213202 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 00351302 Page 1 of 1
ONE CIVIC SQUARE SCOTT TIERNEY CHECK AMOUNT: $51.00
CARMEL, INDIANA 46032 19001 CRESTVIEW COURT
WESTFIELD IN 46074 CHECK NUMBER: 213202
CHECK DATE: 9/2512012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4343002 51 . 00 EXTERNAL TRAINING TRA
Circle Centre Ila]I
FE.E; Niffiber: 12
C-111 bier: Alai) P. Id #127
Cc - 1,:
ff,.allqiicHoll Number: 527384
F-Wered: 09/t4/2012 07:213
Exi ted: 09/14/2012 I8:38
ficket #42347 Dispenser 440
Lot: World Wonders
AI'PFi: Area I
Rate: Standard Rate
Pal k*11)g Fee': 1r).00
Total Fee: 15.00
Cash: 15.00
Val Paid: $ 15.00,
Thank You
Denison Parking
6
DENI5CN PKING
PAN AMERICAN GAME
2018 CAPITOL AVE
INDIANAPOLIS, IN 46225
317-237-4849
RcPt# 9719
09/13/12 18:06 L# 3 A# 7 Txn# 22319
09/12/1215:10 In 09/13/1218:06 Out
Tkt# 085116
CRENT f 36.00
Total Fee $ 36.00
—-CASH PAID--- --$-Y;.O OF —i
Cash Tender $ 40.00
Chase Due $ 4.00.
THAW You
Sn der, Denise W
From: Tierney, Scott A
Sent: Monday, August 20, 2012 3:03 PM
To: Snyder, Denise W
Subject: FW: 2012 IERC Conference Registration Confirmation
From: Indiana Emergency Response Conference [registrations @indianaerc.com]
Sent: Monday, August 20, 2012 1:41 PM
To: Tierney, Scott A
Subject: 2012 IERC Conference Registration Confirmation
Dear Scott Tierney
You are now ready to move on to step 3, choosing your workshops. Please Click HERE.
You have just registered for event Package A: Full Conference with all Meals at Indiana Convention
Center(100 S Capitol Ave., lndianapolis,IN, 46225,United States). The registration detail is as follow:
Conference Registration Type Package A: Full Conference with all Meals
Event date 09-12-2012 12:00 am
Location Indiana Convention Center(100 S Capitol Ave., Indianapolis,IN, 46225,
United States)
User Id 1000458
First name Scott
Last Name Tierney
Email stierney 0_vcarmeI.in.gov
Total amount $315.00
Discount amount $60.00
Grand Total $255-:007
Payment method I wish to pay via offline payment with Purchase order or mail in a check.
Transaction 1 D P6J26C LO
Type of Registration Attendee
Organization Carmel Fire Dept.
Job Title/Rank Captain
EMS/PSID 3390-5202
Contact Phone 317 818 3400
Address 2 Civic Square
Address 2
City Carmel
State IN
Zip 460')?
How many people in your household? 4
i
Age 45
Gender Male
Emergency Contact Phone 317 418 2419
Emergency Contact Name Mindy
IDHS District District 05
Disability
Allergies
Casino Night Additional Meal
Casino Night First Guest Name(if
any)
Casino Night Second Guest Name (if
any)
Casino Night Third Guest Name (if
any)
Awards Banquet Additional Meal
Awards Banquet First Guest Name (if
any)
Awards Banquet Second Guest Name
(if any)
Awards Banquet Third Guest Name
(if any)
Vendor Lunch Additional Meal
Vendor Lunch First Guest Name (if
any)
Vendor Lunch Second Guest Name
(if any)
Vendor Lunch Third Guest Name (if
any)
Associations Indiana Firefighters Association
Associations(Other)
Your Departments Firemarshal
Your Departments Firemarshal Phone
Your Public Education Rep
Your Public Education Rep Phone
First Responder Category FIRE
First Responder Category (Other)
Please PRINT THIS REGISTRATION FORWINVOICE and send the offline payment via US Mail to or
forward this email and call with credit card if this is for a group payment:
Indiana Emergency Response Conference
P. O. Box 364
Zionsville IN 46077
2
Please make checks payable to: Indiana Fire Chiefs Association. If you need a special invoice or have
questions, please email Terry Rake, Conference Coordinator.
If we don't receive your payment before the conference date, we will need a credit card to place on hold until
payment is recevvd in order for you to attend the conference.
Regards,
1 ERC events management team
3
VOUCHER NO. WARRANT- NO.
ALLOWED 20
Scott Tierney
IN SUM OF $
$51.00
ON ACCOUNT OF APPROPRIATION FOR - _-
Carmel Fire Department
PO4/Dept.I INVOICE_NO, ACCT#/TITLE AMOUNT
Board Members
1120 I I 43-430.02 I $51.00 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
SEP 2 4 2012
d
r
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
uvrwnuwmofxCCmmu City e°nNo.201 (Rev 1995)
� ^ ,V"AB/ LVOUCAER
CITY OF CARK8E|
um :r be pmpcdy muui shm*: ;�in,� o[����a.whore pan'ornxed, dulco, service endemd, by
yhun` r^iuo pe/ dz\. houm, mia per hour, number oi uniie. phro peruni|. Cto.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (oi- note attached invoice(s) or biil(s))
l $51.00
| hereby certify that the attached invoioo(o), or bill(s), in(are)true and correct and | have audited same in acunvdunuo
with |C 5-11'10'1.0
20____
Clerk-Treasurer