HomeMy WebLinkAbout232578 05/13/14 lir CggMf
CITY OF CARMEL, INDIANA VENDOR: 368217
® ONE CIVIC SQUARE N C P A A CHECK AMOUNT: $********35.00*
CARMEL, INDIANA 46032 PO Box 241 CHECK NUMBER: 232578
SOUTH BEND IN 46624 CHECK DATE: 05/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4355300 35.00 ORGANIZATION & MEMBER
oce UadejvJ 9 NCPAA MEMBERSHIP APPLICA'T'ION
First name M.1. Last Name
National e�G, Ann Gallagher
wA Is Ltis—r-- bership...... Are you..... !:•--=—.
"tAN,� Eyy� RENEWAL SWORN CIVILIAN
-6 E-mail Address Agallagher@carmel.in.gov
BOX 1 SWORN OFFICERS INFORMATION
Rank/Title
We Need YOU to keep NCPAA and Name of Law Enforcement Agency
CPAA Associations Agency Address
City, State,Zip
GROWING Agency Phone Number( )
Agency Fax Number )
Invite a fellow law enforcement officer
or alumni association member to BON 2 CIVILIAN OCCUPATION INFORMATION j
become part of something special!! Occupation Community Resource
Title(if Applicable) Comm>,rni t-v Resource Spec; St
The mission of the NCPAA National Citizens Name Agency,Organization
carni
el Police Dept
Police Academy Association) is to promote the Address
professional development of information, and —te (l' vi r S;ware
to provide guidance and assistance to law C&MZ,P IN 46032
enforcement agencies and citizens involved or Telephone Number Fax Number
interested in the Citizens Police Academy 1 ( 31 7 ) 571 -2720 ( 317) 571 -2512
concept.
Box 3 CITIZEN POLICE ACADEME' ALUMNI INFO.
Current members can help keep the NCPAA Association Name
growing. Encourage others to complete a Address
registration form and send it in with their
$35.00 almual membership dues. City, State,Zip
Members are eligible to receive quarterly Telephone Number
copies of the NCPAA Newsletter and have I ( )
access to the members only section of the
website. Semi-annually,members will also Box 4 PERSONAL INFORMATION
receive a full Membership Directory. Home Address
Please be sure to check the box indicating City, State,Zip
where you would like to receive NCPAA
mail. Sworn officers will receive mail Home Telephone Number
through their agencies. The box checked ( )
by civilians will also be the information listed MAILING ADDRESS INFORMATION
(Where your NCPAA mailings should be sent)
in the Membership Directory. If possible, list
your e-mail address Same as: ABox l ❑ Box 2 ❑ Box 3 ❑ Box 4
1 affinn that the above infonnation is true and accurate,and 1 authorize
��1Clll�i J%O L!
for helping to support NCPf(A NCPAA to verify any of the above infonnation. Further,I understand that any
unlrthorized use of membership privileges may result in tenni cation of
Me bership rid r v a on of sai privileges.
FOR 1\1CPAA OFFICE USE ONL I,
Ck Date Ck Ahrmber Signatm'e V ate
Please mail completed application with$35.00
pek reek MO Amt.S Check or money order(payable to NCPAA to:
NCPAA*P.O.Box 241 *South Bend,IN 46624
Postel! Expires 07113
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))
05/09/14 membership dues $35.00
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
NCPAA
IN SUM OF $
P.O. Box 241
South Bend, IN 46624
$35.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 43-553.00 $35.00
I hereby certify that the attached invoice(s), or
I I
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
Friday, M y 09, 2014
4Z -Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund