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Home My WebLink About230406 03/26/14 ,q M, CITY OF CARMEL, INDIANA VENDOR: 367453 d I ONE CIVIC SQUARE MARY EVANS CHECK AMOUNT: $*******230.62* ., =a CARMEL, INDIANA 46032 14831 BIXBY DRIVE CHECK NUMBER: 230406 WESTFIELD IN 46074 CHECK DATE: 03/26/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4343000 REIMB 230.62 TRAVEL FEES & EXPENSE A B C D E F G H car-Mel 0 Clay cox 1 Parks&Reclreation MAR 11 2014 2 Employee Expense Reimbursement Request BY: Date of Fund Account Account 3 Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense 4 3/7-8/2014 Hotel Intercontinental Parking Parking $10.00 ✓ Fitness Conference 5 3/7&3/9/14 Illinois State Toll Highways Authority Tolls 7x (.5D A $10.50 ✓ Fitness Conference 6 3/7/2014 Mobil Gas $61.49 ✓ Fitness Conference 7 3/7/2014 McDonalds Breakfast 12 $9.38 ✓ Fitness Conference 8 3/7/2014 Avenues Cafe/Hotel Intercontinental Coffee E $5.41 Fitness Conference 9 3/7/2014 Fresco 21 Dinner $39.76 ✓ Fitness Conference 10 3/8/2014 Avenues Cafe/Hotel Intercontinental Coffee $5.41 ✓ Fitness Conference 11 3/8/2014 Avenues Cafe/Hotel Intercontinental Lunch $8.83 ✓ Fitness Conference 12 3/8/2014 Prasinos Dinner $51.06 Fitness Conference 13 3/9/2014 Fresco 21 Breakfast ) $24.50 ✓ Fitness Conference 14 3/9/2014 Subway Lunch Fitness Conference 15 1All receipts should be attached in the'same order as listed above. No sales tax will be reimbursed. TOTAL: $230.62 ✓ 16 17 18 A B C D E F G H 19 Employee Name(print) Mary L. Evans 20 Address 14831 Bixby Drive Check 21 payable to: City, St, Zip ^ ,. W" Id, IN 46074 22 Signature:L Approved b PP y: 23 Date: 3/10/2014Date: 3 ti 14 24 25 26 Business Services Division,Revised 7-7-08 27 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request of I ^c C, ContinuiMPOWE- RS ng Continuing Education Credit Completion Form EMPOWER! Fusion - Rosemont, IL - March 6-9,2014 Time Session Attended #Credits Earned Sam-9:30am 9:45-11:15am Keynote with Todd Durkin "All Fired Up" 11:30am-fpm (LAW [: S Friday 2 m-3:30 m v ` March 7 P p 3:45pm-5:15pmL 5:30pm-7pm 7am-8:30am 1"S 8:45am-10:15am Saturday 10:45am-12:15pm 0IS March 6r 1:15pm-2:45pm �'}A rrjl, b 3:45pm-5:15pm 5:30pm-7pm tD J 8am-9:30am Tor LS Sunday 10am-11:30amACU March 9 12:15pm-1:45pm Jj- 2pm-3:30pm TOTAL EARNED4 , o L7 EMPOWER!does not determine the number of credits assigned per session. Please contact your certification agency with any questions. Once this form is filled out,please submit to your educa ' ider. Lengtos TYP f Session EXCNE Liffe Time>t�CECs " AF.�CACA#CECs NASM#CECs, 1.5 hour Lecture 0.15 1.5 �. 1.5 10 0.1 1.5 hour Workshop 0.15 1.5 1.5 .0 0.1 Max Credits Offered Provider/Approval# Full Main Conference Friday Saturday Sunda ACE CEP71383 2.3 0.9 0.8. 0.6 AFAA 2014343 AA 22.5 7.5 9.0 6.0 NASM 528 1.6 0.6 1 0.6 0.4 1 EMP030614. 16.0 6.0 6.0 4.0 Life Time Credits EMPFSN2014 24.0 9.0 9.0 6.0 Full Main Conference(Friday-Sunday) Y ur Your Sig ature Date PrnvidPr lianattira INTERCO NTINENTAL CHICAGO O'HARE 03-09-14 Mary Evans Folio No. Room No. 0808 14831 bixby drive A/R Number Arrival 03-07-14 Westfield IN 46074 Group Code EWU Departure 03-09-14 United States Company Lifetime Fitness Conf. No. 63356830 Membership No. PC 300224424 Rate Code Invoice No. Page No. 1 of 1 Date I Description I Charges I Credits 03-07-14 Parking 5.00 03-08-14 Parking 5.00 Thank you for staying at the Intercontinental Chicago O'hare. Qualifying points for this stay Total 10.00 0.00 will automatically be credited to your account. To make additional reservations online, update your account information or view your statement please visit www.priorityclub.com. We look forward to welcoming you back soon. Balance 10.00 13 Guest Signature: I have received the goods and/or services in the amount shown hereon.I agree that my liability for this bill is not waived and agree to be held personally liable in the event that the indicated person,company,or associate fails to pay for any part or the full amount of these charges.If a credit card charge,I further agree to perform the obligations set forth in the cardholder's agreement with the issuer. INTERCONTINENTAL CHICAGO O'HARE 5300 River Road Rosemont, IL 60018 Telephone: (847)544-5300 Fax: (847)447-4281 Ir 1 VPh � CI�_IGL�'lY� V I a ry Evans Registration ID --65576790 Registration Date 2/18/2014 EMPOWER! Fusion 2014 Thursday,March 2014 5300 N.River Road Rosemont, Illinois 60018 Agenda Friday, March 07, 2014 8:00 AM Full Main Conference Session Selections will be ready by January 15th!!! Full registrations includes all sessions(13 sessions)on Friday, Saturday and Sunday(excluding post-con sessions). If you sign up for the full registration at the early,early bird price you will get an email when session selections are ready. YOU WILL HAVE FIRST CHOICE and GET all of your 1st choices- Guaranteed! 9:45 AM "ALL FIRED-UP!" KEY NOTE with Todd Durkin 11:30 AM 11:30am - 1:00pm : OUT WITH THE OLD AND IN WITH THE OLDER 2:00 PM 2:00pm-3:30pm : TRX®Suspension &Rip Training Fusion w/Fraser Quelch 3:45 PM 3:45pm -5:15pm : Body Bar Streamline Strength and Groove w/Jamie Smith 5:30 PM 5:30pm-7:00pm : Piloxing w/Jordan Ballard Saturday, March 08, 2014 7:00 AM 7:00am -8:30am : 101 Ways to BOSUV /w Shannon Fable 8:45 AM 8:45am- 10:15am : Who Takes Care Of You?w/Donna Thomas 10:45 AM 10:45am- 12:15pm : ZUMBA®Step w/Eric Aglia 1:15 PM 1:15pm-2:45p : From Good To Great- NASM's Strageties to Effective Personal Training w/Fabio Comana https://classic.regonline.com/1356369 Page: 134 of 382 3:45 PM 3:45pm-5:15pm. : Body Bar- Barre Trilogy w/Sherry Catlin 5:30 PM 5:30pm-7:00pm. : Leadership That Inspires...And Beyond w/Katie Haggerty 7:00 PM 7:00pm- 10:00pm : Rebok Party! Sunday, March 09, 2014 8:00 AM 8:O0am-9:30am. : IndoRow w/Josh Crosby and Doris Thews 10:00 AM 10:00am - 11:30am : ReCREATE your workout...GROOVE IT- THEGROOVET"° Experience w/Heather Winia 12:15 PM 12:15pm - 1:45pm : The 4-R's of Pain-Free Fitness w/Sue Hitzmann 2:00 PM 2:00pm -3:30pm. : The Physiology of High Intensity Interval Exercise w/Len Kravitz https:Hclassic.regonline.com/1356369 Page: 135 of 382 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. 367453 Evans, Mary Terms 14831 Bixby Drive Westfield, IN 46074 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 3/9/14 Reimb Travel expenses Fitness Conference $ 230.62 Total $ 230.62 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. 367453 Evans, Mary Allowed 20 14831 Bixby Drive Westfield, IN 46074 In Sum of$ I I $ 230.62 ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 Reimb 4343000 $ 230.62 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 20-Mar 2014 Signature $ 230.62 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund