HomeMy WebLinkAbout220969 06/18/2013 CITY 6FICARMEL, INDIANA VENDOR: 359016 Page 1 of 1
ONE CIVIC SQUARE KAREN BREEDLOVE
CARMEL, INDIANA 46032 17330 BIGLEAF MAPLE BLVD#133 CHECK AMOUNT: $120.00
WESTFIELD IN 46074 CHECK NUMBER: 220969
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 31713 120 . 00 OTHER EXPENSES
6/10/13 Account Activity
ASE a
CHASE 0
CREDIT CARD (...
Posted Activity
Statement Ending M 23,2013
_..._..._.. ........ Mar ..............
..
Trans Date Post Date Type Description Amount
--_---_----------_----------_------------------------------------------------_-----------------------------------
03/1-7%2013-Sale- --—USC-FCCCHR
https://cards.chase.condcc/Account/Acti\ib/165395740 1/1
Page 1 of 1
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Thank You! Your order has been submitted. If you are in California and sales tax was added to your order for either
Membership,or a training course,we will manually remove the sales tax charge before submitting your charge to the bank.
The ordering software is currently not set up to separate taxable and non taxable items. Thanks!
A confirmation of your order has been emailed to Kmichellebreed @yahoo.com.
Click here to shop some more.
Below are the details of your order.Please print this page for your records.
Order Number: 699233
Ordered By: Michelle Breedlove
17330 Bigleaf Maple Blvd.
apt. 1334
Westfield,In 46074 US
Kmichellebreed@yahoo.com
317-281-1463
Ship To:Michelle Breedlove
17330 Bigleaf Maple Blvd.
apt. 1334
Westfield,In 46074 US
Payment Method:
Is Destination a Residence?Yes
CCC Programs
Quantity Unit Price Total Price Description
1 $120.00 $120.00 Company Membership
Company Name CCC Programs
First line of address 17330 Bigleaf Maple Blvd.
Second line of address apt. 1334
City State ZIP Westfield,In.46074
Phone number 317-281-1463
FAX Number
Contact Michelle Breedlove
Subtotal: $120.00
Tax: $0.00
TOTAL: $120.00
3/15/2013 10:57:13 AM
4
Billing Shipping
Name:
Company:
Address:
City,State,'Lip:
Phone:
Fax:
e-mail:
QTY PROD# DESCRIPTION PRICE MEMBER EXTENDED
EACH PRICE PRICE
MANUAL10 10th Edition Manual of Cross-Connection Control $95.00 $70.00
LFTP Abbreviated Field Test Procedures(ONLY w/10th Edition) $10.00 $8.00
FTBP10 Field Testing Backflow Preventers,l0th Edition version DVD Video 550.00 S40.00
DVD Working Together for Safe Water DVD Video $35.00 S25.00
a PPT Essentials PowerPoint Presentation 535.00 S25.00
v ;^
INF5 set of 500 Informational Brochures' S145.00 5115.00
v
M 0 INF10 set of 1000 Informational Brochures' $240.00 S190.00
Q
7Ej INF25 set of 2500 Informational Brochures' 5475.00 $375.00
Q l- HINF5 Cross-Connections in Household Plumbing set of 500 info Brochures' 5145.00 $115.00
1 O
ZN HINF10 Cross-Connections in Household Plumbing set of 1000 Info Brochures' $240.00 $190.00
44) HINF25 Cross-Connections in Household Plumbing set of 2500 Info Brochures $475.00 5375.00
u- U
01 0) Tester Course(Fill in PROD#for specific course) $1,000.00 5800.00
C c
CL C Specialist Course(Fill in PROD#for specific course) $1,000.00 $800.00
a•�6
t One Day Update Seminar(Fill in PROD#for specific course) $75.00 $60.00
O Membership Fees(calculated below)
TAX:California residents please add appropriate sales tax(Membership,courses and shipping charges are not taxable)
1'°;d:ie:±,.'-r.te o},1i;rtr iv.'S•F�,;.r e0 d-0 E A1.;z�,$05.e 0.l.OivOe,s!•;,Y, x�"�4°. ��'s:It:'.x•;e.�• .:.,,.�;r.,'r! ,c�.x,, e` ',,. ...�•'?",a•... •.";ti•._.r,-.`n<::l>,g-F:f
SUBTOTAL
round 3Da ve,
xy 0:00rc4$2250='
SHIPPING
; ]; .. P -:T i $57:50:"
z n:' SALES TAX
•=$2SO.OJ'''$SOO:OO:��i�ra.<a5,:�=`�..::a;i..-:x8a`�G$24:50.,r,.�„,t„is�:.„.,$55`'OO,t.rt$67:OO:I:�$86
C O'.`:' _ ..,�;.i. '.ai`rYczly.'°-,`,>2,r Y•,,.,... .,.,>s., ,gn::lq'::ri_. ,.":}�' ]'.
5500i0.1':`,Si1000t00 4 �.•,,a535t50,. ,.i,, t;,xwS103.00. $i`2Z;00`"$169.50 TOTAL(US Dollars Only)
Y
s<;.. y.•x•:k". "'�'v-r..e +r.;n '.�"'.lf, 's" w<,tv e::tG;*t3: r'i'y'.:::'
s`m',_:al'000:01-:$2000.00t^FSk¢ °' .1levki '$43:SOr..,:i"74..;'x1:✓,$12&'.00 r$il'S6:OOalS210:50='.a>.;:::.;`
s.
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--.'.�NLYlO':lti•.,..-...,...fr:"' tYg 3. 8Y .%' 'SA�i',4,..4tL:�' OF.S
2000:0.1;' "�?:': :,$`�-��•:��,�R*'$55:50`�2v,
sousinfi;�as�.r•1:i1`� ;�iY.'!:�' %�, 43 east✓' c�a:ai�ai�.Ei;��ii �:>Kc:S.::�r,;:�.. ;:ar�st•'.�<,:is:�r.-,,•s.•��^zru>;;..;ri<:,:�'
TRAINING COURSE DATES(PROD#in shaded region)
'se drir spacefJ r!!(.!!ltllotrGlltlfOrltiQlJOlf,SttC�1 QS d'/t!(1C7t1 It(lAICS for
arses and iuforrttarion to be itnplinted ou itrfarnmtiona/bror/u(res. !'""`"
SEIY1031p3' One Day Update Seminar 29 April'13(Los Angeles,CA)'
.:�>:lF:rtC€sPN
"SU3Est•<.
13.! Specialist Course 18-22 Marcli'13(Los Angeles)'
�, 1013 ` Tester Course 22-26 April'13(Los Angeles)' $07dt3'l Specialist Course 29 July-2 August'13(Los Angeles)'
r 0�
Tester Course 15-19 July'13(Los Angeles)' °_t SOQ13 x; Specialist Course 23-27 Septemhar'13(Raton Rnu,cl-
Membership - Annual Fees
Purveyor Membership
Credit Card Order(or on the web fccchnusc.edu) ("Ihose deriving income for the sale of water)
❑Visa ❑Mastercard ❑Discover ❑AMEX Water Purveyors with up to 2,400 service connections ❑ $120,00
Purveyors with more than 20,000 service connections ❑ 51000.00
Card Number: - - _ Purveyors with more than 2,400 service connections,but less than 20,000
($0.05 per connection)
Number of service connections_X 50.05=__._ ❑_____
Expires: / CVN: Associate Membersh'
01 Company ❑ $120.00
Name on Card: r -Fc,�.Q P State or Federal Agency ❑ S500 00
Signature: 311 S I 1-NOTE:All Manual Sales are FINAL;No Returns Accepted.
Training Courses Cancelation Policy:50%refund if canceled within four
weeks of the course.Payment not refundable within one week of course.
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PHONE:866 545 6340 Foundation for Cross-Connection Control and Hydraulic Research
FAX:213 740 8394 -- University of Southern California
Kaprielian Hall 200
Federal ID:95-1642394 Los Anoeles.CA 90089-2531
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