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206695 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 365202 Page 1 of 1 ONE CIVIC SQUARE HILTON FORT WAYNE CHECK AMOUNT: $270.18 CARMEL, INDIANA 46032 1020 SOUTH CALHOUN ST FORT WAYNE IN 46802 CHECK NUMBER: 206695 CHECK DATE: 2/2812012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 270.18 TRAINING SEMINARS INVOICE Date: February 22, 2012 Sold to: City of Carmel Police Department 3 Civic Square Carmel, IN 46032 Payment for lodging for Scott Long and Greg Loveall on May 5 8, 2012 in Fort Wayne, IN Confirmation #3456042648 Room Rate Tourism Tax Tax Total $79.00 $11.06 $90.06 x 3 $270.18 TOTAL QUE: $270.18 Please make check payable to: Hilton Fort Wayne at the Grand Wayne Convention Center 1.020 South Calhoun Street Fort Wayne, IN 46802 FOR OFFICIAL USE ONLY AT m®Ee, y 9th Annual Conference May 6th 8th •t4;;i,, $175 Conference Fee Q $20 "Junkyard Shootout" Match $25 Late Fee (After April 20, 2012) Total: Q Additional Banquet Tickets $40 each An application form must be submitted for each and every attendee FIRST NAME M. 1. LAST NAME 4 W 1 ©lam► AGENCY ASSIGNMENT /RANI /TITLE �I��L Pk> L4 a✓ pAT�otMA.r..l AGENCY ADDRESS CITY TATE ZIP CODE 3 GV%C' S 2 tkA,Me CA- tzµt =t— Ir l 4ta032- MAILING ADDRESS (OTHER THAN ENCY( CITY STATE ZIP CODE tt�321 G��ww '��v� �ise+E� -s 1t.t 4 L#03V E -MAIL ADDRESS PHONE Stongt!�C�.*•.,e. 16 i 2 Soa i affirm that the above information is true and accurate. Further, t authorize the Indiana SWAT Officers Association to contact m r ov and verify my e mployment and a ssig nm e n t, i f ne cessary. SIGNATURE DATE IMPORTANT: Will you be ndi the banquet? l`9 YES Q NO Number of additional tickets requested. 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 20, 2012. Any registration form received after April 20, 2012, will result in a $25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be purchased for $40.00 per ticket (limited quantity available). `Registration fee includes: Attendance at Conference, Vendor Appreciation Day, lunch and banquet dinner on Monday, May 7th, and lunch on Tuesday, May 8th *There will be a $3.00 additional processing fee for credit card payments If you are pre registered and cancel prior to April 20, 2012, your registration fee will be refunded less a $50.00 administrative charge. No refunds will be issued after April 20, 2012. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: VISA Q CREDIT CARD NUMBER IMITATION DATE DIGIT AUTHORIZATION CODE NAME ON CREDIT CARD AUTHORIZATION SIGNATURE ADDRESS CITY STATE ZIP CODE IMPORTANT: Your credit card will be charged the day your registration form and payment are received by the iSOA. Please include the billing address where the monthly statement is sent. PLEASE CHECK: Q FULL -TIME Q PART-TIME RETIRED Q AUXILIARY/RESERVE Q ACTIVE MILITARY Q RESERVE MILITARY .e 0 0 FOR OFFICOL USE ONLY ATMD US 1 m 170N t 9th Annual Conference May 6th 8th 3 $175 Conference Fee *20 "Junkyard Shootout" Match $25 Late Fee (After April 20, 2012) [Total: .00 ❑Additional Banquet Tickets $40 each An applicati form must be submitted for each and every attendee FIRST NAM LA57 NAME AGENCY CA M ,eL �vGtc L �i�P/ /�L /!!l,�?it/ �iit AGENCY ADDRESS CITY STATE ZIP CODE 3 C t V IG Stu 4 4-6 C ^2 g �N V60; "LING ADDRESS (OTHER THAN AGENCY) CITY STATE i ZIP CODE E -MAIL ADDRESS PHONE i vlle Wit/ 4 4 l j!I y d 117- 1 affirm that the above information is true and accurate. Further, 1 authorize the Indiana SWAT Officers Association to contact my employer and verify my employment and assignment, if necessary. SIGNATURE j DAYE IMPORTANT: Wilt you be attending the banquet? N YES NO Number of additional tickets requested: 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 20, 2012. Any registration form received after April 20, 2012, will result in a $25.00 late fee. NOTE: We WILL NOT accept registrations on the day of the Conference. Additional banquet tickets can be purchased for $40.00 per ticket (limited quantity available). Registration fee Includes: Attendance at Conference, Vendor Appreciation Day, lunch and banquet dinner on Monday, May 7th, and lunch on Tuesday, May 8th *There will be a $3.00 additional processing fee for credit card payments If you are pre- registered and cancel prior to April 20, 2012, your registration fee will be refunded less a $50.00 administrative charge. No refunds will be issued after April 20, 2012. However, suitable substitutions will be allowed. If paying by credit card, please complete the following: WS j°°` CREDIT CARD NUMDER E %PIRATfON DATE 3 DIGIT AUTHORIZATION CODE NAME ON CREDIT [pR0 AUTHORIZATION SIGNATURE ADDRESS CITY STATE ZIP CODE IMPORTANT: Your credit card will be charged the day your registration form and payment are received by the ISOA. Please include the billing address where the monthly statement is sent. PLEASE CHECK: PFULL -TIME PART -TIME RETIRED AUXILIARY /RESERVE ACTIVE MILITARY RESERVE MILITARY Page 1 of') ev L 1 Mates, Luann CrN-S From: Hilton Hotels Resorts Confirmed [hiltonhotels &resorts @res.hilton.com] Sent: Monday, February 20, 2012 9:22 AM To: Mates, Luann Subject: Hilton Hotels Resorts Confirmation #3456042648 d Hilton Fort Wayne at the Grand Wayne Convention Center 1020 South Calhoun Street Fort Wayne, IN United States, 46802 TeL 1 260- 420 -1100 Pax: 1 260 424-7775 k Confirmation Nu 3456042648 A .v Oi ORS Click here to view or edit your reservation. WrLT'C�tt tl4l"LIICk�' Name: Greg Lcveail Arrival Date 05 May 2012 takRNING PO1NT5 C)N De pa rture Date: 08 May 2012 THI BOCJKING FC9R Check -in Time: 3:00 PM tR �AY Check -out Tune_ 12:0© PM s SAT STINCT RR1hli�5'. 1 X3.3 O Rate Information: Fkate Type: :n y xi L INDIANA SWAT OFFICER Rate per night: 79.00 USD Total for Stay per Room: Rate 237.00 LSD Taxes 33.18 USD Total 270.18 USD a Total for Stay: 270.18 use Y Includes estimated taxes and service charges. (Gratuities not ra included. Tax: Upon Arrival There is a 14.00 per room per night tax. Have extra amenities Additional Charges: waiting for you, such Self parking: 7.00inight as additional towels, beverages, and Rate Rules and Cancellation Policy: more. Your reservation is guaranteed for late arrival. r Please contact us should you need to cancel your reservation. Cancellations are required by 11:59 PM on 02 May 2012 local hotel time. Cancellation penalties may apply. Room Information:. 2/20/2012 Page 2 of 3) Rooms: 1 HILTON Clients Z Adults HHONORS Room Type 2 DOUBLE BEDS Your room type preferences have been submitted with your o a i reservation, and are subject to hotel availability. l a std i. G Comments and Requests: 3 day cancellation To Help You Along on Your Journey... FRO h! HI ill N Our Hotel: tHC390 ccom RS Tour the Hotel Amodations Hotel Factsheet Services and Afnenities: Energize with Hilton Fitness by Precor Hotel Services and Amenities Dining Options: Our Restaurants Visit Hilton.corn for great specials, packages and products. Sion to receive weekly email offers and click hertz to shop for your favorite Hilton products. TREAT YOUR TO SOME SllEA li Transform HHonors points into great gifts like electronics, sporting goads and more at the Wiftars HHtanorsT"" 5i op ing !fall earn More s,. Ser ✓;c2 of alcoho''ic beverage s s!ibject to state and kcal IaL +s. 'r s! E o(legal drinking age. 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VVe also ask that you please notify us of fraud alertrci,hilton.com should you receive such o c:orarnunicr,;;acn. you use a deblucredit card to check in. a held r =.ay be placed on your 23rd account for the full ant €cioated aanount in be owed to me betel including estirnaled nc;de€ la's. through your elate of check nut and such hold niay not be released for 72 hours tram the daiW of check-out Of l0MJ r at the discret o f of tour card issue >f, if you need to MOD or CANCEL your reservation, click here Any chance to the a rival date, departure date or rc amr: tyre of 1161s reseryal is subject to the loafers availability at the time the o#rrnge is requested and may res:,lt in a passible rate change. or an additional fee, Fur exarnp ➢e, shortening or lengthei'ring your reservation is subject to availaoility and may not be posslble at a later date_ Fol more infonnnstlon, please click here to see all the ales and ra,lnctions appllcabe to this reservation. I f you have q uestions regarding your rose €vttticn, please corset Hilton Reservations and Custorner are at 1- 800- HIL70NS (445 8657), choke. here or email os at confirm.at onhelpLa hil;onres.eom, Hilton }donors rnemher> hip. earninj oi FoirrLs Miies and redernptioo of paints are subject to HHonors Terrns and Conditions. View 0or Privacy Policy Create or Uodate a Profile 0,1subsc,ribe To onsubscibe fron all rnarketing email from I lilton'Alorldw;de, please send an email with the subject line Jnsubsci Ibe" to e'_, opt cut fern all Hilton *orldw de. marketinq email will prevent you from receiving your Monthly 2/20/2012 VOUCHER NO. WARRANT NO. Hilton Ft Wayne at the Grand Wayne Conventi ALLOWED 20 IN SUM OF 1020 South Calhoun Street Fort Wayne, IN 46802 $270.18 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 210 570.00 $270.18 I hereby certify that the attached invoice(s), or I I 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 Thursday, February 23, 2012 Chief of Police 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 02/22/12 lodging Long 1 Loveall $270.18 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 2Q Clerk- Treasurer