212169 08/28/2012 a CITY OF CARMEL, INDIANA VENDOR: T359466 Page 1 of 1
ONE CIVIC SQUARE CRISIS PREVENTION INSTITUTE INC
Sl° CARMEL, INDIANA 46032 10850 W PARK PLACE SUITE 600 CHECK AMOUNT: $679.00
MILWAUKEE WI 53224 CHECK NUMBER: 212169
CHECK DATE: 8/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4357004 CUS1211056 679 . 00 EXTERNAL INSTRUCT FEE
® Original Invoice Invoice CUS1211056
Nonviolent Crisis Intervention®program Date 7/6/2012
Prepare Training®program Pa e: 1
Dementia Care Specialists Federal I.D.#39-2012874
CPI Matters at Work
Positive Options
Bill To: Ship To:
Brooke Taflinger
Carmel Clay Parks And Recreation Carmel Clay Parks And Recreation
1235 Central Park Dr E 1235 Central Park Dr E
Carmel IN 46032-4421 Carmel IN 46032-4421
US US
Purchase Order No. Customer ID Shippincj Method ::::Payment Terms Reg Ship Date
02-0R-A001 LKO US UPSG--ND NET 30 7/6/2012
Ordered U&M Shipped B/O Item Number Description Unit Price Ext. Price.
1 EACH 1 0 OPPN0009 NCI 3- Day Renewal $679.00 $679.00
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Program fee payable prior to program start. Thank you Subtotal $679.00
Tax $0.00
Tracking#(if applicable): Freight $0.00
Deposit Received $0.00
Total Z-US$ $679.00
Remit to:CPI Customer Service: 1-800-558-8976
_ _ _ Tax exempt organizations:we must have youur tax exempt certificate on file.
10850 W.Park Place,Suite 600 Accounting/Billing: 1-877-877-5409
Milwaukee,W 1 53224 USA Customer ServiceFax: 1-414-979-7098 Please refer to www.crisisprevention.com or your contract
for program cancellation and product return policies.
Please include invoice number or customer ID with your payment.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
T359466 Crisis Prevention Institute, Inc. Terms
10850 W Park Place, Suite 600
Milwaukee, WI 53224
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/6/12 CUS1211056 Training conference B.Taflinger 31068 $ 679.00
Total $ 679.00
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
Voucher No. Warrant No.
T359466 Crisis Prevention Institute, Inc. Allowed 20
10850 W Park Place, Suite 600
Milwaukee, WI 53224
In Sum of$
$ 679.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 CUS1211056 4357004 $ 679.00 1 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
23-Aug 2012
&Jqk�
Signature
$ 679.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund