188867 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 363105 Page 1 of 1
ONE CIVIC SQUARE INTL POLICE MOUNTAIN BIKE ASSOC
CARMEL, INDIANA 46032 583 FREDERICK ROAD SUITE 5B CHECK AMOUNT: $280.00
BALTIMORE MD 21228 CHECK NUMBER: 188867
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CHECK DATE: 8/18/2010
D EPARTM ENT A CCOUN T PO NUMBE INVO NUMBER AMOUNT DESCRIPTION
1110 4355300 280.00 ORGANIZATION MEMBER
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INVOICE
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Enclosed are my 550.00 membership renewal dues or
INTERNATIONAL POLICE MOUNTAIN BIKE ASSOCIATION
I p NI B A TAX ID 52 -2 1 3778 1 Charge my O Visa O MasterCard
Setting the public .sc{fety cycling since 1991
Expiration date: Signature:
PHONE O Home O Dept. O Cell
DUE DATE: August 31, 2010 EMAIL (for iPMBA use onit)
20090761 08/10 810710 I am not renewing at this time because
D.J. Schoeff O 1 am no longer in public safety. O I have been promoted /transferred off bikes.
12102 Windsor S. Dry O other
Fishers IN 46038 Call 410 -744 -2400 or Fax 410- 744 -5504
Or mail this form to
IPMBA, 583 Frederick Road, Suite 513, Baltimore MD 21228
Address correct.' Please indicate chaw,{es.
Mail today continue to enjoy your member benefits! IT IS TIME TO
cVo IPMBA News— the best and only source for national and international public safety cycling RENEW YOUR
news and information. IPMBA
cab Product Purchase Program money- saving discounts on great products for personal and
professional use. Just one purchase pays for your IPMBA membership! MEMBERSHIP!
cab IPMBA Website your link to the IPMBA training calendar, industry suppliers, educational
and training resources, IPMBA merchandise, and more. I Call 410- 744 -2400
cab Bicycling magazine valuable information to enhance your cycling experience included Fax 410- 744 -5504
Ldl,�) ith your IPMBA membership. (A S20 value, U.S. addresses az1v.)
etworking acce ss to over a decade of expertise and experience, and the best source for MaIl tO I PMBA
ntacts to serve as personal resources and advisors. 583 Frederick Road, Suite 5B MBA Conference the premier public safety cycling training event —yours at a special Baltimore, Maryland 21228
ember price! MBA HQ member volunteers and fiill -time staff working together to promote the c ofession of public safety cycling and deliver the resources you need.
IPNV BA
1PA413A "'s/ led in 1991 uti a 501(.) 3 nonprq it e,,6mat-nal 'gonizaliun.
INVOICE Payment Method
0, RIB:
Enclosed are my $50.00 membership renewal dues or
INTERNATIONAL POLICE MOUNTAIN BIKE ASSOCIATION
I P Ni B A TAX ID 52- 2 13778 1 Charge my O Visa O MasterCard
Setting the standards• for public safety cycling s ince 1991
Expiration date: Signature:
PHONE O Home O Dept. O Cell
DUE DATE: August 31, 2010 ENTAIL (for IPMBA use onl))
20090760 08/10 R10710 I am not renewing at this time because
O 1 am no longer in public safety. O 1 have been promoted /transferred offbikes.
Michael Pitman O Other
150 Springs Ct.
Carmel IN 46033 Call 410- 744 -2400 or Fax 410 744 -5504
Or mail this form to
IPMBA, 583 Frederick Road, Suite 513, Baltimore MD 21228
Address correct? Please indicate changes.
IPMBA MEMBERSHIP AND CERTIFICATION APPLICATION
BENEFITS:
Internationally recognized IPMBA Police, EMS or Security Cyclist Certificate...
IPMBA News (training tips, product reviews, funding information, and resources)
Subscription to Bicycling* Magazine (a $21.98 value)...
Discounted registration to IPMBA's Annual Conference...
Access to advanced training opportunities, including the II'MBA Instructor Course...
Members -only discounts on equipment and gear...
IPMBA member decals?
*U.S. and Canadian addresses only.
IPMBA certification is available
to members only.
FHon-tePhone r Police EMS Security IPMBA membership is open to
ss
Ui SGu individuals only.
Address
ci 1- State ?rr Zip /Country y0 0_71R Membership materials will be
t mailed to your home address.
S C0 Mobile (Allow 6-8 weeks)
E -Mail Address kjhodenk r i /Q eArme f,
Please mail applications and
Department OMM11 RLJcL payment immediately following
Department Address the course.
City State Zip /Country
Dept. Phone Dept. Fax
Membership Number (for current IPMBA members) Mail B A
to:
I have taken the minimum 32 -hour 0 Police EMS Cyclist Course, or the IP
583 Frederick Rd.
minimum 24 -hour O Security Cyclist Course and passed (minimum 76 1 10 the
Suite 5B
Police, EMS, or Security Cyclist Written and On -Bike Examinations. Baltimore MD
Primary IPMBA Instructor's Name: S eA l 21228
Instructor Number.
Dates of the Course: Month Dates A Y".,, /0
Location of Course: r [t dd l ea2!► �C 7. 5T 2- 9— Fax credit card info to:
(Facility Name, City, and State) 416- 744 -5504
1 would like to become an IPMBA- Certified PAYMENT METHOD (U.S. FUNDS ONLY)
Police, EMS, or Security Cyclist and join My check or money order is enclosed (payable to IPMBA)
IPMBA's Registry of Certified Public Safety Pleasechargemy: Visa /MasterCard (Circle0ne)
Cyclists. Name on Credit Card (please print):
(Certification is only available to current, renewing,
Email Address of Card Holder:
or joining members.)
C/$50.00 IPMBA Membership Fee Credit Card Number:
$10.00 Certification Fee (Membership Expiration: Code:
required for Certification)
Billing Address: Home ❑Department
5.00 Police Cyclist Pin gold
or silver) Signature:
5.00 EMS Cyclist Pin (gold only) Purchase orders accepted for
multiple memberships only.
5.00 Security Cyclist Pin (silver only) Federal Tax ID. 52- 2137781
TOTAL
2009 International Police Mountain Bike Association www.ipmba.org
Reset 'Form' F Submit Form
IPMBA MEMBERSHIP AND CERTIFICATION APPLICATION
BENEFITS:
Internationally recognized IPMBA Police, EMS or Security Cyclist Certificate...
IPMBA News (training tips, product reviews, funding information, and resources)
Subscription to Bicycling* Magazine (a $21.98 value)...
Discounted registration to iPMBA's Annual Conference...
Access to advanced training opportunities, including the LPMBA Instructor Course...
Members -only discounts on equipment and gear...
IPMBA member decals!
*U.S, and Canadian addresses only.
IPMBA certification is available
to members only.
Name A )bsall Police EMS Security C1 IPMBA membership is open to
Home Address /✓iC tla2tr individuals only.
City CdZr V_--'L Statel!v Zip /Country q&0_74 Membership materials will be
mailed to your home address.
Home Phone (,31 Mobile (Allow 6--8 weeks)
E -Mail Address J
Department !»�L an,�C Please mail applications and
payment immediately following
Department Address the course.
City State Zip /Country
Dept. Phone Dept. Fax
Membership Number (for current IPMBA members) Mail fv
I have taken the minimum 32 -hour Police EMS Cyclist Course, or the IPM
t0:
583 Frederick Rd.
minimum 24 -hour Security Cyclist Course and passed (minimum 76 the
Suite 5B
Police, EMS, or Security Cyclist Written and On -Bike Examinations.
Baltimore MD
Primary IPMBA Instructor's Name: .3 S t 1H' 21228
Instructor Number: 1(.g w
Dates of the Course: Month Dates c06 Year _'2o y -or-
Location of Course: .oil 'a OU {(`7. �r,�1tZ4 �,J Fax credit card info to.
(Facility Name, City, and State) 410- 7445504
I would like to become an IPMBA- Certified PA YMENT MEMOD (U.S. FUNDS ONLY)
Police, EMS, or Security Cyclist and join M check or money order is enclosed (payable to IPMBA)
IPMBA's Registry of Certified Public Safety Please charge my: visa /MasterCard (Circle One)
Cyclists. Name on Credit Card (please print):
(Certification is only available to current, renewing,
Email Address of Card Holder:
or joining members.)
@450.00 IPMBA Membership Fee Credit Card Number:
$10.00 Certification Fee (Membership
required for Certification) Expiration: Code:
5.00 Police Cyclist Pin (L) gold
Billing Address: O Home ❑Department
or O silver)
Signature:
5.00 EMS Cyclist Pin (gold only) Purchase orders accepted for
multiple memberships only.
5.00 Security Cyclist Pin (silver only) Federal Tax ID: 52- 2137781
TOTAL
2009 International Police Mountain Bike Association www.ipmba.org
Reset fbrm SubmitP&M.
IPMBA MEMBERSHIP AND CERTIFICATION APPLICATION
BENEFITS:
Internationally recognized IPMBA Police, EMS or Security Cyclist Certificate...
IPMBA News (training tips, product reviews, funding information, and resources)
Subscription to Bicycling* Magazine (a $21.98 value)...
Discounted registration to IPMBA's Annual Conference...
Access to advanced training opportunities, including the IPMBA Instructor Course...
Members -only discounts on equipment and gear...
IPMBA member decals!
*U.S. and Canadian addresses only.
IPMBA certification is available
to members only.
Name Police CV EMS Security IPMBA membership is open to
Home �Address C t/+ a L 4042E individuals only.
f
City OUML State �L Zip /Country Membership materials will be
mailed to your home address.
Home Phone P 7 VI 2 00 Mobile (Allow 6-8 weeks)
E -Mail Address !'i'o 7v
Please mail applications and
Department l "pmt t payment immediately following
Department Address the course.
City State Zip /Country
Dept. Phone Dept. Fax
Membership Number (for current IPMBA members) Mail form to:
I have taken the minimum 32 hour &Police El EMS Cyclist Course, or the IPMBA
583 Frederick Rd.
minimum 24 -hour Security Cyclist Course and passed (minimum 75 the
Police, EMS, or Security Cyclist Written and On -Bike Examinations. Suite SB
Baltimore MD
Primary IPMBA Instructor's Name: D 5['h7e 21228
Instructor Number. /191
-or-
Dates of the Course: Month �k Dates 4-dqO'c Year /J
Location of Course: 6Q9 r►+► C K"I ArC 41r141 ,I Fax credit card info to:
(Facility Name, City, and State) 410-744 -5504
1 would like to become an IPMBA Certified PAYMENT METHOD (U.S. FUNDS ONLY)
Police, EMS, or Security Cyclist and join My check or money order is enclosed (payable to IPMBA)
IPMBA's Registry of Certified Public Safety Please charge my: Visa /MasterCard (Circle Cane)
Cyclists. Name on Credit Card (please print):
(Certification is only available to current, renewing,
Email Address of Card Holder:
or joining members.)
$50.00 IPMBA Membership Pee Credit Card Number:
0' Certification Fee (Membership
required for Certification) Expiration: Code:
Billing Address: Home Department
5.00 Police Cyclist Pin gold
or 0 silver)
Signature:
5.00 EMS Cyclist Pin (gold only) Purchase orders accepted for
multiple memberships only.
5.00 Security Cyclist Pin (silver only) Federal Tax ID: 52- 2137781
TOTAL
C 2009 International Police Mountain Bike Association www.ipmba.org
Rese# Form' Submit Fbrm
Prescriked by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form Ho. 201 (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
IPMBA Purchase Order No.
583 Frederick Road, Suite 5B Terms
Bailtimore, MD 21228 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
812110 payment for membership renewal for Officer DJ Schoeff 50.00
8112/10 a ent for membership renewal for Officer M. Pitman 50.00
8/12/10 a ent for membership for Officer Wendy Bodenhorn 180.00
Sgt. Phil Hobson and Officer Greg Dewald
Total 280.00
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
VOWCHER NO. WARRANT NO.
ALLOWED 20
TPMBA IN SUM OF
583 Frederick Road, Suite 5B
Baltimore, MD 21228
280.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT voice(s), or
DEPT. I hereby certify that the attached in
1110 553 280.00 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
August 12 20 10
h&A&"j -b
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund