176388 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 354306 Page 1 of 1
ONE CIVIC SQUARE MICHAEL PITMAN
CHECK NUMBER: 176388
CHECK DATE: 8/19/2009
DE PARTM ENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRI
210 4357000 780.00 SNIPER SCHOOL
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CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: Michael Pitman DEPARTURE DATE: 8/2/2009 TIME: 1200 AM PM
DEPARTMENT: Police RETURN DATE: 8/14/2009 TIME: 1700 AM/PM
REASON FOR TRAVEL: Sniper School DESTINATION CITY: Lexington, KY.
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM
Date Transportation Gas/Tolls/ Meals
Air -fare Car Rental Other Parkin Lodging Misc. Total
9 Breakfast Lunch Dinner Snacks Per Diem
8/2/09 $65.00 $65-00
8/3/09 $65.00 $65.00
8/4/09 $65.00 $65.00
8/5/09 $65.00 $65.00
8/6/09 $65.00 $65:00
8/7/09 $65.00 77 $65.00
8/9/09 $65.00 $65.00
8110/09 $65.00 $65.00
8/11/09 $65.00 $65.00
8112/09 $65.00 $65.00
8/13/09 $65.00 $65.00
8114/09 $65.00 $65.00
$0.00
$0.00
$0.00
$0.00
$0,.00
$0.00
$0.00
1 2 0 0 00 0
Total $o.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0':00. $OAO; $780
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
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Director Signature: Date: a 7 e
ei. City of Carmel Form ER06 Revision Date 8/17/2009 Page 1
POLICE SNIPER 'TRAINING COURSE
APPLICATION FORM
NAME: "l /1
DEPARTMENT: O 4 P&pjr4e
WORD ADDRESS: LI u I C s q Lff4 -F
CITY /STATE/ZLP:
E-MAEL ADDRESS: IYr ell- e ll
W O RD PHONE:
Cw PHONE:
DOB: HEIGHT: 1p z WEIGHT:
SOCIAL, SECURITY NUMBER (Records Ent
PHYSICAL. CONDITION: POOR FAIR GOODY EXCEL
TOTAL YEARS OF LAW ENFORCEMENT EXPERIENCE f Z
TOTAL. YEARS OF SPECIAL. WEAP TEAM EXPERIENCE
TOTAL YEARS OF SHOOTING EXPERIENCE 2 C
HAVE YOU EVER ATTENDED ANY OTHER RIFLE OR SNIPER SCHOOLS?
YES _ZNO WHERE? �2
TYPE AND CALI1B R OF RIFLE YOU PLAN TO SE DURING THE COURSE?
-'o'j 39
i
MAKE AND MODEL OF SCOPE YOU PLAN TO USE DURING THE COURSE?
4 L 1 e aXD
WHAT TYPE OF AMMUNITION DO YOU 1 I A I v F /y U D THE COURSE?
9 k (DOES YOUR (DEPARTMENT HAVE A SPECIAL WEAPONS TEAK? (SWAT, SLIT,
ERIJ, EDT, SEID, ERT, ETC.)
YES z NO
ARE YOU ASSIGNED AS A SNIPER ON THIS TEAM?
YES NO N/A
IF YOU ARE NOT ASSIGNED AS A SNIPER, WILL YOU HOLD THIS POSITION
AFTER YOU COMPLETE THIS COURSE?
YES NO N/A
WHAT SIZE T -SHHIT DO YOU WEAK?
MEDIUM LARGE ?I- LARGE %X-LARGE
POLICE SNIPER TRAINING COURSE
APPLICATION FORM
I CERTIFY Y� 1 4 IS OUR
DEPARTMENT'S SNIPER OR RIFLEMAN AND MEETS ALL PREREQUISI'T'E
REQUIREMENTS AS STATED IN THE PROGRAM OF INSTRUCTION MANUAL.
A ORIZING SIGNATURE TITLE
SWORN AND SUBSCRIED BEFORE ME THIS DAY OF
20
NOTARY PUBLIC COMMISSION EXPIRES
SIGNATURE
Presc: *bed 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
Michael A. Pitman Purchase Order No.
4,
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/17/09 reimburse Det. Mike Pitman for meals while attenidng 780.00
Snipter school in Lexington, KY on August 2 14, 2009
Total
I 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
Michael A. Pitman IN SUM OF
780.00
ON ACCOUNT OF APPROPRIATION FOR
cont ed fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
210 570 780 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
August 17 20 09
Signature
Chief of POlice
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund