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Home My WebLink About228038 1/14/2014 CITY OF CARMEL, INDIANA VENDOR: 00352482 Page 1 of 1 ONE CIVIC SQUARE IMPACT CHECK AMOUNT: $90.00 CARMEL, INDIANA 46032 200 S MERIDIAN ST SUITE 340 INDIANAPOLIS IN 46225 CHECK NUMBER: 228038 CHECK DATE: 1/14/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4355300 10081 20 . 00 ORGANIZATION & MEMBER 1201 4355300 10082 20 . 00 ORGANIZATION & MEMBER 1201 4355300 10094 50 . 00 ORGANIZATION & MEMBER 5"53 Please provide the following information. Name: Barbara Lamb Title: Director of Human Resources Municipality: Carmel Address: One Civic Square Phone No.: Fax No.: Email Address: blamb@carmel.in.gov *EMAIL ADDRESSES ARE CRUCIAL TO KEEPING IN TOUCH WITH OUR MEMBERSHIP Make checks payable to: Indiana Association of Cities and Towns Mail completed form with payment by March 31,2014 to: IMPACT, 200 S.Meridian St., Suite 340, Indianapolis, IN 46225 I understand that as a member of IMPACT, I agree to: (1) maintain the confidentiality of shared information when warranted; (2) share information with other members of the group; (3) abstain from using my official membership position to secure special privilege, gain or personal benefit; (4) contribute relevant materials to the personnel information resource library; and (5) actively participate in training sessions and group meetings. Signature Date E �' ❑ Please check if you would be interested in receiving Actionlines or e-newsletters. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Invoiee: 10094 IMPACT accepts the following credit cards (please compete the following) Paying by: ❑ MasterCard ❑ Visa ❑ Discover Card Amount' R�Check Card Number: (make payable to "IACT"): Expiration date: 3-digit security c Name on Credit Card: te 11 Credit Card Billing Address of Credit Card: �� 4 J Signature: Please provide the following information. Name: Jim Spelbring Title: Office Administrator Municipality: Carmel Address: One Civic Square Phone No.: (317)571-2465 Fax No.: (317)571-2409 Email Address: 1pspelbring@carmel.in.gov *EMAIL ADDRESSES ARE CRUCIAL TO KEEPING IN TOUCH WITH OUR MEMBERSHIP Make checks payable to: Indiana Association of Cities and Towns Mail completed form with payment by March 31,2014 to: IMPACT, 200 S.Meridian St., Suite 340, Indianapolis, IN 46225 I understand that as a member of IMPACT, I agree to: (1) maintain the confidentiality of shared information when warranted; (2) share information with other members of the group; (3) abstain from using my official membership position to secure special privilege, gain o perso jenefit; (4) contribute relevant materials to the personnel information re urcibrary; and (5) actively participate in training sessions and group meetings. Signature Date ❑ Please 6hec you would be interested in receiving Actionlines or e-newsletters. Invoice: 10082 IMPACT accepts the following credit cards (please compete the following) Paying by: ❑ MasterCard ❑ Visa ❑ Discover Card Amount: 12b,oO Check Card Number: (make payable to "IACT"): Expiration date: 3-digit security code Name on Credit Card: .bittedLl ElCredit Card � Billing Address of Credit Card: Signature: Clerk -rreasur S5� Please provide the following information. Name: Sue Wolfgang Title: Employee Benefits Adminstrator Municipality: Carmel Address: One Civic Square Phone No.: (317)`S1=94W Fax No.: (317)4441-4981-- Email Address: swolfgang@carmel.in.gov *EMQA-11 ADDRESSES ARE CRUCIAL TO KEEPING IN TOUCH WITH OUR MEMBERSHIP Make checks payable to: Indiana Association of Cities and Towns Mail completed form with payment by March 31,2014 to: IMPACT,200 S.Meridian St., Suite 340, Indianapolis, IN 46225 I understand that as a member of IMPACT, I agree to: (1) maintain the confidentiality of shared information when warranted; (2) share information with other members of the group; (3) abstain from using my official membership position to secure special privilege, gain or personal benefit; (4) contribute relevant materials to the personnel information resource library; and (5) actively participate in training sessions and group meetings. Signature\� w , Date ❑ Please check if you would be interested in receiving Actionlines or e-newsletters. Invoice: 10081 IMPACT accepts the following credit cards (please compete the following) Paying by: ❑ Master Card ❑ Visa ❑ Discover Card Amount:40 v" Check Card Number: (make payable to "IACT"): Expiration date: 3- abInte Name on Credit Card: Sub-Mitted "'o F 41 ❑ Credit Card Billing Address of Credit Card:Signature: ri)r VOUCHER NO. WARRANT NO. Indiana Association of Cities and Towns ALLOWED 20 IMPACT IN SUM OF $ 200 S. Meridian St., Suite 340 Indianapolis, IN 46225 $90.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 10094 43-553.00 $50.00 i- 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1201 10082 43-553.00 $20.00 materials or services itemized thereon for 1201 1 10081 I 43 553.00 I $20.00 which charge is made were ordered and received except Monday, January 13, 2014 Director, HR Title Cost distribution ledger classification if claim paid motor 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 01/13/14 10094 B Lamb membership $50.00 01/13/14 10082 J Spelbring membership $20.00 01/13/14 I 10081 I S Wolfgang membership $20.00 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120 Clerk-Treasurer