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Home My WebLink About214069 10/23/2012 i CITY OF CARMEL, INDIANA VENDOR: 00351270 Page 1 of 1 0 ` ONE CIVIC SQUARE BRIAN E SCHMIDT CARMEL, INDIANA 46032 CHECK NUMBER: 214069 CHECK DATE: 10/23/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 250 . 00 TRAINING SEMINARS '4\lT iF CITY OF CARMEL Expense Report (required for all travel expenses) 1 A-14 EMPLOYEE NAME: Brian Schmidt DEPARTURE DATE: 9/24/2012 TIME: 5:00 � /�M DEPARTMENT: Carmel Police RETURN DATE: 9/28/2012 TIME: 4:00 AM/(_N REASON FOR TRAVEL: K-9 Certification DESTINATION CITY: Elkhart, IN EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN TRAVEL PER DIEM X Transportation Gas/Tolls/ Meals Date Lodging Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem 9/24/12 $50.00 $50.00 9/25/12 $50.00 $50.00 9/26/12 $50.00 $50.00 9/27/12 $50.00 $50.00 9/28/12 $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 Total 1 $0.001 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $250.00 $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 10/12/2012 Page 1 2012 INDIANA ST'A'TE WORKSHOP September 24th through September 28th, 2012 REGISTRATION FORM(PLEASE PRINT LEGIBLE) Name:_Brian E. Schmidt Home Address:_13983 Marilyn Court City: Carmel State: _IN Zip Code: _46032 E Mail:_bschmidt@carmel.in.gov Agency: _Carmel Police Department Agency Address:_3 Civic Square City:_Carmel State:_IN Zip Code:_46032 Work Phone: (317_)_571-2500 Home Phone: (317__428-8074 NAPWDA Workshop Waiver: The undersigned participant recognizes the possibility of injury occurring as a result of his/her participation in the K9 Workshop. I furthermore state that my canine and I are in a physical condition necessary to be able to participate in the events, as needed for training and certification purposes. I hereby waive and relinquish the North American Police Work Dog Association, further referred to as NAPWDA, the Elkhart County Sheriff Department and the County of Elkhart, their employee's, affiliates, sponsors, organizers, and or all participants, for any injury, mental or physical, to myself or my canine. I also agree to abide by all rules and regulations as set forth by NAPWDA and the event organizers. I furthermore will accept responsibility for any damage caused by my canine or myself to any and all property,persons and to include the ho el accommodations and or any training venue. Date: _08 /_31_/_2012_Sign Name: – `��-- Print Name: ,,4.r, E . 5'c4fA4 A a'f Current NAPWDA Member? Yes No_ K9 Breed:_Lab/Bull Terrier Mix K9 _Leo K9 Age: `1.5 Type of K9(check appropriate descriptions): Patrol_Narcotic_X_Cadaver_Dual Purpose— K9'S Working Ability: Beginner_X_Intermediate_Advanced_ Handler's Ability: Beginner_X_Intermediate_Advanced_ Purpose(s) of Attending Workshop(check at least one): Training_Certification(New)_X_Certification (Renewal) If certifying, which areas of certification you will be attempting:_Narcotics detection and tracking_ Registration Form Page 1 of 2 **** NOTE: **** Reminder: Registration Form is a two (2) page document, PLEASE RETURN BOTH PAGES OF REGISTRATION FORM. NAPWDA Membership Dues (must be a member to test for certification): Membership dues are $45.00 per year. Make NAPWDA Membership dues a separate check Payable to NAPWDA. Do not include this money in the same check as the workshop registration fee. Civilian SAR Handlers applying for Associate Membership must be sponsored by a current NAPWDA Regular member and provide a current Criminal History Records Check at the time they initially join and upon renewing yearly. This record check must be obtained from a Law Enforcement Agency and cover that person for the entire United States or entire State that they live in (not just a city or county level). Associate Membership Info &Application may be printed out from the NAPWDA web site (Membership Information tab). View Certification Test Rules at www.napwda.com/about Workshop Fee: The cost of the workshop is $125.00 per K9 team. A K9 team is I handler with 1 dog. There is an additional workshop fee of$75.00 per additional doe for any K9 Handler wishing to train or test with an additional doe. Make workshop fee checks payable to Indiana Police Canine Workshop Mail checks and completed Registration Form in before September 1 2012 No refunds at all after September 1, 2012. Cadaver Detection Teams-Please respond by September 1 2012 so that we may make the necessary arrangements for this phase. Mail Registration to: Indiana Police Canine Workshop 52677 CR I l Elkhart, In 46514 Attention: Mike McHenry Mail checks and completed Registration Form in before September 1, 2012. No refunds at all after September 1, 2012. Cadaver Detection Teams - Please respond by September 1, 2012 so that we may make the necessary arrangements for this phase. Workshop Coordinator/ Contact: Sgt. Michael McHenry Cell: 574-320-7419 E-mail: mmchenryaa,elkhartcountysheriff.com Registration Form Page 2 of 2 **** NOTE: ****. Reminder: Registration Form is a two (2) page document, PLEASE RETURN BOTH PAGES OF REGISTRATION FORM. -z- � 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 3 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10/17/12 K-9 training $250.00 q s I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance Iwith IC 5-11-10-1.6 20 el Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Brian E. Schmidt IN SUM OF $ $250.00 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 210 -570.00 $250.00 I hereby certify that the attached invoice(s), or I I 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 Thursday, October 18, 2012 A h Chief Cost distribution ledger classification if claim paid motor vehicle highway fund