332465 11/21/18 CITY OF CARMEL, INDIANA VENDOR: 034261
® 'I ONE CIVIC SQUARE TREASURER OF STATE OF INDIANA CHECK AMOUNT: $.`"•***493.46"
CARMEL, INDIANA 46032 CAMP ATTERBURY-DRM CHECK NUMBER: 332465
v;ETON_ ` PO BOX 5000 CHECK DATE: 11/21/18
EDINBURGH IN 46124-5000
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 19008-7 493.46 TRAINING SEMINARS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 034261 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
TREASURER OF STATE OF INDIANA IN SUM OF$ CITY OF CARMEL
CAMP ATTERBU RY-DRM An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
PO BOX 5000 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
EDINBURGH, IN 46124-5000
Payee
$493.46
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
19008-7 43-570.00 $493.46 1 hereby certify that the attached invoice(s),or 11/13/18 19008-7 Range usage fees $493.46
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, November 16,2018
Jim Barlow
Chief
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
DEPARTMENT OF THE ARMY
ATTERBURY-MUSCATATUCIC TRAINING CENTER
PO Box 5000 Bldg.245
Edinburgh,Indiana 46124-5000
NGIN-AMR
INVOICE# 19008-7 13 NOVEMBER 2018
CARMEL PD
Attn: GREG LOVEALL
#3 CIVIC SQUARE
CARMEL,IN 46032
Description:Usage Fees for Camp Atterbury 3-4 OCTOBER 2018
Training Area Price Per Day Number of Days Total
Due
RANGE 5 110.00 2 220.00
FaGil ':. 'otal 220.00
Range Support 228.60
Billeting Support 0
SUA.T'Q " 448.60
10% Surcharge for Non- 44.86
DOD Entities
493.46
TOTAL AMOUNT DUE$493.46
If you have any questions please call me at(812)526-1499 X62225
Make check payable to: TREASURER OF THE STATE OF INDIANA
TAX ID#35-6000158
REIV=TO:
Treasurer of the State of Indiana
Camp Atterbuiy-DRM
PO Box 5000,Bldg 245
Edinburgh,IN 46124-5000
0Janu=enaud
Accos Receivables/Payables Director
ATTERBURY/MUSCATATUCK OCCUPANCY AGREEMENT
THIS AGREEMENT IS MADE BY AND BETWEEN THE ADJUTANT GENERAL'S AGENCY OF THE STATE OF INDIANA
ON BEHALF OF THE INDIANA NATIONAL GUARD(hereinafter referred to as"State"),and CARMEL PD
(hereinafter referred to as"User")by and through its authorized Representative GREG LOVEALL
In consideration of the mutual promises made herein,the parties to the agreement hereby agree as follows:
1. Purpose: The State agrees to furnish the subject military property(or portion of a military facility set forth in paragraph 6)for the
purpose of conducting training,an exercise,or other event as established by the User and approved by the State.The established perimeter or
designated facility also includes access to,and use of,the restrooms(when military facilities are used that contain a permanent structure
restroom)and parking areas. No other areas shall be accessible unless specifically provided for in this Agreement
2. Term: This Occupancy Agreement will commence on the 3 day of OCTOBER 2018 at 7:30 o'clock
AM/PM and will terminate on the 4 day of OCTOBER 2018 at 6:00 o'clock AM/PM.
3. Total Rental Payment: The User agrees to pay the State for rental of said military property/facility,the sum of$ 493.46
as established on the Installation Cost Worksheet,attached hereto and made a part hereof as Exhibit"A"Said payment is to be made payable
to the Treasurer of the State of Indiana. Payment is to be made within 30 days of invoice date.
4.Facilities Request and Renortina
A. The User agrees to submit a written facilities request to the Camp Atterbury Future Operations Service Center(hereinafter
"FOSC")no less than one hundred eighty(180)days prior to the proposed event. Requested events are not approved until the
User receives acknowledgment from the State in writing.
B. Upon arrival at Camp Atterbury on the first day of the Event,the User shall report to Building 127,and agrees to attend the
Training Coordination Meeting prior to the start of the scheduled Event,as well as any additional meetings required by the
State,up to and including daily meetings. R is the User's responsibility to contact the FOSC to schedule this required training
prior to the start of the scheduled Event.
C. This Agreement may be unilaterally terminated by the Installation Commander or the Adjutant General,within their sole
discretion,and said termination determination is not subject to appeal or review. The User acknowledges and agrees that the
State will not be held liable for any damages or loss resulting from a unilateral termination of all or pari of this Agreement.
5. Covenants and Conditions:
A. In case said military properly/facility,or any part thereof,shall be destroyed or damaged by fire or by any other cause,or if
any casualty,unforeseen occurrence or military necessity shall render fulfillment of this Occupancy Agreement by the Lessor
impossible,the said State shall not in any case be held responsible to the User for any damage or loss caused thereby.
B. In renting a portion of said military property/facility to the User,the State does not relinquish the right to control the
management and operation of the remainder of the property/facility.The Installation Commander and/or his representative
may enter the property/facility at any time and on any occasion. The State also reserves the right,through its Representatives,
to eject any objectionable person or persons from the said properly/facility.
C. The Installation's Environmental Management Policy applies to all personnel who enter the State's property. The User is
responsible for providing a POC in writing to represent environmental compliance and is responsible for reporting any
environmental hazards,accidents,risk assessments,and concerns to the Environmental Office.
D. The Installation's Safety Policies apply to all personnel who enter the State's property.The User is responsible for providing a
safety POC in writing and is responsible for reporting any hazards,accidents,risk assessments,and concerns to the Installation
garrison safety officer.
E. The User agrees to provide general liability insurance,in a form acceptable to the State,in the amount of:
i. $300,000.00 for injury to any person in any single occurrence and
ii. $1,000,000.00 for injury to all persons involved in such occurrence
iii. $25,000.00 for property damage per occurrence
The policy shall name the Military Department of Indiana,the Adjutant General's Office,the Indiana State Armory Board,the
State of Indiana,and the Indiana National Guard,their representatives,agents,and officers as additional insured parties. The
policy shall provide for no less than ten(10)days advance notice of cancellation of the policy,with said notice provided
directly to the FOSC. A copy of such policy detailing the coverage laid out above shall be attached hereto and made a pari
hereof as Exhibit`B."
F. The User shall not damage or deface said property/facility and shall not permit the said property/facility to be in any manner
injured.For property use estimated to exceed one thousand dollars($1000.00)in costs the User shall be required to provide a
damage deposit of at least one hundred dollars($100.00)or up to ten percent(101/6)of the'I'otal Rental Payment,whichever is
greater,to the FOSC as part of the submission of the Event Agreement Packet. Payment of the damage deposit shall be made
payable to the Treasure of the State of Indiana,and may be counted against the Total Rental Payment at the conclusion of the
Event provided that the User has not caused any damage to occur to the State's property. The User shall be responsible for all
damage to the property/facility caused by it or by persons permitted to enter the property/facility for the purpose of this
Occupancy Agreement. The User also assumes full responsibility for the character,acts,and conduct of all persons admitted
to the property/facility under this Agreement.
G. Any Occupancy Agreement involving alcoholic beverages requires an Alcoholic Beverage Commission Permit(temporary
permit for an individual renting the property/facility or an off premises permit for a licensed caterer)and proof of sufficient
insurance coverage to protect the liability of the State(such determination shall be made by the Adjutant General's Office).
The Occupancy Agreement accompanied by the Alcoholic Beverage Commission Permit and proof of insurance must be
forwarded to the FOSC for approval no less than ten(10)business days prior to the rental. Failure to comply with this
provision may constitute immediate and automatic cancellation of this Occupancy Agreement.
H. In the event that the User terminates this Agreement less than ten(10)business days prior to the rental,or otherwise fails to
appear for the rental at the agreed upon time and location,the User shall be assessed an early termination fee of fifty dollars
($50.00). If the User fails to remit the early cancellation fee within thirty(30)business days of the invoice,the User's name
and organization(if applicable)shall be placed upon a non-rental list and the User will not be permitted any other rentals or
use of the State's property until or unless they are removed from the list at the sole discretion of the Installation Commander.
I. All events scheduled on Installations are further subject to termination or rescheduling as a result of any military necessity as
designated by the Installation Commander or the Adjutant General. A military necessity determination is final and conclusive,
and is not subject to further appeal or review,and requires no advance notification to become effective. No penalty may be
assessed or paid if termination is triggered by execution of this clause.
6.Indemnification: The User agrees to indemnify,defend,and hold harmless the State,its agents,officers,and employees from all claims
and suits including court costs,attorney's fees,and other expenses caused by any act or omission of the User and/or its occupants,in the
performance of this Occupancy Agreement. The State shall not provide such indemnification to the User or any other party.
7. TOTAL RENTAL FEE: $ 493.46
IN WITNESS OF THIS AGREEMENT,the said parties have set their hands hereto on the day of 2018. This
written agreement constitutes the entire agreement between the parties. It may be amended only by a written instrument signed by each of
the parties.
STATE OF INDIANA: CAMP ATTERBURY USER(Print):
By: ICATHERINA ROE Sign:
Sign Address:
Date: Phone:
Camp Atterbury Utilization Report
Overhead Cost(OC)Ildentlfiable incremental Cost(ICC)Checklist -
Instructions: This form will be used for all units/organizations that may be charged OC/ICC costs and be
filled out after each unit/organization clears. This form and any other documentation will be forwarded
to CA-DRM no more than 5 working days after training event.
Unit/Organization Name: PD—CARMEL
Training Date; 3-4 OCT 2018
Unft/Organization Address:if 3 CIViC SQUARE,CARMEL, IN 46032
Unit/Organlzation Telephone Number:317-955-8723
Unit/Organization Point of Contact: GREG LOVEALL
Unit/Organizatlon POC E-mail Address:GLOVEALL@CARMEL.IN.GOV
Questions Yes No
• Does the Unit organization have a current MOU? [X] [ J
• Does the Unit/Organization have a current Certificate of Insurance? [X] [
• Does the Unit/Organization have an Event Release? [X] [ I
• Did the Unit/Organization submit the Liability Waivers? [X] [
• Did the Unit/Organization use specialized ranges/facilities(special cost)? [ ] [X]
• Did the Unit/Organization use other ranges? [X I [
• Did the Unit/Organization use training areas? j ] f X]
• Did the Unit/Organization submit a strength report? [X) [ )
Does the Unit/Organizatlon expect to have ICC charges? [X j [
• Does the Unit/Organization have MiPR/other financial instrument on file? [X] [
Documents to be attached: Yes No
o Strength Report [X] [ j .
o Approval forwaiver of Overhead Costs [X] [
• Documentation for ranges and training areas used [X] [ I
Dates Forwarded to DRM: 7 NOV 2018
By: KELLY WILKINS
- i -
CAw ATTBRBTjxy JOINT MANuuvBR TRAI qmo CBNTBR
Daily Strength.Report
C[Mmetion tbrcomploting 11 is form an revema or may bo obtained from SohedalhigBrarch)
OfFica use.
Date: Doli(201
IteportingUniUOrganizatlon;
Address; S e%g%C- SOMA-- CA—VL-. 1N L-1006 2.
Telephone; srn
On Yost Hq Bldg No: Yost Yltono Lxi.
Unit (D)C?YC Training Total *Training Status
Status*
COM
CAr:sa�L vp SwKr ori y� AT.............................AnnualTYalniug .
IDT...........Diactivo Duty for Thining
MOB..............................Mobilization
DMOB.......................Demobilization
NU...............MOB/DOMOB Support
AC...................................Active Duty
(HaagG orResma)
OTS........................I-—.............Other
(CIV other NOI+Tmllltary)
SAD..................State/ItedBrm orgency
FTS........................Fall Time support
(1SU&TonantONLY)
'Pflmtad?game/Reak i gae! 0 Aa
AReceivedBy: f rA IbEl -
Prinlad Namto(Rark slg�tahue Date
CAJMTC Form 44(25 MAY 2005 OBSODBTl:) lir 23 OCrOBBR2006
CAze ATTEimuRY.)Oin MAmuvpR TRAme CFNTHR
Daily Strength Repofl
()nslructionfor completing Ihis fomi on raverso or may bo obtained ficin Schedullog Broach)
Office use.
Date: Rl OG�,� •
JReportiug Unit/Orgnnitattem: (MAW,,t- � Svj M
Address. s& ft, C{ amr-.L,od Wtao3 L
Telephone: �•en 5—tit —2b0
On Post Hq Bldg No; Post Plione.Irxf:
Unit (D)LIC Trabling Total- *Tyalniug Status
CODE
t«as� PS? •—'
(AAA 3 AT..........................AmualTmining
IDT...........Inactive Duty forlYalnbg
MOB...............................Mob i ilmdon
DMOB..............I........DomobRintion
MSP.......I.......MOB/Devoo Support
AC...................................Active Duty
(Not NO or Reserve)
4TH...........................................Other
(CIV otherNOi�T milittay)
SAD..................State/FedEmergemy
FTS........................Fall Time Support
(MMT&Tonant ONLY
CerifBCation: A4,n IZ)vv fttt-( acK t
PrlatedNamcfRank i ro Da
Received By. h
Prtnlo<INamelRank Si Ettu[o Date .
CAIMTC Forza 14(25 MAY 2005 OBSOI.BTE) 23 OCTOBER 2006
START DATE: 0311012018 INSTALLATION: CAMPATTERBURY
PERSONNEL TRAINED REPORT BY UNIT END DATE: 03110/2018 FIRE DESK ALL
im Jo K
fl
PDL.CARMEL RG005 SNIPER TRNG UNDER 600 4
ISTRENGTH OTHER EVENT 1 4
Total For PD CARMEL. a
GRAND TOTAL a
10
PAGE 111 PRINTED ON 07/11/2018 12:12 PRINTED BY BILLSK FOR OFFICIAL USE ONLY-PRIVACY SENSITIVE RANGE FACILITY MANAGEMENT SUPPORT SYSTEM
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