207089 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