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HomeMy WebLinkAbout187884 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 354777 Page 1 of 1 1� ONE CIVIC SQUARE INDIANA SWAT OFFICERS ASSOC, INC CHECK AMOUNT: $550.00 0 CARMEL, INDIANA 46032 PO Box 1850 N o VALPARAISOIN 46384 -1850 CHECK NUMBER: 187884 CHECK DATE: 7/21/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 21328 100.00 TRAINING 210 4357000 21343 300.00 TRAINING 210 4357000 21852 150.00 TRAINING P.O. Box 1850 INVOICE 1,` 11 Valparaiso, IN 46384 -1850 sib info @indianasoa.com DATE. JULY 7, 2010 TO: FOR: Carmel Police Department 2010 ISOA Conference 3 Civic Square Carmel, IN 46032 DESCRIPTION AMOUNT Conference Jellison, Ryan $100.00 REF: PO #21328 Conference /Membership Collins, Shane $150.00 Conference /Membership Myers, Brady $150.00 REF: PO #21343 Conference /Membership Barlow, Jim $150.00 REF: PO #21852 TOTAL $550.00 Make all checks payable to ISOA Payment is due within 30 days. If you have any questions concerning this invoice, contact Nick Kokot at (219 713 -9555 Thank you for your support! FWD, comcaL Is>= ONLY Anuiou RE(NsTanoN 7 Annual Cvnfewce May 2nd P -a $100 ISOA Member J $10 "Steelyard Shoot' Match $150 Non Member' $25 Late Fee (Member/Non Total: j $150 Glock Course Fee J Additional Banquet Tickets $25 each An application form must he submitted for each and every attendee FIRST NAME N AM E lAS T AGENCY n ASSIGNMENT /RANK /TITLE AGENCY ADDRESS ;CITY j TATE ,ZIP CODE MAILING ADDRESS (OTHER THAN AGENCY) l- CITY :STATE =ZIP CODE i N_ lzs I o L. 2 E-MAIL ADDRESS PHONE I affirm that the above information is true and accurate. Further, 1 authorize the Indiana SWAT Officers Association to contact my employer and verify my employment and assignment, if necessary. SIGNATURE I DAATT E IMPORTANT: Will you be attending the banquet? RYES U NO Number of additional tickets requested Federal Tax ID Number: 57 1177923 You are considered pre- registered if your registration form* and payment (agency purchase order, check, credit card`, DOJ voucher, or money order) are received prior to April 9, 2010. Any registration form received after April 9, 2010, will result in a $25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be purchased for $25.00 per ticket (limited quantity available). *Registration fee includes: Attendance at Conference, vendor appreciation day, lunch and banquet dinner on Monday, May 3rd, and lunch on Tuesday, May 4th. 'There will be a $3.00 additional processing fee for credit card payments If you are pre registered and cancel prior to April 9, 2010, your registration fee will be refunded less a $50.00 administrative charge. No refunds will be issued after April 9, 2010. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: I CREDIT CARD NUMBER PIRA EXPIRATION DATE 3 DIGIT AUTHORIZATION CODE I I NAME ON CREDIT CARD AUTHORIZATION SIGNATURE i_._.. ADDRESS CITY STATE ZIP CODE IMPORTANT: Your credit card will be charged the day your registration form and payment are received by the ISOA. Please include the billing address where the monthly statement is sent. PLEASE CHECK: FULL -TIME J PART-TIME J RETIRED 'J AUXILIARY /RESERVE J ACTWE MILITARY U RESERVE MILITARY e o� FOR OFFICIAL USE ONLY ADEE RE(;&9TmnoN te1 t nh Annual Confider May 2nd 4th Q $100 ISOA Member Q $10 "Steelyard Shoot" Match r x$150 Non Member' Q $25 Late Fee (Member/Non-Member) Total: Q $150 Glock Course Fee Q Additional Banquet Tickets $25 each An application form must be submitted for each and every attendee EIRST NAME M. LAST NAME r.. c AGENCY A551GNMENT /RANK /TITLE AGENCY ADDRESS �CRY STATE IIP CODE MAILING ADDRESS (OTHER THAN AGE CRY STATE ZIP I E•MAIL hDDR65 I affirm that the above information is true and accurate. Further, I authorize the Indiana SWAT Officers Association to contact my e a nd veri my employmen and assign if necess SIG RE DATE IMPOR ANT: Will you be attending the banquet? RYES Q NO Number of additional tickets requested: 4 Federal Tax ID Number. 57- 1177923 You are considered pre- registered if your registration form" and payment (agency purchase order, check, credit card', DOJ voucher, or money order) are received prior to April 9, 2010. Any registration form received after April 9, 2010, will result in a $25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be purchased for $25.00 per ticket (limited quantity available). *Registration fee includes: Attendance at Conference, vendor appreciation day, lunch and banquet dinner on Monday, May 3rd, and lunch on Tuesday, May 4th. *There will be a $3.00 additional processing fee for credit card payments If you are pre registered and cancel prior to April 9, 2010, your registration fee will be refunded less a $50.00 administrative charge. No refunds will be issued after April 9, 2010. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: (D Q Q CREDIT CARD NUMBER I EXPIRATION DATE 3 DIGIT AUTHORIZATION CODE 1 NAME ON CREDIT CARD AUTHORIZATION SIGNATURE ADDRESS CRY STATE ZIP CODE IMPORTANT. Your credit card will be charged the day your registration form and payment are received by the ISOA. Please include the billing address where the monthly statement is sent. PLEASE CHECK: FULL -TIME Q fART-TIME RETIRED AUXILIARY /RESERVE ACTIVE MILITARY Q RESERVE MILITARY o o 0 A A A o A FoFf OFFIC;AL USE O,N,Y ATTER m W Ri� Er GIS� A, 77/0 T Conference day 2nd 4th j J $100 ISOA Member iJ $10 "Steelyard Shoot' Match X $150 Non Member' J $25 Late Fee (Member/Non- Member) Total: 1_�a .00 J $150 Glock Course Fee J Additional Banquel Tickets $25 each An application form must be submitted for each and every attendee FlRST HAMS M -I. LAST NAME 5 r. C� 11thS AGENCY ASSIGNMENT /RANI /TITLE rm¢L_..0 ®I�fe t. Serget AGENCY ADDRESS CITY STATE ZIP CODE 3 Cr' S �H C Y, CITY STATE ZIP CODE r e �r rn�,1 T4/1 y ©3 MAILING ADDRESS (OTHER THAN A r3 p r�At l rn 1..... y 6033 Ew"IL ADDRESS PHONE -as S7] o I affirm that the above information is true and accurate. Further, I authorize the Indiana SWAT Officers Association to contact my employer and verify my employment and assignment, if necessary. SIGNATURE DATE IMPORTANT.' Will you be attending the banquet? )(YES J NO Number of additional tickets requested: Federal Tax ID Number: 57 1177923 You are considered pre- registered if your registration form" and payment (agency purchase order, check, credit card', DOJ voucher, or money order) are received prior to April 9, 2010. Any registration form received after April 9, 2010, will result in a $25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be purchased for $25.00 per ticket (limited quantity available). 'Registration fee includes: Attendance at Conference, vendor appreciation day, lunch and banquet dinner on Monday, May 3rd, and lunch on Tuesday, May 4th. 'There will be a $3.00 additional processing fee for credit card payments If you are pre registered and cancel prior to April 9, 2010, your registration fee will be refunded less a $50.00 administrative charge. No refunds will be issued after April 9, 2010. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: J IJ CREDIT CARD NUMBER EXPIRATION DATE i 3 DIGIT AUTHORIZATION CODE ..1... NAME ON CREDIT CARD AUTHORIZATION SIGNATURE ADDRESS CITY STATE 'ZIP CODE IMPORTANT: Your credit card will be charged the day your registration form and payment are received by the ISOA. Please include the billing address where the monthly statement is sent. PLEASE CHECK: FULL -TIME PART-TIME J RETIRED 'J AUXILIARY/RESERVE J ACTIVE MILITARY J RESERVE MILITARY a i A o A A s A 4 For C)FFK;rA: USE ONLY ArrmwE E f y 7th Annual Cankmn(e May 2nd 4th J $100 l$0A Member J $10 "Steelyard Shoot" Match )($150 Non Member Z $25 Late Fee (Member/Non Total: .00 J $150 Glock Course Fee J Additional Banquet Tickets $25 each An application form must be submitted for each and every attendee FIRST NAME M.I. LAST NAME AGENCY ASSIGNMENT /RANK /TITLE AGENCY ADDRESS CITY STATE 2VP COOS MAILING ADDRESS (OTHER THAN AGENCY) CITY :STATE ZIP CODE 7- v �4 f t f 1 7 EMAIL ADDRESS PHONE v C affirm that the .L ter r^� .t /1 V /'.:3 above information is true and accdrate. Further, 1 authorize the Indiana SWAT Officers Association to contact fny employer and verify my employment and assignment, if necessary. SIGNATURE /1 DATE IMPORTANT. Wiltau y ttendr the banquet? YES J NO Number of additional tickets requested: Federal Tax ID Number: 57 1177923 You are considered pre registered if your registration form" and payment (agency purchase order, check, credit card', DOJ voucher, or money order) are received prior to April 9, 2010. Any registration form received after April 9, 2010, will result in a $25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be purchased for $25.00 per ticket (limited quantity available). *Registration fee includes: Attendance at Conference, vendor appreciation day, lunch and banquet dinner on Monday, May 3rd, and lunch on Tuesday, May 4th. *There will be a $3.00 additional processing fee for credit card payments U if you are pre registered and cancel prior to April 9, 2010, your registration fee will be refunded less a $50.00 administrative charge. No refunds will be issued after April 9, 2010. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: J��� I J J CREDIT CARD NUMBER EXPIRATION DATE 3 DIGIT AUT1iORIZATK3N CODE I NAME ON CREDIT CARD AUTHORIZATION SIGNATURE ADDRESS CITY STATE ZIP CODE IMPORTANT: Your credit card will be charged the day your registration form and payment are received by the 1SOA- Please include the billing address where the monthly statement is sent, PLEASE CHECK: FULL-TIME IJ PART -TIME J RETIRED J AUXILIARY/RESERVE J ACTIVE MILITARY J RESERVE MILITARY C it y f� INDIANA RETAIL TAX EXEMPT PAGE o JL Carmel CERTIFICATE NO.003120155 002 0 Y PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 2132 3QNR 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 T v 1(1 training VENDOR Nick Kokot ISOA Vice *P'resident SHIP City 66 Carmel Police 1Departmmnt P.O. Box 1850 TO 3 Civic Square Valparaisom, IN 46384 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Indiana SWAT Offices Association conference 100.00 for Sgt. Ryan Jellison on May 2 4, 2010 in Ft. Wayne, In. A C V City of Carmel Poo Ir," Send Invoice To: ATTN: Teresa Anders`a 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 210 570 cant edd£und PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. 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 SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED, ORDERED BY f I.l�.fif f' l J17 PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 2 n 0 CLERK- TREASURER DOCUMENT CONTROL NO. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR a 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 Y i 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund i PAGE AC....a, INDIANA RETAIL TAX EXEMPT Ci o�-'I�I anal CERTIFICATE N0. 003120155 002 0 1 1+• PURCHASE ORDER NUMBER Poli Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 71 30„NE CIVIC SQUARE FTHI UMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 ER, DELIVERY MEMO, PACKING SLIPS, NG 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 March 11, 2010 training VENDOR Indiana Swat Officer Assoliation (ISOA) SHIP City of Carmel Police Department Nick Kokot TO 3 Civic Square P.O. Box 1850 Carmel, IN 46032 Valparaiso, IN 46384 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Indiana SWAT Conference for Major Jim Barlow 150 on May 2 w 4, 2010 in Ft. Wayne, IN 717, 4� Send Invoice To: City of Carmel Pol et I ATTN: Teresa Anderson 3 Ciatc Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE i' DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT 210 570 cont ed fund PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. 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 PUHCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO- 2-1k. CLERK TREASURER DOCUMENT CONTROL NO A.R. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO.__ ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR i 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_ s 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund INDIANA RETAIL TAX EXEMPT PAGE City li o I' Carmel CERTIFICATE NO.003120155 002 0 1 cif 1 PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 21343 3 1 =90VIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP 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 Februar 3. 20 L training VENDOR ISOA SHIP City of Carmel Police Department Nick Kokot TO 3 Civic Square P.O. Box 1850 Carmel, IN 46032 Valparaiso, IN 46384 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 7th Annual ISOA Conference for Sgt. Shane 150.00 300.00 Collins and Sgt. Brady Myers on. May 2 4, 2010 in Ft. Wayne, IN JV AO m Send Invoice To: C'Ity of Carmel Po ce a t ATTN: Teresa Anders t 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 210 570 coat ed tun PAYMENT AJP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. F 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., A' C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. DOCUMENT CONTROL NO. A.0 COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. —WARRANT NO._..- ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #i7lTLE 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 20 Signature Title i Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed 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 ISOA Purchase Order No. 21328F 21852F 2134 P.O. Box 1850 Terms Valparaiso, IN 46384 1850 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 7/7/10 a ent for Indiana Swat Officers Association 550.00 conference for Sgt. Ran Jellison Major Jim Barlow S°t. Shane Collins and Sgt. Brady Myers on May 2 4 2010 in Ft. Wayne, IN 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 zsnA IN SUM OF P.O. sox 1850 Valparaiso; IN 46384 -1850 550.00 ON ACCOUNT OF APPROPRIATION FOR cont ed fund Board Members of or INVOICE NO. ACCT #/TITLE AMOUNT EPT. I hereby certify that the attached invoice(s), or 213ZF 570 100.00 bill(s) is (are) true and correct and that the 21343F 570 300.00 materials or services itemized thereon for 21852 570 150.00 which charge is made were ordered and received except July 13 20 10 Signature Chief-.of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund