308573 02/28/17 ^/ ;F• CITY OF CARMEL, INDIANA VENDOR: 00350628
® ONE CIVIC SQUARE INST OF POLICE TECHNOLOGY MGT CHECK AMOUNT: $..."2,190.00'
CARMEL, INDIANA 46032 UNIV OF NORTH FLORIDA CHECK NUMBER: 308573
M�roN 12000 ALUMNI DRIVE CHECK DATE: 02/28/17
JACKSONVILLE FL 32224-2678
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 100195 2,190.00 TRAINING CONT ED
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00350628 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
INST OF POLICE TECHNOLOGY MGT IN SUM OF$ CITY OF CARMEL
UNIV OF NORTH FLORIDA 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.
JACKSONVILLE, FL 32224-2678
Payee
$2,190.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Terms
Date Due
t0# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
100195 0 43-570.00 $2,190.00 1 hereby certify that the attached invoice(s),or 2/22/17 0 training-Bay,Gossett $2,190.00
1110 210 1110 210
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, February 24,2017
Green,Tim
Chief of Police
I 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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Institute of Police Technology and Management
University-of NorthFlorida
Registration Form
INFORMATIONSTUDENT
First Name: l��s�� h�✓ -Day Phone: / x-57/.
Middle,Initial::. Student Fax Number: . 34� 7S�
Last Name: Student Email: e:(fi92W-e I T—l) �a
Address::
Address.2: -.
Zip Code: -
Americans with Disabilities Act Program Accessibilify:
City:' lndividualswho require reasonable accommodation in order
to participate must notify the"registrar at(904)62NI?TM
State: y
aT least five working.da s prior To the class..
Occupation (Rank): �A
Employer (Agen.cy'Name):-
COURSE
�/'�i-�
INFORMATION
Course Title: %"_ G6e,I�. 219 L .�� ra Fi pi t t c J`� /!�c'S�
$S�./
Course Dates: . .�1ohl
Full must
Course Location: _rV�"/-e e-.A l tl✓�'✓/L� ; � nt
• • -
accompanyregistrations!
1 . �� no.:
Course.Fee: . $ /
Please.do.not:make:cirline reservctions unti(you receive:written"notification confirming that the:course.will run ds scheduled..
PAYMENT • . •
Payment must be submitted with your registration.
5�. . . p y .. 9Y 9
heck enclosed for: $. �: Make check a able;to:'Institute.of Police.Technolo and Mand ement
Bill my: Visa MasterCard .E]American_Express E.Discover:' for $ -.
Card #: 3- or:.4=digit security code:
Name as it-appears on card: Expiration Date:.
Email receipt to.
CANCELLAVON/REFUND POLICY.
Complete.the Cancellation.Request.Form-found at www.iptm.org'and return it to IPTM :No telephone cancellations will be accepted.
A,20%.administrative fee will be assessed:to all.refunds if the.cancellation request is received.within.]4 days of.the course start date.
In{leu of a refund,.student substitutions:can.be made or:a;credit.can beissuedfora future course. No refunds.will be given for no-shows:
REGISTERING PERSON'S INFORMATION (if different than student)
Registering Person's Name:
Registering Person's Title: MIAI,11. //,+/7 /7SS�S '"� Phone Number: 17=:fP/a-S30
Registering,Person.'s Email: /�If� �S : C��''' �- oy
.� �.
eturn t'-o•.Plnstituteof Poli a Technology dnd"Mariagement�University bf North Florida
12000 Alumni`Drive • Jacksonville,.Florida 322242678
Phone: (904)620-1PTM• Fax: (904) 620-2453 • E-mail:info@iptm.org
Institute of Police Technology and Management
University of North Florida
Registration Form
STUDENT INFORMATION
First Name: Lucas Day Phone: 317-571-2500
Middle Initial: Student Fax Number: 317-571-2512
Last Name: Gossett Student Email: Igossett@carmel.in.gov
Address: 3 Civic square
Address 2:
Zip Code: 46032
Americans with Disabilities Act Program Accessibility:
Carmel Individuals who require reasonable accommodation in order
Clty:
to participate must notify the registrar at(904)620-IPTM
State: IN at least five working days prior to the class.
Occupation (Rank): Patrol Officer
Employer (Agency Name): Carmel Police Department
COURSE • ' • •
Course Title: At Scene Traffic Crash/Traffic Homicide Investigation
Course Dates: 6/19/2017-6/30/2017
paymentFull
Course Location: Lawrence, Indiana accompany all registrations!
Course Fee: $ 1,095.00
Please do not make airline reservations until you receive written notification confirming that the course will run as scheduled.
PAYMENT INFORMATION
Payment must be submitted with your registration.
0 Check enclosed for: $i PS -"YO Make check payable to: Institute of Police Technology and Management
❑ Bill my: ❑Visa ❑MasterCard ❑American Express Discover for $
Card #: 3- or 4-digit security code:
Name as it appears on card: Expiration Date:
Email receipt to:
`CANCELLATION/REFUND POLICY:
Complete the Cancellation-Request.Form found at www.iptm.org.and return it to IPTM.- No telephone cancellations will be accepted..=
A 20%administrative fee will be assessed to all refunds if the cancellation request is received within 14 days of the course start date.
In.lieu-of a refund,student substitutions can be made ora credit can be issued fora future-course. No refunds-will.be given for no-shows.
REGISTERING PERSON'S INFORMATION (if different than student)
Registering Person's Name: Luann Mates
Registering Person's Title: Administrative Assistant Phone Number: 317-571-2530
Registering Person's Email: (mates@carmel.in.gov
�Refurn to.,'Instituteof Police`Technology and Management University of North Florida;
12000 Alumni Drive• Jacksonville, Florida 32224-2678
Phone: (904) 620-IPTM• Fax: (904) 620-2453 9 E-mail: info@iptm.org