219283 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 356012 Page 1 of 1
ONE CIVIC SQUARE COLT DEFENSE LLC
"*. CHECK AMOUNT: $600.00
CARMEL, INDIANA 46032 PO BOX 118
HARTFORD CT 06141 CHECK NUMBER: 219283
CHECK DATE: 4/2412013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 25591 26174 600 . 00 TRAINING
C LT) COLT DEFENSE LLC
P.O. BOX 118, HARTFORD, CONNECTICUT 06141-0118
SOLD-TO: CARMEL POLICE DEPARTMENT ATTN: TERESA ANDERSON
YOUR ORDER NUMBER CUSTOMER CODE INVOICE DATE OUR ORDER NUMBER
PO #255491 54188 04/17/2013 26174
COMMENTS: TERMS :TO BE PAID
MODEL DESCRIPTION QUANTITY UNIT PRICE EXTENSION NET AMOUNT
No.
Armorer School Tuition: 2 $300.00 $600.00
• FEE FOR RIFLE ARMORER COURSE
• APRIL 15 - 17,2013
STUDENTS: PARIS &JELLISON
Respectfully Submitted: 04/17/13
Seth Bielucki
Law Enforcement Training Coordinator
sbielucki @colt.com
(860)244-1408
F.I.N. 32-0031950
DUNS# 12-139-6217
PLEASE MAKE CHECKS PAYABLE TO:
COLT DEFENSE LLC
REMIT PAYMENT TO:
COLT DEFENSE LLC SUB- $600.00
Atha: SETH BIELUCKI TOTAL
PO BON 118
HARTFORD,CT 06141-0118
USA SHIPPING $0.00
TOTAL
DUE $600.00
LAW ENFORCEMENT INVOICE Employer Number (FID) 32-0031950
PLEASE PAY FROM THIS INVOICE. PLEASE INCLUDE THIS FORM WITH PAYMENT.THANK YOU
AggiNk LTS COLT DEFENSE LLC
P.O. BOX 118,HARTFORD, CONNECTICUT 06141 860/244-1408
Training Course Registration Form
Directions:
To secure a seat in the Colt Armorer course this form must be tilled out and submitted to Colt Defense with a
form of pavment to secure a seat in a course. Fax#'860-244-1352 or sbielucld(a;colt.com Check and Purchase
orders may be mailed and credit card info may be entered below. Questions please contact Seth Bielucki .
Studejtts are requiered to bring the following with theni to the course:Picture ID,pen & notebook, eye protection.
KM-16/AR-15 Armorers School($450.00)❑ 1911 Armorers School($375.00) ❑ Both ($25 Discount)
Section 1
$100 of registration fee is non-refundable should the student withdraw from the course 30 days or less before the course.
Course Location: Course Date:
FISHERS, IN RIFLE APR 15-17 1911 APR 18-19
Title/Rank First Name Last Name /
Agency Name
Address , L
City State Zip Dept.Phone. Dept. Fax
Email Address J e/ri SON ��/'�E'� 1'�'Gv r�
Payment section must be filled out to indicate form of payment. Please email or fax
registration ahead of any mailed PO or Check Payment.
Section 2
PAYMENT SECTION ❑ MC ❑ Visa ❑ Discover ❑ Check Dept. PO
Colt Defense, LLC Tax ID # 32-0031950
Credit Card# Ex p. Date 3 Digit Security Code Amount
Contact Name Contact Phone Contact Fax
(JCc�•�.� ��r���S 3l?- S-,7/-d 53ZJ 3.) z 5-/Z
Billing Address City State Zip
Email Address
Do You Want A Receipt Faxed or Emailed? Yes ❑No Citizen of the USA? ❑ Yes ❑No
*THIS COURSE IS RESTRICTED TO ACTIVE LAW ENFORCMENT,
CORRECTIONS, MILITARY AND NUCLEAR SECURITY.
SYMBOL OF QUALITY SINCE 1836
LT
COLT DEFENSE LLC
P.O. BOX 118, HARTFORD, CONNECTICUT 06141 860/244-1408
Training Course Registration Form
Directions:
To secure a seat in the Colt Armorer course this form must be filled out and submitted to Colt Defense with a
form of payment to secure a seat in a course. Fax#'860=2'4,4-1352 or sbieluck0d colt.com Check and Purchase
orders may be mailed and credit card info-may-be entered below. Questions please contact Seth Bielucki .
Students are requiered to bring the following with Mein to the'con•se:Picture ID,pelt & notebook, eye protection.
�
M-16/AR-15 Armorers School($450.00)[1 1911 Armorers School($375.00) ❑ Both($25 Discount)
Section 1
$100 of registration fee is non-refundable should the student withdraw from the course 30 days or less before the course.
Course Location: Course Date:
FISHERS, IN RIFLE APR 15-17 1911 APR 18-19
Title/Rank First Name Last Name
Agency Name
Address
City State Zip Dept. Phone Dept.Fax
`4y,-9),- / 3i2- s--?1-.;253v
Email Address S ��}�n�e./. — - (l'O(/
Payment section must be filled out to indicate form of payment. Please email or fax
registration ahead of any mailed PO or Check Payment.
Section 2
PAYMENT SECTION ❑ MC ❑ Visa ❑ Discover ❑ Check �*Pt. PO
Colt Defense, LLC Tax ID # 32-0031950
Credit Card# Exp. Date 3 Digit Security Code Amount
Contact Name Contact Phone Contact Fax
FZ-61olol- .317- /-2- 12�7-S--71-z'K-/z
Billing Address City State zip
6 J
Email Address
Do You Want A Receipt Faxed or Emailed? ❑Yes^ ❑No Citizen of the USA? ❑ Yes ❑No
*THIS COURSE IS RESTRICTED TO ACTIVE LAW ENFORCMENT,
CORRECTIONS, MILITARY AND NUCLEAR SECURITY.
SYMBOL OF QUALITY SINCE 1836 r
�r; INDIANA RETAIL TAX EXEMPT PAGE
City ®f c.,
�'�Me l CERTIFICATE NO.003120155 002 0 Y Y PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 21
• 35-60000972
ONE CIVIC 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
119, 13
Colt Defense LLC Carmel Police Department
VENDOR Both Bloluchl 4 Last Enforcoment Tmg Coordifiito SHIP 3 CIVIC Squatu
P.O. Box 918 TO Carrel, IN 46032
Haftfofd, CT 08W.0ilS (w)671-25%
CONFIRMATION I BLANKET I CONTRACT PAYMENT TERMS FREIGHT
I
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00=670.00
2 Each training $450.00 $900.00
Sub Total: $900.00
� � a
Coh Rife &1011 A aror Coufso for Sgt. r April 15 - 19,2013 In FIshors, IN
Send Invoice To:
Carmel Police Deparfmont
Attn: Teresa Anderson
3 Civic Square
Caramel, IN 4S0329 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
Carmel Police Dept. -� PAYMENT $!3120.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID:
THIS APPROPRIAT ONISUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL /. V
SHIPPING LABELS. hid of.Policeof.Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
V CLERK-TREASURER
DOCUMENT CONTROL NO. A. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
_ IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
j
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 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))
04/17/13 26174 training $600.00
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
Colt Defense LLC
Seth Bielucki - Law Enforcement Trng Coordin IN SUM OF $
P.O. Box 118
Hartford, CT 06141-0118
$600.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Depot. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25591r I 26174 I -570.00 I $600.00 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
Thursday, April 18, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund