247204 07/15/15 CITY OF CARM L, INDIANA VENDOR: T359466
® ONE CIVIC SOME CRISIS PREVENTION INSTITUTE INC CHECK AMOUNT: S*....
***2,419.00*
:. CARMEL, INDIANA 46032 10850 W PARK PLACE SUITE 600 CHECK NUMBER. 247204
�yiTON�. MILWAUKEE WI 53224 CHECK DATE: 07/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4357004 CUSIO049253 2,419.00 EXTERNAL INSTRUCT FEE
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• Original Invoice r :nvoice CUS10049253
Nonviolent Crisis Intervention®program Date 6/22/2015
Prepare Training®programP CJUN 2 2 2015 8 e 1
Dementia Care Specialists Federal I.D.#39-2012874
CPI Matters at Work DUNS 1091660 61
Bill To:
Ship To: -----_--_=—;
Dawn Koepper-Administrator Dawn Koepper-Administrator
Carmel Clay Parks And Recreation Carmel Clay Parks And Recreation
1411 E 116th st 1411 E 116th st
Carmel IN 4603 Carmel IN 46032
US US
PO#38729 1 333887 US UPSGND Net 30 6/22/2015Date -
Purchase Order N'o. (Customer ID Shi I Metf tid Pa me t Terdis Re Shi
Ordered,.,'UofM hi' ed: B/0: Item Nlamber'-.'Descri tion; =Unit Price Ext :Price`
1 EACH 1 0 ISSN0005 NCI 4 Day Instructor Certification On-Site $2,419.00 $2,419.00
Aimee Rich Cincinnati 6/23/2015
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Program fee payable prior to program start. vs Thank you Subtotal $2 419.00
Tax - $0
Tracking#(if applicable): Freight $0.00
-.
De `osit.Received :.c' $0.00
;Total:-:..Z=US$` .: $2,419.00
Remit to:CPI Customer Service: 1-800-558-8976 Tax exempt organizations:we must have your tax exempt certificate on file.
10850 W.Park Place,Suite 600 Accounting/Billing: 1-877-877-5409
Milwaukee,WI 53224 USA Customer ServiceFax: 1-414-979-7098 Please refer to www.cdsisprevention.com or your contractfor program cancellation and product return policies.
Please include invoice ice number or customer ID with your payment.
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
T359466 Crisis Prevention Institute, Inc. Terms
10850 W Park Place, Suite 600
Milwaukee, WI 53224
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
6/22/15 CUSI0649253 CPI Instruction course for ESE Inclusion Supervisro 38729 $ 2,419.00
June 23-25,2015
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Total $ 2,419.00
I hereby certify that th�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
2Q_
Clerk-Treasurer
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Voucher No. Warrant No.
T359466 Crisis Prevention Institute, Inc. Allowed 20
10850 W Park Place, Suite 600
Milwaukee,WI 53224
In Sum of$
$ 2,419.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
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PO#orINVOICE NO. CCT#/TITL AMOUNT I Board Members
Dept#
1081-99 CUS10049253 4357004 $ 2,419.00 �, 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
t' which charge is made were ordered and
received except
July 9, 2015
Signature
$ 2,419.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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