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Home My WebLink About229004 2/11/2014 CITY OF CARMEL, INDIANA VENDOR: 367947 Page 1 of 1 ONE CIVIC SQUARE WILLIAM FOELSCH CHECK AMOUNT: $568.00 CARMEL, INDIANA 46032 73 FARM ROAD • oN o HILLSBOROUGH NJ 08844 CHECK NUMBER: 229004 CHECK DATE: 2/11/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4359000 568 . 00 SPECIAL PROJECTS Carmel achy Parks& ecreati®n e&Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense Flight for CAPRA Accreditation 2/3/2014 United 101 1125-1-4359000 Special Projects $568.00 visitor All receipts should be attached in the same order as listed above. No sales tax will be reimbursed. TOTAL: $568.00 _.. -Name (print) Wi lltS*n Bill)Foelsch Purpose: NRPA Program Committee Meeting Address 73 Farm Road Check payable to: City, St, Zip Hillsborough NJ 08844 Signature: Approved by: Date: 2/3/2014 Date: 2/3/2014 Business Services Division, Revised 7-7-08 FILE: Shared\Administrative\Forms\Staff Forms\Employee Exp Reimb Request Michael Klitzing From: Foelsch Bill <bfoelsch@Morristwp.com> Sent: Monday, February 03, 2014 11:31 AM To: Michael Klitzing Subject: William Foelsch - eTicket Itinerary and Receipt for Confirmation ME261V Michael — My flights are confirmed. Can you use this receipt to process reimbursement? ---------- Forwarded message ---------- From: United Airlines,Inc. <unitedairlines@united.com> Date: Mon, Feb 3, 2014 at 11:24 AM Subject: eTicket Itinerary and Receipt for Confirmation ME261 V To: BILLFPARKS@gmail.com 111j" N 1 T EE D A STAR 4WANCE MEMBER V1,7- Confirmation: ■ ME261 V Check-In > Issue Date: February 03, 2014 Traveler eTicket Number Frequent Flyer Seats FOELSCH/WILLIAMDMR 0162395543844 UA-WN 13XXXX 11 C/11 C FLIGHT INFORMATION Day, Date Flight Class Departure City and Time Arrival City and Time Aircraft Meal Sun, 16MAR14 UA4395 H NEWARK,NJ INDIANAPOLIS, IN ERJ-145 (EWR - LIBERTY) 1:31 PM (IND) 3:46 PM Flight operated by EXPRESSJET AIRLINES INC doing business as UNITED EXPRESS. lWed, 19MAR14 UA4395 H., INDIANAPOLIS, IN NEWARK, NJ ERJ=145 (IND) 4:16 PM (EWR - LIBERTY) 6:20 PM Flight operated by EXPRESSJET AIRLINES INC doing business as UNITED EXPRESS. FARE INFORMATION Fare Breakdown Airfare: 507.91USD Fonn of Payment: U.S. Federal Transportation Tax: 38.09 September 11th Security Fee: 5.00 U.S. Passenger Facility Charge: 9.00 Per Person Total: 568.00USD eTicket Total: 568.00USD i The airfare you paid on this itinerary totals: 507.91 USD The taxes, fees, and surcharges paid total: 60.09 USD Fare Rules: Additional charges may apply for changes in addition to any fare rules listed. NONREF/OVALUAFTDPT/CHGFEE Cancel reservations before the scheduled departure time or TICKET HAS NO VALUE. Baggage allowance and charges for this itinerary. Baggage fees are per traveler Origin and destination for checked baggage 1"ba 2"d ba Max wt/dim per piece gg g P 3/16/2014 Newark, NJ (EWR - Liberty) to Indianapolis, 0.00 35.00 50.Olbs (23.Okg) - 62.0in IN (IND) USD USD (I57.Ocm) 3/19/2014 Indianapolis, IN (IND) to Newark, NJ (EWR - 0.00 35.00 50.Olbs (23.Okg) - 62.Oin Liberty) USD USD (I57.Ocm) MileagePlus® Explorer Card member and one companion on the same reservation are each eligible for waiver of the service charge for the first checked bag (within specified size and weight limits). Must be a MileagePlus Explorer Card member at time of check-in, and ticket(s) must have been purchased using the Card in order to qualify. Applies only on United- and United Express-operated flights, and when baggage check-in occurs with United. Additional Baggage Information Carry-on baggage information United accepts one carry-on item of no more than 45 linear inches or 114 linear centimeters in the aircraft cabin, along with one personal item (such as a shoulder or laptop bag). Due to FAA regulations, operating carriers may have different carry-on requirements. Please check with the operating carrier for more information or go to united.com. General Baggage Information First and second bag service charges do not apply to active-duty members of the U.S. military and their accompanying dependents. For additional information regarding baggage charges allowances, weight/size restrictions, exceptions or embargoes, or charges for overweight, oversized, excess, odd-sized baggage, special items or sporting equipment, visit.united.com/baggage. eTicket Reminders z ONSITE VISIT OVERVIEW Part of the accreditation process is an onsite visit to the agency by a team of individuals qualified and trained as CAPRA visitors. Most visitation teams are comprised of three individuals, although this number may vary from two to four depending on the complexity of the agency being reviewed and other factors, such as agencies eligible for the reaccreditation visit option. The typical visit is usually scheduled for a three-day period during the spring(January—March) or summer(May—July); with accreditation hearing the following fall. Visits under the reaccreditation visit option are scheduled for a two-day period during the spring (January— March) or summer(May—July); with accreditation hearing the following fall The purpose of the visit is fact finding on behalf of the Commission to ensure a clear and complete picture of the degree to which the agency meets specified standards. It is the responsibility of the visitation team to clarify and verify the self-assessment report, to seek additional information that may be pertinent to the Commission's evaluation, and to write a summary report of its findings. PURPOSES The specific purposes of the visit are to: • Verify and clarify the self-assessment report; • Evaluate the agency's status using the CAPRA accreditation standards, • Report findings and recommendations to the Commission; and • Suggest any appropriate revisions in the content or use of the accreditation documents to the Commission. As previously mentioned, the principal role of the visitation team is fact finding on behalf of the Commission. Visitation team members may discuss strengths and weaknesses of the agency as related to specific standards for which evidence is provided; however visitation team members do not act as consultants. EXPENSES No honoraria are given to members of the visitation team; however the agency under review covers all visitor expenses (e.g., transportation, parking, meals, and lodging). If possible, all costs shall be incurred by the agency and not by the visitor. If visitors make their own travel arrangements,the agency must be prepared to reimburse the individual(s) either in advance of the visit or during the visit. In no situation should a visitor incur credit card interest expenses waiting for reimbursement. In addition, for an initial review, the agency is responsible for travel expenses of the visitation team chair(or his/her designee)to attend the Commission hearing at which the agency is reviewed. If a visitor is unable to continue with the visit process due to a bona fide hardship, he/she must notify the Accreditation Manager as soon as possible. If the cancellation is made after travel arrangements have been made on the visitor's behalf, a determination will be made by the Commission Executive Committee and the Accreditation Manager about who (CAPRA or the visitor) will cover the expenses caused by the cancellation. In addition, if the cancellation reason 21 Michael Klitzing From: Danielle Price <dprice@nrpa.org> Sent: Tuesday, December 03, 2013 1:11 PM To: Michael Klitzing; BillFoelsch; linda.smith@townofcary.org; 'jillwait@msn.com'; Henderson, John (John.Henderson@pgparks.com);juliep@tacomaparks.com; jweiss@coconino.az.gov Subject: CAPRA - Accreditation Visit Introductory Email - Carmel Clay, IN Attachments: CAPRA Visitation Report Template_11-01-1l.docx; CAPRA Visitor Agreement and Conflict of Interest Form.pdf, CAPRA Self-Assessment Report Template_11-01-11.docx; CAPRA Visit Chair Checklist 05-30-13.docx Dear Visitors, Commission Reviewers, &Agency Representative, Please find below the list of individuals who will be involved with the Carmel Clay,IN initial accreditation review. Visit team -Thank you in advance for serving on this accreditation review; your assistance is invaluable. If for any reason you cannot serve, please notify me immediately. The agency will email the self-assessment(electronic copy) directly to each Commission Reviewer and as well as a copy to me via CAPRAAnMa.org at least eight weeks prior to the visit. After review of the self-assessment,the Commission Reviewers will discuss with the visitation chair any issues they feel warrant particular attention during the visit. Should serious concerns arise as a result of reviewing the self-assessment report, the agency will be notified in advance of the visit. Once the Commission Reviewers approves the self-assessment, the Agency Representative will be permitted and required to email the self-assessment report to the Visit Team. Also, the Visit Chair and the Agency Representative, in collaboration with the other visitors, can determine the specific visit dates and start making the necessary travel arrangements. Travel arrangements should not be made prior to receiving the approval by the Commission. The Evaluation Forms have been converted to online submission forms to create a more efficient and"green" process. The Agency Representative, Visitation Team members, and Commission Lead Reviewer will be responsible for submitting the appropriate evaluation form(s) listed below at the completion of the visit. • The Agency Representative will complete an evaluation on the Visit Team: (link to be provided later) • The Visitors will complete an evaluation of the other Visitors: (link to be provided later) • The Commission Lead Reviewer will complete and evaluation of the Visitation Chair and vice versa: (link to be provided later) Additionally, the updated Self-Assessment Template,Visitation Report Template, Conflict of Interest Form, and Visit Chair Checklist are attached. The Visitation Report Template will assist the visitation chair in developing the visit report. The Conflict of Interest Form is to be completed by each visitor and returned prior to the start of the visit via email to CAPRARnMa.org. The Visit Chair Checklist is a new resource material provided by the Commission (this form has been updated,therefore please be sure to review it). Additional information, including the CAPRA Standards and the updated CAPRA Handbook(15"'edition), is available at www.nrpa.org/CAPRA. Please review your contact information below and reply to the group(including CAPRA g,nrpa.org) should any corrections be necessary. Initial visit with preliminary dates of March 17-28,2014: Agency Contact Michael W.Klitzing Assistant Director Carmel Clay Parks& Recreation t Administrative Office 1411 E. 116th Street Carmel, IN 46032 P 317.573.4018 mklitzingp,cannelclayparks.com Chair Bill Foelsch Director of Parks&Recreation Township of Moms PO Box 7603 Convent Station NJ 07961-7603 (973) 326-7371 bfoelsch(iDmorristwp.com Visitor Linda Smith Business Development Manager Cary Parks Rec&Cultural Resources PO Box 8005 Cary NC 27512-8005 (919) 380-2765 linda.smith(&townofcary.org Visitor Jill Wait 16631 Eolus Way Broomfield CO 80023-8309 (303)906-7445 jillwaitna,msn.com Lead Reviewer John Henderson Research& Evaluation Manager Maryland Natl Cap Pk&Plan Comm 2833 Walker Dr Greenbelt MD 20770-3211 301-446-6851 john.henderson(a)pgparks.com Second Reviewer Julie Parascondola Metro Parks Tacoma 4702 S 19th St Tacoma WA 98405-1175 (253)305-1060 juliep(a,tacomaparks.com Commission Mentor Judith Weiss D]RECTOR Coconino Co Parks&Recreation 2446 Fort Tuthill Loop Flagstaff AZ 86005-8846 (928)679-8004 jweiss(&coconino.az.gov z Form W=9 Request for Taxpayer Give Form to the Department r Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service Name(as shown on your income tax return) V.)�1�t14wt 17. �c5cL5Ci-( N Business name/disregarded entity name,if different from above m rn M a Check appropriate box for federal tax C o classification(required): proprietor Individual/sole ro m p p' El Corporation ❑S Corporation ❑ Partnership ❑Trust/estate 0.0 '4'; ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► ❑Exempt payee `o2 ------------------------------- G W •C C p- ❑ Other(see instructions)No Address(number,street,and apt.or suite no.) v Requester's name and address(optional) U) 7-3 i�+4C2 Qo1RD m City,,state,and 1ZIP code 1 j rn 1-1711 5 b o P v v; t1 N J O 8 7-S 14 List account number(s)here(optionaQ Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line Social security number to avoid backup withholding.For individuals,this is your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a TIN on page 3. Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identification number number to enter. Certification Under penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and 2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding,and 3. 1 am a U.S.citizen or other U.S.person(defined below). Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 4. Sign Signature of Here U.S.person► �. — Date 0- General General Instructions Note.If a requester gives you a form other than Form W-9 to request your TIN,you must use the requester's form if it is substantially similar Section references are to the Internal Revenue Code unless otherwise to this Form W-9. noted. Definition of a U.S.person.For federal tax purposes,you are Purpose of Form considered a U.S.person if you are: A person who is required to file an information return with the IRS must 'An individual who is a U.S.citizen or U.S.resident alien, obtain your correct taxpayer identification number(TIN)to report,for •A partnership,corporation,company,or association created or example,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the United States, you paid,acquisition or abandonment of secured property,cancellation .An estate(other than a foreign estate),or of debt,or contributions you made to an IRA. Use Form W-9 only if you are a U.S.person(including a resident 'A domestic trust(as defined in Regulations section 301.7701-7). alien),to provide your correct TIN to the person requesting it(the Special rules for partnerships.Partnerships that conduct a trade or requester)and,when applicable,to: business in the United States are generally required to pay a withholding 1.Certify that the TIN you are giving is correct(or you are waiting fora tax on any foreign partners'share of income from such business. number to be issued), Further,in certain cases where a Form W-9 has not been received,a partnership is required to presume that a partner is a foreign person, 2.Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a 3.Claim exemption from backup withholding if you are a U.S.exempt partner in a partnership conducting a trade or business in the United payee.If applicable,you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S. allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership income. is not subject to the withholding tax on foreign partners'share of effectively connected income. Cat.No.10231X Form W-9(Rev.1-2011) Michael Klitzing From: Danielle Price <dprice@nrpa.org> Sent: Tuesday, December 03, 2013 1:11 PM To: Michael Klitzing; BillFoelsch; linda.smith@townofcary.org; 'jillwait@msn.com'; Henderson,John (John.Henderson@pgparks.com);juliep@tacomaparks.com; jweiss@coconino.az.gov Subject: CAPRA - Accreditation Visit Introductory Email - Carmel Clay,IN Attachments: CAPRA Visitation Report Template_11-01-1l.docx; CAPRA Visitor Agreement and Conflict of Interest Form.pdf; CAPRA Self-Assessment Report Template_11-01-1l.docx; CAPRA Visit Chair Checklist 05-30-13.docx Dear Visitors, Commission Reviewers, & Agency Representative, Please find below the list of individuals who will be involved with the Carmel Clay,IN initial accreditation review. Visit team -Thank you in advance for serving on this accreditation review; your assistance is invaluable. If for any reason you cannot serve, please notify me immediately. The agency will email the self-assessment(electronic copy) directly to each Commission Reviewer and as well as a copy to me via CAPRA(a_)gMa.org at least eight weeks prior to the visit. After review of the self-assessment, the Commission Reviewers will discuss with the visitation chair any issues they feel warrant particular attention during the visit. Should serious concerns arise as a result of reviewing the self-assessment report, the agency will be notified in advance of the visit. Once the Commission Reviewers approves the self-assessment, the Agency Representative will be permitted and required to email the self-assessment report to the Visit Team. Also, the Visit Chair and the Agency Representative, in collaboration with the other visitors,can determine the specific visit dates and start making the necessary travel arrangements. Travel arrangements should not be made prior to receiving the approval by the Commission. The Evaluation Forms have been converted to online submission forms to create a more efficient and "green" process. The Agency Representative, Visitation Team members, and Commission Lead Reviewer will be responsible for submitting the appropriate evaluation form(s) listed below at the completion of the visit. • The Agency Representative will complete an evaluation on the Visit Team: (link to be provided later) • The Visitors will complete an evaluation of the other Visitors: (link to be provided later) • The Commission Lead Reviewer will complete and evaluation of the Visitation Chair and vice versa: (link to be provided later) Additionally, the updated Self-Assessment Template, Visitation Report Template,Conflict of Interest Form,and Visit Chair Checklist are attached. The Visitation Report Template will assist the visitation chair in developing the visit report. The Conflict of Interest Form is to be completed by each visitor and returned prior to the start of the visit via email to CAPRAAnrpa^org. The Visit Chair Checklist is a new resource material provided by the Commission (this form has been updated,therefore please be sure to review it). Additional information, including the CAPRA Standards and the updated CAPRA Handbook(15°i edition), is available at www.n!pa.org/CAPRA. Please review your contact information below and reply to the group (including CAPRA(d)pMa.org) should any corrections be necessary. Initial visit with preliminary dates of March 17-28,2014: Agency Contact Michael W.Klitzing Assistant Director Carmel Clay Parks& Recreation t Administrative Office 1411 E. 116th Street Carmel, IN 46032 P 317.573.4018 mklitzing_Acarmelclayparks.com Chair Bill Foelsch Director of Parks&Recreation Township of Morris PO Box 7603 Convent Station NJ 07961-7603 (973) 326-7371 bfoelsch(c�morristwp.com Visitor Linda Smith Business Development Manager Cary Parks Rec &Cultural Resources PO Box 8005 Cary NC 27512-8005 (919)380-2765 linda.smithAtownofcary.org Visitor Jill Wait 16631 Eolus Way Broomfield CO 80023-8309 (303) 906-7445 jillwait@msn.com Lead Reviewer John Henderson Research&Evaluation Manager Maryland Natl Cap Pk& Plan Comm 2833 Walker Dr Greenbelt MD 20770-3211 301446-6851 john.henderson(a,pgparks.com Second Reviewer Julie Parascondola Metro Parks Tacoma 4702 S 19th St Tacoma WA 98405-1175 (253) 305-1060 juliep(&tacomaparks.com Commission Mentor Judith Weiss DIRECTOR Coconino Co Parks &Recreation 2446 Fort Tuthill Loop Flagstaff AZ 86005-8846 (928) 679-8004 j weiss(ai)coconino.az.gov z ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Foelsch, William Terms 73 Farm Road Hillsborough, NJ 08844 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 2/3/14 Reimb Flight for CAPRA visitor $ 568.00 Total $ 568.00 1 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. Foelsch, William Allowed 20 73 Farm Road Hillsborough, NJ 08844 In Sum of$ $ 568.00 ON ACCOUNT OF APPROPRIATION FOR 101 -General Fund PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members Dept# 1125 Reimb 4359000 $ 568.00 1 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 6-Feb 2014 Signature $ 568.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund