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Home My WebLink About229108 2/11/2014 CITY OF CARMEL, INDIANA VENDOR: 00353241 Page 1 of 1 ONE CIVIC SQUARE MARRIOTT BUSINESS SERVICES CARMEL, INDIANA 46032 PO BOX 742274 CHECK AMOUNT: $1,248.84 ATLANTA GA 30384-2274 CHECK NUMBER: 229108 CHECK DATE: 2/11/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 1, 248 . 84 TRAINING SEMINARS INVOICE Date: January 30, 2014 Sold to: City of Cannel Police Department 3 Civic Square Cannel, IN 46032 Payment for lodging for Ann Gallagher on April 26 - 29, 2014 at the Gaylord Opryland, in Nashville, TN Confirmation #92119864 Payment for lodging for Lee Goodman on April 26 - 29, 2014 at the Gaylord Opryland, in Nashville, TN Confirmation #92121334 Room Rate Tax Total $194.00 $14.14 $208.14 TOTAL DUE: $1,248.84 Please snake check payable to: Marriott Business Services PO Box 742274 Atlanta, GA 30384-2274 * # # $ * * t: it • * * * * * PAGE 1 s Appil 21-20, 20141 **** 2014 Gaylopd Oppyland I Nashville REGISTRATION FORM NATIONAL CONFERENCE ON HIGHWAY SAFETY PRIORITIES ALTTEN DEE INFORIMALTION First name: ?&A-1 Last name: n N�/ Preferred first name for badge: !T Privacy Disclaimer. By registering la the conference Organization:— M 'f C i f ; you acknoMedge that your contact 2G information will be included on the Address: v ` .c �t Gf attendee list made available to t'b U3 L all meeting registrants,including City: ltv/12� State f'' Zip: exhibitors. Only exhibitors have the opportunity to purchase Telephone: ( 3r 7 ) S7/`� Cell. ( ) _ the attendee list. For upla es on will not be printed in program materiak Attendee Email: /g GA�I✓��>hP� QCtr�Y,r e/•=L� /� � Initial here 0 you do not Email a copy of registration to(Altemate email onry): �/YI �S ��9�m�� it/- y 'fit your contact information included in conference materials. Special Requests: Emergency Contact Name(required): Day Phone:( ) Cell Phone: ( ) ave read and accepted the Cancellation Policy and Liability/Photography Waiver on page 2 of this registration form. Please check food functions you will be attending: Sunday:OSxlunch ing Reception I Monday.G-Oontinental Breakfast 9VTSAAwards Luncheon I Tuesday ng Luncheon Plenary Will you be staying at the Gaylord Opryland? F s ❑No If not,where will you be staying? Is this your first Lifesavers Conference? ❑Yes C What field do you work in? ❑Consultant/Researcher ❑Community Programs ❑Local Government ❑Advocac onsumer Group ❑Insur a Industry ❑EMS/Fire ❑State/Federal Govt. ❑Judge/Prosecutorild Passenger Safety ild Restraint Manufacturer ❑Auto Industry [�Uw Enforcement ❑Public Health/Medical ❑Student Which workshop track(s)will you most likely be attending? (Check all that apply) ❑Distracted Driving ❑Teen Traffic Safety ❑Impaired Drying ❑ cupant Protection for Children ❑Other Highway Safety Priorities ❑Criminal Justice/Law Enforcement ❑Adult Occupant Protection/Vehicle Technology ❑Communications ❑Vulnerable Populations(Bicyclists/Motorcyclists/Pedestrians/Older Drivers) !RE.C®NI°ERENCE WORKS ®!S (Details provided on website) am registering for. El Strategic Communication Training ❑ Carl it Technician Training Curriculum Revision and Rollout(for State OP/OPC Coordinators only) Latest Technology Workshop of Boosters-The New Frontier:Extending Occupant Protection to Reach Kids 8-15 REG.Y95TRALTI®N ]SEES (Check one) Your registration fee includes an opening reception,a breakfast,three lunches,refreshment breaks,exhibits,workshops,and program materials. Xrly-Bird Special-Until January 24,2014 $350 ❑ Regular Registration-January 25 until March 14, 2014 S400 ❑ Late/On-Site Registration-After March 14,2014 $500 ❑ Moderator/Speaker S350 ElModerator/Speaker(attending day of presentation onik Indicate day: $0 Paying by credit card or purchase order? ❑ Poster Presenter 5350 ❑ Approved Undergraduate/Graduate Student-Registration Code: S75 You can also securely `� register online of Note:Additional exhibit personnel-please use the exhibit registration form. Total Amount Due $ ✓ 52'00 www itfesaversconference.org « * * * * * * * >f PAGE t 9 sky R S April 27-20, 2014 ***** ZU14 Gaylord OprYIe�d I N88h MB REGISTRATION FORM NATIONAL CONFERENCE ON HIGHWAY SAFETY PRIORITIES ATTENDEE INFORMATION First name: Lu.A J t Last name: l�l 00 I "XVA�N 0 LPrivacy Dlsdaurrer: Preferred first name for badge: /mBy registering for this conference Organization: 1J7� Tel l- tR you ad=Medge that your contact information will be included on the Address: l4f}/-t attendee list made available to /-- /, all meeting registrants,including City: N'1 State�— Zip: 7 r! &4-3.2-1 exhibitors. Onty exhibitors have the opportunity to purchase Telephone: ( 3/� ) ��' (J Cell: ( ) the attendee list. For updates a*-wf l not be pn��tteed in program materials Attendee Email: OO d m�9,� +L'/4✓►M e/. �i�l • Cry✓ // Initial here ii you do not Email a copy of registration to(Alternate emaii ony): /�l R is f9rM el ,kJ 6y Ll want your contact information included in conference materials. Special Requests: Emergency Contact Name(required): L.Auri A Gori►y�•,J Day Phone:( ) Cell Phone: I have read and accepted the Cancellation Policy and Uability/Photography Waiver on page 2 of this registration form. Please cher)-food functions you will be attending: Sunday: B'Box Lunch ❑Opening Reception 1 Monday: fJ Continental Breakfast ❑NHTSA Awards Luncheon I Tuesday: ❑Closing Luncheon Plenary Will you be staying at the Gaylord Opryland? W'Yes ❑No If not,where will you be staying? Is this your first lifesavers Conference? V?es ❑No What field do you work in? ❑Consultant/Researcher ❑Community Programs ❑Local Government ❑Advocacy/Consumer Group ❑Insurance Industry ❑EMS/Fire ❑State/Federal Govt. ❑Judge/Prosecutor ❑Child Passenger Safety ❑Child Restraint Manufacturer ❑Auto Industry t aw Enforcement ❑Public Heafth/Medical ❑Student Which workshop track(s)wig you most likely be attending? (Check all tha tKDistracted Driving � Traffic Safety Impaired Driving El Occupant Protection for Children ,Other Highway Safety Priorities riminal Justice/Law Enforcement ❑Adult Occupant ProtectionNehicle Technology ❑Communications �lulnerable Populations(Bicyclists/Motorcyclists/Pedestrians/Older Drivers) PRE-CONFERENCE WORNSHOPS (Details provided on website) am registering for. ❑ Strategic Communication Training ❑ CarFit Technician Training ❑ CPS Curriculum Revision and Rollout(for State OP/OPC Coordinators only) ❑ CPS Latest Technology Workshop ❑ Out of Boosters-The New Frontier:Extending Occupant Protection to Reach Kids B-15 REGISTRATION FEES (Checkone) Your registration fee includes an opening reception,a breakfast,three lunches,refreshment breaks,exhibits,workshops,and program materials. Early-Bird Special-Until January 24,2014 $350 ❑ Regular Registration-January 25 until March 14, 2014 $400 ❑ Late/On-Site Registration-After March 14,2014 $500 ❑ Moderator/Speaker $350 ❑ Moderator/Speaker(attending day of presentation onlo Indicate day: $0 Paying by credit card or ❑ Poster Presenter $350 purchase order? ❑ Approved Undergraduate/Graduate Student-Registration Code: $75 You can also securely /gym register oNlne at Note:Additional exNbft personnel–please use the exhibit registrabon form. Total Amount Due $ 7 k! �� www.ft_gversconference.org VOUCHER NO. WARRANT NO. ALLOWED 20 Marriott Business Services IN SUM OF $ P.O. Box 742274 Atlanta, GA 30384-2274 $1,248.84 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 210 -570.00 $1,248.84 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday, February 06, 2014 Chief of Police 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)) 01/30/14 lodging $1,248.84 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 20 Clerk-Treasurer