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HomeMy WebLinkAbout236878 09/10/14 �% CITY OF CARMEL, INDIANA VENDOR: 139800 ® °1 ONE CIVIC SQUARE INDIANA ASSOC OF CHIEFS OF POLICECHECK AMOUNT: $....***550.00* �•, � CARMEL, INDIANA 46032 10293 N MERIDIAN ST STE 175 CHECK NUMBER: 236878 �M.. _.a, INDIANAPOLIS IN 46290 CHECK DATE: 09/10/14 ., �TpN� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 32444 74323 550.00 CONFERENCE Name Shane VanNatter Department Carmel Police Department Rank Officer First Name for Badge Shane Address 3 Civic Square city Carmel State IN Zip 46032 Phone 317-571-2500 Fax 317-571-2512 Cell Phone Home Phone Email Syannatter@carmel.in.gov REGISTRATION FEE Member Fees Non-Member Fees ❑ Member: $200 ❑ Non-Member: $300 ❑✓ D.A.R.E. Officer or SRO from ❑ Non-Member D.A.R.E. Officer or SRO: $200 Member Agency: $150* ❑ School Official: $200 "Available after a member of your agency is already registered at the member fee. PAYMENT METHOD ❑Check ❑ VISA ❑ MasterCard ❑✓ Purchase Order Credit Card Account Number Expiration Date Security Code Signature(as it appears on card) Credit Card Billing Address if different than above: Address City State Zip If paying by check, mail completed form, along with full payment to: Indiana Association of Chiefs of Police 10293 North Meridian Street, Suite 175 Indianapolis, IN 46290 If paying by credit card or purchase order, fax completed form to 317.816.1633 Cancellation Policy: No refund for "No Shows". Cancel by September 2, 2014, 100% refund. Cancel between September 2-8, 2014, 50% refund. Cancel after September 8, 2014, no refund. Cancellations must be made in writing. Name Tim Green Department Carmel Police Department Rank Chief of Police First Name for Badge Tim Address 3 Civic Square City Carmel State I N zip 46032 Phone 317-571-2523 Fax 317-571-2512 Cell Phone Home Phone Email tgreen@carmel.in.gov REGISTRATION FEE Member Fees Non-Member Fees ❑✓ Member: $200 ❑ Non-Member: $300 ❑ D.A.R.E. Officer or SRO from ❑ Non-Member D.A.R.E. Officer or SRO: $200 Member Agency: $150" ❑ School Official: $200 *Available after a member of your agency is already registered at the member fee. PAYMENT METHOD ❑Check ❑ VISA ❑ MasterCard ❑✓ Purchase Order Credit Card Account Number Expiration Date Security Code Signature(as it appears on card) Credit Card Billing Address if different than above: Address City State Zip If paying by check, mail completed form, along with full payment to: Indiana Association of Chiefs of Police 10293 North Meridian Street, Suite 175 Indianapolis, IN 46290 If paying by credit card or purchase order, fax completed form to 317.816.1633 Cancellation Policy: No refund for "No Shows". Cancel by September 2, 2014, 100% refund. Cancel between September 2-8, 2014, 50% refund. Cancel after September 8, 2014, no refund. Cancellations must be made in writing. •. •� . . . . Name Randy Schalburg Department Carmel Police Department Rank Major First Name for Badge Randy Address 3 Civic Square City Carmel State I N Zip 46032 Phone 317-571-2532 Fax 317-571-2573 Cell Phone Home Phone Email rschalburg@carmel.in.gov REGISTRATION FEE Member Fees Non-Member Fees ❑✓ Member: $200 ❑ Non-Member: $300 ❑ D.A.R.E. Officer or SRO from ❑ Non-Member D.A.R.E. Officer or SRO: $200 Member Agency: $150* ❑ School Official: $200 *Available after a member of your agency is already registered at the member fee. PAYMENT METHOD ❑Check ❑ VISA ❑ MasterCard ❑✓ Purchase Order Credit Card Account Number Expiration Date Security Code Signature (as it appears on card) Credit Card Billing Address if different than above: Address City State Zip w • If paying by check, mail completed form, along with full payment to: Indiana Association of Chiefs of Police 10293 North Meridian Street, Suite 175 Indianapolis, IN 46290 If paying by credit card or purchase order, fax completed form to 317.816.1633 Cancellation Policy: No refund for "No Shows". Cancel by September 2, 2014, 100% refund. Cancel between September 2-8, 2014, 50% refund. Cancel after September 8, 2014, no refund. Cancellations must be made in writing. 't= INDIANA RETAIL TAX EXEMPT PAGE Ci-Ey ®f C4_rmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 32444 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD,OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 1M14 Indiana A000c. of ChIG?o of Pollco, Inc. ltmol Polle© Dop tmont VENDOR SHIP 3 Civic 9qum 902M N. Meridian Stroot, Sulte 176 TO Comol, IN Indim2polls, IN 4M (317)571 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT MEASURE DESCRIPTION UNIT PRICE EXTENSION OF Account 00-670.0 1 Each conference $550.00 $550.00 Sub Total: $550.00 ° a IACP Fall Conforonco -Chlof Groan,Major Sad I 0fha Vanm dr-Iml Is 15194 -9190/94 Send Invoice To: Carmol Pollco DoR artmont Attn: Pat Young 3 Chic squama Cereal, IN 462- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Camel Police Dept. PAYMENT 4550.0 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROERr O�SUFFICIENT TO PAY FOR THE ABOVE ORDER. •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL Chief SHIPPING LABELS. Chief oQ Y pollco •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO. 33424 4 4 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. �_.WARRANT NO.__ ALLOWED 20 IN THE SUM OF$ i ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# 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 20 Signature _..._.......--._....-.. ..............--.-.-...-..-........- Title r 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)) 09/03/14 74323 IACP Fall Conference, Green, Schalburg, VanNatter $550.00 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 Indiana Assoc. of Chiefs of Police, Inc. IN SUM OF $ 10293 N. Meridian Street, Suite 175 Indianapolis, IN 46290 $550.00 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 32444 I 74323 I -570.00 I $550.00 1 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 Friday, September 05, 2014 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund