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Home My WebLink About198210 06/06/2011 CITY OF CARMEL, INDIANA VENDOR: 365070 Page 1 of 1 ONE CIVIC SQUARE NATIONAL CHILDREN'S ADVOCACY CE�ACK AMOUNT: $499.00 CARMEL, INDIANA 46032 210 PRATT AVE HUNTSVILLE AL 35801 CHECK NUMBER: 198210 CHECK DATE: 6/6/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 27264 2011 499.00 TRAINING Invoice No: 2011 Symposium -04 THE NATIONAL CHILDREN'S ADVOCACY CENTER P. 0. ORDER NO cE Terms: DATE 210 Pratt Avenue PO# 27264 5/24/11 Due Upon Receipt HUNTSVILLE, AL 35801 (256) 327 -3791 www. @nationalcac.org Send Paynieiit To: Attention: Ann Blalock, Finance Dept. FEDERAL I.D. 63- 0891512 National Children's Advocacy Center 210 Pratt Avenue Huntsville, AL 35801 BILL TO: SHIP TO: Carme Police Depart Attention: Teresa Anderson ATTENTION: Accounts Payable 3 Civic Square Carmel, IN 46032 UNIT TOTAL UNIT DESCRIPTION PRICE PRICE 1 Registration for Mike Pitman to attend the 27th $499.00 $499.00 National Symposium on Child Abuse that was held March 28 -31, 2011 in Huntsville, Alabama. Please reference this Invoice when Payment is Made. Total Due: $499.00 FEQ The !National Children's �J Advocacy Center 27 National Symposium on Child Abuse, Huntsville, AL March 28 -31, 2011 First and Last Name: Agency: C�6 lne Address: City: �R t State:{ Zip: 11 �0U3 Work Phone: 3 1 S'21- D y Fax Number: 3 t 2 S 7 2 S/ Z Email Address: {9 Discipline: (Please check the one that most closely describes your current position) 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 Heal th /Treatment Child Forensic Interviewer Law Enforcement Other (Please Specify Conference Registration 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.) $449 on or before January 22, 201 1 $99 NICHD Interview Protocol 101 )4$499 after January 22, 201 1 $99 Using What Sex Offenders Tell Us to Improve Child Safety When paving by Military Order or Purchase Order: O $499 regardless of registration date TOTAL AMOUNT ENCLOSED OR TO BE CHARGED Method of Payment Check or Money Order For Enclosed Payable to NCAC (MUst be ui U.S. Dollars Drawn on U.S. Bank) P9 Order on Organization's Form enclosed. Military Voucher Enclosed. Credit Card: VISA MASrr:RCAK1) American Express Card Holder's Name (Please Print): Card Expiration date Si °nature: Please Send This Form and Payment to: Mail: National Children's Advocacy Center Iax: 256 -327 -3856 (with credit card information) Attn: Ann Blalock 210 Pratt Avenue Register On -Line: www.nationaleac.org I- luntsville, Alabama 35801 (Using Credit Card) Federal I.D. #63- 0891512 CANCL:LI.ATION POLICY Whitten cancellations received by Pcbruary 28. 2011 will be refunded. less a S75 administratiae charge. NO REFUNDS will be made after February 28, 2011. (Registration 1ec is Tiansferahle at no additional charge.) ALL Replacements and /or Changes \vill be handled On- Site.) INDIANA RETAIL TAX EXEMPT PAGE ci Of l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2M 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 V27 =99 Nationml Childran's Advoemcy ContGr Cwn ®l Police Dopcitmont VENDORAnn B121OCk SHIP 3 CIVI squm TO 290 Pry Avenue Cunol, IN 40932 buntsyillo, AL X09 (W) 579 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 006 0.00 9 Each Braining $499.00 $499.00 Sub Teel: $499.00 �e a� k a P S T j cN v' paslum an Child Abuzo for D ..1 _i�It AD 2011 In U` untaville, AL Cmrmel Police DopiAmont Attn: Tom& Anderson 3 CIVIC squm Cumcl, IN 41a PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT Cannel Police Dept. h PAYMENT $499m A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. I SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFI ENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY ,g, SHIPPING LABELS. h1af o f I Police THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THfRETO. CLERK- TREASURER DOCUMENT CONT R 2 7 QZ5 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO`____ ALLOWED 20___ |N THE SUM 0F$ C)N ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO, ACCT#/TITLE AMOUNT DEPT hereby certify that the attached invoioe(a), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge iu made were ordered and received except 20 Signature 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)) 05/24/11 2011 payment for training for Det. Pitman $499.00 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 VOUCHER NO. WARRANT NO. ALLOWED 20 National Children's Advocacy Center Ann Blalock IN SUM OF 210 Pratt Avenue Huntsville, AL 35801 $499.00 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 27264 2011 570.00 $49900 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. June 03, 2011 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund