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Home My WebLink About182872 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 361689 Page 1 of 1 ONE CIVIC SQUARE HOLIDAY INN EXPRESS HOTEL 8. SUIT �g i 0 S ECK AMOUNT: $564.30 CARMEL, INDIANA 46032 1706 SKIBO ROAD FAYETTEVILLE NC 28303 CHECK NUMBER: 182872 CHECK DATE: 3/3/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 564.30 TRAINING SEMINARS INVOICE Date: February 24, 2010 Sold to: City of Carmel Police Department 3 Civic Square Carmel, IN 46032 Payment for lodging for Ryan Jellison and Brady Myers on March 23 March 28, 2010 in Fayetteville, NC Confirmation 960113737 Room Rate Tax. Total $99.00 $13.86 $112.86 x 5 $564.30 TOTAL DUE: $564.30 Please make check payable to: Holiday Inn Express Hotel Suites 1706 Skibo Road Fayetteville, NC 28303 N Viking Tactics, Inc. 3725- Heatherbrooke Drive Fayetteville, NC 28308 -9718 PHONE: (910) 9137 -5983 FAX (910) 425 -0700 www.VIKINGTACTtCS.COM Registration and Applicati ®n for Training Viking Tactics, Inc. 1 Team VTAC, Inc. IN ACCORDANCE WITH ITAR REGULATIONS, ONLY U.S. CITIZENS WILL BE ACCEPTED TO PARTICIPATE.IN VTAC COURSES r P First Name MI D Last Name Email Address: 1 m s, c` r\,CA f A Date of Birth: c, Zta 1 L Age: Home Address: City: 1 5 7t State Zip La_ Occupation: Military or LE Affiliation: Rank: f` Work Address: c- G; u,t City: ar-M t State Zip c-/(, o Zi Home Phone Work Phone: Former Student; 1 No If yes, provide prior dates: S' 6,;ja Weapon Information: If Civilian, Pistol License Number, State of Issuance and Expiration Date: Primary Weapon Type and Caliber. r4 Pistol License Number: Secondary Weapon Type and Caliber. i�_ Z 2 Ll0 it State of Issue Expiration Dale: COURSEDATE: TJ 3/7- COURSE.NAME: A) +.�Lk t Pre- Requisites Met:�s) No Emergency Name: F{ r �1 r l; s Emergency Phone: ;1 LE1MilitaryOnly Courses: Must include credentials verifying active LE status or active Military ID. An application without one of the options below will be rejected. There are NO'exceptions. VTAC: reserves the absolute right to refuse training for any reason whatsoever to any applicant. Submission of this .application indicates, your clear understanding of this requirement. Credentialing Policy: VTAC has a strict credentialing policy. A photocopy or completion of ONE of the following options should accompany your application. LE /Military: Select one of the following options. .s Certificate of Good Conduct (from your local Police Departme)J i, Active. Duty Police Id; Police Dept /Unit 0_, r t� r Badge c 2! 1 t Active Duty Military; (No ID copy required) Unit Branch of Service If Civilian Provide Either: r Pistol License No. (ahy:state) or'CCW Permit No. Exp. Date_ State of Issue 7 A current:ccpy of a Criminal Record History Check from your state of residence within twelve (12),months of training; course date showing no criminal activity: Payment Information: SEE VTAC INSTRUCTION PAGE AND FAQ PAGE FOR UPDATED INFORMATION v A deposit is required to reserve your seat. Refer to the Course Announcement for the amount. Course Cancellation Policy: We require the full tuition upfront to reserve your slot. If you cancel outside of 30 days, we will refund 100% of'you'r tuition. If you cancel inside, of 30 days, and we cannot GII your slot, we retain 50% of your tuition. Deposit is waived for PO remitiances.and Mil Orders. Payment method: Check Purchase Order Credit Card Amount (add 5% to course fee) If paying by credit card: MAKE CHECKS PAYABLE TO: Viking Tactics, Inc. -(Note an additional 5% will be added to course fee for processing CC payments) Send Payments to: Payment Information: Viking Tactics, Inc. Name-on Credit Card: 3725 Heatherbrooke Drive .Credit Card Number: Fayetteville, NC 28306 11 7 on Date of Card: Code,: J' Viking Tactics, Inc. 3725 Heatherbrooke Drive Fayetteville, NC 28306 -9718 PHONE: (910) 987 -5983 FAX: (9 10) 425 -0700 www.V(KINGTACTICS.COM Registration and Agglication for Trainin Viking Tactics, Inc. I Team VTAC, Inc. IN ACCORDANCE WITH TAR REGULATIONS, ONLY U.S. CITIZENS WILL BE ACCEPTED TO PARTICIPATE IN VTAC COURSES First Name L-i'J MI Last Name K4 1!5 Email Address: b 5 1P Date of Birth: to I 1 2y Age: Home Address ,,,r,,: City: rA lf. c.G� r_i� i State TJ Zip !2L L 2'/ 2'/ Occupation: -p I,; Military or LE Affiliation: c:(fl ik -I PO i".k Rank: Work Address: City: C n State Zip Home Phone Work Phone: Former Student Y I No If yes, provide prior dates: /11-:X Weapon Information: If Civilian, Pistol Lioense umber, Stat f issuance and Expiration Date: Primary Weapon Type and Caliber. t_ L "3 7 Pistol License Number: Secondary Weapon Type and Caliber Ln.�,� T '�G State of Issue: Expiration Date: COURSE DATE: VII &I COURSE NAME: !`1 I,, <l,,1.k/ Pre- Requisites Meta No Emergency Name: LlA z _N Emerg ency Phone: f 7 (Q S Vin LE/Military Only Courses: Must include credentials verifying active LE status or active Military ID. An application without one of the options below will be rejected. There are NO exceptions. VTAC reserves the absolute right to refuse training for any reason whatsoever to any applicant. Submission of this application indicates your clear understanding of this requirement. Credentialing Policy: VTAC has a strict credentialing policy. A photocopy or completion of ONE of the following options should accompany your application. LE/Military: Select one of the following options. 4 Certificate of Good Conduct (from your local Police Department) T Active Duty Police Id: PoliceDept/Unit C. I' r�� a:,fi5 Badge# 7(e T Active Duty Military; (No ID copy required) Unit Branch of Service If Civilian Provide Either: t Pistol License No, (any state) or CCW Permit No. Exp. Date_ State of Issue V A current copy of a Criminal Record History Check from your state of residence within twelve (12) months of training course date showing no criminal activity. Payment Information: SEE VTAC INSTRUCTION PAGE AND FAQ PAGE FOR UPDATED INFORMATION V A deposit is required to reserve your seat. Refer to the Course Announcement for the amount. t Course Cancellation Policy, We require the full tuition up front to reserve your slot. If you cancel outside of 30 days, we will refund 100% of your tuition. If you cancel inside of 30 days, and we cannot fill your slot, we retain 50% of your tuition. 'r Deposit is waived for PO remittances and M' qrders. Payment method: Check Purchase Order Credit Card_ Amount (add 5% t If paying by credit card: AKE CHECKS PAYABLE TO: Viking Tactics, Inc. "(Note an additional 5% will be added to course fee for processing CC payments)" Send Payments to Payment Information: Viking Tactics, Inc. Name on Credit Card: 3725 Heatherbrooke Drive Credit Card Number: Fayetteville, NC 28306 Expiration Date of Card: Code: Prescrit;ed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER 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 Holiday Inn Express HOte1 Suites Purchase Order No. 1706 Skibo Road Terms �ayet_teville, NC 28303 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 2/24/10 payment for lodging for Sgt. Ran Jellison and Sgt. 564.30 Brady Myers while attending Ni htfi titer school on March 25 27, 2010 in Fayetteville, NC 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 Holiday Inn Express Hotel Suites IN SUM OF 1706 Skibo Road Fayetteveille, NC 28303 564.30 ON ACCOUNT OF APPROPRIATION FOR cont ed fund Board Members EP or INVOICE NO. ACCT #/TITLE AMOUNT DEPT_ I hereby certify that the attached invoice(s), or 210 570 564.30 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 25 20 10 Signature Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund