182406 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 363105 Page 1 of 1
ONE CIVIC SQUARE INTL POLICE MOUNTAIN BIKE ASSOC
i+ CARMEL, INDIANA 46032 583 FREDERICK ROAD SUITE 5B CHECK AMOUNT: $1,800.00
BALTIMORE MD 21228
CHECK NUMBER: 182406
CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 21321 21230 1,800.00 TRAINING
International Police Mountain Bike Association Invoice
583 Frederick Rd. Ste 5B
Baltimore, MD 21228 DATE INVOICE
410-744-2400/Fax: 410-744-5504 1/27/2010 21230
BILL TO SHIP TO
Carmel Police Dept.
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 46032
DUE DATE P.O. NUMBER FED TAX 10 52- 2137781
2/11/2010 21321
QUANTITY DESCRIPTION PRICE EACH AMOUNT
2 IPMBA Instructor Course 550.00 1,100.00
2 Police on Bikes Pre Conference Registration 350.00 700.00
Re: Pitman Schoelf
Please enclose a copy of this invoice with payment and include invoice Total
number on all correspondence. $100,00
The International Poiice Mountain Bike Association is a non profit organization dedicated to providing
training and resources to police and EMS personnel on bikes.
ti
iD10
20th Annual IPMBA Conference
Chesterfield -St. Louis, Missouri May 2010 Registration Form Page 1 of 2
lease read "Registration Checklist" on back of lease check all boxes that apply and add
workshop descriptions before filling out this up the right column for your total.
registration form. PRINT LEGIBLY.
rainin re n en e
TO avoid rush fee, registration forms must be received by April 1, 2010. You must be a current member to attend any of the pre conference
Name (As you would like it to appearon yournametag, and in all correspondence) training courses. Join or renew below if you are not currently a member.
®�0 T❑ ❑0�❑ Bicycle Response Team Training $375
IJ
First Last EMS Cyclist Course $325
Home C Address �,r�+ D IPMBA Instructor Course 550
fCt -S CpytiA r IPMBA Instructor Application encl used $125
f
S� Street Address You must apply and be approved to attend. Contact the IPMBA office with questions.
�f6Q,39 Maintenance Officer Certification Course $525
City state Postal code °oun°ry Home MMR -IPMBA Core Skills Scenarios Clinic. $495
Persona[ Telephone yo f -L�to (0 °te9 Police Cyclist Course $325
E -Mail Departmental authorization for live -fire exercises enclosed....__
/J (F o r IPMRAUSe nly, Public Safety Cyclist 11 Course $450
Dept. Name lAf'F m E r r!'[ t c P_ Departmental authorization for live -fire exercises enc losed
(As I v,W appearon YO nametegl
Dept. Address 43 uyiC t. r+' 2r
C n 5treel- dre55(.T" El $400
p�(� IPMBA Member Fee
MUST be current; you must provide your current IPMBA membership
City State Pastel Code Country number on this form orioin/ranew with this registration.
Dept. Telephone �L- 2-1100 Non -IPMBA Member Fee $475
IPMBA Membership Number 2— 9 Fee for Pre- Conference Attendees d$350
!f you are attending any of the seven Pre Conference training
(Mandatory For -1 and renewing members) courses, this is the fee you will pay to attend the conference.
IPMBA Instructor Number Bike Team Rate $350
See box in left column for details.
'Confirmations will be sent via e-mail. They will NOT be mailed.
Guest Fee (per guest) Guests x $50
The guest fee entities your guest admission to the exhibit
Lunches are included in the cost of each pre conference course. During the hall and two lunches. NAME(s):
conference, lunches will be served on Thursday and Friday; please check the Rush Fee 25
appropriate boxes on the reverse. All other meals are on your own. Registrations submitted after April 1, 2010, must include the rush foe.
SaVe Exhibit Hall -only Pass (Pre- Registration Required) Free
..Bike Team Rate Register three or m 9re and
IPM M embe r s hi p
Register three or more members from the same agency at a flat rate of
$350 per team member! The following conditions apply: New q Renew :3 50
Applies to CONFERENCE fees only. Tee Shirt Size ❑M ❑L I(XL ❑XXL ❑XXXL
Does NOT apply to Pre Conference Course Fees.
Can be used by both conference -only attendees and those attending both a n
pre- conference course and the conference. TOTAL ENCLOSED d
Registrants MUST be IPMBA members (current, joining or renewing). CANCELLATION POLICY: Refund requests must be made in writing and postmarked by
Registrations MUST be submitted together (offer not available online). April 1, 2010. Refunds, less a $50 administration fee, will be processed following the
conference. No refunds after April L if you must cancel after April 1, you may locate a
substitute and submit his/her registration form and a letter of explanation. Membership,
HAVE YOU COMPLETED THE OTHER SIDE OF THIS FORM? certification, and instructor application foes are non-refundable.
Mail -OR- Fax (not both) to IPMBA, 583 Frederick Rd., Suite 5B, Baltimore MD 21228 Fax 410-744-5504
Form of Payment
[MUST ACCOMPANY REGISTRATION] Purchase Order number f
Check or money order (payable to IPMBA) enclosed, or departmental equivalent: I
Visa /MasterCard accepted (circle one).
Department to which the invoice should he sent
Expire: 1 Signature: Attantlon
Name on card: Address
Email address for receipt: city State ZIP
Contact phone:
Phone
Police on Bikes, Inc. dba Mlernalional Police Mountain Bike Associalion's Federal LD. Number.- 52- 2137781 W 1 d
2 u
Annu "th PMB f
Chesterfield -St. Louis, Missouri May 2010 Registration Form Page 1 of 2
lease read "Registration Checklist" on back of l lease check all boxes that apply and add
workshop descriptions before filling out this up the right column for your total.
registration form. PRINT LEGIBLY.
To avoid rush fee, registration forms must be received by April 1, 2010. You must be a current member to attend any of the pre conference
Dame (As you would like if to appear on your narnetag, and in all correspondence) training courses. Join or renew below If you are not currently a member.
Bicycle Response Team Training $375
EMS Cyclist Course $325
First Last
Home Address r� IPMBA Instructor Course $550
3 hl y1 p yagi—_ IPMBA Instructor application enc losed $125
1 Street Address You must apply and be approved to attend. Contact the IPMBA office with questions.
u 03 r r�. Maintenance Officer Certification Course $525
C;t State Postal Code Country O Home MMR -IPMBA Core Skills Scenarios Clinic. $495
Personal Telephone I ;L Police Cy clist Course $325
E -Mail ds&0e f& CQ622e I In 01)V Departmental authorization for live-fife exercises enclosed I......❑
(Foil 1seon1y) I Public Safety Cyclist 11 Course $450
Dept. Name C r Departmental authorizatian for live-fire exercises enclosed
(As d will appear on your nemetagl
Dept. Address (Iv)f SuU42C
Street Address
�1r�3 a 11 SR IPMBA Member Fee $400
MUST be current; you must provide your current IPMBA membership
ov state Postal Code Country numberon this form or join/renew with this registration.
Dept. Telephone 71 S7 'o? Non -IPMBA Member Fee $475
IPMBA Membership Number Fee for Pre Conference Attendees $350
p if you are attending any of the seven Pre Conference training
(Mandofory for current and renewing members) courses, this is the fee you will pay to attend the conference.
IPMBA Instructor Number Bike Team Rate $350
See box in left column for details.
*Confirmations will be sent via a -mail. They will NOT be mailed.
Guest Fee (per guest) Guests x $50
The guest fee entitles your guest admission to the exhibit
Lunches are included in the cost of each pre conference course. During the hall and two lunches. NAME(s):
conference, lunches will be served on Thursday and Friday; please check the Rush Fee 25
appropriate boxes on the reverse. All other meals are on your own. Registrations submitted after April 1, 2010, must Include the rush fee.
Exhibit Hall -Only Pass (Pre- Registration Required) Free
Register three or more members from the same agency at a flat rate of New Renew 13 50
$350 per team member! The following conditions apply: 3X
Tee Shirt Size ❑M UL ❑XXL ❑XXXL
Applies to CONFERENCE fees only.
Does NOT apply to Pre Conference Course Fees.
Can be used by both conference -only attendees and those attending both a TOTAL ENCLOSED 00 1 Do
pre conference course and the conference.
Registrants MUST be IPMBA members (current, joining, or renewing). CANCELLATION POLICY: Refund requests must be made in w and postmarked by
April 1, 2010. Refunds, less a $50 administration fee, will be processed following the
Registrations MUST be submitted to offer not available online). tag conference. No refunds after April f. if you must cancel after April i, you may locate a
substitute and submit his/her registration form and a letter of explanation. Membership,
certification, and instructor application fees are non refundable.
HAVE YOU COMPLETED THE OTHER SIDE OF THIS FORM?
Form of Payment
(MUST ACCOMPANY REGISTRATION] 11 Purchase Order number
or departmental equivalent:
Check or money order (payable to IPMBA) enclosed.
Visa/MasterCard accepted (circle one).
Department to which the invoke shaub Oe sent
Expire: Signature: Attention
Name on card: Add`ess
Email address for receipt: city state ZIP
Contact phone:
Phone
Police on Bikes, Inc. dba Inrernalional Police Mountain Bike Association's Federal ID. Number: 52-213 7781 W1 0
A INDIANA RETAIL TAX EXEMPT PAGE
of C armei CERTIFICATE NO. 003120155 002 0 1 of
PURCHASE ORDER NUMBER
n Police Department FEDERAL EXCISE TAX EXEMPT 21321
35- 60000972
30NE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A!P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
January 14, 2010 training
VENDOR IPMBA SHIP City of Carmel Police Department
583 Frederick Road, Suite. 5B TO 3 eiuic Square
Balftore, MD- 21228 CarnEl, IN 46032
CONFIRMA BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
20th Annual IPMBA Conference for Det. Mike 0
Pitman and Officer DJ Aehoeff on May 1 8, 9bb-co
2010 in Chesterfield, MO �1�1LCJ'W
7 7
i'T f
lu
�T aeare
r
City of Carmel Po'
Send Invoice To: ATIN: Teresa Anders
T
3 Civic Square
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT J PROJECT PROJECT ACCOUNT AMOUNT
210 570 cont ed fund py� PAYMENT
y A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
l 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
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID-
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 69r��
PURCHASE ORDER NUMBER MUST APPEAR ON ALL y r
SHIPPING LABELS. F
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief Of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. A• 1 COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF
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,_______ ^T
20
Signature
Title
i
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescritl,d by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 203 (Rev. 1995)
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
International Police Mountain Bike Assoc. Purchase Order No. 21321F
583 Frederick Road, Suite 5B Terms
Baltimore, MD 21228 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/27/10 21230 payment for 20th Annual IPMBA conference for Det. 1 800.00
Mike Pitman and Officer DJ Schoeff on Ma I 8 2010
in Chesterfield MO
Total
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
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
i`
International Police Mountain Bike Ass IN SUM OF
583 Frederick Road, Suite 5B
Baltimore, MD 21228
1,800.00
ON ACCOUNT OF APPROPRIATION FOR
cont ed fund
Board Members
Po# or INVOICE NO. ACCT# /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
21321F 21230 570 1,800. 0 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
February 10 20 10
Signature
Chief of POlice
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund