HomeMy WebLinkAbout209342 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 278140 Page 1 of 1
a ONE CIVIC SQUARE CURTIS D. SCOTT CHECK AMOUNT: $175.00
at�!� CARMEL, INDIANA 46032 14309 NOLAN DRIVE
FISHERS IN 46038 CHECK NUMBER: 209342
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4343002 175.00 EXTERNAL TRAINING TRA
Y
M i
CITY OF CARMEL Expense Report (required for all travel expenses)
�NDIANP.
EMPLOYEE NAME: Curtis Scott DEPARTURE DATE: 5/5/2012 TIME: 2:00 AM
DEPARTMENT: Carmel Police RETURN DATE: 5/8/2012 TIME: 1700 AM /e
REASON FOR TRAVEL: SWAT Conference DESTINATION CITY: Ft. Wayne
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air -fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
5/5/12 $25.00 $25.00
5/6/12 $50.00 $50.00
5/7/12 $50.00 $50.00
5/8/12 $50.00 $50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
L 0.00
Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $175.00 $0.00.
DIRECTOR'S STATEMENT: I hereby affirm that all expenses listed conform to the City's travel policy and are within my department's appropriated budget.
Director Signature: Date:
City of Carmel Form ER06 Revision Date 5/19/2012 Page 1
FoR OFFICiAL USE ONLY ArTENDEE
R E(;tSTRATtoN
9th Annual Conference may 6th 0
s
VS175 Conference Fee $20 "Junkyard Shootour Match
S25 Late Fee (After April 20, 2012)
Total 00 0 AdNional Banquet Tickets $40 each
An application form must be submitted for each and every attendee
FIRST NAME M I I NAME
AGENCY ASSIGNMENT /RANK /TITLE
I
Cc�r►n1� 1 (c e e I P C, p it trk
AGENCY ADDRESS CI STATE ZIP C00[
C;vtc SQLk Cow P" -1: 1 L
MAILING ADDRESS (OTHER THAN AGENCY) CITY STATE ZIP CODE
E MAN ADDRESS
'HONE�
C 5 Z OA c �rw��t �t 9 o '5 r 2'S
l affirm that the above information is true and accurate Further,/ authorize the Indiana SWAT Officers Association
to contact my employer and verify my employment and assignment, if necessary
SIGNATURE
DATE
IMPORTANT Will you be attending the banquets U 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
substitut will be allowed.
If paying by credit card, please complete the following
V ISA I 0
CREDIT CARD NU.UR E11U11TtON DATE 7 DIGIT AUTHORIZATION CODE
NAME ON CREDIT CARD AUTNORIZATNJN SIGHATUR[
ADDRESS CITY STATE ZIP CODE:
IMPORTANT: Your credit card will be charged the day your registration form and payment are received by the 1SOA.
Please include the billing address where the monthly statement is sent.
PLEASE CHECK FULL -TIME O PART -TIME CI RETIRED AUXILIARY /RESERVE O ACTIVE MILITARY G RESERVE MILITARY
r.
CARMEL POLICE DEPARTMENT
APPLICATION FOR SPECIALIZED TRAINING
Today's Date. 02/10/2012 Employee: Scott, Curtis
Name of School: 2012 ISOA Conference
Cost: $175.00
Location of School: Ft. Wayne, Indiana
State: IN
Topic Subject Matter: Various subject matter relating; to SWAT operations.
ILEA Course Certification (if available)
Dates of School: From: 05/06/2012 To. 05/08/2012
Contact Person: Kuhlcnsehmidt, Tom Email: kulhlaid50 @yahoo.com
Telephone Number: (219) 488 -4421
Instructor: Various ILEA Instructor #(ifavailable)
How will this School benefit you and the Department? The school conference offers a vanety
of classroom and practical hands on training and instruction relating to a variety of tactical,
psycological and operational aspects which would benefit Carmel SWAT operations both
individually as well as the team level echelon.
Will you need a rental car? []Yes ®No
Will you need air transportation? ❑Yes ®No
Will you need accommodations? ®Ycs ❑No
"OVERTIME COMPENSATION WILL NOT BE PAID IF YOU VOLUNTEER TO
ATTEND A SCHOOL ONLY IF YOU ARE ORDERED TO ATTEND.
Officer's Signature:
l./
Supervisor' Signature Date: c�) /k
Division Commander: Date: 2
Training Officer: Date
*OFFICE USE ONLY BELOW THIS L NE*
2011 -02 -222
VOUCHER NO. WARRANT NO.
ALLOWED 20
Curtis D. Scott
IN SUM OF
14309 Nolan Drive
Fishers, IN 46038
$175.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1110 43- 430.02 $175.00
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
Monday, May 21, 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))
05/21/12 reimbursement for meals for training $175.00
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