEMBER#: 0 ?j Last Fir t Initial _ TITLE: I►� t Y V\ A 2 _ ORGANIZATION: ADDRESS: _�`"! b w• CITY/STATE/ZIP: C 6 tAA'a- I N `7 � y 7 � OFFICE TELEPHONE: (-?)-? t� S S FAX: (3 7 ) O EMAIL: REGISTRATION FEES Employees of Companies holding a Service Provider membership qualify for the Member rates. Full conference-member ❑ Advance:$125 ❑ On-site:$185 Full conference-non-member ❑ Advance:$175 ❑ On-site:$185 One day-member X Advance:$100 ❑ On-site:$135 Day:— 0 r3 One day-non-member ❑ Advance:$125 ❑ On-site:$135 Day: COMPLIMENTARY REGISTRATIONS ❑ Student,full-time ❑ Retired(AWWA members only) ❑ Guest(Admittance to receptions only) Name: EARLY BIRD REGISTRATION Monday, Feb. 11,3:00-8:00 p.m. MEALS—Tickets required ❑Tuesday,Feb.12, 12-noon:Keynote luncheon with Howard Kellman-$25 ❑Wednesday, Feb. 13, 12-noon:Awards luncheon-$25 ❑Thursday, Feb. 14,7:30 a.m.:Breakfast-$15 ---------------------------------------- - ---------------------------------------------- r��b1 Total AmountZ-., c —100 -CMG � Return this completed form with payment to the address below. ❑ Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) ❑ Please charge to my: ❑Visa ❑MasterCard ❑American Express ❑ Discover Name as it appears on card: Billing address: Card number: Exp.date: Signature: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM,PLEASE Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration made to accommodate special ment by written request, post- Indiana Section AWWA form for use by others needs.Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite 300 Indianapolis, IN 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office:(866)213-2796 www.inawwa.org with your request. that date cannot be honored. FAX:(866)215-5966 f� 105th Aiinua1 Meeting Il��A SEC110N AWWA Marriott Hotel-Indianapolis,IN February 12-14,2013 U T I L I T Y 1 0 P E R A T 0 R I G 0 V E R N M E N T NAME: 'e- I � 1.1.7 k' I I' I 1'�'\ '\ (only one name perform) AWWA MEMBER#:_6 Last First Initial TITLE: () P °1—/'A 0,4 ORGANIZATION: C t (z �A �✓'� `�- ADDRESS: �q 56 u.), 13 1 JT S 4 CITY/STATE/ZIP: OFFICE TELEPHONE: (,?I FAX: (-?/ ) -73-? — 0 6T2 i EMAIL: AWA Lk.-6-r--fl I C- f►ie I-1 ) 6 L1. REGISTRATION FEES Employees of Companies holding a Service Provider membership qualify for the Member rates. Full conference-member ❑ Advance:$125 ❑ On-site:$185 Full conference-non-member ❑ Advance: $175 ❑ On-site:$185 One day-member AZ Advance:$100 ❑ On-site:$135 Day: ) One day-non-member ❑ Advance:$125 ❑ On-site:$135 Day: COMPLIMENTARY REGISTRATIONS ❑ Student,full-time ❑ Retired (AWWA members only) ❑ Guest(Admittance to receptions only) Name: EARLY BIRD REGISTRATION Monday, Feb. 11,3:00-8:00 p.m. MEALS—Tickets required ❑Tuesday,Feb.12, 12-noon:Keynote luncheon with Howard Kellman-$25 ❑Wednesday, Feb. 13, 12-noon:Awards luncheon-$25 ❑Thursday, Feb. 14,7:30 a.m.:Breakfast-$15 ------------------------------------- ----=� nv_o V CJ�-------------------------------------------------- Total Amount 1� 100-W Return this completed form with payment to the address below. ❑ Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) ❑ Please charge to my: ❑Visa ❑MasterCard ❑American Express ❑ Discover Name as it appears on card: Billing address: Card number: Exp.date: Signature: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM,PLEASE Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration made to accommodate special ment by written request,post- Indiana Section AWWA form for use by others needs.Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite 300 Indianapolis, IN 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office:(866)213-2796 www.inawwa.org with your request. that date cannot be honored. FAX: (866)215-5966 t [y"t 105t1i AnnL�al Meeting F SECTION Marriott Hotel-Indianapolis,IN February 12-14,2013 I U T I L I T Y 1 0 P E R A T 0 R 1 G 0 V E R N M E N T NAME: 606 2�la K 4 (only one name per form) AWWA MEMBER M Last First Initial t; TITLE:_Pl _. J.p _--,; ORGANIZATION: C L d N.' ADDRESS: _ U W. 13 I p* CITY/STATE/ZIP: OFFICE TELEPHON : (�� ) 73 ? ��_S S FAX: (�f 7 ) 3 EMAIL: • G�oJ� &CCtr"k--f- - 11�• aloj REGISTRATION FEES Employees of Companies holding a Service Provider membership qualify for the Member rates. Full conference-member ❑ Advance:$125 ❑ On-site:$185 ° Full conference-non-member ❑ Advance:$175 ❑ On-site:$185 One day-member /1�Advance:$100 ❑ On-site:$135 Day:One day-non-member ❑ Advance:$125 ❑ On-site:$135 Day:__ COMPLIMENTARY REGISTRATIONS ❑ Student,full-time ❑ Retired(AWWA members only) ❑ Guest(Admittance to receptions only) Name: EARLY BIRD REGISTRATION Monday, Feb. 11,3:00-8:00 p.m. MEALS-Tickets required ❑Tuesday,Feb.12,12-noon:Keynote luncheon with Howard Kellman-$25 ❑Wednesday, Feb. 13, 12-noon:Awards luncheon-$25 ' ❑Thursday, Feb. 14,7:30 a.m.:Breakfast-$15 --------------------------------------------------------------------------------------------------------- Total AmountZnc1oaeq+$_:S ( __�_��__ a Return this completed form with payment to the address below. ❑ Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) ❑ Please charge to my: ❑Visa ❑MasterCard ❑American Express ❑ Discover Name as it appears on card: Billing address: Card number: Exp.date: Signature: I ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM PLEASE Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration I made to accommodate special ment by written request, post- Indiana Section AWWA form for use by others i needs.Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite 3 Indianapolis,IN 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office:(866)213-2796 www.inawwa.org i with your request. that date cannot be honored. FAX:(866)215-5966 p, , minim 105th Annual Meeting MLANA SECTION AWWA Marriott Motel-Indianapolis,IN February 12-14,2013 U T I L I T Y I O P E R A T O R / G O V E R N M E N T NAME: ^t '_` r`�S A (only one name per form) AWWA MEMBER#: 6 a y 3 9 b Ii Last First Initial TITLE:_ IA t �U_�p rv.A J ORGANIZATION: _!'�' f2 C / �✓� 2 J ADDRESS: *' CITY/STATE/ZIP: l t h 1 �J 6 U _7V OFFICE TELEPHONE: (J 11 )� _.�= FAX: (-?) 7 33- O�� EMAIL: d�1—v�e��trJC�✓/`��r i�.�dJ REGISTRATION FEES Employees of Companies holding a Service Provider membership qualify for the Member rates. Full conference-member ❑ Advance:$125 ❑ On-site:$185 ° Full conference-non-member ❑ Advance:$175 ❑ On-site:$185 One day-member AL Advance:$100 ❑ On-site:$135 Day: - GL PLO 1 One day-non-member ❑ Advance:$125 ❑ On-site:$135 Day:_ COMPLIMENTARY REGISTRATIONS ❑ Student,full-time ❑ Retired(AWWA members only) ❑ Guest(Admittance to receptions only) Name: EARLY BIRD REGISTRATION Monday,Feb. 11,3:00-8:00 p.m. MEALS-Tickets required ❑Tuesday,Feb.12,12-noon:Keynote luncheon with Howard Kellman-$25 ❑Wednesday, Feb. 13, 12-noon:Awards luncheon-$25 ❑Thursday, Feb. 14, 7:30 a.m.:Breakfast-$15 ------- ---------- ----------- - Total Amount£ele"$ �_ h�n�Cn__l Return this completed form with payment to the address below. ❑ Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) ❑ Please charge to my: ❑Visa O MasterCard ❑American Express ❑Discover Name as it appears on card: Billing address: Card number: Exp.date: Signature: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY REUNN COMPLETED FARM,PLEASE Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration I made to accommodate special ment by written request, post- Indiana Section AWWA form for use by others needs.Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite Indianapolis,s, 00 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office:(866)213-2796 www.inawwa.org I with your request. that date cannot be honored. FAX(866)215-5966 IIIQ Mimi; Effm 105th Annual Meeting MLANA SECTION AWWA Marriott Hotel-Indianapolis,IN February 12-14,2013 mom 3 T R A T 0 N F 0 R M U T I L I T Y I O P E R A T O R I G O V E RN M E N T NAME: ,Pi'q R 5 0 qG� �� (only one name perform) AWWA MEMBER#: 0 a�� O I last First Initial TITLE: ,L4,,,,-X i/liort— ORGANIZATION: ADDRESS: 3'45_0 IUJ CITYISTATEIZIP: C,a2VORzL OFFICE TELEPHONE: ( '31 ) 1 3 3- y 5 FAX: ( 3 � ) 7 '3 EMAIL: pe ftw_s v_v>7kC , o. �oU REGISTRATION FEES Employees of Companies holding a Service Provider membership qualify for the Member rates. The DEADLINE for ADVANCE registration is Full conference-member ❑ Advance:$125 ❑ On-site: $185 Feb.1,2013 Full conference-non-member ❑ Advance:$175 ❑ On-site: $185 One day-member p<Advance:$100 ❑ On-site:$135 Day: 2' ' 2 0 3 One day-non-member ❑ Advance:$125 ❑ On-site: $135 Day: COMPLIMENTARY REGISTRATIONS ❑ Student,full-time ❑ Retired (AWWA members only) ❑ Guest(Admittance to receptions only) Name: EARLY BIRD REGISTRATION Monday, Feb. 11, 3:00-8:00 p.m. MEALS-Tickets required [I Tuesday,Feb.12, 12-noon:Keynote luncheon with Howard Kellman-$25 ❑Wednesday, Feb. 13, 12-noon:Awards luncheon-$25 ❑Thursday, Feb. 14, 7:30 a.m.:Breakfast-$15 --------------------------------------------------------------------------------------------------------- ToW Amounts$ (001__tn/_p_,K_a_ D Return this completed form with payment to the address below. ❑Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) ❑ Please charge to my: ❑Visa ❑ MasterCard ❑American Express ❑ Discover Name as it appears on card: Billing address: Card number: Exp.date: Signature: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM,PLEASE Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration made to accommodate special ment by written request, post- Indiana Section AWWA form for use by others needs. Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite 300 Indianapolis, IN 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office: (866)213-2796 www.inawwa.org with your request. that date cannot be honored. FAX: (866)215-5966 Indiana Section AWWA PRS S FIRST CLASS US POSTAGE \\ 8365 Keystone Crossing P A I D INDIANA SECTION, Suite 300 Indianapolis, IN Permit No. 5677 Indianapolis, IN 46240 l�t�l�:fitl��l:llt,,,,,1!lt:t„#tt,t,tttttt�utttlt:t:ttltl�t„!,t ***:**AU JTO**3-DIGIT 460***j***8***1002 Jack 3 Spears City of Carmel Utilities 3450 W 131st St Carmel, DI 46074-8267 105th Annual Meeting MLANA SECTION AWWA Marriott Hotel-Indianapolis,IN INDIANA February 1214,2013 SECTIO!"I'll with special guest Howard Kollman key note speaker 105th Annual Meetin6 MMA SECTION AWWA Marriott Motel-Indianapolis,IN February 12-14,2013 RE TRATo0H FORM U T I L I T Y I O P E R A T O R / G O V E R N M E N T NAME: ! 'M i -T-4- J (only one name per form) AWWA MEMBER#: Last First Initial TITLE: ORGANIZATION: L /Zwl L a/4�T� (� • ADDRESS: 34 S-0 L,,j 1 S �7-/ CITY/STATE/ZIP: C�✓j'►'"��l— �./ y to 0 -7 OFFICE TELEPHONE: ( 30 FAX: ( jl7 ) 773 Zo Tj EMAIL: J C'LAA i t1 o t/ REGISTRATION FEES Employees of Companies holding a Service Provider membership qualify for the Member rates. The DEADLINE for ADVANCE registration is Full conference-member ❑ Advance: $125 ❑ On-site: $185 Feb. 1 Full conference-non-member ❑ Advance: $175 ❑ On-site: $185 One day-member Nuance: $100 ❑ On-site: $135 Day: 15 b xlts 13 One day-non-member ❑ Advance:$125 ❑ On-site: $135 Day: COMPLD4ENTARY REGISTRATIONS ❑ student,full-time ❑ Retired (AWWA members only) El/Guest(Admittance to receptions only) Name: C1 n/D,/ S✓vk EARLY BIRD REGISTRATION Monday, Feb. 11, 3:00-8:00 p.m. � J(� MEALS-Tickets required DTue.%day,Feb. 12, 12-noon:Keynote luncheon with Howard Kellman-$25 Aednesday, Feb. 13, 12-noon:Awards luncheon-$25 ��- ❑Thursday, Feb. 14,7:30 a.m.: Breakfast-$15 --------------------------------------------------------------------------------------------------------- Total Amount Enclosed:$ /;;15'.11 J� Return this completed form with payment to the address below. ❑ Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) ❑ Please charge to my: ❑Visa ❑ MasterCard ❑American Express ❑ Discover Name as it appears on card: Billing address: Card number: Exp. date: Signature: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY RETURN COMPLETED FORM,PLEASE! Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration made to accommodate special ment by written request, post- Indiana Section AWWA form for use by others needs. Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite 300 Indianapolis, IN 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office: (866)213-2796 www.inawwa.org with your request. that date cannot be honored. FAX: (866)215-5966 �\\ Indiana Section AWWA PRSRT. FIRST CLASS US POSTAGE 8365 Keystone Crossing P A I D INDIANA SECTION Suite 300 Indianapolis, IN Permit No. 5677 Indianapolis, IN 46240 llr { tl:{ 1�{{t,,,,,{I III:„ttl,I,tttuttultt{l:Itt�{t{tt.,{,t ^:*»:**AUTO**3-DIGIT 460***3***8***09Q, Greg Hollander City of Carmel Utilities 3450 W 131st St Carmel, IN 46074-867 105th Annual Meeti116 INDIANA SECTION AWWA Marriott Hotel-Indianapolis,IN INDIANA February 12-14,2013 SECTION with special Guest Howard Kellmein keig note speaker i 105th Annual Meeting MMA SECTION AWWA Marriott Hotel-Indianapolis,IN N Februari3 12-14,2013 DOME G` D S T R A T O N F O R A U T I L I T Y 1 0 P E R A T 0 R 1 G 0 V E R N M E N T NAME: (��°�-(��N "r/L— �� (only one name per form) AWWA MEMBER#: Last First Initial TITLE: ORGANIZATION: e�/'"'��L r,✓/a r� b�� ADDRESS: 3 So W CITY 1 STATE 1 ZIP: C/4�— OFFICE TELEPHONE: ( J( 7 ) -73 3- Zr S5 FAX: ( 3 1-7 7 3 3 - Z-o S 3 EMAIL: r5 tiUoe_L A► 0_3 REGISTRATION FEES Employees of Companies holding a Service Provider membership quality for the Member rates. The DEADLINE for ADVANCE registration is Full conference-member ❑ Advance:$125 ❑ On-site:$185 Feb.1,2013 Full conference-non-member ❑ Ad ance:$175 ❑ On-site:$185 One day-member dvance:$100 ❑ On-site:$135 Day: One day-non-member ❑ Advance:$125 ❑ On-site:$135 Day: COMPLtMENIARY REGISTRATIONS ❑ Student,full-time ❑ Retired (AWWA members only) ❑ Guest(Admittance to receptions only) Name: EARLY BIRD REGISTRATION Monday, Feb. 11,3:00-8:00 p.m. MEALS-Tickets required ❑Tuesday,Feb.12, 12-noon:Keynote luncheon with Howard Kellman-$25 f�'Wednesday, Feb. 13, 12-noon:Awards luncheon-$25 ❑Thursday, Feb. 14,7:30 a.m.:Breakfast-$15 --------------------------------------------------------------------------------------------------------- Total Amount Enclosed:$100,DO 0 C-a AP Return this completed form with payment to the address below. • Check made payable to Indiana Section AWWA is enclosed. (Check no.: ) • Please charge to my: ❑Visa ❑ MasterCard ❑American Express ❑ Discover Name as it appears on card: Billing address: Card number: Exp.date: Signature: ONLY ONE NAME PER SPECIAL NEEDS REFUND POLICY REII COMPLETED FORM,Pi FASFI Every reasonable effort will be You can recover your pre-pay- FORM TO: Photocopy the registration made to accommodate special ment by written request, post- Indiana Section AWWA form for use by others needs. Please contact Mary marked no later than Feb. 1, 8365 Keystone Crossing or go to our web site Jane Miller at(866)213-2796 or 2013,to MaryJane Miller. Suite 300 Indianapolis, IN 46240 for additional forms. mjmmiller @att.net Request for refunds made after Office:(866)213-2796 www.inawwa.org with your request. that date cannot be honored. FAX: (866)215-5966 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee T2010 INDIANA SECTION AWWA* Purchase Order No. ATTN MARY JANE MILLER Terms PO BOX 534 Due Date 2/2/2013 NASHVILLE, IN 47448 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/2/2013 6397 $775.00 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 l3//3 -- Date Officer VOUCHER # 123451 WARRANT # ALLOWED T2010 IN SUM OF $ INDIANA SECTION AWWA* ATTN MARY JANE MILLER PO BOX 534 NASHVILLE, IN 47448 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 6397 01-6040-03 $525.00 6397 01-6040-05 $250.00 Voucher Total $775.00 Cost distribution ledger classification if claim paid under vehicle highway fund