224162 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 367509 Page 1 of 1
ONE CIVIC SQUARE VALPARAISO FRATERNAL ORDER OF Pp��
CARMEL, INDIANA 46032 355 WASHINGTON STREET n CK AMOUNT: $500.00
VALPARAISO IN 46383
«o a CHECK NUMBER: 224162
CHECK DATE: 9/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357002 25403 500 . 00 TRAINING
INVOICE
August 28, 2013
City of Carmel Police Department PO 425403
3 Civic Square
Carmel, IN 46032
Patrol, Explosive & Narcotic Detection training for Officer Ben Fisher, Officer Katy Malloy,
Officer Scott Moore and Officer Brian Schmidt on September 16 —20, 2013 in Valparaiso,
IN
TOTAL AMOUNT DUE: $500.00
Please make check payable to:
Valparaiso Fraternal Order of Police Lodge #76
Valparaiso Police Dept., ATTN: Todd Kobitz
355 Washington Street
Valparaiso, IN 46383
f
2013 NAPWDA Indiana Fall State Workshop
September 16th- 20th, 2013
REGISTRATION FORM (PLEASE PRINT LEGIBLE)
Name: 31f .A-..i C
Home Address: , ,X3
City: (.!A-4 L State: .}- Zip Code: ,;Z Home Phone: 3 �(aY
E Mail: k,
Agency: P.-
Agency Address: 3 C•S c
City: Cke,�-� State: r., Zip Code: ��.: S,C Work Phone: (j_,�7 S--7 1
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 Valparaiso Police Department and the County of Porter; City of Valparaiso, 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 hotel accommodations and or any training venue.
Date: 11 1:,i, Sign Name:
Print Name: SNP–,A--I t . qtr- ;0 V--
Current NAPWDA Member? Yes No
K9 Breed: 1_A,b !At J�- K9 Name: Li!� o K9 Age: 3
Type K9 (check all appropriate descriptions)Patrol— Narcotic V Explosive_ Cadaver_ SAR
K9'S Working Ability: Beginner Intermediate ✓ Advanced
Handler's Ability: Beginner Intermediate ,/ Advanced
Purpose of Attending Workshop (check at least one):
Training Certification (New) Certification (Renewal) v/
If certifying, LIST ALL areas of certification you will be attempting: !,I&-Lc-
Workshop Fee:
The cost of the workshop is $125.00 per K9 team. A K9 team is 1 handler with 1 dog. There is
an additional workshop fee of$75.00 per additional dog for any K9 Handler wishing to train
or test with an additional dog.
Make workshop fee checks payable to Valparaiso Fraternal Order of Police Lodge #76.
Mail checks and completed Registration Form in before September 1, 2013.No refunds at
all after September 1, 2013.
Mail Registration to:
Valparaiso Police Department
355 Washington St
Valparaiso, IN., 46383
Attention: Todd Kobitz
Mail checks and completed Registration Form in before September 1, 2013.No refunds at
all after September 1, 2013.
2013 NAPWDA Indiana Fall State Workshop
September 16th- 20th, 2013
REGISTRATION FORM (PLEASE PRINT LEGIBLE)
Name: ��a��leri,n2c.�toy
Home Address: lq%19 Wt EV'IlAe'-o, D
City: } ,Lwsv Ile State: IN Zip Code: Home Phone: 3)3 ) 5-7 1 - ZSoo
EMail: Km'kko.@ Ca'-Md ';r,-9c�'
Agency: CC"r N� I ?b l;(e
Agency Address: 3 C;v c Sv,vare
City: car,,01 State: lu Zip Code: H(oo 3Z Work Phone: 5-11 - 2 5 oc,
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 Valparaiso Police Department and the County of Porter, City of Valparaiso, 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 hotel accommodations and or any training venue.
Date: S / i e / Zu,3 Sign Name: ��r�Z daVi�
Print Name:
Current NAPWDA Member? Yes .-,/ No
K9 Breed: ��+c1� S11a� K9 Name: KQs<'v K9 Age: a1
Type K9 (check an appropriate descriptions)Patrol X Narcotic'V Explosive Cadaver_ SAR
K9'S Working Ability: Beginner_ Intermediate � Advanced
Handler's Ability: Beginner Intermediate X Advanced
Purpose of Attending Workshop (check at least one):
Training X Certification (New) Certification (Renewal) >(
If certifying, LIST ALL areas of certification you will be attempting: KbV-(o6cc;
Workshop Fee:
The cost of the workshop is $125.00 per K9 team. A K9 team is 1 handler with I dog. There is
an additional workshop fee of$75.00 per additional dog for any K9 Handler wishing to train
or test with an additional dog.
Make workshop fee checks payable to Valparaiso Fraternal Order of Police Lodge #76.
Mail checks and completed Registration Form in before September 1, 2013.No refunds at
all after September 1, 2013.
Mail Registration to:
Valparaiso Police Department
355 Washington St
Valparaiso, IN., 46383
Attention: Todd Kobitz
Mail checks and completed Registration Form in before September 1, 2013.No refunds at
all after September 1, 2013.
h.
2013 NAPWDA Indiana Fall State Workshop
September 16th- 201h, 2013
REGISTRATION FORM (PLEASE PRINT LEGIBLE)
Name: AA2�t-S !L.
