HomeMy WebLinkAbout225034 10/08/2013 CITY OF CARMEL, INDIANA VENDOR: 357102 Page 1 of 1
ONE CIVIC SQUARE MARK PARIS
CARMEL, INDIANA 46032
CHECK NUMBER: 225034
CHECK DATE: 10/8/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 216 . 00 TRAINING SEMINARS
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J/) CITY OF CARMEL Expense Report (required for all travel expenses)
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EMPLOYEE NAME: Mark Paris DEPARTURE DATE: 10/2/2013 TIME: 7:00 AM / PM
DEPARTMENT: Carmel Police Dept RETURN DATE: 10/4/2013 TIME: 17:00 AM / PM
REASON FOR TRAVEL: Shoot House Instructor School DESTINATION CITY: Camp Atterbury, Indiana
EXPENSES ARE FOR (check all that apply) TRAVEL ADVANCE TRAVEL REIMBURSEMEN X TRAVEL PER DIEM X
Transportation Gas/Tolls/ Meals
Date Lodging Misc. Total
Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem
10/2/13 $33.00 $50.00 $83.00
10/3/13 $33.00 $50.00 $83.00
10/4/13 $50.00 $50.00
$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
0.00
Total $0.001 $0.001 $0.00 $0.00 $66.00 $0.001 $0.00 $0.00 $0.00 $150.00 $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 10/6/2013 Page 1
Camp Atterbury Folio
ATTN: Billeting Office Building#402
Edinburgh, IN 46124
Phone: 812-526-1128 Date Invoice# . (.:;.._ Page
2-Oct-2013 0 1
MARK PARIS
Arrival ( , Departure
2-Oct-2013 4-Oct-2013 147200
Date 1)escri tion Amount .: Tax Balance
30-Sep-13 248-116-*NON OFFICIAL $6.00 $0.00 $6.00
02-Oct-13 248-116- $66.00 ($60.00)
02-Oct-13 248-116- *Room Charges $30.00 $0.00 ($30.00)
03-Oct-13 248-116- *Room Charges $30.00 $0.00 $0.00
Camp Atterbury Total due:. $0.00
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BLDG TMT 82 HOSPITAL R)
EDINBURGH, IN 46124
812-526-1128
5436845555595510
Merchant ID: 555559551000
Ref n: 0001
Sale
XXX.X:(XXAxXX9331
MASTERCARD Entry Method: Swiped
Total: 8 66,00
100?�13 OZ:44:42
Inv 4: 000001 APpr Code: 002507
Tran5action ID: 1002MPLLK635I
Apprvd: Online 000310
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Date:2-Oct-2013-7:44am-v3.07d Page: 1
EGM
Evergreen Mountain, LLC COURSE REGISTRTION
lLAtfE M OCCUPATION RANK/ASST Nt/71T1F
� Enforcement JMilitaryiJOther
PREFERRED ADDRESS CITY STATE ZIP CODf
PREFERRED TELEPHONE II.R PREFERRED E-MAIL ADDRESS
AGENCY/BASF ADOP.f SS CITI STAFF ZIP CODE
AGENCY/BASE TELEPHONE NUMBER EXTTI15101I AGENCY/BASE EMAIL ADDRESS
Evergreen Mountain, LLC requires the submission, with this form, one of the following documents:
IdCurrent active duty/reserve Law Enforcement ID OR ❑ Current Military ID OR ❑ Current Drivers Lic
A COURSEISEMINAR SELECTION: Price is per student n
V ❑ Basic Night Vision Course(3 Day)(S600) ructor Shoothouse(3 Day)($6o0)
V ❑ Principles of Urban Conflict(3 Day)($600)(4 Day)($800) ❑Carbine/Pistol Course($zpo/day)
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K
Rural Area Small Unit Tactics($zoo/day) CJ Course($zoo/day) Q
❑Team Leader Planning& Decision Making(5 Day)(Si,000) 0 Leadership Seminar($85)
COURSE LOCATION COURSE DATT(5)
Vi
By signing and submitting this registration form, I understand and agree to the following: �1
v -That the credentials included with this registration form meet the requirements as specified by Evergreen Mountain,LLC,and n
that I will be required to show proof of identification on the first day of the course/seminar.
-Where applicable, that Evergreen Mountain, LLC courses will depend upon the careful control of deadly weapon(s) by me; d
therefore , I understand and agree that my participation may be terminated at any time during the course if the staff] �1
instructor deems my behavior,conduct or weapon handling skills to be unsatisfactory. a
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-That 1 will abide meticulously by any and all safety procedures as outlined and specified by Evergreen Mountain,LLC and that I
will agree to signing a liability waiver f orm releasing Evergreen Mountain,LLC frorn any injury i may sustain during the course. n
UU .1 understand that my deposit is non-refundable and non-transferable. However, in the case of an emergency,I understand d
U that Evergreen Mountain,LLC will work to provide a fair and equitable solution for both parties. d
SIr FIATUNF !''•/.." DATE
i
If paying by credit card,please complete the following. , ❑ VISA
NAME AS IT APPEARS(III CREDIT CARD AUTHORIZATION SIGNATURE DATE
CREDIT CARD HUMBER f KPIRATIOI.DATE 7 DIGIT AUTHORIIA11011 COOL
IMPORTANT: Your credit card will be charged the day your registration form is received. Please include the bill-
ing address where the monthly statement is sent.
ADDRESS CITY STATE ZIP COOT
t E,
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))
10/07/13 meals/lodging $216.00
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.
Mark J. Paris ALLOWED 20
IN SUM OF $
$216.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
210 -570.00 $216.00_
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
Monday, October 07, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund