188326 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 100000 Page 1 of 1
ONE CIVIC SQUARE DWIGHT D FROST
CARMEL, INDIANA 46032
CHECK NUMBER: 188326
CHECK DATE: 8/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231400 113.00 GASOLINE
1110 4237000 14.89 REPAIR PARTS
210 4357000 442.15 TRAINING SEMINARS
SUPER 8 RICHFIELD
4845 BRECKSVILLE ROAD
RICHFIELD, OH 44286 US
Phone:330- 659 -6888
Fax: 330-659-6857
Email: super8richfield @gmail.com
Printed: 7/19/2010 8:43:44 AM
F® Detailed)
Name: DWIGHT, FROST Confirmation Number: 59464572
Account Number: 093 103692
Address: CARMEL POLICE
CARMEL, IN 46032 US
Room: 305 Room Type: NQQ1, 2 QUEENS NSMK Nights: 1 Guests: 2/0
Rate Plan: RACK Daily Rate: $40.00 $6.00 Tax GTD: CA CASH
Arrival: 7/18/2010 (Sun) Departure: 7/19/2010 (Mon)
Room Rate:
7/18/2010 (Sun) 7/18/2010 (Sun) $40.00 $6.00 Tax per night.
Date Code Description Amount Balance
7/18/2010 CA CASH ($46.00) ($46.00)
7/18/2010 RM ROOM CHARGE $40,00 ($6.00)
711812010 TAXI LOCALTAX $1.20 ($4.80)
7/18/2010 TAX2 COUNTY TAX $2.20 ($2.60)
7/18/2010 TAX3 STATE TAX $2.60 $0.00
Summary
Room Tax F &B Other CC Cash DB
$40.00 $6.00 $0.00 $0.00 $0.00 ($46,00) $0.00
By signing below, I agree to these terms and conditions.
Guest Signature:
(1) Regardless of charge instructions, the undersigned acknowledges the above as personal indebtedness. (2) This property is privately owned and
management reserves the right to refuse services to any one, and will not be responsible for injury or accidents to guests or loss of money, jewelry or
any personal valuables of any kind.
"We or our affiliates may contact you about goods and services unless you call 888- 946 -4283 or write to Opt Out/Privacy, Wyndham Hotel Group, LLC,
22 Sylvan Way, Parsippany, N1 07054 to opt out. View our website about privacy."
3
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2008 F ACTORY SC H O OL R EGISTRATioN FO RM
Please complete ALL information for each attending student Print legibly
Registration: To tentatively reserve your seat this registration form must be completed and mailed or faxed to Remington Arms Company, Inc., and the Host Agency (fax
number can be found et www.remingtorle com J. Tuition must be paid in full in order to guarantee a seat in the class. This form may be reproduced as necessary; however, a
separate copy is required for each attending student.
Course Dates Requested:, �v 2 0 f�2 3 d
Student's Full Name: bi 1, f it c9 S
"`Please provi a valid email address as Confirmation will be sent via Email.
Email: c jj r-o S 4 _L rrn, l. I n q0
PROFESSIONAL INFORMA
DeptiRgency Name: r-r e-
Malting Address: a
City: C.Q ote /Province: Zip /Postal Code:.
Valid Work Phone: S 7l- 9 Occupati q 1 r o u z
P AYMENT $7Z5,00 ALL PAYMENTS MUST BE RECEIVED 45 DAMS PRIOR TO CLASS
LATE PAYMENTS I REFUNDS: Requests for refunds must be submitted in writing no less than 30 days prior to scheduled class. There will be a S100.00 administration fee
for any cancellations received less than 30 days prior to the scheduled class. Failure to show for the scheduled class will result in a charge for the entire tuition, Payments
received less than 45 days prior to class will result in a late payment fee of $50.00 Students must attend the entire course and payment must be received in order for the
Student to receive his/her Certificate,
C RED rr CARD CHECK ENCLOSED 0 E LECTRONIC Fl1NDS TRANSFER
Billing Address (if different from Dept mailing address
Name on Card: Type of Card:
Card Number: Card Expiration:
Purchase Order Number: 4(1319
Authorization for Student to Attend Armorers Course and Guarantee Payment-
Print Name Signature
*REGISTRATION FORMS MUST BE FAXED TO BOTH REMINGTON 315- 895 -3661 TH H AGENCY
ALL CORRESPONDENCE AND PURCHASE ORDERS, SHOULD BR SENT TO:
Remington Arms Co., Inc., Attn: LETrgDiv
14 Hoefler Avenue Phone: 315- 895 -3352
Ilion, New York 13357 Fax: 315 -895 -3661
Payment Terms: All payments are to be in US Funds payable at least 45 days in advance to:
Remington Arms Co., Inc., P.O. Box 503810, St Louis, MO, 63150 -3810
Remington's Tax ID #51- 0350935
V xs�rkyi C
CITY OF CARMEL Expense Report (required for all travel expenses)
'JN01 pNP..
EMPLOYEE NAME: Dwight Frost DEPARTURE DATE: 7/18/2010 TIME: 4 AM E DEPARTMENT: Carmel Police RETURN DATE: 712412010 TIME: 1 AM
REASON FOR TRAVEL: Training DESTINATION CITY: Ilion NY
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL_ REIMBURSEMEN TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Totaf
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
7118110 $3.00 $46.00 $32.50 $81.50
7119/10 $65.00 $65.00
7/20110 $65.00 ,.$65. 00
7/21110 $55.01 $65.00 (344
7/22/10 $65.00 '$6
7/23110 $61.14 $65.00 $126.14
7124110 $32.50 $32.50
$0.00
$9.00
$0 :00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Yofal $0:00 $'119.15 $46:00 $0.00 $0A0 so.00 $0.00 $390:00 J
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature. Date: D
,.City of Carmel Form ER06 Revision Date 7/26/2010 Page 1
Prescribed by Stale Board otACCOUnts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev- 1995)
CITY OF CARMEL
4.
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
Dwight D. Frost Purchase Order No.
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoices) or bill(s))
7/29/10 reimburse Lt. Dwight Frost for lodging, meals tolls 570.04
and gasoline while attending the Remington Arms
Factory School on July 20 23, 2010 in Ilion NY:?
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
Dwight D. Frost IN SUM OF
570.04
ON ACCOUNT OF APPROPRIATION FOR
police general fund cont ed fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 314 113.00 bill(s) is (are) true and correct and that the
1110 370 14.89 materials or services itemized thereon for
210 570 442.15 which charge is made were ordered and
received except
July 29 2 0 10
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund