195004 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 00352395 Page 1 of 1
ONE CIVIC SQUARE COUNTRY INN SUITES BY CARLSON CHECK AMOUNT: $291.96
CARMEL, INDIANA 46032 HUNTSVILLE
4880 UNIVERSITY DRIVE CHECK NUMBER: 195004
HUNTSVILLE AL 35816
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 291.96 TRAINING SEMINARS
INVOICE
Date: February 23, 2011
Sold to: City of Carmel Police Department
3 Civic Square
Carmel; IN 46032
Payment for lodging for Mike Pitman on Mareh 28 31.2011 in Huntsville, AL
Confirmation 98MV3LG6
Room Rate Tax Total
$87.00 $10.32 $97.32 x 3 $291.96
TOTAL DUE: 5291.96
Please make check payable to:
Country Inn Suites by Carlson Huntsville
4880 University Drive
Huntsville, AL 35816
l'� E
The National Children's
Advocacy Center
27 National Symposium on Child Abuse, Huntsville, AL March 28 -31, 2011
First and Last Name: 112;
Agency: C& mP 0 I CQ
Address: I Cr �`LG(►�^�—
City: C',49,2 M 1
State: rq r—,
Zip: CO 3
Work Phone: l S 7/ rte'` Q
Fax Number: 3 1 7 S 71 a S`/ Z
Email Address: e -e N J 6—,9
Discipline: (Please check the one that most close1v describes vour current uosition)
To mark an "X" in the box below, double click on the box, under, "Default Value," select, "Checked" and then click, "OK"
Medical Prevention Victim Advocate Child Protective Services
Legal Administration Mental Health /Treatment Child Forensic Imell'le Wet"
Law Enforcement Other (Please Specify
Conference Rep_istration Rates Per Person: Pre Conference Sessions:
When paying by Credit Card or Check (Held on Monday, March 28, 2011, 8:30 a.m. 4:00 p.m.)
S449 on or before January 22, 2011 $99 NICHD Interview I'rotocol 101
'<$499 after January 22, 2011 $99 Using What Sex Offenders 'fell Us to Improve Child Safety
When paving by Military Order or Purchase Order:
$499 regardless of registration date
TOT AMOUNT ENCLOSED OR TO BE CHARGED
Method of Payment
Check or Money Ordcr For 5 Fncloscd Payable io NCAC (Must be in U.S. Dollars Drawn on U.S. Bank)
J -tirchasc Order on Organization's Form enclosed.
;Mihiary Voucher Fncloscd.
Credit Card: VISA KIASI KCAxD American Express
Card I lolder's Manic (Please Print):
Card R: Expiration data
Si��nalure:
Please Send This Form and Payment to:
IT Mail National Children's Advocacy Center 1-ax: 256 327 3856 (with credit card information)
Ann: Ann 131alock
210 Priw Avcnuc Rcgisrer On -Line: wlswmaiionalcac.org
Huntsville. Alabamu 35501 (Using Credit Card)
Federal 1.D.963- 0891512
CANCELLATION POLICY
!i When cancellations recciVLcI by I 28, 201 1 will he rofmtdcd. less a S75 NO Rt"FUN'DS he made after
FehruarY 28, 201 I. (Registration [cc is l n;nsfcrablc at no additional charge.) A1.1. Itc)l:icemenls and /or Changes will he handled On -sac.l
VOUCHER NO. WARRANT NO.
Country Inn Suites by Carlson Huntsville ALLOWED 20
iN SUM OF$
4880 University Drive
Huntsville, AL 35816
$291.96
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO# Dept. INVOICE NO. ACCT #(TITLE AMOUNT
Board Members
I hereby certify that the attached invoice(s), or
570.00
bill(s) is (are) true and correct and that the
210 570.00 $291.96
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, February 24, 2011
i
Chief of Police
Title
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
National Symposium on Child Abuse in March
02/23/11 payment for lodging for Det. Pitman while attending the $291.96
I hereby certify that the attached involce(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