Home Address: J I EY ,, PCACL
City: State: Zip Code: 4&07 Home Phone: 317 cllo - 73W
EMail: Cc;S"he,-P Cc: i C4,
Agency: Cr2,�AL-,- pocr-f..,
Agency Address: 3 Cr;;r c- S Q i.,4A(Z L
City: State:1,,� Zip Code: L(io e3 L Work Phone: (3i2_) S-71 - 7 sz o
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 Valparaiso Police Department and the County of Porter, City of Valparaiso, 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 b y canine or myself to any
and all property,persons and to include the hotel acc o y training.venue.
Date: P l °I l Zeta Sign Name:
Print Name: ��lk/Lc�;
Current NAPWDA Member? Yes No
K9 Breed: S.a L 0:1 E 2 K9 Name: LJ AZ�r�z- K9 Age:
Type K9 (check all appropriate descriptions)Patrol -Narcotic Explosive_ Cadaver_ SAR
K9'S Working Ability: Beginner Intermediate x Advanced_
Handler's Ability: Beginner 7L Intermediate _Advanced
Purpose of Attending Workshop (check at least one):
Training Certification (New) Certification (Renewal)X
If certifying, LIST ALL areas of certification you will be attempting: A2 s
Workshop Fee:
The cost of the workshop is $125.00 per K9 team. A K9 team is 1 handler with I dog. There is
an additional workshop fee of$75.00 per additional dog for any K9 Handler wishing to train
or test with an additional dog.
Make workshop fee checks payable to Valparaiso Fraternal Order of Police Lodge #76.
Mail checks and completed Registration Form in before September 1, 2013.No refunds at
all after September 1, 2013.
Mail Registration to:
Valparaiso Police Department
355 Washington St
Valparaiso, IN., 46383
Attention: Todd Kobitz
Mail checks and completed Registration Form in before September 1, 2013.No refunds at
all after September 1, 2013.
S
R"
2013 NAPWDA Indiana Fall State Workshop
September 16th- 20th, 2013
REGISTRATION FORM (PLEASE PRINT LEGIBLE)
�
Name: `�CC mt9ftlt
Home Address: 06 v mn t4 r
City: CO3a)lQ- I State: I Zip Code: Home Phone: (-317 ) M 51- -1
EMail: sox t't&GwA0,(r1, 96V
Agency: Grit
Agency Address: 3 C-i
City: C,,*I& State-�l�Zip Code: e Work Phone: 3 _)
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 Valparaiso Police Department and the County of Porter, City of Valparaiso, 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 hotel ac c m odat' sand or any training venue.
Date: / Q / 6Q Sign Name:
Print Name: 6 ore k
Current NAPW Acc Member? Yes �� No
K9 Breed: G t J K9 Name: J/T K9 Age:
Type K9 (check all appropriate descriptions)Patrol_ arcotic_ Explosive_ Cadaver_ SAR
K9'S Working Ability: Beginner Intermediate !/Advanced
Handler's Ability: Beginner Intermediate VAdvanced
Purpose of Attending Workshop (check at least one):
Training Certification (New) Certification (Renewal)
If certifying, LIST ALL areas of certification you will be attempting: IV dv(Qo i 4 P6LI-KI
Workshop Fee:
The cost of the workshop is $125.00 per K9 team. A K9 team is 1 handler with 1 dog. There is
an additional workshop fee of$75.00 per additional dog for any K9 Handler wishing to train
or test with an additional dog.
Make workshop fee checks payable to Valparaiso Fraternal Order of Police Lodge #76.
Mail checks and completed Registration Form in before September 1, 2013.No refunds at
all after September 1, 2013.
Mail Registration to:
Valparaiso Police Department
355 Washington St
Valparaiso, IN., 46383
Attention: Todd Kobitz
Mail checks and completed Registration Form in before September 1, 2013. No refunds at
all after September 1, 2013.
r
INDIANA RETAIL TAX EXEMPT PAGE
City o Carmel CERTIFICATE NO.003120155 002 0 li PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 264M
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
8OPM3
Valparaiso Fraternal Order a?Pollee Lodge#76 Camel Police Department
VENDORVMPaMISO Police Department, ATTN:Todd Koblt0 SHIP 3 CIVIC Square
TO
3%Washington Street Carmel, IN
Valparaiso, IN 463 (397)671
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS F
FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 01-670.(M
4 Each training $125.00 $5 04.06
— Barb Taal: $500.00
A,
W
"I $
Patrol Emelocivo&Narcofitm Dootectien s ee9 � a � � , &Schmidt an Sept 16 -20, 2013 In
va%mar�anlv�°vice�To: ,w w r
Cannel Police Department
Attn: Teresa Anderson
3 CIVIC Squart
Carmel, IN 46 - PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT $500.00
• 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 CERTIFYT-vYAHERE IS AN UNOBLIGATED BALANCE IN
SHIPREPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ssrw� $ �3
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Cue of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO-
t') f�J 4 V 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
20
...........................................................................................................................--_........--...............................
Signature
................ .................................................................................................... . ....
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Valparaiso Fraternal Order of Police Lodge #76
Valparaiso Police Dept., ATTN: Todd Kobitz IN SUM OF $
355 Washington Street
Valparaiso, IN 46383
$500.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. INVOICE NO. ACCT#(TITLE AMOUNT Board Members
25403 -570.00 $500.00
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
Thursday, September 05, 2013
Chief of Police
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))
08/28/13 training $500.00
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