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Home My WebLink About224162 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