230170 03/12/14 CITY OF CARMEL, INDIANA VENDOR: 368050
d r ONE CIVIC SQUARE JILL WAIT CHECK AMOUNT: $*******309.00*
CARMEL, INDIANA 46032 16631 EDLUS WAY CHECK NUMBER: 230170
BROOMFIELD CO 80023 CHECK DATE: 03/12/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4359000 REIMB 309.00 SPECIAL PROJECTS
Carmel e Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
Flight for CAPRA
2/6/2014 Southwest Airlines 101 1125-1-01-4359000 Special Projects $ 284.00 Accreditation Visitor
Flight for CAPRA
2/6/2014 Southwest Airlines 101 1125-1-01-4359000 Special Projects $ 25.00 Accreditation Visitor
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $309.00
Employee Name (print) Jill P. Wait
Address 16631 Eolus Way
Check
payable to: City, St, Zip Broomfield, CO 80023
Signature: Approved by: I
Date: Date:
Business Services Division, Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request cpTVFD
MAR 0 4 2014
BY:
Paula Schlemmer
From: Southwest Airlines <SouthwestAirlines@luv.southwest.com>
Sent: Thursday, February 06, 2014 1:13 PM
To: JILLWAIT@MSN.COM
Subject: Flight reservation (ZPXE7S) 116MAR14 I DEN-IND I Wait/Jill Phelps
You're all set for your trip!
My Account I View My Itinerary Online
SOUTHWEST`
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Ready for takeoff! /
NSA�
M
.0� G
Thanks for choosing Southwest'for your trip! You'll find everything
' you need to know about your reservation below. Happy travels)
Upcoming Trip: 03/16/14-Indianapolis
4
AIR Confirmation: ZPXE7S Confirmation Date: 02/6/2014 E . ... _ xi4 -
HECK-IN"'s
Rapid Est. Points ;ears
Passenger(s) Rewards# Ticket# Expiration Earned
WAIT/JILL PHELP 122191915 5262189872401 Feb 6, 1462
S 2015
Need a Hotel?
Rapid Rewards points earned are only estimates.Visit your(MySouthwest,Southwest.com or Book Mzh5cmhmmttolakeo&.,ii iUgeof.
Rapid Rewards)account for the most accurate totals-including A-List&A-List Preferred
bonus points. Be=t Rate CU�rltttee
..
Plexihility to Pook
Date Flight Departure/Arrival
Now&Pay Latt-t
Ptus,Earn uP to
750 Rapid Rewards Points
Sun Mar 16226 Depart DENVER,CO(DEN)on Southwest Need a Rental Car?
Airlines at 3:50 PM er,A;arh>aahti+sttot<,ft,,,JYDN:1�eof:
Arrive in INDIANAPOLIS, IN (IND)at 8:10 PM 5;,trreLnwEitrtr�sA<
Travel Time 2 hrs 20 mins TheOthei Guys
Wanna Get Away _
14 Gar Conihanies
To[hoo>e From
Ptus,Earn
Wed Mar 1192 Depart INDIANAPOLIS, IN (IND)on Southwest Rapid Rewards Points
19 Airlines at 4:15 PM
Arrive in DENVER,CO (DEN) at 5:00 PM
Travel Time 2 airs 45 mins
1
Wanna Get Away
t i
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Air Cost: 284.00 �aE
K, , tWM et
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pply Fare Rule(s): 5262189872401:
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Valid only on Southwest Airlines. All travel involving funds from this
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travel funds may only be applied toward the purchase of future travel for
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DEN WN IND121.86HLNUVNR WN DEN121.86HLNUVNR 243.72 END
ZPDENIND XFDEN4.51ND4.5 AY5.00$DEN2.50 IND2.50
Important Reminders:
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Select fares,will be forfeited.
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Boarding Process „eHi:cKat� Check-Ing" Details
Cost and Payment Summary
Lj AIR -ZPXE7S
Base Fare $243.72 Payment Information
2
Excise Taxes $ 18.28 Payment T,,,
Segment Fee $ 8.00 XXXXXXXXX'
Passenger Facility Charge$ 9.00 Date: Feb 6, 2014
September 11th Security $ 5.00 Payment Amount: $284.00
Fee
Total Air Cost $284.00
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4
Paula Schlemmer
From: Southwest Airlines <SouthwestAirlines@luv.southwest.com>
Sent: Thursday, February 06, 2014 1:08 PM
To: JILLWAIT@MSN.COM
Subject: Southwest Airlines EarlyBird Confirmation - ZPXE7S
My Account I View My Itinerary Online
SOUTHWEST-
Ready for takeoff!
p � Thanks for purchasing EarlyBird Check-In for your
CHECK-IN' Indianapolis trip! Conveniently print your boarding pass
N with your pre-assigned boarding position anytime within
24 hours of departure. We'll see you onboard!
Upcoming Trip: 03/16/14- Indianapolis
Confirmation Number: ZPXE7S
Passenger Departure/Arrival Flight Date
Jill Wait Depart Denver, CO(DEN)on #226 Sun Mar
Southwest Airlines at 3:50 PM ,16
Arrive in Indianapolis, IN (IND)at I Travel
8:10 PM Time
2In20m
Jill Wait Depart Indianapolis, IN (IND)onr #1192 Wed Mar
Southwest Airlines'at 4:15'PM fig-
Arrive
1g-Arrive in Denver, CO(DEN).at 6:00 ;Travel
PM . Time
h-45 m
Price: $12.50 per person, one-way
Total Cost: $25.00
Cost and Payment Summary
Payment Information
Cardholder: Jill Wait
Payment Type:Al\
Account#XXXXXXXXXXX
Payment Amount: $25.00
1
"EarlyBird Check-In is non-refundable. Some exclusions may apply.
