Loading...
HomeMy WebLinkAbout170433 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 359000 Page 1 of 1 ONE CIVIC SQUARE I N C A S A CHECK AMOUNT: $200.00 CARMEL, INDIANA 46032 55 MONUMENT CIRCLE SUITE 1124 INDIANAPOLIS IN 46204 CHECK NUMBER: 170433 CHECK DATE: 4/1/2009 D EPARTMENT ACCO 'PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION 1110 4357004 20078 3242009 -02 200.00 TRAINING INCASA INDIANA COALITION AGAINST SEXUAL ASSAULT 55 Monument Circle Suite 1224 Indianapolis, Indiana 46204 Invoice No. 03242009 -02 Sold To: City of Carmel Police Department Purchase Order #20078 3 Civic Square Carmel, IN 46032 Description of Services Attendance at INCASA Annual Conference on March 26 and 27 2009 Lana Howard Non member Rate $200.00 Please make check payable to INCASA Thank you! ..e 7 eee eee go 8 s 0 Ohe per parson, pease rpaga copies The Adam's Mark Hotel— Indianapolis Contact Hotel directly for reservations: 2544 Executive Drive, Indianapolis, Indiana 46241 317 248 -2481 Make checks payable for the Conference to INCASA. Fax registration forms to: 317 423 -0237 Attn: Annual Conference or mail to: 55 Monument Circle, Ste. 1224 Indianapolis, IN 46204. A $40.00 processing fee will be retained on all cancellations. NO refunds will be made on cancellations received after March 1, 2009. Sorry, INCASA is not set up for credit /debit card payments however, INCASA is very happy to invoice. INCASA must have an e -mail address to invoice. All registrations received without payment included will automatically generate an invoice. Call 317 -423- 0233 ext 10 with questions regarding the conference; extension 12 for billing questions. INCASA will invoice for payment with an e address Name (Please Print DARK) Organization 3 C/ v 41 �IU r'-e_ Address (for billing and regis ration information) 4 L 6 1ha3z City State Zip Code 3 -5 �S�C> 1_1 r_5k1 0 nh_,_�/ _2__;V1 (1 Phone email address (needed for billing and confirmation) MEMBERS must include Special Rates Must include proper ID with NON MEMBERS: copy of 2009 certificate) registration or will be invoiced at non member rate) $150.00- $100.00 Foster care givers, government $200.00 employees (state and federal only), full -time students, $75.00 Completed 40 Hour Victim Advocacy Standards Course (MUST send card with registrations) No other discounts TOTAL DUE Check continuing education credit tWe; Conference: Law Enforcement 10.0 Contact Hours Mental Health- LSW, LCSW, LMFT, and LMHC 20% Discount 10.0 Contact Hours- Category 1* If payment received by 3/2 Legal (pending) *The Indiana Social Worker, Marriage, and Family Therapist and Mental Health Counselor Board has approved INCASA to provide Category I Continuing Education for L.S.W., Total Due: L.C.S.W., L.M.F.T., and L.M.H.C.. However, licensees must judge the program's relevance to their professional practice." Cloty INDIANA RETAIL TAX EXEMPT PAGE C CERTIFICATE NO. 003120155 002 0 j PURCHASE ORDER R NUMBER a o 11 Pol ice Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 '20078 3 ©NE 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 MA 7-rh In 700Q t-n VENDOR x r i Ty` SHIP City of Carmel Police DeparMent u ATTN: Annual Conference TO 3 Civic Square 55 Monument Circle, Suite 1224± Carmel, IN 46003 Indianapolis, IN 46004 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION We can Make a Difference Conference for Det. Lana 200.00 Howard on March 26 27, 2009 in Indianapolis D -4 g# a l: spa. Send Invoice To:� PLEASE INVOICE IN DUPLICATE 1 DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 570 -04 instructional fees PAYMENT i A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. i NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND i VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. L'/ C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE As� s:tant Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 0 G 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 Board Members PO# or INVOICE NO. ACCT #/TITLE 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 k 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 INCASA Purchase Order No. 20078F 55 Monument Circle, Suite 1224 Terms Indianapolis, IN 46204 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 32A2_009 Davment for We Can Make a Difference Conference for Det 200.00 Lana Howard on March 26 27 2009 in Indianapolis 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 NCASA IN SUM OF 55 Monument Circle, Suite 1224 Indianapolis, IN 46204 200.00 ON ACCOUNT OF APPROPRIATION FOR p olice genera l fund Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 20078F 3242009 -02 570 -04 200.00 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 March 26 20 09 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund