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Home My WebLink About195496 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 00352848 Page 1 of 1 ONE CIVIC SQUARE INT CONFERENCE OF POLICE CHAPLAI�g CARMEL, INDIANA 46032 8814 TIMBERWOOD DRIVE CHECK AMOUNT: $150.00 INDIANAPOLIS IN 46234 CHECK NUMBER: 195496 CHECK DATE: 3/16/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 27267 150.00 TRAINING 8814 Timberwood Dr. Indianapolis, IN 46234 Invoke Date: March 8, 2011 RE: PO 4 27267 To: Carmel Police Department 3 Civic Square "Serving All Carmel IN 46032 Law Enforcement From: Rick. Kassel, ICPC Region 4 Chaplains Region Director 8814 Timberwood Dr Indianapolis IN 46234 Thank you for registering your chaplain, George Davis, for the International Conference of Police Chaplains Rick Kassel Region 4 training seminar at Perrysburg, OH March 14- Regional Director 16, 2011. Chere Bates The fee for Chaplain Davis to attend the advanced CISM Secretary Comparison Model workshop and other classes plus the banquet is $1.50.00. Please make the check payable to Deb O'Neil Lewis ICPC =RTS 2011. The check should be mailed to me at Treasurer the above address. Looking forward to seeing George at the RTS. Blessings to the entire department. Rick. Kassel., Region 4 Director 0 International Conference of Police Chaplains THE INTERNATIONAL CONFERENCE OF POLICE CHAPLAINS REGION 4, REGIONAL TRAINING SEMINAR LAW ENFORCEMENT CHAPLAINS Perrysburg, OH March 14 -16, 2011 PLEASE PRINT CLEARLY Is this your first ICPC training? Yes No Name: v1 NIMS Trained? Yes No What Level? f f Street: '7� A, l S L CISM Trained? Yes No What Level? City: Law Enforcement Agency Serving: P ,Q State: N Size of Agency: I� 2 S r Zip: [7 J -C Faith Organization: v i I f r J i Phone No. (Home): 1-7- Z 7 Number of years in chaplaincy: Phone No. (Office): j Are you career full -time chaplain? Email: CIS car x'11 J I II, G' v Are you paid part -time chaplain? Last 4 of Social Sec. No. (For Academic C edit): Z 0 Are you a volunteer chaplain? ICPC Member: Yes No Spouse's Name: Kar ICPC Credentialed: Basic Senior ZMaster Spouse's first ICPC event? Yes No Not Attending Diplomat Fellow Spouses: Speaker (Care for the Caregiver) -Trips (Shopping- Art Museum) Host: Mrs. Sandy Vascik Banquet Special Dietary Needs: 1. Must Complete Class Selections on reverse side Gluten Free 2. One Banquet Ticket is included in registration fee. Kosher 3. Banquet Tickets must be purchased for Spouse or Guests. Vegetarian Ride Along: Sunday -Yes No Monday: Yes No Handicap or Special Needs: Basic Classes PC/ Your Toledo Airport Information Enrichment Workshop Conference Arrival Date: Participants Advanced 2 3 Advance 1 Fees Arrival Time: Departure Date: ICPC Member $150.00 $170.00 Departure Date: Non member $225.00 $240.00 Flight Information: Guest /Spouse Banquet Tickets $30.00 each Checks payable to: ICPC -RTS 2011 Registration Fee Extra Banquet Meals Mail this completed registration Late Registration $25.00 form (front &back) and fees to: After February 20, 2011 Michele Miller, OH Registrar TOTAL PAID ICPC RTS TOTAL DUE 280 Riverside Dr. Rossford, OH 43460 -1049 CLASS REGISTRATION CHOOSE ONLY ONE CLASS FOR EACH TIME SLOT (Advanced class is ALL DAY) This class registration must be returned along with completed form on reverse side. Monday, March 14, 2011 8:45- 1.0:15 a.m. 10:30 -12:00 p.m. 1:00 -2:30 p.m. 2:45 -4:1.5 p.m. (Circle One Only) (Circle One Only) (Circle One Only) (Circle One Only) B 1 Intro to Law Enforcement Chaplaincy B2 Death Notification B3 Stress Management B4 Ceremonies Events E1 Gangs/Narcotic RecognitionNiolent Crimes E2 Healing in the LODD E3 Life Flight I E4 Life flight 11 Al Pastoral Crisis Intervention (ALL DAY) ec haplaincy Center 1 (ALL DAY) A3 Stops Training for Chaplains (ALL DAY) Tuesday, March 15, 2011 8:00 -9:30 am 9:45 -11:15 am 12 :15 -1:45 pm 2:00- 3:30pm 3:45-5:15 pm (Circle One Only) (Circle One Only) (Circle One Only) (Circle One Only) (Circle One Only) B5 Legal Liability Confidentiality B6 Ethics B7 Responding to a Crisis Situation B8 Law Enforcement Family B9 Substance Abuse E5 Weapons Familiarization I E7: Weapons Familiarization 1I E9 Domestic Violence Elder Abuse E10 The Forgotten Dispatchers El 1 Satanic Cults E6: CPR -First Aide -AED I E8: CPR -First Aide -AED 11 Al Pastoral Crisis Intervention e (ALL DAY) haplaincy Center (ALL DAY) A3 STOPS (ALL DAY) Wednesday, March 16, 2011 8:00 -9:30 am 9:45 -11:15 am 11:30 -1:00 pm (Circle One Only) (Circle One Only) (Circle One Only) B10 Suicide B 11 Officer Injury or Death B 12 Sensitivity Diversity E12 Relating to Police /Hospital Chaplains E13 Losing Ones' Self E14 Child Suicide INDIANA RETAIL TAX EXEMPT PAGE C ity o irme CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER x r �a FEDERAL EXCISE TAX EXEMPT 2727 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION MWM I ICPC4M Carmel Police Department VENDOFAicholo MIllGr, ON RGgisQrar SHIP 3 CIVIC ftmm Rivorslde Drive TO Cwmol, IN 462 Rassford, OH 43M-1049 (W) 571.2M CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT 't QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 00- 670.00 1 Each training $150.00 $150.00 Sub Total: $150.09 3w u r IN m I Oar 41an 1 an4eeeax of Police Chaplains can �2 ar Ij41 iw b is on March 14 -16, 2011 in Perrysburg, �e c nvolce o: f Camol Police Attn: Toresm Andemon 3 Civic Squam C2rrnel, IN 41 4 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT Camel Palico D ept. PAYMENT $950•'tI9 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. I HEREBY CERTIFY THAT THERE IS•AN UNOBLIGATED BALANCE IN SHIPPING INSTRUCTIONS THIS APPROPRIATION.SI�FF G� SHIP REPAID. NT% O PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. Chid (�f ®Ilcg THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO, CLERK TREASURER DOCUMENT CONTROL No-27265 A.P.V. 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 /TITLE AMOUNT DEP 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 Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. s V iv ALLOWED 20 ICPC -RTS Rick Kassel, /CPC Region 4 IN SUM OF 8814 Timberwood Drive`'C/ Indianapolis, IN 46234 $150.00 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 27287 570.00 $150.00 C 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 Friday, March 11, 2011 Chief of Police Title 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 03/08/11 payment for training for Chaplain Davis $150.00 E 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