174072 06/24/2009 "c «e CITY OF CARMFL, INDIANA VENDOR: 362959 Page 1 of 1
ONE CIVIC SQUARE TEAM VTAC, INC
CARMEL, INDIANA 46032 3725 HEATHERBROOKE DRIVE CHECK AMOUNT: $2,063.49
FAYETTEVILLE NC 28306
a CHECK NUMBER: 174072
CHECK DATE: 6/24/2009
�ZZP f ACCOUNT P O NUMBER INVO NUMBER_ AMOUNT DESCRIP T
210 4357000 2.1023 1035 2,063.49 TRAINING
pyr
Jun 17 09 01:00p VTAC 9105653710 p.3
r
Team VTAC Inc. In voi ce
3725 Heatherbrooke Drive
Fayetteville, NC 28' 306 Date Invoice
6;1712009 103
Bil I To Ship To
City of Carmel Police Dept. City of Carmel Police Dept.
ATTN: Teresa Anderson 3 Civic Square i
3 Civic Square Carmel, IN 46032 -2584
Cannel. IN 46032 -2584
i
E
P.O. Number Terms Rep Ship Vi F.D.B. Project
21 023 Net 30 NlLamb 6:1712009
i
Quantity Item Code Description Price Each Amount
3 Instruction Mikz 1.5 Tactical Carbine School; Sgt. Brady Myers; Lt, Dwight 687.83 2.063.49
I Frost; Officer Ryan Jellison; July 14 -kv, 2009
I
I
1 1
i
i
i
i
We look forward to working with you soon!
Total 52,063.49
Viking Tactics, Inc.
3725 Heatherbrooke Drive
Fayetteville, NC 28306 -9718
PHONE: (910) 987 -5983
FAX: (910) 425 -0700
www.ViKINGTACTICS.COM
Registration and Application for Trainino
Viking Tactics, Inc. I Team VTAC, Inc.
IN WITH rrAR REGULATIONS, ONLY U.S. CITIZENS WILL BE ACCEPTED TO PARTICIPATE IN VTAC COURSES
First Name !8re.4 MI Last Name ,N1 f
Email Address; s &Z Date of Birth: _10 1 z r 1 Y Age:
Home Address: rysz.'r cZ• City: J State T Zip y
Occupation: Military or LE Affiliation: Rank:
Work Address: 3 c_,`� S� u�•.� City: C ✓:1L= State _7�A/ Zip Z/& o 3 z_
Home Phone (k:L) Slat -z...Yq' Work Phone: '-t 4& o ci f 7 c>
Former Student: Yes /(EO If yes, provide prior dates:
Weapon Information: If Civilian, Pistol License Number, State of Issuance and Expiration Date:
Primary Weapon Type and Caliber: 45:-4. r &2L- Z2. 3 Pistol License Number.
Secondary Weapon Type and Caliber: U to t-k 7 No cam_ State of Issue: Expiration Date:
COURSE DATE: t f7 COURSE NAME: Pre Requisites Met: Yes 1 No
Emergency Name: .5cu-ew V Emergency Phone: S f SU 5"Y(� 9
Credentialing Policy: VTAC has a strict credentialing policy. A photocopy of ONE of the following must be emailed (lamb(a)vikingtactics.com) faxed (910 -987-
5983), or mailed USPS:
Certificate of Good Conduct (from your local Police Department)
t Active Duty Police Id; Police DeptlUnit Cc- P-A-1 P. ise /c(Oxr: -a o n 3 Badge 'R Q k
Active Duty Military Id; Unit Branch of Service
If Civilian Provide Either:
Pistol License No. (any state) or CCW Permit No. Exp. Date_ State of Issue
A current copy of a Criminal Record History Check from your state of residence within twelve (12) months of training course date showing no criminal
activity.
LEIPolice- Military Only Courses: Must include credentials verifying active LE status or active Military ID. An application without one of the above will be
rejected. There are NO exceptions. VTAC reserves the absolute right to refuse training for any reason whatsoever to any applicant. Submission of this
application indicates your clear understanding of this requirement.
Payment Information:
SEE VTAC INSTRUCTION PAGE AND FAQ PAGE FOR UPDATED INFORMATION
Y A deposit is required to reserve your seat. Refer to the Course Announcement for the amount.
S Course Cancellation Policy: We require the full tuition up front to reserve your slot. If you cancel outside of 30 days, we will refund 100% of your tuition.
If you cancel inside of 30 days, and we cannot fill your slot, we retain 50% of your tuition.
Deposit is waived for PO remittances and Mil Orders.
If submitting online, fax or email, deposit or p ent in full must be made within 5 days of submission.
Payment method: Check Purchase Order 1 Credit Card Amount
If paying by credit card: MAKE CHECKS PAYABLE TO: Viking Tactics, Inc.
Payment Information: Send Payments to:
Name on Credit Card: Viking Tactics, Inc.
Credit Card Number: 3725 Heatherbrooke Drive
Expiration Date of Card: Code: Fayetteville, NC 28306
y
1
Viking Tactics, Inc.
ri 3725 Heatherbrooke Drive
Fayetteville, NC 28306 -9718
PHONE: (910) 987 -5983
OC FAX: (910) 425 -0700
www.VIKINGTACTICS.COM
Registration and Acclication for Training
Viking Tactics, Inc. 1 Team VTAC, Inc.
IN ACCORDANCE WITH [TAR REGULATIONS, ONLY U.S. CITIZENS WILL BE ACCEPTED TO PARTICIPATE IN VTAC COURSES
First Name I J, 4 MI Last Name
Email Address: &'-o Date of Birth: n Q,I 9 1 �6 i Age:
Home Address: 5- 6 S f City: c c d r State yJ Zip gi 63 o
Occupation: (rc= Military or LE Affiliation: C. A'C1V' P n Rank:
Work Address: fsu -f� City: LA44.0 -1 State Zip z
Home Phone (31-) Work Phone; y7r Zrb n
Former Student: Yes If yes, provide prior dates:
Weapon Information: If Civilian, Pistol License Number, State of Issuance and Expiration Date:
Primary Weapon Type and Caliber: Pistol License Number:
Secondary Weapon Type and Caliber: l or y 2 State of Issue: Expiration Date:
COURSE DATE; 7 3 o9 COURSE NAME: Pre Requisites Met XRI No
Emergency Name: L c-v--•e" rem S Emergency Phone: —31 '2- Q I
Credentialing Policy: VTAC has a strict credentialing policy, A photocopy of ONE of the following must be emailed (lambOvikinatactics.coml taxed (910 -987-
5983), or mailed LISPS:
T Certificate of Good Conduct (from your local Police partment)
t Active Duty Police Id; Police Dept/Unit ru t Badge J� 3
Active Duty Military Id; Unil Branch of Service
If Civilian Provide Either:
T Pistol License No. (any state) or CCW Permit No. Exp. Date_ State of Issue
V A current copy of a Criminal Record History Check from your state of residence within twelve (12) months of training course date showing no criminal
activity.
LElPolice Military Only Courses: Must include credentials verifying active LE status or active Military ID. An application without one of the above will be
rejected. There are NO exceptions. VTAC reserves the absolute tight to refuse training for any reason whatsoever to any applicant. Submission of this
application indicates your clear understanding of this requirement.
Payment Information:
SEE VTAC INSTRUCTION PAGE AND FAQ PAGE FOR UPDATED INFORMATION
'r A deposit is required to reserve your seat. Refer to the Course Announcement for the amount.
T Course Cancellation Policy: We require the full tuition up front to reserve your slot It you cancel outside of 30 days, we will refund 100% of your tuition.
If you cancel inside of 30 days, and we cannot fill your slot, we retain 50% of your tuition.
t Deposit is waived for PO remittances and Mil Orders.
t If submitting online, fax or email, deposit or pay in full must be made within 5 days of submission.
Payment method: Check Purchase Order Credit Card Amount
If paying by credit card: MAKE CHECKS PAYABLE TO: Viking Tactics, Inc.
Payment Information: Send Payments to:
Name on Credit Card: Viking Tactics, Inc.
Credit Card Number. 3725 Heatherbrooke Drive
Expiration Date of Card: Code: Fayetteville, NC 28306
i Viking Tactics, Inc,
H 3725 Heatherbrooke Drive
Fayetteville, NC 28306 -9718
PHONE: (910) 987 -5983
FAX: (910) 425 -0700
www.VIKINGTACTICS.COM
Registration and Application for Training
Viking Tactics, Inc. Team VTAC, Inc.
IN A WITH ITAR REGULATIONS, ONLY U.S. CITIZENS WILL BE ACCEPTED TO PARTICIPATE IN VTAC COURSES
First Name MI A Last Name
Email Address: A k i 5J11 Ciro r\. u V Date of Birth: I Q j— I Age:
Home Address: q IJ r,r c�„e Dr. City: N Ae-s -A C_ State .y-J Zip cv z
Occupation: LL= o Military or LE Affiliation: L Atz m I P Rank:
N __fiL PLC
Work Address: City: L p cry. l State Zip ylva T z
Home Phone ?1-) 65G g L 1 Work Phone: 2 i ZS
Former Student: Yes If yes, provide prior dates:
Weapon Information: If Civilian, Pistol License Number, State of Issuance and Expiration Date:
Primary Weapon Type and Caliber. ?—t7 L L 3 Pistol License Number:
Secondary Weapon Type and Caliber: t LIle 2 State of Issue: Expiration Date:
COURSE DATE: COURSE NAME: A_#_ Pre Requisites Met: eOl NO
Emergency Name: 1 4 _T-rlY s .v Emergency Phone: ci 'l
Credentialing Policy: VTAC has a strict credentialing policy. A photocopy of ONE of the following must be emailed (lambno vikingtactics.coml faxed (910-987-
5983), or mailed USPS:
Certificate of Good Conduct (from your local Police Qepartment)
Active Duty Police Id; Police DeptlUnit c e crr l Badge L I k
Yi Active Duty Military Id; Unit Branch of Service
If Civilian Provide Either:
T Pistol License No. (any state) or CCW Permit No. Exp. Date_ State of Issue
T A current copy of a Criminal Record History Check from your state of residence within twelve (12) months of training course date showing no criminal
activity.
LE1Police Military Only Courses: Must include credentials verifying active LE status or active Military ID. An application without one of the above will be
rejected. There are NO exceptions, VTAC reserves the absolute right to refuse training for any reason whatsoever to any applicant. Submission of this
application indicates your clear understanding of this requirement.
Payment Information:
SEE VTAC INSTRUCTION PAGE AND FAO PAGE FOR UPDATED INFORMATION
A deposit is required to reserve your seat. Refer to the Course Announcement for the amount.
t Course Cancellation Policy: We require the full tuition up front to reserve your slot. If you cancel outside of 30 days, we will refund 100% of your tuition.
If you cancel inside of 30 days, and we cannot fill your slot, we retain 50% of your tuition.
't Deposit is waived for PO remittances and Mil Orders.
t If submbng online, fax or email, deposit or pa in full must be made within 5 days of submission.
Payment method: Check Purchase Order Credit Card —Amount
If paying by credit card: MAKE CHECKS PAYABLE TO: Viking Tactics, Inc.
Payment Information, Send Payments to:
Name on Credit Card: Viking Tactics, Inc.
Credit Card Number: 3725 Heatherbrooke Drive
Expiration Date of Card: Code: Fayetteville, NC 28306
INDIANA RETAIL TAX EXEMPT PAGE C i ty II C sane l CERTIFICATE NO.003120155 002 0 a
tiS� o JL PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972
3 QZLEFCIVIC 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
June 8 2009 trainin
VENDOR Viking Tactics, Inc. SKIP Cit of Carmel PoRIce Dlepar=ent
3725 Hemtherbrooke Drive TO 3 Civic Square
Fayetteville, NC 28306 Carmel, IN 46032
CONFIRMATION BLANKET i CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.5 Tactical Carbine school for Sgt. Brady Myers, 687.83 2,063.49
Lt. Dwight Frost and Officer Ryan Jellison on
July 14 2009 at CED Range
LO
a
Send Invoice To: City of Carmel P
ATTN: Teresa Anders
3 Civic Square
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
210 570 cont ed fund I 1' PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOB GATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. 1
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY O
f �1'
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE As start Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO.
�A COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO._
y
ALLOWED 20
IN THE SUM OF
�I
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 it
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
T eam VTAC, Inc. Purchase Order No. 21023F
3 725 Heatherbrooke Drive Terms
F ayetteville, NC 28306 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6/17/09 1035 payment for 1.5 Tactical Carbine school for Sgt. Brady 2,063.49
Myers, Lt. Dwight Frost and Officer Ryan Jellison on
July 14 16, 2009 At the CPD Range
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
T eam VTAC, Inc.
IN SUM OF
3725 Heatherbrooke Drive
Fayetteville, NC 28306
2,063.49
ON ACCOUNT OF APPROPRIATION FOR
c ed fund
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
21023F 1035 5 570 2,063.49 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
June 17 2009
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund