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Home My WebLink About171891 04/29/2009 a F CITY OF CARMEL, INDIANA VENDOR: 354777 Page 1 of 1 ONE CIVIC SQUARE INDIANA SWAT OFFICERS ASSOC INC CARMEL, INDIANA 46032 CHECK AMOUNT: $100.00 PO BOX 90205 INDIANAPOLIS IN 46290 -0205 CHECK NUMBER: 171891 CHECK DATE: 4129/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE N AM OUNT DESCRIPTION 210 4357000 20098 2009 -04 -13 100.00 TRAINING y i 4' �I I s r swar aa�P O Indiana SWAT Officers Association, Inc. Inv oice Post Office Box 90205 A SSOCIATION Indianapolis, IN 46290 -0205 G Date 4/20/2009 www.indianasoa.com Invoice 2009 -04 -13 Carmel Police Department Teresa Anderson 3 Civic Square Carmel, IN 46032 N �Descri trop k 3 3 k! Amount„ �0� ?a Indiana SWAT Officers Association Conference Participant 100.00 Registration Fee Gilbert, William Your Interest, Participation, and Support is Greatly Appreciate! Be Safe! Indiana SWAT Officers Association, Inc. Total $100.00 Treasurer Sherilyn C. Kindig Payments /Credits $0.00 sck4isoa.acctng @yahoo.com Balance Due $100.00 615 503 -7860 P $war o Jftwdee -1 ASS ON RA &Real contem flay Stir $75.00 MEMBER 11 $100.00 NON MEMBER El $100/$125 LATE FEE (MEMBER/NOWMEMBER) ..0......0 ..,...00_ 00.00 0000 An applica form m ust be submitted for each and every attendee 0. 0 .,0 000__ 1 ...0 0 ..00 0 000 FIRST NAME M.I. LAST NAME C NARc.E 3 4kt(1 0000 0000. 0000. 0000 0000. 0000._ 0000 AGENCY I ASSIGNMEHT RAHX /TITLE C� b Of AGENCY ADDRESS CITY STATE i ZIP CODE 3..CS�rsc....S�u.a.. ;_._..Ca2M.- 0000. z..... 0000 MAILING ADDRESS (OTHER THAN AGENCY) j CITY I STATE I ZIP CODE :.ant `/.471 ......._GRAnl9.._ 90.W_ .Lct. /QPT:._G �.ZAAApossS Y6.2.8 E -MAIL ADDRESS PHONE t? affirm I 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 Evtc«±........2L, 200.9.... IMPORTANT: Will you be attending the dinner banquet on Tuesday night? YES )<NO 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 17, 2009. Any registration form received after April 17, 2009, will result in a $25.00 late fee. NOTE: We will accept registrations on the day of the Conference at a cost of $100.00/$125.00 per attendee (member /non member). Additional banquet tickets can be purchased for $25.00 per ticket (limited quantity available). 'Registration fee includes: Attendance at Conference, vendor appreciation day, lunch and banquet dinner on Tuesday, continental breakfast, lunch and barbecue dinner on Wednesday. If you are pre registered and cancel prior to April 17, 2009, your registration fee will be refunded less a $25.00 administrative charge. No refunds will be issued after April 17, 2009. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: VISA 09 r ............._......00._99-..... CREDIT CARD NUMBER EXPIRATION DATE 3 DIGIT AUTHORIZATION CODE 0000 0000..... ...i 0......000... .i ,0.0.0..0... .0...000 ...,._.0. NAME ON CREDIT CARD AUTHORIZATION SIGNATURE 0000._ 0000. 0000.. .........00. IMPORTANT: Your credit card will be charged the day your registration form is received by the Treasurer. Please include the billing address where the monthly statement is sent. 0000. ADDRESS CITY STATE ZIP CODE 0000. 0000 .i.....9-...... 0000........ 0000 0000 Please check: FULL -TIME PART -TIME RETIRED AUXILIARY /RESERVE ACTIVE MILITARY RESERVE MILITARY T1 00:6RM AND PAYMENT To INDI ANAPOL'IS 'IND I I 5WAT va ALS OCIA TION fth gala' C CO Ara y sth fth $75.00 MEMBER I $100.00 NON MEMBER E) $1001$125 LATE FEE (MEMBERINON- MEMBER) An application form must be submitted for each a nd every attende FIRST NAME M.I. LAST NAME W 1 ti S j` t c' 4- AGENCY ASSIGNMENT/RANI /TITLE C k ..cl b'1' k y AGENCY ADDRESS CITY STATE ZIP CODE ��r< arv- 4. -T f4 4(aa -La MAILING ADDRESS (OTHER THAN AGE J CITY STATE ;ZIP CODE C�'e W R r G/ hn! I TN E� i1 i Z E-MAIL ADDRESS PHONE vJ` 1 l tr+ A- P rr.tll Gv C3 11 X1 0 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 11 1 1 .11 1-11 1—— I I 1 1. 