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227261 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 010025 Page 1 of 1 ONE CIVIC SQUARE AMERICAN BACKFLOW PREVENTION ACF�gg RpE CARMEL, INDIANA 46032 ECK AMOUNT: $65.00 PO BOX 3051 BRYAN TN 77805-3051 CHECK NUMBER: 227261 CHECK DATE: 12/17/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 R2048-14 65 . 00 EMPLOYEE PEN & BENEFI AMERICAN BACKFLOW PREVENTION ASSOCIATION December 5, 2013 INV®ICE R2048- 14 MICHELLE BREEDLOVE CITY OF CARMEL Please return a copy of this notice 3450 W. 131 ST with payment for proper credit. CARMEL, IN 46074 Our records indicate that your membership in the American Backflow Prevention Association will expire on _ — -- ---i/� 1/201-4.-In zhe Iasi year ABFN hus experienced a tremendous gruprth in membership and with your continued support we can continue to provide technical assistance, educational opportunities,public information and much more. Please note that application fees for national membership are 5'60.00 yearly,per person; this includes your subscription to the ABPA publication, ABPA News. We also have you as a member of the Indiana Chapter and their fees are an additional cost of 55.00. Both the national and local chapter dues may be paid with one payment to national headquarters, the local dues will be forwarded on to your local chapter along with any changes you let us know of with your renewal. Please take this opportunity to make any necessary changes to the information below and return it along with your payment so your membership will remain in good standing. If pgvnzent has already been remitted,please disregard this notice. Credit card payment may be fay-ed in. LAST NAME BREEDLOVE FIRST NAME MICHELLE COMPANY CITY OF CARMEL ADDRESS 3450 W. 131 ST CITY, STATE ZIP: CARMEL, IN 46074 E-MAIL: mbreedlove @carmel.in.gov PHONE: (3 17) 733-2855 FAX: (317) 733-2053 ---MEMBERSHIP-NO: P204S -- EXPIRATION DATE: 1/31/2014 LOCAL CHAPTER: INDIANA NATIONAL DUES: $60.00 LOCAL DUES: 5.00 TOTAL DUE: $65.00 CREDIT CARD: Visa MC ❑ AE ❑ Discover ❑ # _ _, Exp. - CVV NAME ON CARD: CHECK NO & AMT.: ABPA TAX PAYER I.D. # 74-2395100 POST OF i7icrl Box 3051 a BRYAN,TX 77805-3051 •979-•846-7606 e,979-846-7607 FAX e www.abpa.org VOUCHER # 133650 WARRANT # ALLOWED TABPA IN SUM OF $ AMERICAN BACKFLOW PREVENTION PO BOX 3051 BRYAN, TX 77805-3051 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code R2048-14 01-6040-05 $65.00 Voucher Total $65.00 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee TABPA AMERICAN BACKFLOW PREVENTION ASSOC Purchase Order No. PO BOX 3051 Terms BRYAN, TX 77805-3051 Due Date 12/13/2013 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/13/201: R2048-14 $65.00 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 Date Officer