Flight Status Alerts t `
�i
Stay on your way with flight Get exclusive travel deals
departure or arrival status via straight to your desktop or
text message or email. Phone.
g Subscribe Now Download DING!
Useful Tools Know Before You Special Travel
Go Needs
Check-In Online
Early Bird Check-In In the Airport Traveling with Children
View/Share Itinerary Baggage Policies Traveling with Pets
Change Air Reservation Suggested Airport Arrival Unaccompanied Minors
Cancel Air Reservation Times Baby on Board
Security Procedures Customers with
Check Flight Status
Customers of Size Disabilities
Flight Status Notification
In the Air
Book a Car
Purchasing and Refunds
Book a Hotel
Legal Policies & Helpful Information
Privacy Policy Customer Service Contact Us
Notice of Incorporated Commitment
Terms FAQs
Book Air I Book Hotel I Book Car!Book VacaiionRackacLes I_Pecial Offers I Manage My
Account
This is a post-only mailing from Southwest Airlines.Please do not attempt to respond to
this message.Your privacy is important to us.Please read our Privacy Policy.
See Southwest Airlines Co. Notice of Incorporation
Southwest Airlines
P.O. Box 36647-1 CR
Dallas,TX 75235
Contact Us
Copyright 2013 Southwest Airlines Co.All Rights Reserved.
2
Form
Request for Taxpayer Give Form to the
(Rev.January 2011) requester.Do not
Department of the Treasury Identification Number and Certification send to the IRS.
Internal Revenue Service
Name(as shown onyour jncarne tax return)
N Business name/disregarded entity name,if different from above
N
CL Check appropriate box for federal tax
C ,
i classification(required): Individual/sole proprietor ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate
of
u I ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)0, Exempt payee
w
C
a ❑ Other(see instructions)►
Address(number,street,and apt,or suite no.) Requester's name and address(optional)
a [(e(,3 1 E-0 L Lk S (-AJ ,
_.__...._ ,.._..... _._............._.._..__............... ...._.._._......._.............__.....__............._........................._......................
...._.....•.__•-._.__?
a) 1 City,state,and ZIP code i
_.._..........
List account number(s)here(optional)
Taxpayer Identification Number(TIN)
P......................--- ....____�__._ _ _._._...._ ._..........._......__..............._...----.........................._._.__........................_..__._._. ._............__................
.
Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line t.Soclai 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 How 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 l @mpicyer)dcntirication number
number to enter, j
( Illj
r
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 retum.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 t
Here U.S.person► Date Il-
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 info?nation return with the IRS must '14mindividual who is a'U.S.citizen or U.S.resident alien,
obtain your correct taxpayer identification number(TIN)to report,for A partnership;oorporaiion,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
tax on any foreign partners'share of income from such business.
1.Certify that the TIN you are giving is correct(or you are waiting fora
Further,in certain cases where a Form W-9 has not been received,a
number to be issued), 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-g(Rev.1-2011)
COMMISSION FOR ACCREDITATION
OF PARK AND RECREATION AGENCIES
fOR
� 2
® EC ETNO
ACCREDITATION HANDBOOK
Fifteenth Edition
2013
National Recreation and Park Association
Remised September 2013
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 maybe-
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, howeverk,the agencyunder review
covers�all visr11'.1�e�xpenses(e:g ,Ftransportatio. parking; meals;`and,lodgzng),' 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;reyiew, 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@ pg parks.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,nrpa.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.
a The Agency Representative will complete an evaluation on the Visit Team: (link to be provided later)
a 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 CAPRAna,nrpa.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(a`rpa.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
1
Administrative Office
1411 E. 116th Street
Carmel, IN 46032
P 317.573.4018
mklitzing(a-)carmelclayparks.com
A
Bill; F6elsch5
Director of Parks&Recreation
Township of Morris
PO Box 7603
Convent Station NJ 07961-7603
(973)326-7371
bfoelschAmorristwp.com
Visitor
Linda Smith
Business Development Manager
Cary Parks Rec&Cultural Resources
PO Box 8005
Cary NC 27512-8005
(919)380-2765
linda.smith(a)townofcary.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.hendersonApgparks.com
Second-Reviewer— '
Julie Parascondola
Metro Parks Tacoma
4702 S 19th St
Tacoma WA 98405-1175
(253) 305-1060
julie�d,tacomaparks.com
Commission Mentor
Judith Weiss
DIRECTOR
Coconino Co Parks&Recreation
2446 Fort Tuthill Loop
Flagstaff AZ 86005-8846
(928)679-8004
jweissA oconino.az.gov
2
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.
Wait, Jill P. Terms
16631 Eolus Way
Broomfield, CO 80023
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
2/6/14 Reimb Flight for CAPRA Accreditation visit $ 309.00
Total $ 309.00
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.
Wait, Jill P. Allowed 20
16631 Eolus Way
Broomfield, CO 80023
In Sum of$
$ 309.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1125 Reimb 4359000 $ 309.00 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-Mar 2014
Signature
$ 309.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund