191599 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: T359466 Page 1 of 1
ONE CIVIC SQUARE CRISIS PREVENTION INSTITUTE INC CHECK AMOUNT: $100.00
f tr CARMEL, INDIANA 46032 10850 W PARK PLACE SUITE 600
MILWAUKEE WI 53224 CHECK NUMBER: 191599
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4355300 IUSI011501 100.00 ORGANIZATION MEMBER
Original Invoice
Nonviolent Crisis lntervention ®program Invoice IUS1011501
Prepare Training@ program Date== 10/6/2010
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Dementia Care Specialists c Federal Lb.: #39- 2012874
CPI Matters at Work
GST 86192 3753 RT0001
Positive Options
Bill To: Ship To:
Brooke Taflinger Brooke Taflinger
1235 Central Park Dr E 1235 Central Park Dr E
Carmel IN 46032 Carmel IN 46032
US US
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Purchase Order No �a
IM 6 9 C 6 erlD a. Shi` in IUlethod uPa: meet "Terms- Re _SF i Date
803058 NET 30 10/6/2010
0fder' d 1- SF ipped B10 Item "Number Des,&riition
1 1 0 GPI RECERT FEE Annual Membership Fee $100.00 $100.00
Cert Year from 12/512010 to 12/5/2011
Purchase
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a Thank you total Z us$ 7 $100.00
Remit to: CPI
10850 W. Park Place, Suite 600 Please include invoice number or customer ID with payment
Milwaukee, WI 53224 USA
Call toll -tree:
Canadian Customers Please remit to: US /Canada: 1 -877- 877 -5390
ns evention Inst Inc Australia: 800 55 3247
Lockbox New Zealand: 0800 44 9187
PO B 66, Sta
Toronto, ON M5W 3N9 Canada
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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
Purchase Order No.
T359466 Crisis Prevention Institute, Inc. Terms
10850 W Park Place, Suite 600
Milwaukee, WI 53224
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1016110 IUS1011501 Annual membership 100.00
Total 100.00
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
Voucher No. Warrant No.
T359466 Crisis Prevention Institute, Inc. Allowed 20
10850 W Park Place Suite 600
Milwaukee, WI 53224
newaddress In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -99 IUS1011501 4355300 100.00 1 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
4 -Nov 2010
Y&A a---
Signature
Is 100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund