221133 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 00353043 Page 1 of 1
ONE CIVIC SQUARE SCOTT LONG
i+ CARMEL, INDIANA 46032
CHECK NUMBER: 221133
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 227 . 50 TRAINING SEMINARS
Of 4
CITY OF CARMEL Expense Report (required for all travel expenses)
EMPLOYEE NAME: Scott Long DEPARTURE DATE: 6/3/2013 TIME: 6:00 AM / PM
DEPARTMENT: Carmel Police Department RETURN DATE: 6/6/2013 TIME: 5:00 AM / PM
REASON FOR TRAVEL: SWAT (Less Lethal School) DESTINATION CITY: Hebron, KY
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
6/3/13 $32.50 $32.50
6/4/13 $65.00 $65.00
6/5/13 $65.00 $65.00
6/6/13 $65.00 $65.00
$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
0.00
Total 1 $0.001 $0.001 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $227.50 $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 6/11/2013 Page 1
TEtA1NING
INSTITUTE
REGISTRATION FORM
Please print name as it should appear on the certificate
Last Name: ��/�/� First Name: SC407-7- MI: �s '
Department: Cam`A'F_h'1C[, L!G5 1 Ag'�-�ytEn!1
Dept. Address: S d,/'v/c'- -Q u f+R.r
City: C4R,M-�C_ ST: �/ Zip: 0-_t
Work Phone: 3 (7 —5-71 --0.500 Cell: .3/7 ' '( �
Email Address: rlg 0 CAS,r- L. /h °I a V
COURSE LOCATION & DATES: CIEtg1L 1,6 2013
TYPE GAS GUN AGENCY USES: 37mm �<40MM _12 Gauge Shotgun
CTSTI INSTRUCTOR & OPERATOR COURSES
OC ICP (Day 1 Only - $90.00) _ Corrections Course (3 Days - $350.00)
_ CM ICP (Day 2 Only - $220.00) _ Basic Breaching Operators Course (1 Day - $110.00)
IM ICP (Day 3 Only - $190.00) _ Field Force Grenadiers Course (2 Days - $350.00)
_ FB ICP (Day 4 Only - $220.00) _ SWAT Grenadiers Course (2 Days - $300.00)
All 4 ICP (Full 4 Day - $695.00) _ Penn Arms Armorer's Course (2 Days - $125.00)
Al �r�� �� �'� � _ Breaching Instructor Course (2 Days - $225.00)
Custodial Handcuffing & Restraints (1 Day - $95.00)
BECAUSE ATTENDANCE IS LIMITED,A FIRM COMMITMENT IS REQUIRED. Therefore, a purchase order OR request for attendance
on departmental letterhead to Combined Systems, Inc.from your department must be submitted to us by fax(724-932-2157),emailed to
aiones combinedsystems.com or mail to CTS Training Institute, P. 0. Box 506,Jamestown PA 16134.
As the P. 0.'s/requests for attendance are anticipated to be greater than the number of spaces available,cancellation of a designated
attendee must be made in writing to Combined Systems thirty(30)days before the class date. Should a student not appear for a class,
and a cancellation notice not be received,that agency will be charged the full amount of the cost associated with this class. Notification of
cancellation will allow us to offer the vacant spot to another interested agency. Substitution of an attendee within the same agency is
acceptable.
MAIL Payment TO: COMBINED SYSTEMS, INC. - TRAINING
388 KINSMAN ROAD
JAMESTOWN, PA 16134
Payment Method: _Check Enclosed _Credit Card _ Dept. Purchase Order#
CC #&V CODE#: Exp. Date:
Name as it appears on card:
Billing address & Phone Number
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))
06/14/13 training $227.50
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
Scott D. Long
IN SUM OF $
$227.50
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
210 -570.00 $227.50
I hereby certify that the attached invoice(s), or
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
Friday, June 14, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund