HomeMy WebLinkAbout195950 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 365202 Page 1 of 1
ONE CIVIC SQUARE HILTON FORT WAYNE
CARMEL, INDIANA 46032 1020 SOUTH CALHOUN ST CHECK AMOUNT: $180.12
FORT WAYNEIN 46802 CHECK NUMBER: 195950
CHECK DATE: 3/29/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 180.12 TRAINING SEMINARS
INVOICE
Date: March 25, 2011
Sold to: City of Carmel Police Department
3 Civic Square
Carmel, IN 46032
Payment for lodging for Marc Paris on May 1 3, 2011 in Fort Wayne, IN
Confirmation 93423097770
Room Rate Tax Total
$79.00 $11.06 $90.06 x 2 180.12
TOTAL DUE: 5180.12
Please make check payable to:
Hilton Fort Wayne
1020 South Calhoun Street
Fort Wayne, IN 46802
For, G'F,�ICIAL f CNLY Al T ma E
nom
REoisTFu
j SM Annual Conference may 1st -rd
J $135 Conference Fee (J $15 "Junkyard Shootouf' Match
J $25 Late Fee (After April 15, 2011)
Total: .00 Additional Banquet Tickets $40 each
An application form must he submitted for each and every attendee
FlRST NAME LAST HM1E
AGENCY ASSIGWAENT /RANK /TITLE
AGENCY ADDRESS CITY STATE ZIP CODE
MAILING ADDRESS (OTHER THAN AGENCY) CITY STATE ZIP CODE
119.7 Sic ✓d a� ls-5 i'J t/(oo3
E -MAIL ADDRESS ff PHONE �y
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1 affirm that the above information is true and accurate. Further, I authorize the Indiana SWAT Officers Association
to contact my employer and verify my employment and assignment, if necessary.
SIGNATURE DATE T
IMPORTANT: Will you be attending the banquet? /9YES ONO Number of additional tickets requested:
Federal Tax ID Number: 57- 1177923
You are considered pre- registered if your registration form and payment (agency purchase order, check, credit card`, DOJ
voucher, or money order) are received prior to April 15, 2011. Any registration form received after April 15, 2011, will result in a
$25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be
purchased for $40.00 per ticket (limited quantity available).
*Registration fee includes: Attendance at Conference, Vendor Appreciation Day, lunch and
banquet dinner on Monday, May 2nd, and lunch on Tuesday, May 3rd.
*There will be a $3,00 additional processing fee for credit card payments
If you are pre registered and cancel prior to April 15, 2011, your registration fee will be refunded less a
$50.00 administrative charge. No refunds will be issued after April 15, 2011. However, suitable substitu-
tions will be allowed.
If paying by credit card, please complete the following: [j VISA
CREDIT CARD NUMBER EXPIRATION DATE 3 DIGIT AUTHORIZATION CODE
NAME ON CREDIT CARD AUTHORIZATION SIGNATURE
ADDRESS CITY i STATE ZIP CODE
IMPORTANT: Your credit card will be charged the day your registration form and payment are received by the ISOA.
Please include the billing address where the monthly statement is sent
PLEASE CHECK: J FULL -TIME J PART -TIME J RETIRED J AUXILIARY/RESERVE U ACTIVE MILITARY J RESERVE MILITARY
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hilton Fort Wayne
IN SUM OF
1020 South Calhoun Street
Fort Wayne, IN 46802
$180.12
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
210 57000 $180.12 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
Friday, March 25, 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))
03/25/11 payment for lodging for Officer Paris to attend training $180.12
1 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