171009 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 00353324 Page 1 of 1
0 ONE CIVIC SQUARE NATIONAL PARK AND RECREATION AS NECK AMOUNT: $390.00
o CARMEL, INDIANA 46032 10900 GRANITE STREET
�ti4ion _o CHARLOTTE NC 28273 CHECK NUMBER: 171009
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUN PO NUMBER INVOICE NU MBER AMOUN DESCRIPTION
1047 4358300 390.00 OTHER FEES LICENSES
i.:
�f
Ca rmel @Clay
Parks &Recreati ®n CHECK REQUEST APR 4 7 2009
Date: BY: `,1..
Check payable to
Name:
Address: aLoq W j6u l' CSYI C� PC) SoNc 9S t�
City, State, Zip Oj (QL I N (P 0
y
Mail check to payee Return check to requestor
Check Amount r �V Date Required
Check needed for ��i I 1 f` t J C9'� A6
To be paid from
PO (if applicable) I
Budget account GL `-1 1 oU 0 0
Budget Line Description 0 LLr
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): :f62S Rn �e r
Requested by (signature): Q,60
Approved by (signature of Division Manager):
on this date
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
NRPA CPRP Exam Application
ASK Computerized Test K
Arm
Please complete application and return with $195 examination fee to your State Professional Certification Board (PCB) or
the NRPA for Direct National Certification. (Direct National Certification is only for those that are employed by the military or
federal government and those residing in Alaska, California, District of Columbia, Hawaii, Minnesota, Montana, North Carolina, or
Texas. If eligible for the exam, the state association will forward the application and fee to NRPA. A postcard/email will be sent
from AMP testing company with instructions to set up a time and date to sit for the exam.
Special Instructions:
1. Please complete both sides of the application. Once your application is processed by your state PCB or
DNC and your testing postcard and/or email have been sent from AMP, the testing company, you will be
able to schedule your exam. You must take your exam by_the date on your postcard, which will match the
testing eligibility expiration date assigned to you by your state PCB or DNC office.
2. Please download a Certification Handbook from www.nrpa.org/cerffication. Please read carefully. This
will explain the procedures, proper ways to prepare, and provide exam tips.
3. Refer to the test postcard/email from AMP to identify the phone number to call or website to use to set up the
date, time, and the location of your exam. Please go to www.goamp.com to view a list of testing centers.
4. The test must be taken bN the date on the postcard /email from A-MP Testing Company-.
APPLICATION FEE IVILL BE FORFEITED IF TEST IS NO T T.9h'E:,N B3'DEADLLN"E!!
To be completed by applicant. (Please type or print clearly) Ist sitting Retake
NAME Dr. Mr. rs.�Ms. 1 i� es -s 1�
Last First M.I.
PERMANANT
MAILING 1 7�1(1� Ln
ADDRESS Street Apt
City State Zip
E-mail Address :S�k (yQ_A LCo,rraC� kS. Cf- AYE
TELEPHONE Work ?A- 5 39 3 Home O alq
If residing outside of continental United States, Name of Country
Do you have a disability that would require special accommodations for taking the examination:
Yes `KNo
If yes, please complete the Special Accommodation Request Form, available At www.nrpa.org /CPRPforms.
METHOD OF PAYMENT OF EXAMINATION FEE
Check (Payable to NRPA) VISA MasterCard American Express
Money Order (Payable to NRPA) Account
Expiration Date
Signature
CERTTEST
a NRPA CPRP Exam Application
K Computerized Test ClEAT K
ANO RE+CR£A7'ION Af[O REGREAX O
Pf35tORAL PROFESSIONAL
Please complete appNeadon.and return with $195 examination fee to your State Professional Certification Board (PCB) or
the NRPA for Direct National Certification. (Direct National Certification is only for those that are employed by the military or
federal gov.emment;and:those residing in Alaska California, District of Columbia, Hawaii, Minnesota, Montana, North Carolina, or
Texas. If eligible for the exam, the state association will forward the application and fee to NRPA. A postcard/email will be sent
from AMP testing company with instructions to set up a time and date to sit for the exam.
Special .Instructions:
1. Please complete both sides of the .application. Once your application is processed by your state PCB or
DNC and your testing postcard and /or email have been sent from AIMP, the testing company, you will be
able to schedule your exam. You must take your exam by the date on your postcard, which will match the
testing eligibility expiration date assigned to you by your state PCB or DNC office.
2. Please download a Certification Handbook from www.nrpa.org/certification. Please read carefully. This
will explain the procedures, proper ways to prepare, and provide :exam tips.
3. Refer to the test postcard/email from AIMP to identify the phone number to call or website to use to setup the
date, time, and the location of your exam. Please go to www.goamp.com to view a list of testing centers.
=1. The test must be taken by the date on the postcard /email from :SNIP 'Testing Company.
iPPLICATION FEE HILL BE FORFEITED IF TEST IS YOT T.4I:F_: BI'DE.9DLI: \'F!!
To be completed by applicant. (Please type or print clearly) Is( sitting Retake
NAME Dr. Mr. Mrs. his. �Azlt A
Last First M.I.
PER,itANANT 21 J
MAILING�
ADDRESS Street Apt
City State Zip
E -mail Add ress ctwl—
TELEPHONE Work 7 7 j- 5"Z !�Z3 Home (a( y 75
If residing outside of continental United States, Name of Country
Do you have a disability that would require special accommodations for taking the examination:
Yes o
If yes, please 6omplete the Special Accommodation Request Form, available at www.nrpa.org /CPRPforms.
METHOD OF PAYMENT OF EXAMINATION FE (5195.00)
Check (Payable to NRPA) VISA MasterCard American Express
Money Order (Payable to NRPA) Account
Expiration Date
Signature
CERTTEST
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
NRPA Terms
10900 Granite Street
Charlotte, NC 28273
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/7/09 NRPA CPRP Exam Application T. Pinter 195.00
4/7/09 NRPA CPRP Exam Application S. Carling 195.00
8 77:7
Total 780.00
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
NRPA r ad Allowed 20
10900 Granite Street
Charlotte, NC 28273
In Sum of
390.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 T.Pinter 4358300 195.00 1 hereby certify that the attached invoice(s), or
1047 S.Carling 4358300 195.00 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
9 -Apr 2009
Signature
390.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund