222441 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 139800 Page 1 of 1
` ONE CIVIC SQUARE INDIANA ASSOC OF CHIEFS OF POLICECHECK AMOUNT: $175.00
CARMEL, INDIANA 46032 10293 N MERIDIAN ST STE 175
�•�'? INDIANAPOLIS IN 46290
CHECK NUMBER: 222441
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357004 25370 74158 175 . 00 CONFERENCE
Indiana Association of Chiefs of Police
10293 N Meridian Street, Suite 175 Invoice
Indianapolis, IN 46290
Telephone 317.816.1619 Date Invoice No.
Fax 317.816.1633
7/19/2013 74158
Bill To
Carmel Police Department
3 Civic Square
Carmel, IN 46032
TERMS
i
Due Upon Receipt
DESCRIPTION QUANTITY RATE AMOUNT
2013 IACP Fall Conference 1 175.00 175.00
September 4& 5, 2013
Crown Plaza Hotel, Indianapolis, Indiana
Registration for: Tim Green
Purchase Order 25370
Total $175.00
IACP Fall Conference I September 4-5, 2013 1 REGISTRATION FORM
Name Timothy J. Green
Department Carmel Police Department
Title Chief of Police
First Name for Badge Tim
Address 3 CivicrSmtarP
City Carmel,
State Indiana Zip 46032
Work Phone (317) 571-2523 Cell Phone
Email tgreen@carmel.in.gov
REGISTRATION FEE
Member Fees Non-Member Fees
® Member: $175 ❑ Non-Member: $250
❑ DARE Officer or SRO from ❑ Non-Member DARE Officer or SRO: $175
Member Agency: $100* ❑ School Official: $100
"Available after a member of your agency is already registered at the member fee.
PAYMENT METHOD
❑ Check ❑ VISA ❑ MasterCard Ll Purchase Order
Account Number
Expiration Date Security Code
Signature (as it appears on card)
Credit Card Billing Address if different than above:
Address
City State Zip
CANCELLATION POLICY
Prior to July 31st 100% refund; July 31 -August 21, 50% refund; After August 21, no refund.
Cancellations must be in writing.
If paying by check, mail completed form, along with full payment to:
IACP Fall Conference,10293 North Meridian Street, Suite 175, Indianapolis, IN 46290
If paying by credit card, fax completed form to 317.816.1633
QUESTIONS? Call 317.816.1619 for more information.
D
r—
INDIANA RETAIL TAX EXEMPT PAGE
City o Qarmei CERTIFICATE NO.003120155 002 0 Jl PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �®
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
Indiana Assoc. of Chiefs of Police, Inc. Carmel Police Department
VENDOR SHIP 3 Civic Square
TO
10203 N. Meridian Stmet, Suite 175 Carmel, IN 46032
Indianapolis, IN 46200 (317) 0
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00.670.00
1 Each conference $175.00 $175.00
Sub Total: $175.00
•ley
Se invoice Fall l Conforoneo for Chief Tlm Gmon A � r� 20 polls, IM
Camel Pollee Department
Attn: Teresa Anderoon
3 Civic Square
Carmel, IN 46 - PLEASE INVOICE IN DUPLICATE
DEPARTMENT _ ,ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cwmel Police Dept. �. �` PAYMENT $175.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS`HE PROPER SWO2AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY€FLStFY THAT THEVeISAN UNOBLIGATED BALANCE IN
THIS APPROP IATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. If
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. f U
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY I
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE (�hief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25370 CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.— WARRANT NO.-__
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
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))
07/19/13 74158 IACP fall conference $175.00
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.
Indiana Assoc. of Chiefs of Police, Inc. ALLOWED 20
IN SUM OF $
10293 N. Meridian Street, Suite 175
Indianapolis, IN 46290
$175.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. _ INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25370 74158 -570.00 $175.00
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
Wednesday, July 24, 2013
4/Z/ Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund