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Home My WebLink About180121 12/08/2009 '1 CITY OF CARMEL, INDIANA VENDOR: 363643 Page 1 of 1 ONE CIVIC SQUARE I A A T I CHECK AMOUNT: $75.00 CARMEL, INDIANA 46032 PO BOX 223 CLINTON NY 13323 -0223 CHECK NUMBER: 180121 CHECK DATE: 12/8/2009 DEPARTMENT ACCOUNT PO NUMBER IN VOIC E NUMBER AMOUNT DESCRIPTION 1110 4355300 75.00 ORGANIZATION MEMBER 1 International Association I o Auto Theft Investigators P.O. Box 223, Clinton, New York 13323 -0223 (315) 853 -1913 FAX (315) 793 -0048 APPLICATION FOR MEMBERSHIP RENEWAL NAME S 61 Co 11t ►1S MEMBER (Renewals) HOME ADDRESS I 4 9 AA woo d tent CITY Crf Mt/ STATE /PROVINCE Z41 ZIP/POSTAL CODE ti 6 ®3 3 CODE COUNTRY OS AGENCY OR BUSINESS NAME C9rrhe l P o k pTf- ADDRESS f ylc S CITY Cy rrntj STATE /PROVINCE ZIP/POSTAL CODE 1 160 33 CODE /COUNTRY OCCUPATION ®m 1 rt O f �r der RANK/TITLE I effC tl ye HOME PHONE 3i7 56N'us WORK PHONE 317 S7 aS 3"7 FAX X17 "5 AS 7 3 E -MAIL ADDRESS S co 1 I rns Q Cfr" f. i h. gov If you belong to an IAATI Chapter(s) and /or State Theft Association, Please list here: If you are retired from a law enforcement agency: Date Retired Name of Agency MAIL CORRESPONDENCES TO: BUSINESS ADDRESS HOME ADDRESS E] THIS SECTION MUST BE COMPLETED FOR ALL NEW MEMBERSHIP APPLICATIONS. T Supervisor: S g t JOn1� McA l h S I 1 er Name and Position: X 5 4. CriMr1141 TrvQS 99 f OA5 Of "-I'S/' Telephone: 71 S 71 as 619 ALL INFORMATION WILL BE VERIFIED BYAN IAATI REGIONAL REPRESENTATIVE PRIOR TO THE PROCESSING OF THE MEMBERSHIP APPLICATION BY IAATL INSTRUCTIONS: Mail completed application, along with check, money order or credit card information to: IAATI Executive Offices P.O. Box 223 Clinton, New York 13323 0223 Make checks payable to IAATI. Payment of dues must accompany membership application All payments must be made in U.S. Dollars. Dues are 525:00 for a new member and $20.00 for renewal. VISA and MasterCard only accepted. Credit Card No. Expiration Date Cardholders Name Signature International Association o Aauto Th eft Investigators P.O. Box 223 Clinton New York 13323 -0223 (315) 853 -1913 FAX (315) 793 -0048 APPLICATION FOR MEMBERSHIP RENEWAL NAME C l-,,gl 171 5[) MEMBER (Renewals) HOME ADDRESS J 1 a3 1 i" S CITY �_}�,2rw2\ STATE /PROVINC ZIP/POSTAL CODE `-1 b o3 3 CODE /COUNTRY AGENCY OR BUSINESS NAME ADDRESS UAL CITY �,�12.;�.e STATE /PROVINCE ZIP/POSTAL CODE y 0 3,), CODE /COUNTRY U OCCUPATION Pr, .ct 04} .cs x RANK/TITLE 'J 2,i HOME PHONE .3l? ~SS's -oL.5q WORK PHONE 3 f )'t S?1- J 6j FAX 3 57/ .)-J'7 3 E -MAIL ADDRESS If you belong to an IAATI Chapter(s) and/or State Theft Association, Please list here: If you are retired from a law enforcement agency: Date Retired Name of Agency MAIL CORRESPONDENCES TO: BUSINESS ADDRESS HOME ADDRESS THIS SECTION MUST BE COMPLETED FOR ALL NEW MEEM APPLICATIONS. Supervisor: Name and Position: ��f yi STt -j +51� Telephone: ALL INFORMATION WILL BE VERIFIED BY AN IAATI REGIONAL REPRESENTATIVE PRIOR TO THE PROCESSING OF THE M EM BERSHIP APPLICATION BY IAATI. INSTRUCTIONS: Mail completed application, along with check, money order or credit card information to: IAATI Executive Offices P.O. Box 223 Clinton, New York 13323 0223 Make checks payable to IAATI. Payment of dues must accompany membership application All payments must be made in U.S. Dollars. Dues ar" for a new member and $20.00 for renewal. VISA and MasterCard only accepted. Credit Card No. Expiration Date Cardholders Name Signature International Association 11. ofAuto Theft Investigators 'L P.O. Box 223, Clinton, New York 13323 -0223 (315) 853 -1913 FAX (315) 793 -0048 APPLICATION FOR MEMBERSHIP RENEWAL NAME J x'4 M t-� -IS i MEMBER (Renewals) HOME ADDRESS 1 7 7 62- e ,41 j L /AA CITY 114 &25'V l LL'2 STATE /PROVINCE 41-fA ZIP /POSTAL CODE Lo(. Z CODE /COUNTRY AGENCY OR BUSINESS NAME C A QMU L ADDRESS 3 C- 0J L CITY C Ak -L— STATE /PROVINCE /A- O k ZIP/POSTAL CODE CODE /COUNTRY 00-%f T� J OCCUPATION RANK/TITLE HOME PHONE 3 4 "bL L( W L/ 0RK PHONE 3/7 E -MAIL ADDRESS SS�C -II�L� (s i 4� t� -LL 1` If you belong to an IAATI Chapter(s) and /or State Theft Association, Please list here: If you are retired from a law enforcement agency: Date Retired Name of Agency MAIL CORRESPONDENCES TO: BUSINESS ADDRESS HOME ADDRESS THIS SECTION MUST BE COMPLETED FOR ALL NEW MEMBERSHIP APPLICATIONS. Supervisor. V /y 1 L r /'"T`` lj p Name and Position: T— ll Telephone: l I 1 L AL INFORMATION WILL BE VERIFIED BYAN IAATI REGIONAL REPRESENTATIVE PRIOR TO THE PROCESSING OF THE MEMBERSHIP APPLICATION BY IAATI. INSTRUCTIONS: Mail completed application, along with check, money order or credit card information to: IAATI Executive Offices P.O. Box 223 Clinton, New York 13323 0223 Make checks payable to IAATI. Payment of dues must accompany membership application -All payments must be made in U.S. Dollars. Dues are.$25 ;00;for a new member and $20.00 for renewal. VISA and MasterCard only accepted. Credit Card No. Expiration Date Cardholders Name Signature Prescred 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 International Association of Auto Theft Purchase Order No. Investigators P.O. Box 223 Terms Clinton, NY 13323 -0223 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 2 payment for membe 12"/,3/09 payme tn for membership for Officer Shane Collins 25.00 12/3/09 payment for membership for Det. Clark Tilson 25.00 Total 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 VOLUCHER NO. WARRANT NO. ALLOWED 20 International Association of Auto IN SUM OF Theft Investigators P.O. Box 223 C linton, NY 13323 -0223 75.00 ON ACCOUNT OF APPROPRIATION FOR po genera fun Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1110 553 75.00 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 December 3 20 09 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund