HomeMy WebLinkAbout203413 11/09/2011 CITY OF CARMEL, INDIANA VENDOR: 00353420 Page 1 of 1
ONE CIVIC SQUARE GEORGE W DAVIS
CARMEL, INDIANA 46032 3854 CORNWALLIS LANE CHECK AMOUNT: $75.00
CARMEL IN 46032
CHECK NUMBER: 203413
CHECK DATE: 11/9/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 75.00 TRAINING SEMINARS
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Carmel ®tic a r i m ent
Carm( 032
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September 27 2011
International Conference of Police Chaplains.
Application for Master Certification.
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Attached: r �C)
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1. Letter from Carmel Police Department. 2 bam o r d d
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2. Letter from United Methodist Church. K 0 a
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3. Copy of ICPC Academic Records. d
4. Check to ICPC for $75.
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I will not be able to attend the ATS in 2012. Ln
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Please let me know if you need anything else.
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Sincerely,
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George W. Davis, CSC
ICPC #05316
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(317) 571 -2500 A Nationally Accredited�,LUN e Agency 1F.. (317) 571 -2512
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: 2 r VI DAV1 NIMS Trained? Yes 1Z. No _What Level? 4 10 0 f f
Street: <L S CISM Trained? Yes No What Level?
City: f Law Enforcement Agency Serving: C P P
State: Size of Agency: J 5 wo C
Zip: 03 Z q3 q Faith Organization: u 1 i S
Phone No. (Home): I 2 j� Number of years in chaplaincy:
Phone No. (Office): Are you career full -time chaplain?
Email: Y IS r' C4 C Are you paid part -time chaplain?
Last 4 of Social Sec. No. (For Academic C edit): q 1 L 0 Are you a volunteer chaplain?
ICPC Member: Yes Z No Spouse's Name: K
ICPC Credentialed: Basic Senior ZMaster Spouse's first ICPC event? Yes No Not Attending l✓
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 _Z Monday: Yes No
Handicap or Special Needs:
Basic Classes PC/ Your
Toledo Airport Information Enrichment Workshop Conference
4rrival Time:
4rrival Date: Participants Advanced 2 3 Advance 1 Fees
departure Date: ICPC Member $150.00 $170.00 5p
departure Date: Non member $225.00 $240.00
=light Information:
Guest /Spouse
Banquet Tickets $30.00 each
:hecks payable to: ICPC -RTS 2011
Registration Fee 150
Extra Banquet Meals
Mail this completed registration Late Registration $25.00
orm (front back) and fees to: After February 20, 2011
Michele Miller, OH Registrar TOTAL PAID
CPC RTS TOTAL DUE
1 80 Riverside Dr.
iossford, OH 43460 -1049
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))
09/28/11 certification fee for Chaplain Davis $75.00
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
George Davis
IN SUM OF
3854 Cornwallis Lane
Carmel, IN 46032
$75.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO# Dept. INVOICE NO. ACCT #frITLE AMOUNT Board Members
210 570.00 $75.00
I hereby certify that the attached invoice(s), or
I I
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
Monday, November 07, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund