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Home My WebLink About174072 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