111 DATE 3/Z r/a 9 IMPORTANT: Will you be attending the dinner banquet on Tuesday night? YES P(No 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 17, 2009. Any registration form received after April 17, 2009, will result in a $25.00 late fee. NOTE: We will accept registrations on the day of the Conference at a cost of $100.00!$125.00 per attendee (member /non- member). Additional banquet tickets can be purchased for $25.00 per ticket (limited quantity available). 'Registration fee includes: Attendance at Conference, vendor appreciation day, lunch and banquet dinner on Tuesday, continental breakfast, lunch and barbecue dinner on Wednesday. If you are pre registered and cancel prior to April 17, 2009, your registration fee will be refunded less a $25.00 administrative charge. No refunds will be issued after April 17, 2009. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: VISA CREDIT CARD NUMBER EXPIRATION DATE 3 DIGIT AUTHORIZATION CODE NAME ON CREDIT CARD AUTHORIZATION SIGNATURE IMPORTANT. Your credit card will be charged the day your registration form is received by the Treasurer. Please include the billing address where the monthly statement is sent. ADDRESS CITY STATE ZIP CODE Please Check: FULL -TIME PART -TIME RETIRED AUXILIARY/RESERVE ACTIVE MILITARY RESERVE MILITARY o r e r A O .r 'I r r •e r 'I I I 0 INDIANA RETAIL TAX EXEMPT PAGE I� Carmel CERTIFICATE NO. 003120155 002 0 1 �Sy 1a PURCHASE ORDER NUMBER ro FEDERAL EXCISE TAX EXEMPT 20098 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES. A/P CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION Aprit,4, 2009 Training VENDOR ISOA SHIP City of Carmel Police Deparment TO Sheri C. Kindig Treasurer 3 Civic Square PO Box 90205 Carmel, IN 46032 TnrIn1, TN A n ?O; CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE I II DESCRIPTION UNIT PRICE EXTENSION 2009 Annual Conference Indiana Swat Officers Association $100.00 May 5th 6th in Ft. Wayne Officer Will Gilbert 2009 Annual Confer r Off icers Association No Cost May 5th 6th .I.. 'I n� (instructor) Officer Ben, u 6 .."oi1: �F Ian 5d Q a Send Invoice To: City of Cl rmel Polio! t AT TN: Teresa Anderson 3 Civic Square Carinel., IN 46032 PLEASE INVOICE IN DUPLICATE $100.00 DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT .v PAYMENT 1 O Y 570 CorJ ed. 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. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL f t F r• q SHIPPING LABELS. Chief of �y lice THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE I AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK- TREASURER DOCUMENT CONTROL NO A,P. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR a Board Members PO# or INVOICE NO. ACCT #i7lTLE AMOUNT DEPT. 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 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 Indiana SWAT Officers Association, Inc. Purchase Order No. 20098F P.O. Box 90205 Terms Indianapiis, IN 46290 -0205 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 200KA for SWAT Officers Association conference for 100.00 Officer Will Gilbert and Officer Ben Fisher on May 5 6 2009 in Ft. Wayne, IN 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 'I ndiana SWAT Officers Association, Inc IN SUM OF P.O. Sox 90205 Indianapolis, IN 46290 --0205 100.00 ON ACCOUNT OF APPROPRIATION FOR c ont. ed. fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 20098F 2009 -04 -13 570 100.00 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 April 21 2009 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund