309874 4/4/2017 CITY OF CARMEL, INDIANA VENDOR: 361521
ONE CIVIC SQUARE ANTHONY KEATON CHECK AMOUNT: $*******317.80*
r3` CARMEL, INDIANA 46032 7655 MADDEN LANE CHECK NUMBER: 309874
FISHERS IN 46036 CHECK DATE: 04/04/17
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4231400 25.30 GASOLINE
1120 4343002 292.50 EXTERNAL TRAINING TRA
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03-16-17
Tony Keaton Folio No. Cashier No. 12 Room No. 102
7655 Madden Ln A/R Number Arrival 03-12-17
Fishers IN 46038-1303 Group Code Departure 03-16-17
United States Company BUSINESS Conf. No. 60818924
Membership No. PC 675956264 Rate Code : IMGOV
Invoice No. Page No. 1 of 1
Date I Description I Charges I Credits
03-12-17 Deposit Transfer at Check-In check#307245 507.12
03-12-17 `Accommodation 115.00
03-12-17 State Tax-Room 7.18
03-12-17 Tourism Fee-City 3.45
03-12-17 Tourism Fee-State 1.15
03-13-17 'Accommodation 115.00
03-13-17 State Tax-Room 7.18
03-13-17 Tourism Fee-City 3.45
03-13-17 Tourism Fee-State 1.15
03-14-17 *Accommodation 115.00
03-14-17 State Tax-Room 7.18
03-14-17 Tourism Fee-City 3.45
03-14-17 Tourism Fee-State 1.15
03-15-17 *Accommodation 115.00
03-15-17 State Tax-Room 7.18
03-15-17 Tourism Fee-City �1 �5 3.45
03-15-17 Tourism Fee-State oti`� 1.15
Thank you for staying with us! Qualifying points for th' will tt natic Ily be credited o Total 507.12 507.12
your account. Please tell us about your stay by writin �leyv q Y ww .com/review .
We look forward to welcoming you back soon.
Balance 0.00
Guest Signature:
I have received the goods and/or services in the amount sho heron. I agree that nly i or this bill is not waived and agree to be held
personally liable in the event that the indicated person,company',NLassociate faii}9any part or the full amount of these charges. If
a credit card charge, I further agree to perform the obligations set fo ' the cardhel agreement with the issuer.
Independently Owned and Operated by Sima Ventures,
Holiday Inn Express Hotel&Suites Richmond
1990 Colby Taylor Drive
Richmond, KY 40475
Telephone: (859)624-4055 Fax: (859)623-8775
Invoice
Fire Seminar -KY Invoice Number:
857 Tallevast Rd. 1653
Sarasota, FL 34243 Invoice Date:
USA Dec 8, 2016
Due Date:
March 6, 2017
Registration For:
Anthony Keaton
Carmel Fire Dept
2 Civic Square
Carmel.IN 46032
Pre-paid fees are fully refundable until February 13, 2017; therea/ter individual registrants may be substituted, but refunds will not be
made. This registration is NOT a reservation but a commitment to attend and pay for the training program. Registrants who do not cancel
or transfer their registration by March 6. 2017 will be charged a$200"No Show"fee.
Description Amount
ational Fire,Arson and Explosion Investigation Training Program- March 13-16, 2017 775.00
Program Handouts 50.00'.
Discount for Early Registration -50.00'
Payment
Subtotal $ 775.00
Reference: Payment Received
TOTAL $ 775.00
Please return the bottom portion with your payment
For: Keaton,Anthony Check or Money Order in US Funds Only
Balance: $ 775.00 Visa.MasterCard.American Express. Discover
Invoice Number: 1653 Account Number:
Please remit payment to: Expiration Date
Fire Seminar-KY
857 Tallevast Rd. Billing Zip Code CVV#
Sarasota.FL 34243.USA
Telephone:941-355-9079 Card Holder Signature:
Fax:941-351-5849
Card Holder Name:
Tax ID:36-6071438