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Home My WebLink About207089 03/13/2012 F CITY OF CARMEL, INDIANA VENDOR: 365202 Page 1 of 1 ONE CIVIC SQUARE HILTON FORT WAYNE CARMEL, INDIANA 46032 1020 SOUTH CALHOUN ST CHECK AMOUNT: $270.18 FORT WAYNE IN 46802 CHECK NUMBER: 207089 r ah c CHECK DATE: 3/1312012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 270.18 TRAINING SEMINARS INVOICE Date: March 9, 2012 Sold to: City of Carmel Police Department 3 Civic Square Carmel, IN 46032 Payment for lodging for Todd Clark and Curtis Scott on May 5 8, 2012 in Fort Wayne, IN Confirmation #3459103996 Room Rate Tourism Tax Tax Total $79.00 $11.06 $90.06 x 3 $270.18 TOTAL, DUE: 5270.18 Please make check payable to: Hilton Fort Wayne at the Grand Wayne Convention Center 1020 South Calhoun Street Fort Wayne, IN 46802 Fop oFF1cIAL USE ONLY ATM1dDEE -i5l 1,' Y i r 9th Annual Conference May fith a 0 175 Conference Fee 01$20 "Junkyard Shootout" Match $25 Late Fee (After April 20, 2012) Total: .00 Additional Banquet Tickets $40 each An appl form must be submitted for each and every attendee FIRST NAVE M.I. LAST NAME C --L;L ti 5 S CCU' AGENCY t ASSIGNMENT' /RANK /TITLE AGENCY ADDRESS C! STATE ZIP CODE 1 C i V i c- kk 6r 1 4 603 'L MAILING ADDRESS (OTHER THAN AGENCY) CITY STATE i 2 {P CODE E'-MAIL ADDRESS PHONE. I affirm that the above information is true an accurate. Further, I authorize the Indiana SWAT Officers Association to contact my employer an verify my empl a n d ass ignm e n t if ne SIGNATURE DATE 3 J IMPORTANT: Will you be attending the banquet? Q) YES IVO Number of additional tickets requested: Federal Tax !D 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: _V#SA f CREDIT CARD NUMBER E%PIRATION DATE 3 DIGIT' AUTHORIZATION CODE NAME ON CREDIT CARE AUTHORIZATION SIGNATURE ADDRESS Clry STATE 21p 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. FULL-TIME PART -TIME RETIRED AUXILIARY /RESERVE ACTIVE MILITARY RESERVE MILITARY ID Fop OFPCIAL USE ONLY ArMND 9th Annual Confereme May 6th 8th am $175 Conference Fee $20 "Junkyard Shootout" Match $25 Late Fee (After April 20, 2012) Total: 00 U Additional Banquet Tickets $40 each An application form must be submitted for each and every attendee FIRST NAME M.I. LAST NAME AGENCY ASSIGNMENTIR ITLE AGENCY ADDRESS CITY STATE ZIP CODE l- MAKING ADDRESS IOT THAN AGENCYI CITY STATE ZI➢ COD E-MAIL ADDRESS PHONE y ice' C ^'7 '!1 u'V l _5 1 affirm that the above informa is true and accurate. Further, i authorize the Indiana SWAT Officers Association y m toyer and verify my employm and assi gnmen t, if ne SIGNATURE DATE IMPORTANT: Will you be attending the banquet? yEs NO Number of additional tickets requested: ?1 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: Cj A a _p ago_+ CREDIT CARD NUMBER E %PIRATION DATE 3 DIGIT AUTHORIZATION CODE NAME ON CREDIT CARD Al7EHORIZATION SIGNATURE ADDRESS CITY STATE ZIV 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: FULL -TIME PART-TIME RETIRED AUXILIARY /RESERVE ACTIVE MILITARY 0 RESERVE MILITARY A 4 a r• VOUCHER NO, WARRANT NO. ALLOWED 20 Hilton Ft Wayne at the Grand Wayne Conventi IN SUM OF 1020 South Calhoun Street Fort Wayne, IN 46802 $27 0.1 8 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO# Dept. MOICE NO. ACCT /TITLE AMOUNT Board Members 210 570.00 $270.18 I hereby certify that the attached invoice(s), or 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 Friday, March 09, 2012 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board or 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)) 03/09/12 lodging for Officers Clark Scott $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 20 Clerk- Treasurer